the myth of authenticity
TRANSCRIPT
The Myth of Authenticity: Benefits of a Clearly-Defined Self to Confused
Antidepressant Users
By
Samantha J. Kilpack
April 22, 2014
A thesis submitted to the Department of Philosophy of Westminster College in partial fulfillment of the requirements for the degree of Bachelor of Arts in Philosophy.
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Samantha J. Kilpack PHIL 490 Dr. Nick More 4/22/14
The Myth of Authenticity: Benefits of a Clearly-Defined Self to Confused Antidepressant Users
The use of antidepressants is a growing phenomenon, and the decision to use
them has significant consequences for how one perceives their selfhood and its
authenticity, or lack thereof. Antidepressant users often express feelings of guilt,
confusion, and/or uncertainty about who they really are, and wonder whether their true
selves are masked or revealed by the antidepressants.1 This paper will explore the nature
of the self and the role that antidepressants play in the authenticity of that self in order to
alleviate such concerns for antidepressant users and to remove the social stigma of
antidepressant use. This is important because there is a growing moral ideal of
authenticity, especially in Western culture, which urges us to cultivate our individuality
and be the most authentic possible version of ourselves. Opponents of antidepressants
have viewed them as “a threat to an ‘un-enhanced’ and ‘un-drugged’ self which is lost
and ambiguously obscured by the drugs.” Proponents, on the other hand, claim that
antidepressants “free us so that we can encounter the world as it is and we can be given
back our ‘self’ and what is most our own,” thereby restoring “the self which was masked
by the pathology.”2
1 See, for example, Giovanni Frazzetto, "Antidepressants and the Multiplicity of Authentic Selves," History of the Human Sciences 20, no. 3 (08, 2007), 149-154.
2 Ibid., 151.
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People have different conceptions of the self; therefore, they have different ideas
of how antidepressants affect that self. In this paper I will illustrate this by applying
antidepressants to five different theories of self, including my own. I propose a definition
of self that, if adopted, can provide peace of mind to antidepressant users who are
concerned about how authentic they are while taking them. I argue that the self is a
person as the object of reflective and introspective thought, and the result of a
complicated, fluid mix of genes, culture, physiology, and experience that form the ways
in which people view, evaluate, and experience themselves. It is also not only a person,
but the experience of being a person separate from other people; the experience of being
the person that has been affected in such a way by the things listed above. Due to the
fluidity of the self, then, antidepressants have no essential, “natural,” or “authentic” self
to affect in the sense that these concepts imply a static self. Rather, authenticity is just as
dynamic as the self, and therefore an irrelevant measure of the self, as I will later show.
Our memory tells us, though, that the self does persist through time despite the changes it
endures, as I know that I am the same person who was traumatized by pulling a stink bug
out of her shoe as a child. This view of the self renders the confusion, identity crisis, and
feelings of guilt and confusion that a growing number of people experience when taking
antidepressants unnecessary, and the stigma unwarranted.
There is no shortage of research on the effects of antidepressants on the self. The
first thing to be done to address this topic is to define the self in order to establish how
antidepressants may affect it. The biggest obstacle to evaluating the literature, however,
is the variety of different conceptions of the self and the conflation of terms for the self.
Many authors use terms such as self, identity, ego, and/or personhood interchangeably
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without defining them, which comes at the cost of imprecision and confusion. Marlene
Benjamin exemplifies this problem in her essay about mental illness and self. In
explaining how antidepressants, depression, and her experience in a psychiatric ward
have affected her, she uses the terms self, identity, and character interchangeably and
without defining any of them, but claims that they, as concepts, are tenuous and built on
weak grounds. This tells her readers very little about the “disordered self” that mental
illness has affected despite the fact that the title of her essay leads us to believe
otherwise.3 Having no consistent meaning of self renders it impossible to have a cohesive
discussion about the relationship between antidepressants and self. Additionally, with a
few exceptions, authors do not seem to address one another and have a discussion about
the topic; rather, most articles regarding antidepressants and self seem to be either
isolated from one another or talking past each other.
Another complicating issue with this topic is the fact that multiple fields engage
in the discussion and have different focuses. Philosophy, sociology, and psychology/
psychiatry have different ways of conceiving of the self. While this is primarily a
philosophy paper, all of these fields have significance to a philosophical discussion of
antidepressants and self. Sociology calls attention to the fact that the use of
antidepressants is a cultural phenomenon, and the society in which we live affects the
ways we view cultural phenomena and philosophical ideas such as that of the self.
Psychiatry also clearly and inextricably links pill and personhood. While psychiatry
explains how antidepressants affect one’s view of one’s own self as a result of the
medication, sociology can explain how society affects the ways in which one views
3 Marlene Benjamin, "The Disordered Self: Philosophy, Memoir, and Mental Illness," (1-9).
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oneself as a result of social pressures. In these ways, both psychiatry and sociology can
add depth to a philosophical discussion of the ways in which antidepressants affect, or do
not affect, the self.
I will begin a review of the literature with a discussion of the self before adding
the antidepressant dimension to the discussion. I will first discuss four different
philosophical views of the self: those of Rene Descartes, David Hume, Martin Heidegger,
and Charles Taylor, before moving on to a sociological conception of selfhood. I will
then outline some contributions to the topic of how antidepressants affect the self. This
will put me in a position to point out the limitations of the existing literature and
contextualize my own contribution to the discussion and its importance. Following the
literature review, I will be able to enter the discussion by applying antidepressants to
these different conceptions of the self, and my own, to show how they would affect each
one.
Rene Descartes’ theory of self does not include the word ‘self.’ Because of the
reflexive nature of the “I,” he used it to denote the mind (which he does not distinguish
from the soul, but used these terms interchangeably), and he considered the mind to be
the essence of one’s consciousness and, therefore, existence. He viewed the entire human
body (which is material, and therefore does not include the immaterial soul), however, as
a physiological machine, while thoughts are “mental acts of the rational soul that remain
in the soul and are not coded in the brain at all.”4 He did, however, believe in the union of
the body and the mind, and claimed that thoughts still affect human behavior via his
4 Raymond Martin and John Barresi, The Rise and Fall of Soul and Self (New York: Columbia University Press, 2006), 129.
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(erroneous) physiological theory.5 Speaking more to the link between mind and body, the
immaterial soul directly experiences all bodily experience.6 He maintained the distinction
between body and mind, but also claimed that “each human soul, or mind, is so
intimately connected to its own body as to form with it a separate substance of a third
sort” that brings about changes in both body and mind through their interaction in the
pineal gland, part of his aforementioned physiological theory.7 Finally, he proposed that
only beings with nonmaterial souls, or minds, could have consciousness in the full sense
because all thought, which can only be the product of a mind, is necessarily reflexive.8
This means that to think is to be aware of one’s thinking, and therefore one’s existence.
Hence, “I think; therefore, I am.” Overall, Descartes views the self as an immaterial
mind/soul that exists independently of one’s body, but the mind and body compose “a
certain unity” such that they affect one another.
David Hume contradicts Descartes by positing that the self does not exist at all.
He believed that time creates change to the extent that the substantiality and persistence
of anything, including the self, is illusory.9 But because many perceptions resemble one
another, we mistakenly “forge a succession of perceptions into a persisting object.”10 The
reason for this, he claims, is that we easily imagine that a perception persists when
successive perceptions resemble each other, and we have a strong propensity to
5 Ibid.
6 Ibid.
7 Ibid., 130.
8 Ibid., 128.
9 Ibid.
10 Ibid.,153.
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unknowingly make this mistake.11 In the case of the self, part of the problem for him was
that people often imagine that the self partly consists of “some unifying substance, such
as a soul, or some unifying mode, such as life or consciousness.”12 Even if we did have
some sort of unifying substance, its “continued existence after our bodily deaths would be
irrelevant unless it were attended with consciousness and memory,” which he claims is
unlikely.13 Ultimately, he maintains, our conception of self is created by the imaginary
links we create between our perceptions of people at different points in time.14 Time is
indeed important to the self and creates significant changes; however, I believe that
Hume goes astray by claiming that the self does not exist because it changes so often.15
Martin Heidegger re-asserts the existence of the self, but in a way distinct from
and opposed to Descartes and Hume. He believed that language was a significant barrier
to understanding ourselves because we differentiate between self and world, when really,
“self and world are not two entities, like subject and object;”16 rather, the self is a
dynamic system of physical, social, and historical interrelationships of meanings or
signification that must be seen in terms of temporality and situatedness. Humans are “not
only enmeshed in, but are constituted of”17 these relationships. Self is not only being, but
11 Ibid.
12 Ibid., 153-154.
13 Ibid., 155.
14 Ibid.
15 I will return to this point.
16 Ibid., 234.
17 Ibid.
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“being-in-the-world,”18 and Heidegger sought to erase the distinction between person and
world. Heidegger makes use of the word Dasein, meaning existence (literally, being-
there), but he argues that Dasein is not only existence, but also an awareness, a “making
intelligible”19 of our condition and the structure of our being. Dasein is the true structure
of the self and “affords the only true access that we have to ourselves.”20 Without
understanding Dasein, we exist and understand inauthentically. In using the word Dasein
in this way, Heidegger attempted to break down the language barrier that prevents us
from understanding ourselves authentically. In sum, Heidegger maintained that the self is
an understanding of our condition as being made up of both the world and our bodies, the
relationship between which is constantly changing to actualize new selves.
In chapter four of The Ethics of Authenticity, Charles Taylor introduces his own
view of self. He suggests that human life is “fundamentally dialogical [in] character,”21
but maintains the distinction between self and world, claiming that we can become full
human agents and define our identity (or self; he uses these terms interchangeably)
through modes of expression that are “always in dialogue with, sometimes in struggle
against, the identities our significant others want to recognize in us.”22 For Taylor, we can
only define our identity against “horizons,” or “backgrounds of intelligibility,” which
determine what is relevant to one’s identity in a given society, and we cannot choose
18 Ibid.
19 Ibid., 233
20 Ibid., 234
21 Charles Taylor, "Inescapable Horizons," in The Ethics of Authenticity [The Malaise of Modernity] (Cambridge, Massachusetts and London, England: Harvard University Press, 1991), 31.
22 Ibid., 33.
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what these are.23 In other words, our culture and the significant people in our lives help to
shape our identities; to use Taylor’s example, the amount of hairs on my head does not
make up part of my identity because nobody cares how many hairs I have. Even if I
cared, nobody else would recognize that part of my identity—it is not intelligible in my
society and therefore is irrelevant to my identity. However, Taylor does emphasize the
importance of being original. He calls this idea “self-determining freedom,” which “is the
idea that I am free when I decide for myself what concerns me, rather than being shaped
by external influences.”24 But being original can only work to a certain degree, because
once an identity trait goes beyond the “horizon” of intelligibility, it becomes irrelevant.
Like Heidegger, Taylor recognizes interaction between person and world as an
important component of the development of the self. However, Heidegger includes no
other aspect than that, and in doing so he neglects several components of a definition of
self that I believe are important (for example, genes). Furthermore, Taylor establishes the
need to find what is significant in one’s difference from others, while Heidegger does not
concern himself with this issue, and would in fact disagree with this view because he
does not differentiate between self and world, “I” and “they.” Taylor’s “horizon” can be
compared to Heidegger’s Dasein: Horizons and Dasein are, for each of these
philosophers, what is necessary for determining and understanding the self.
23 Ibid., 37. For a discussion of identity-relevant traits from a moral and legal standpoint, see section 9 of Michael Shapiro’s “The Identity of Identity: Moral and Legal Aspects of Technological Self-Transformation.”
24 Taylor, The Ethics of Authenticity, 27.
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According to sociologists James Holstein and Jaber Gubrium, the self is a “project
of everyday life,”25 both “artfully agentic and culturally circumscribed. Never the mere
reflection of social responses, it is actively crafted in light of biographical particulars,
using culturally endorsed formats.”26 Despite their anecdote of an unremarkable, passive
girl in class who became confident and assertive and displayed a radical attitude change
after being treated as smart and interesting by her classmates,27 Holstein and Gubrium
hesitate to lay too much weight on the social influence of self by stressing the
significance of one’s own agency in self-determination. They share this concern with
Heidegger, to an extent: Heidegger believed that the world constantly shaped a self that
constantly evolved based on one’s choices, though unlike Heidegger, Holstein and
Gubrium maintain the distinction between self and world. These thinkers also all believed
in the multiplicity of selves, but in slightly different ways. For Holstein and Gubrium,
different selves are in “greater demand than ever” and emerge in different institutional
settings (school, work, family, church).28 Unlike these thinkers, I maintain the existence
of a single self whose essence as a unique, introspective person continues, but whose
roles, opinions, appearance, and experiences continually change, rather than multiple
selves that may actualize at different times.
Turning now to the self and its relationship to antidepressants, most of the
academic interest in this subject seems to have been spawned by psychiatrist Peter
25 Jaber F. Gubrium and James A. Holstein, "Restorying the Self," in The Self we Live by: Narrative Identity in a Postmodern World (New York: Oxford University Press, 2000), 13.
26 Ibid., 12.
27 Ibid., 6-8.
28 Ibid., 13.
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Kramer’s 1993 book Listening to Prozac, in which Kramer addresses the nature of
character and the mutability of the self. Although his work contains many case studies of
people who find themselves able to feel like their true selves after taking Prozac, Moira
Fracassa criticizes Kramer’s endorsement of the use of Prozac for social reasons: Kramer
enthusiastically helps his patients by merely making them the kinds of people that society
demands.29 Fracassa also claims that the practice of prescribing drugs to a patient and
then basing a diagnosis on the patient’s reaction suggests the “dangerous” view that “by
listening to biology, we can define the self.”30 This biological reductionism is problematic
because, according to Fracassa, the self is socially determined as well. The effects of
antidepressants on a purely biological self would be tremendous, but my conception of
self is much more multi-faceted and comes closer to Fracassa’s view that the self is
culturally determined as well. Fracassa specifically supports Elizabeth Wurtzel’s
sociological mindset and critical, measured support of antidepressants in her book Prozac
Nation, which argues that antidepressant use is connected to a cultural desire to explain
phenomena biologically. Also reviewing Listening to Prozac, sociologist Pauline Norris
takes note that society rewards certain traits (confidence, flexibility, quickness, energy)
over others,31 and Prozac can help bring about these traits. My conception of the self
includes the influence of culture and society, but I do not support the view that the
influences on the self are limited to society and biology. These authors fail to treat the
29 Moira Fracassa, "Medicating the Self: The Roles of Science and Culture in the Construction of Prozac," Journal of Popular Culture 32, no. 4 (1999), 24-25.
30 Ibid., 24
31 Pauline Norris, "Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Shelf," New Zealand Sociology 10, no. 1 (05, 1995), 143.
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importance that experience, genetics, and one’s place in time and space hold to the
development and evolution of one’s self.
The argument that antidepressants are too often used to repair a social problem
rather than a pathological one is common among critics of antidepressants, and it has
significant implications for the self that arises from these social problems. While
antidepressants often seem to reveal the true self that was hidden by pathology, many
believe the self that is revealed is a creation of socially constructed norms that can create
depression and, when complied with, can alleviate it. In “Enhancement Technologies and
the Modern Self,” philosopher Carl Elliott shows how Charles Taylor’s work32 reveals the
often objectionable social roots of the demand for enhancement technologies, and how
focusing on using these technologies changes the individuals affected by larger social
problems, rather than addressing those problems themselves.33 Elliott emphasizes the
importance of understanding authenticity as a way to express a modern moral aspiration,
rather than as a literal description of the effects of a drug or procedure.34 In other words,
Elliott argues that authenticity, a common desire among antidepressant users, is sought
after by being true to a set of socially prescribed and desirable characteristics, rather than
being true to oneself independently of social expectations. He seems to suggest that the
self that is entirely culturally created is inauthentic.
The society that dictates which characteristics should be valued can create
depressed people if they do not live up to these standards. However, if we subscribe to a
32 Taylor, Inescapable Horizons, 31
33 Carl Elliott, "Enhancement Technologies and the Modern Self," Journal of Medicine & Philosophy 36, no. 4 (04, 2011), 364-374.
34 Ibid., 371.
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view of the self that encompasses the influence of biology and society, antidepressants
can bring about a self (perhaps a more confident, flexible, quick, and/or energetic self 35)
that makes people more happy and comfortable in that society. Charles Taylor would not
count this as an authentic self, however, and the cultural ideal of authenticity of self is
very real.36 If antidepressant users subscribe to this ideal, it can produce anxiety if they
view antidepressants as a compromise to their authentic selves, which they often do.37 If a
person takes antidepressants because they are unhappy with themselves due to their
(socially produced) feelings of not measuring up, in Taylor’s line of thinking, they are not
being their authentic selves because they are acting solely on a notion that is a result of
external influences; namely, social pressures. I, however, reject the notion of an
“inauthentic” self and instead assert that a self is always authentic, though it can be
shaped in different ways by one’s choices (for example, the choice to take
antidepressants).
Phenomenologist Frederik Svenaeus draws from the work of Thomas Fuchs on
how depression affects the self38 to create his version of the relationship between
antidepressants and the self. To him, Peter Kramer’s Listening to Prozac “lack[s] a
comprehensive understanding of what the term ‘self’ means in this context,”39 which
35 Norris, “Listening to Prozac,” 143.
36 Taylor, Ethics of Authenticity, 28-29.
37 Frazzetto, Antidepressants and the Multiplicity of Authentic Selves, 152. See also: Fredrik Svenaeus, "Do Antidepressants Affect the Self? A Phenomenological Approach," Medicine, Health Care and Philosophy 10, no. 2 (2007), 153-166.
38 Thomas Fuchs, "Corporealized and Disembodied Minds: A Phenomenological View of the Body in Melancholia and Schizophrenia," Philosophy, Psychiatry & Psychology 12, no. 2 (06, 2005), 95-107.
39 Fredrik Svenaeus, "Do Antidepressants Affect the Self? A Phenomenological Approach," Medicine, Health Care and Philosophy 10, no. 2 (2007), 153-166.
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Svenaeus intends to remedy in his own paper. Following in the Heideggerian tradition, he
claims that the self emerges out of being-in-the-world, but also out of bodily resonance
and attunement.40 Svenaeus focuses on the body and its spatiality as a tool for
understanding the self; to him, resonance and attunement are terms for the body’s
“capacity to be affected by the world”41 that can help one feel at home in the world or,
potentially, make one feel estranged from the world if one is “out of tune.”42 Here, his
views diverge from Heidegger’s, as Svenaeus draws a distinction between self and world.
When one is “out of tune,” the self cannot develop because it cannot truly connect with
the world on which it depends, which creates depression. By altering the concentrations
of neurotransmitters in the synapses of the brain, antidepressants alter bodily resonance in
ways that make new forms of transcendence to the world possible.43
Though I agree that we must acknowledge the importance of our temporality and
situatedness in terms of our selfhood (to use Heideggerian terms, though Taylor values
these in his own words), there is more to the self than that: by “temporality and
situatedness,” Heidegger seems to mean spatial and temporal location, to the exclusion of
biological and genetic composition, which, I argue, carry significant weight in one’s
selfhood. Taylor orients his theory of self in terms of culture and significant others, also
to the exclusion of biology and genetics. And while I support Peter Kramer’s view that
biology significantly impacts our selves, there is more to it than that as well, as his focus
40 Ibid., 156.
41 Ibid., 160.
42 Ibid.
43 Ibid., 162. Svenaeus uses transcendence in the same way that Heidegger uses Dasein: as a form of awareness of our connectedness to the world.
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on biology largely ignores the factors that Heidegger and Taylor stressed, factors that I
believe to be important to the self. All of these thinkers have brought up significant
aspects of self, but none presents a complete picture. My definition of the self
encompasses all of the factors pinpointed by other philosophers.
The long history of interest in the self testifies to the importance of this topic to
human beings, and the growth of depression and the prevalence of antidepressants have
added a new dimension and urgency to the question of the nature of the self.
Unfortunately, a lack of clarity has severely impaired this discussion. Fracassa, Norris,
Frazzetto, Benjamin, Elliott, and several other authors neglect to define the self in their
works,44 rendering their analysis of the effects of antidepressants incommensurable,
which hinders the discussion on this vital topic. Descartes, Hume, Heidegger, Holstein
and Gubrium, and Taylor, on the other hand, provide excellent definitions of self, each of
which is both similar and distinct from my own, that will help me to make intelligible
claims about the effects of antidepressants on the self. Svenaeus was the only author I
came across who provided an adequate definition of self and applied antidepressants to it
in a meaningful way. In this sense, his work is exemplary.
In this paper I hope to provide the grounds for a more commensurable discussion
about self and antidepressants by example: by outlining several views of the self,
including my own, then applying antidepressants to each of these conceptions of self, I
will illustrate the clarity that becomes possible when selfhood is defined before analyzing
its interaction with antidepressants. Before getting deeper into this discussion, however, I
44 See, for example, Gloria Dura-Vila and Victor Dura-Vila, "Reply to Gold and Olin: Antidepressants and the Identity of Persons," Transcultural Psychiatry 47, no. 2 (2010), 322-334.
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will pause to give a brief overview of the function of antidepressants and the condition
that they treat.
The academic and clinical communities seem to generally agree that depression is
a real concern, and not necessarily something that can be overcome without the use of
antidepressants. According to the DSM-IV, major depressive disorder is characterized by
some or all of the following symptoms for at least two weeks: a pervasive and persistent
depressed or irritable mood, decreased interest or pleasure in activities, changes in
weight, appetite, sleep, and/or activity, fatigue, feelings of guilt or worthlessness,
decreased concentration, and suicidality.45 Diagnosis is based on the patient’s self-
reported experiences, behavior reported by relatives or friends, and a mental status
examination.46 Antidepressants can alleviate these symptoms and restore normal
functioning to patients. The most commonly used antidepressants, selective serotonin
reuptake inhibitors (SSRIs), are believed to increase levels of serotonin, a substance in
the brain believed to be a contributor to feelings of happiness and well-being.
Unfortunately, it is not known what causes depression, and there is no laboratory test for
it. Psychologists consider depression to be a mood disorder, and antidepressants work
biologically to re-elevate one’s mood. 47
For the next section of my paper, I will apply antidepressants to the theories of
self of Descartes, Hume, Heidegger, and Taylor. The point is not to show how these 45 DSM-IV, "Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes," Project Safety Net, http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf
46 Ibid.
47 For a fascinating phenomenological characterization of depression, see Thomas Fuchs, "Corporealized and Disembodied Minds: A Phenomenological View of the Body in Melancholia and Schizophrenia," Philosophy, Psychiatry & Psychology 12, no. 2 (06, 2005), 95-107.
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philosophers did or would have felt about depression or antidepressants. Rather, it is to
show how different conceptions of self can affect one’s views on antidepressant use,
using four philosophers as examples. I chose each one because of how different each is
from the next, thereby giving a variety of resulting attitudes toward antidepressants.
Descartes justified his conception of the self as an immaterial mind that exists
independently of one’s body in several ways in his Meditations on First Philosophy.48 He
says that although he has a clear and distinct idea of himself as a “thinking and
unextended thing,” he possesses a distinct idea of the body as an “extended and
unthinking thing,” so he must be “entirely and truly distinct from [his] body, and may
exist without it” because one cannot be both extended and unextended, thinking and
unthinking; therefore there must be two separate entities. He further justifies his claim by
arguing that the mind is indivisible and that the body is divisible:
For in truth, when I consider the mind, that is, when I consider myself in so far only as I am a thinking thing, I can distinguish in myself no parts, but I very clearly discern that I am somewhat absolutely one and entire; and although the whole mind seems to be united to the whole body, yet, when a foot, an arm, or any other part is cut off, I am conscious that nothing has been taken from my mind…
Because one thing cannot be both divisible and indivisible, Descartes claims that the
mind and the body must be separate entities.
Mind and body, he held, do not hold the relationship of a sailor to a ship, but
intermingle with one another, “so that I and the body form a unit.”49 To illustrate his
point, he explained that when “our bodies are being stimulated, we feel that something
48 Unless otherwise specified, this section derives from Rene Descartes, "Meditation VI: Of the Existence of Material Things, and of the Real Distinction between the Mind and Body of Man," http://oregonstate.edu/instruct/phl302/texts/descartes/meditations/Meditation6.html (2014).
49 Barressi and Martin, Soul and Self, 130.
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has happened to us, rather than merely think that it has happened to our bodies.”50 He
instead suggested that, although separate entities, the “mind and body compose a certain
unity” and that they are so intimately linked with each other that they affect each other.
Thoughts from the soul, he claimed, affect one’s bodily behavior, and bodily sensations
are “directly experienced by the immaterial soul.”51 Descartes’ conception of the unity of
body and self suggests an experience of self that is predominantly internal and perhaps
phenomenological, as one’s own experience of bodily sensations informs the experiencer
of the uniqueness of their own consciousness and offers a distinction between their
experiences and those of another.
Although Descartes conceptualized the self in terms of our essence as thinking
beings, he did not see the brain as the same organ responsible for thinking and feeling
that we know it to be today; instead, for Descartes, thinking comes from the mind (soul),
not the brain (which makes sense, given that, for Descartes, thoughts and the soul that
produces them are both immaterial things). However, he assumed that, although the mind
and the body are separate entities, they interact, communicate, and affect one another
through the pineal gland, a small organ located in the brain, which he also believed to
house the soul (which is a separate but immaterial entity residing within the body).52
Because of Descartes’ erroneous physiological theory involving, among other
things, the pineal gland, the Cartesian view of the self has been rendered obsolete in this 50 Ibid., 131.
51 Ibid., 127.
52 Descartes believed that emotions, or “passions,” were sensitive movements that the soul experienced due to its union with the body, and “melancholy” (depression) was a corruption of the emotions preventable by the soul keeping such dysfunctions under control. Therefore, Descartes probably viewed depression as a disease of the soul. See Francisco López-Muñoz et al., "Sadness as a Passion of the Soul: A Psychopathological Consideration of the Cartesian Concept of Melancholy," Brain Research Bulletin 85, no. 1 (04/25, 2011), 42-53.
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way. However, Cartesian dualism is very much alive and we can easily work with it in a
contemporary setting. Although we know that the pineal gland does not exist as Descartes
understood it, we can still assume, as many do, that the soul and the body are connected.
Antidepressants therefore work, though in varying degrees depending on one’s beliefs, in
a mechanistic and physiological way. Antidepressants are, of course, material things, so
they at least begin to effect change through the material part of one’s existence: through
the body. Where antidepressants would really matter, however, would seem to be the
soul, as that is the source of one’s identity and essence. For Descartes, antidepressants
would travel through the body, to the pineal gland, and finally to the soul. Not in a
physical way, I might add; but rather, the changes that antidepressants produce in the
brain and body would be “directly experienced”53 by the soul through the pineal gland,
though Descartes does not address the mechanism by which this would happen. But I
repeat: the pineal gland is not necessary for this theory to be relevant today. Many people
believe that the soul and the body are connected, regardless of the logistics of the
phenomenon. Moreover, like Descartes, they believe soul and body to be separate,
separable, and quite different kinds of things.
Since the Cartesian self is the soul, antidepressant users with a Cartesian view of
self could quite plausibly feel confused or guilty about what they are doing to their body,
because bodily experience affects the soul. As Descartes does not characterize the self
beyond its nature as an immaterial mind, he leaves the self’s mutability open to
interpretation, and whether one interprets the self as permanent or as mutable, unpleasant
consequences are probable: to one who assumes the natural permanence of the self, 53 Barresi and Martin, Soul and Self, 127.
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taking antidepressants could be viewed as morally wrong as an unnatural corruption of
the self, causing feelings of guilt. To one who assumes the mutability of the self, taking
antidepressants could cause confusion as to which self, medicated or unmedicated, is the
true self, and this confusion would not result from any moral concern. In spite of
Descartes’ ambiguity on this topic, he placed tremendous weight on the power of the
mind to discover truth much more reliably than the body and senses (“for it is, as appears
to me, the office of the mind alone, and not of the composite whole of mind and body, to
discern the truth…”).54 Presumably Descartes would not want to alter the mind when it is
so crucial to our understanding of the nature of the world, of ourselves, and of the divine;
therefore, the mind should be considered sacred to Cartesians. Furthermore, in regards to
our contemporary cultural ideal of authenticity, altering the very essence of one’s being
(via the body) could endanger one’s pursuit of this ideal and generate considerable
criticism from its proponents, causing further feelings of guilt and confusion.
However, if one believes (as Descartes likely did55) that depression is a disease of
the soul, what better remedy than antidepressants, if they will affect the soul as well?
Under this circumstance, too, however, Cartesian antidepressant users who believe in a
naturally permanent self could feel guilty for taking antidepressants. There are other
options that could remedy the soul while preserving its integrity—things such as talk
therapy or philosophy could comprise a treatment that takes place entirely in the soul, as
it involves only an unextended, immaterial substance: rational thought. Our culture often
views taking antidepressants as “taking the easy way out” and treating one’s condition
54 Descartes, “Meditation VI”.
55 See footnote 56.
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without any real, hard work because talk therapy or philosophy presumably requires
considerably more effort than taking a pill.
In sum, Descartes believed that the soul and the body are separate entities that are
nonetheless connected and affect one another. Our essence, and the idea of the “self,”
reside in the soul, as it is where all rational thought occurs, which is what sets us as
humans apart from other living and nonliving things. Antidepressants begin their effects
in the body but also affect the soul, and therefore the self, which is something that people
either want understand, or leave entirely intact (or both). Therefore, a Cartesian view of
the self allows for the possibility that antidepressant users could feel guilty and conflicted
about their decision.
I argue, unlike Descartes, that the body is part of the self and part of the “I.”
Descartes claims that the mind is indivisible and the body is divisible because when a
part of the body is cut off, one is “conscious that nothing has been taken from [their]
mind,” so the mind and body must be separate entities. If one loses, for example, their
arm, nothing is taken from their mind. But neither is anything taken from their legs or
their nose, and both are considered by Descartes to be parts of a single but divisible thing.
Therefore, his example does not effectively show that the mind and body are separate.
Furthermore, while Descartes refuted the claim that the mind and body are related as a
sailor to a ship because he wanted to show that they are actually connected, the same
metaphor can argue that they are not merely connected, but rather, a single entity.
Descartes himself claimed that they form a “unit,”56 but although what he meant was that
the two parts maintain their identities, as people do in a marriage, the metaphor provides
56 Barresi and Martin, Soul and Self, 130.
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no reason that their combination could not form an altogether new entity, such as when
water mixes with Kool-Aid powder. While I do not argue that mind and body lose their
individual identities because of their oneness, I do argue that a more intimate connection
exists between the two than Descartes realizes. The fact that we say things like, “I am
fat,” rather than, “My body is fat” suggests that we feel a certain oneness with our
body—so much so that we intuitively know it to be a part of our self and our essence,
rather than a separate entity from it, even if we are unaware of this knowledge. I argue
that the ways in which we experience our bodies easily affects the way we think about
and experience ourselves. Being, for example, overweight often affects one’s self-worth,
ability to perform certain tasks, and even one’s social circle, all of which affect one’s
experience of self. Our body is therefore crucial to the experience and development of the
self.
Turning now to Hume, he claims in A Treatise of Human Nature that the self is
“nothing but a bundle or collection of different perceptions, which succeed each other
with an inconceivable rapidity, and are in a perpetual flux and movement.”57 Whether due
to the resemblance, causation, or contiguity of successive perceptions, we mistakenly
conceive of them as a single entity. He proposes that the mind is a fictional construction
and compares it to a theatre in which actors—“perceptions [that] successively make their
appearance”—are what we might call the traditional self. In other words, the successive
perceptions we experience are like actors on a stage that “pass, re-pass, glide away, and
mingle in an infinite variety of postures and situations.” We are not seeing a single person
on the stage, but a series of actors that we mistake for, or accept as, a single entity, and 57 Unless otherwise specified, this section derives from David Hume, A Treatise of Human Nature, Project Gutenberg, http://www.gutenberg.org/files/4705/4705-h/4705-h.htm (accessed 3/24, 2014).
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this applies whether we are looking at ourselves or at another. Paradoxically, he does
suggest that there is an introspective “I” doing the viewing, but he claims that this, too, is
only a perception. He reasons:
For my part, when I enter most intimately into what I call myself, I always stumble on some particular perception or other…. I never can catch myself at any time without a perception, and never can observe any thing but the perception. When my perceptions are removed for any time, as by sound sleep; so long am I insensible of myself, and may truly be said not to exist.
Though this mental performance has an audience, he leaves the nature of this audience
rather unclear. More problematically, the mind in which this mental performance occurs,
according to Hume, does not exist, “nor have we the most distant notion of the place,
where these scenes are represented, or of the materials, of which it is compos’d.” He does
not elaborate on this gap in his reasoning, and overall, Hume’s metaphor is quite vague
and leaves his readers with seemingly more questions than answers.
Hume claims that in our forging of successive perceptions “we often feign some
new and unintelligible principle, that connects the objects together, and prevents their
interruption or variation,” and this is where we “run into the notion of a soul, and self.”
By comparing the soul instead to a republic, however, Hume attempts to prove otherwise:
the continuity of a republic depends on the relations among, not the persistence of, its
parts.58 He discusses an example of a church that is destroyed and rebuilt of different
materials:
Here neither the form nor materials are the same, nor is there any thing common to the two objects, but their relation to the inhabitants of the parish; and yet this alone is sufficient to make us denominate them the same. But we must observe, that in these cases the first object is in a manner annihilated before the second comes into existence; by which means, we are never presented in any one point of time with the idea of difference and multiplicity; and for that reason are less
58 Barresi and Martin, Soul and Self, 154.
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scrupulous in calling them the same.59
This scenario illustrates the mistake that we make in identifying human selves, as well.
For example, because Smith is always changing, we cannot assume that the Smith we
perceive is the same Smith we may have known five years ago, or seen five minutes ago.
In another metaphor, Hume compares the soul (or self; he uses these terms
synonymously) to a republic: the members of the republic (the successive perceptions
that we forge into a single entity) are united by their relationship to the government (or
one’s relationship to the memory of previous self perceptions) and give rise to other
persons (or perceptions), who propagate the same republic (or self conception) in the
incessant changes of its parts. “And as the same individual republic may not only change
its members, but also its laws and constitutions; in like manner the same person may vary
his character and disposition, as well as his impressions and ideas, without losing his
identity. Whatever changes he endures, his several parts are still connected by the relation
of causation.” For republic and person alike, contiguity, resemblance, and causation
create the misconception that their identity remains constant. Hume’s problem with this
mistake is that he considered even the smallest change to a mass of matter as a
destruction of its identity as a whole. When the laws of a republic change, Hume would
consider it to be a new republic; when a person’s ideas change, a new person is formed.
In his words, “an oak, that grows from a small plant to a large tree is still [considered to
be] the same oak; tho’ there be not one particle of matter, or figure of its parts the same.”
Similarly problematic to Hume, infants undergo constant change as they grow into adults,
yet are misrecognized as an “uninterrupted” whole. Human beings do indeed constantly
59 Hume, Treatise.
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change, even in material makeup, as does the church that is destroyed and rebuilt in
Hume’s example, but a persistent name masks this flux.
The responsibility for forging these connections between perceptions, according
to Hume, lies with the memory. If we had no memory, we would have no recollection of
previous perceptions of our self, and would therefore have no basis on which to build a
persisting identity. The memory creates a connection between the person doing the
remembering and the person in the memory because they resemble and succeed one
another. Yet like everything else, presumably, the brain is in constant flux as new
memories are added, but Hume does not address why a brain would relate such personal,
self-referential, and meaningful memories to the person doing the remembering if the
person in the memory is literally a different person from the one doing the remembering.
Memories are not only recollections of past events, but often carry with them emotional
valence. Why would our present selves experience, for example, embarrassment at
something that a different person did in the past? This is a weak point in Hume’s
argument that he does not address.
However, I posit that if the self truly does not exist, as Hume claims, we must still
assume the existence of some sort of self for practical reasons, and it is likely that Hume
recognized this because, although he considers it a mistake, he himself still calls the small
plant that grew into an oak the same oak. Strictly speaking, one cannot plausibly live
their life assuming that everything they encounter is something utterly new and foreign;
we would be forced to introduce ourselves repeatedly to people we’ve already met, and
we would live in constant fear and tension not having any idea how any given entity may
behave at any moment. Without assuming that my dog is the same friendly and well-
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behaved dog I had yesterday, I would be perpetually nervous that he would bite me, and I
would have to constantly babysit him to ensure that he wouldn’t urinate on the carpet. It
would be incredibly time consuming, inefficient, and unproductive to live this way.
Therefore, we must feign some sort of persisting identity as a practical matter. This
makes Hume’s position a bit clearer, but it does not answer the question of why, if we are
truly only feigning a connection between perceptions, we would feel embarrassment for
something that another self did. Thus, his position on the self remains vague.
For the purposes of this paper, I will assume that contemporary people with a
Humean view of self recognize this necessity of a practical, if illusory, self, and do not
live their lives in the way described above.
A Humean conception of self, then, presents a radically different framework from
that of Descartes to which one may apply antidepressants. Within his theory,
antidepressants would have no bearing upon a soul or self, because they do not exist. The
effects they could have on one’s body would be seemingly inconsequential, as one does
not possess a single body, but rather, the changes that the body undergoes while taking
antidepressants would contribute to the incessant change already taking place that render
the body different from the one that immediately preceded it. On the other hand, the
successive bodies perceived will alter what one’s memory has for connecting, and the
practical self with which one identifies would indeed change, which may cause anxiety,
guilt, or confusion. But a true Humean would know that these connections are only
feigned, so this view of self does not attribute much importance to the maintenance of a
specific identity, nor does it lend much weight to the idea of a sacred self deserving of
preservation. Therefore, a contemporary antidepressant user holding a strictly Humean
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view of the self would not likely be concerned with their decision to do so because they
would not believe that the person who took the antidepressants to be the same person that
feels their results, so they would also have no reason to feel conflicted about their identity
or its authenticity.
However, an antidepressant user would still undoubtedly feel the effects of the
antidepressants in one way or another, and although memory would create the impression
that the person who took the drug is the same person who experiences its effects, a
Humean antidepressant user would know this to be an illusion. This appears to be
beneficial to antidepressant users as it relieves them of guilt for their decision and it
allows them to believe that their essence remains unthreatened by antidepressants
because it does not exist. However, how would they cope with the fact that they are
feeling the results of something a past person has done to them? Again, Hume leaves this
unanswered.
With one’s existence being a succession of different selves, there is no pressure to
maintain one’s identity or to come to know oneself because the self’s constant change
would render the endeavor useless. However, having a Humean conception of self seems
to create confusion and anxiety in its own way by giving people first-person memories of
literally different people. I could posit that what Hume really means is that some part of
us does persist and we should just not take the idea of the self so seriously because of
how often it changes, which seems to be the only plausible explanation for the
unanswered question of memory. There is no evidence to support this, though, as he
spoke in quite literal terms throughout his work and gave no indication that he was
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anything but serious.60 Antidepressants, then can provide much-needed psychological
relief without the guilt and confusion to a Humean depressive, but only if they can come
to grips with their first-person memories of endless people.
But there are further problems with Hume’s conception of self: it does not tell us
how different a self is from any other external object. When he defines the self as
“nothing but a bundle or collection of different perceptions, which succeed each other
with an inconceivable rapidity,” he does not differentiate the self from other things we
perceive. Yet experiencing oneself is a different phenomenon than experiencing a table:
we experience how a table looks to us, and how it feels to the touch, but we do not
experience the table itself independently of our perception. We don’t know what it is to
be a table. He does talk about the role of memory in creating a link between past and
present selves, but memory also creates a link between past and present objects and
people other than oneself. Why is the experience of being oneself so different from our
experience of the external world? Like Descartes and Heidegger, I argue that being in
one’s own body and having one’s own mind is a unique experience because of its
reflexivity and subjectivity and its “sense of “always-being-my-own-being” and
“ownness.” We can reflect upon ourselves, and notice and account for changes in
ourselves.
Another problem lies with Hume’s republic metaphor in which he claims that a
person does not maintain a persistent identity, since they change in so many ways and so
often. I agree that we are constantly in flux, but this does not destroy our identities and
60 To give one example of this, he quotes in his Treatise: “If any one, upon serious and unprejudiced reflection thinks he has a different notion of himself [than the one I suggest], I must confess I call reason no longer with him.”
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create new ones. Hume does not characterize the successive perceptions that make up his
illusory self, but they are inconceivably rapid, as he says, which would seem to mean that
each self, so to speak, lasts only a miniscule amount of time before it is destroyed and
replaced by another. I argue instead that the self is changing, but continuous, and memory
allows us access to past versions of ourselves and lets us know that phenomenologically
we are the same person, if changed, that we were in the past, even if colloquially we
sometimes say that we are “different people” now than we were before. Hume did not
address why a brain would relate such personal, self-referential, and meaningful
memories to the person doing the remembering if the person in the memory is an
altogether different person from the one doing the remembering, which significantly
weakens his argument as well. The self is real and practical, while Hume’s conception
gives us no practical way to complete day-to-day activities and interactions by making
identities unnecessarily confusing and temporary.
Heidegger conceptualized the self as something much larger than any individual
person. For him, the self is a mode of being, which he called Dasein. He outlines this
concept in Being and Time. Although the 500-page book is devoted to explaining what it
means to exist, I will keep my analysis as simple, but as accurate, as possible.
Heidegger sought to erase the distinction between person and world. He argued
that they form a single entity, but that the world and the person constantly affect one
another. The world, in this sense, is not necessarily the earth, but rather, the group or
community or place in which one finds oneself at a particular time. Thus, the immediacy
of the things and people surrounding a person at a certain point in time constitutes their
world and, therefore, the possibility of selves they can actualize: “The everyday
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possibilities of being of Da-sein are at the disposal of the whims of the others. These
others are not definite others. On the contrary, any other can represent them.”61 The
“others” he refers to are the people and relationships that occur in a world, and they are
not definite, meaning they vary between times and worlds. Alternatively phrased,
“[e]veryday Da-sein derives the pre-ontological interpretation of its being from the
nearest kind of being of the they.”62 This means that (in the inauthentic mode of being,
which I will explain momentarily) we determine who we are based on who and what
surrounds us.
Furthermore, “one belongs to the others oneself,”63 which illustrates the
connection Heidegger draws between a person and their world in the constitution of the
self. Although for him the “inauthentic” “they-self” is a mode of being characterized by
not distinguishing oneself from the others, the “authentic being [of] one’s self is not...a
state detached from the they, but is an existentiell [sic] modification of the they as an
essential existential.”64 In other words, the authentic self is not the annihilation of the
they-self, but a modification of it to include the awareness and distinction of oneself
amongst the crowd. One must be a part of, but acutely distinct from, the world in order to
exist authentically.
A sense of “always-being-my-own-being” is a central characteristic of Dasein, of
authentic existence. It is the awareness of one’s ownness, as distinct from the
61 Martin Heidegger, Being and Time, trans. Joan Stambaugh (Albany: State University of New York Press, 1996) 118-119.
62 Ibid., 121.
63 Ibid.
64 Ibid., 122.
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inauthenticity of a consciousness in which one is lost in the crowd and unaware of one’s
individual existence. We tend to become so engrossed in everyday life, surrounded by
other people and things, that we lose consciousness of our very existence, and indeed
become aware of ourselves only as others see us. “The self of everyday Da-sein is the
they-self which we distinguish from the authentic self, the self which has explicitly
grasped itself.”65 But, he claims, “the inauthenticity of Da-sein does not signify a “lesser”
being or a “lower” degree of being.”66 Hence Heidegger merely describes what it means
to be, without ascribing any moral value to it. He postulates that we are all inauthentic
“initially,” and eventually come to be authentic once we understand Dasein, from which
point authenticity and inauthenticity alternate; but “Da-sein is the they and for the most
part it remains so,”67 since for most of our time we are not consciously aware of our
existence or of its nature as constitutively dependent on the surrounding world.
Furthermore, Heidegger believed in and emphasized the importance of choices in
the formation of the self: “he argues that our ordinary feelings of guilt bear witness to the
fact that as we make choices, we are always actualizing one possible self at the expense
of others.”68 For example, if I were to steal money from a friend, the guilt I would feel
would illustrate the possibility that I could have acted otherwise, and in so doing,
actualized a different self than the one I chose to actualize.69 Possibilities are an important
aspect of Heidegger’s idea of an “authentic” self. For Heidegger, “Da-sein is always its 65 Ibid., 121.
66 Ibid., 40.
67 Ibid., 121.
68 Barresi and Martin, Soul and Self, 234.
69 This also emphasizes how the self is a relation to the world rather than a separate entity in it.
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possibility. It does not ‘have’ that possibility only as a mere attribute of something
objectively present,”70 but the very awareness of different possibilities characterizes and
makes Dasein possible. “And because Da-sein is always essentially its possibility, it can
‘choose’ itself in its being.”71 To exist authentically, then, is to choose from among, and
perhaps create, these possibilities. In inauthentic existence, one’s possibilities are
determined by the others, the they, rather than by oneself. One is not aware of their
possibilities, and in their unawareness they let the others dictate their life.
By applying antidepressants to this conception of self, I will also put Heidegger’s
idea into a more accessible, everyday setting. According to him, the varied collection of
people and things in a person’s world make up their self and affect the possibility of
selves they can actualize. When I move around a room, for example, the furniture in that
room affects my self spatially because I cannot actualize a self that moves about the room
as if it were empty. I only have so many options as to which spatial self to actualize.
Antidepressants are also a part of one’s world, and their existence creates the possibility
of taking them, or of not taking them. To be authentic, a depressed person must be aware
of this possibility and make a decision. But would this decision itself affect the
authenticity of one’s self?
Although Heidegger did not use “authenticity” in the most conventional way, we
can still see its relevance in an everyday setting. The argument that authenticity comes
from being aware of one’s own self amongst the crowd and not solely based on our
surroundings seems to suggest that the self comes from within and without rather than
70 Heidegger, Being and Time, 40.
71 Ibid.
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strictly from without. One must choose their mode of existence amongst many
possibilities. Heidegger may also mean that to exist authentically, we must, to some
extent, choose our possibilities themselves. For example, by rearranging the furniture in a
room, we are actualizing a different set of possibilities of motion about that room.
Inauthentic existence would be to allow the world to dictate the sets of possibilities we
have. Although choosing our possibilities in the context of antidepressants seems less
possible than in the context of furniture, one can still be aware of, and choose from, the
possibilities that are given. If one chooses to take antidepressants, one must be aware of
the influence of the outside world, in this case antidepressants, but also recognize one’s
self as separate and distinct from them. This means that one must recognize their identity
as a depressed person and be conscious of the effects of the antidepressants on their self,
including its future possibilities.
Since Heidegger does not ascribe moral value to the difference between
authenticity and inauthenticity, it seems that taking antidepressants would be morally
blameless regardless of whether or not one is acting authentically. Since he argues that
for the most part our existence is inauthentic anyway, we can discard any moral concern
in taking antidepressants.
However, as the others do constantly affect the self, one may run into the problem
of a negative perception of antidepressants, which would affect their self if that negativity
enters their world somehow, whether it is from a person or one’s culture. Even before one
is confronted with the choice of taking or not taking antidepressants, they will have
entered one’s world simply by one’s being aware of their existence. Most people will
have a pre-existing notion of antidepressants before the antidepressants enter their world
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in a more concrete way. Even if there is no moral concern to being authentic, one may
perceive a moral concern in taking antidepressants, which may constrict one’s perceived
possibilities, and in this way, one is letting the world dictate their possibilities, rather than
creating them oneself. In other words, I may immediately dismiss, without thought, the
idea of taking antidepressants because of a negative perception caused by the they. If this
were the case, I would be existing inauthentically. Because I do not consider this
possibility, I am letting the world dictate what is possible for me, rather than choosing my
own possibilities and allowing for the possibility of taking them, even if I eventually
decide not to.
The Heideggerian worlds (surrounding places, people, cultures, etc.) in which we
find ourselves affect the possibilities of selves we can actualize; different worlds allow
for different possibilities. Heidegger’s position resembles my own because I argue that
the self is in constant flux, and to some degree, we control that flux, and he argues that
we can choose our worlds, which greatly affect our self. Heidegger’s claim that “worlds”
affect the self is quite similar to my claim that culture and other people affect the self, as
all of these things are part of Heidegger’s world.
However, I do not wish to erase the distinction between person and world as
Heidegger does. I concede that they do affect each other, and they occupy the same
space. But they are not one and the same. I live in and am a part of the world, and the
world affects me. Even if I were to leave the earth and travel through space, I would still
be entering a different world that would affect me, and my presence would affect that
world, if only spatially. Worlds are constantly changing and inescapable because we
always find ourselves in a world of some kind. Death may be an exception to this, as
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death, for Heidegger, is the possibility of the impossibility of Dasein. For this reason,
person and world must be separable: even if one ceases to experience the world, the
world still continues its existence. One’s physical body remains in the world forever,
though not in the same form as when it was alive, so I do not agree that the world is
merely a subjective experience that ceases with loss of consciousness. Person and world
must be separable, though they have close ties.
Thinking about Heidegger’s particular use of the term ‘authenticity,’ though
problematic, can still yield beneficial results for antidepressant users. Today, authenticity
is typically understood as a certain realness and manner of being true to oneself while for
Heidegger, it is a consciousness of oneself as a distinct part of the larger world. The
subtle difference between the two is that an ‘authentic self’ is not one that acts according
to cultural ideas of innate individuality, but one that recognizes its distinctness from the
crowd. Seeing authenticity this way makes the idea of antidepressants possibly disturbing
one’s ‘authentic’ self nonsensical, because antidepressants would have the opposite
effect: antidepressants can help its users awaken from their inauthentic slumber and
become more conscious of their unique and distinct being. As antidepressants tend to
give this kind of clarity to its users, it may be seen as helping one achieve authenticity.
Despite the probable irrelevance of this atypical understanding of authenticity to
antidepressant users with a goal of authenticity in the traditional sense, this would still
seem to be a beneficial result.
Charles Taylor defines the self largely through the context of the “ethic of
authenticity,” which he calls a “powerful moral ideal that has come down to us”72 through
72 Taylor, Ethics of Authenticity, 29.
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the history of our culture. This ethic of authenticity is grounded in the idea that one’s self
can only be articulated and discovered by the self-same person, and not by others. But the
“ideal of self-choice…couldn’t stand alone, because it requires a horizon of issues of
importance, which help define the respects in which self-making is significant.”73 Hence,
Taylor does not accept this ideal to be the only determining factor in the constitution and
development of the self. Though he acknowledges that there are certain ways of being
that are unique to each of us, he emphasizes the importance of those who matter to us—
George’s Herbert Mead’s “significant others”—in the formation of the self.74
Taylor’s self must first be defined against horizons (backgrounds of things that
matter in a given culture), and then by oneself within the context of these horizons. If we
attempt to define ourselves in ways that are not intelligible to our culture or significant
others, our identity will not be recognized.75 For example, if I tried to define myself by
the color of socks that I wear on a Monday, people would not recognize my identity. I
would first have to consider whether the color of socks one wears on a Monday is a
significant factor to one’s identity before I could try to define myself by it. If, on the
other hand, my culture were one in which the color of socks one wears on a Monday was
valuable and relevant, then whatever color I chose to wear would be a part of my identity.
But although I can choose what color of socks I wear on Mondays, I can’t choose
whether or not it matters, no matter how I may feel about the importance of my decision.
73 Ibid., 39-40.
74 Ibid., 33.
75 Taylor uses “self,” “mind,” and “identity” interchangeably.
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So neither can I choose whether it really constitutes part of my identity. Horizons are not
chosen by individuals, Taylor claims, but “given” to us by our culture and surroundings.
Taylor also claims that in our “culture of authenticity,” there are “certain demands
inherent in the ideal of authenticity” that we must reconcile with the “dialogical feature of
our condition.”76 He writes:
We are expected to develop our own opinions, outlook, stances to things, to a considerable degree through solitary reflection. But this is not how things work with important issues, such as the definition of our identity. We define this always in dialogue with, sometimes in struggle against, the identities our significant others want to recognize in us.77
For example, a father may want his son to follow in his footsteps and be a successful
lawyer, and the son may fight this desire, begrudgingly starting law school but eventually
quitting to pursue his own dreams to be a therapist, forcing his father to see him as such,
and not as a future lawyer. Although Taylor claims that our identity is dependent upon
recognition, he also maintains that we define it, albeit within these parameters. However,
notice that despite forming our “opinions, outlook, and stances to things,” they do not
(necessarily) make up a part of the self: Taylor later outlines what he does consider
important to the self as the following: “history, nature, society, the demands of solidarity,
[and] everything but what I find in myself.”78 Although unclear, the idea seems to be this:
What we find within ourselves consist of things like our opinions and preferences, which
we don’t really choose; we rather just find ourselves drawn to them. Since we can’t
choose these things, they don’t significantly differentiate us from others. It is instead the
76 Ibid., 35.
77 Ibid., 33.
78 Ibid., 40-41.
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things we are able to choose that matter to our identities, but only if the things we choose
have significance to some aspect of life beyond one’s inner life. Essentially, the things
that make up the self are the things that we choose, just by virtue of being chosen rather
than given. Choice is a horizon only against other horizons. The authentic self, then, may
be discovered by recognizing this fact and defining one’s self within this framework.
“Authenticity is not the enemy of demands that emanate from beyond the self; it supposes
such demands.”79
Finally, Taylor says that the self evolves and undergoes change, but persists
nonetheless. In his words,
Identities do in fact change, but we form them as the identity of a person who has partly lived and will complete the living of a whole life. I don’t define an identity for “me in 1991,” but rather try to give meaning to my life as it has been and as I project it further on the basis of what it has been.80
Hence, our memories and our ideas for the future enable the persistence and continuity of
the self through time. Horizons, again, partly determine “meaning” he refers to, without
which one cannot define their self.
In order to analyze the effects of antidepressants on a self within Taylor’s
framework, we must ask the question: Would taking antidepressants constitute a horizon
of significance? Although Taylor does not clearly define what counts as a horizon beyond
something that has “human significance,” the answer would seem to be yes: Although
depression, according to most, is not a choice, treating it with antidepressants is, so an
antidepressant user with a Taylorian conception of self would likely consider this to be
significant to their identity, and something that would be recognizable to others as such. 79 Ibid.
80 Ibid., 52-53.
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Antidepressants have been a hot topic for decades, which seems to speak to their human
significance. Hence, I will consider antidepressants as a horizon of significance. Now that
we have established that antidepressants constitute part of one’s identity, how do they
affect it from a Taylorian standpoint? One’s significant others and culture will shape, to a
large degree, how one feels about their decision.
American culture values independence, perseverance, and meritocracy, and some
see antidepressants as a threat to these values. Antidepressant users sometimes worry that
because they take antidepressants, they do not earn their accomplishments entirely on
their own if they are taking antidepressants, because the antidepressants helped them or
gave them an advantage, which threatens both meritocracy and independence. Moreover,
depression may be seen as something that can be dealt with through perseverance, and
drugs fly in the face of perseverance if one believes that drugs are an easy way out. These
cultural values affect the ways in which one’s significant others see them, so taking
antidepressants may have negative effects on one’s self-conception if those significant
others do not support the decision based on reasons culturally-defined or otherwise,
because “identity can be formed or malformed in our contact with significant others.”81
There is, of course, the possibility that others will be supportive of one’s decision
to take antidepressants. Advertisements for antidepressants can be found everywhere, and
a society that views many problems through a medical lens is more likely to accept the
problem of depression, and therefore the medical solution of antidepressants. Some
claim, however, that the invention of diseases follow the invention of cures: depression
was much more widely regarded as a medical problem after the invention of Prozac, and
81 Ibid., 49.
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therefore depression is only a real issue because we call it so and because we can treat it.
If it can be treated, then it’s a problem, as the mentality goes. But from Taylor’s
perspective, the fact that it matters to our culture means that it matters to individuals and
their identity. We return to the issue then, of how it can affect these individuals.
Suppose a person decides to take antidepressants after visiting the prescribing
doctor or psychiatrist, who was accepting and supportive of his depression. But after
informing some of his friends and family of his decision, he begins to question it because
they don’t recognize his depression and don’t support his decision. 82 Their refusal to
recognize his identity as someone who is depressed and needs medical help can be
detrimental to his self-conception. As Taylor puts it, this refusal “can inflict damage on
those who are denied it, according to a widespread modern view. The projecting of an
inferior or demeaning image on another can actually distort and oppress, to the extent that
it is interiorized.”83 For example, women often interiorize cultural expectations of them
and begin to see, judge, and critique themselves through the eyes of others. Body
shaming is an effective advertising strategy for women’s weight loss because it makes
ordinary women feel inadequate for not living up to the cultural ideal of immaculate
beauty, thinness, and youth. Antidepressant users, then, are also susceptible to this
phenomenon if they find themselves with a particular group of people or belong to a
particular culture that stigmatizes antidepressants.
Overall, a Taylorian conception of self highly depends on one’s surroundings to
determine the effects of antidepressants on a self. Because of the susceptibility of the self
82 For an excellent example of a misunderstanding of depression, see Allie Brosh, "Depression Part Two," http://hyperboleandahalf.blogspot.com/2013/05/depression-part-two.html (accessed 3/25, 2014).
83 Taylor, Ethics of Authenticity, 49-50.
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to surroundings, however, there is quite a danger of running into negative points of view
that can be psychologically damaging. In a culture that exalts authenticity and makes it a
moral standard, making the choice to take antidepressants, and thereby altering one’s way
of being, seems wrong to many people, often including the antidepressant users
themselves. This perceived wrongness causes, and in fact defines, feelings of guilt. This
is an obvious problem for antidepressant users who subscribe to this self-theory, and it’s
not the only problem Taylor’s theory of self has, both for antidepressant users and in and
of itself.
While Taylor abides by the standard, contemporary idea of authenticity as the
moral ideal of being true to oneself, I claim that authenticity is an irrelevant measure of
one’s self because authenticity is already embedded in every person’s every action. For
example, if I feel that I’m being fake or untrue to myself around certain people, I’m still
making the decision to pretend, and the decision to actualize that possibility over another
reveals something about my character and, therefore, my self. Being authentic is not
optional, but constant and unceasing; therefore, it would be a mistake to tell someone that
they are being inauthentic, or for a person to search for and strive to be their authentic
self. Taylor is wrong because he assumes that one can be inauthentic by acting out of
character, when actually, every endeavor and every choice and every action is authentic
by its very nature.
Though this conception of authenticity may not constitute a horizon of
significance for Taylor, and though I agree with Taylor that horizons play a role in the
development of the self, I argue that they are not necessary for defining the self because
one does not have to accept another’s self for it to be a true self. Feminist philosopher
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bell hooks chooses not to capitalize her name, which goes against linguistic and cultural
rules. Naturally, hooks’ wishes to have her name in lowercase are not always heeded. But
even when she is not gratified, her unconventional choice still has meaning to her and
plays a significant part in how she views, defines, and evaluates herself, and as Taylor
claims and I concur, the self is largely self-defined. However, the self does not need to be
defined within the parameters that Taylor outlines; the self is affected by, but does not
depend on, recognition by others. I believe that he overstates the significance of
recognition by others in the development of the self.
Though Taylor emphasizes the effects of others on the self, he also acknowledges
that there are certain ways of being that are unique to each of us, which seems to be an
implicit acknowledgement that we have inherent qualities that are unique to us and
perhaps unchangeable. I include genes and one’s natural disposition in my theory of self,
and this could perhaps be what Taylor is referring to. I believe I am a naturally kind
person because in my daily life I do not consciously choose to be kind to people; it comes
easily and automatically. But to Taylor, this would not be a significant part of my identity
because I didn’t choose it. To me, however, this is still a significant part of my identity
because I see it as a defining factor of me, as do others. People choose their jobs, but this
is often based on one’s interests, which one does not choose either. Yet people often say
things like “I am a teacher” rather than “My occupation is teaching” because they identify
with their choices even though they’re driven by interests, which one cannot control. So,
choices actually go hand in hand with preferences, although we sometimes make choices
against our preferences and dispositions. Even when we do so, we are still being
authentic and these choices set us apart from the crowd in a significant way.
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As a whole, these philosophers’ theories of self neglect many important factors of
the self, though collectively they touch on nearly every aspect of my own conception of
self. A Cartesian self is an immaterial mind/soul that exists independently of one’s body,
but the mind and body compose “a certain unity” such that they affect one another. A
Humean self is illusory, a succession of different perceptions that we mistakenly forge
into a single entity, which we call a soul, mind, or self. An authentic Heideggerian self, or
Dasein, is a state of being in which one is explicitly aware of the nature of one’s
existence; that is, as a part of an always-changing world of which the self is composed
and from which the self is inseparable. Finally, Taylor posits that the self is dialogical,
largely self-made, and the result of choices, but also subject to the constraints of
“horizons” of significance; in other words, it is also culturally and socially defined. A
complete conception of self will include what it is, what affects it, and its relationship to
time, and none of these philosophers adequately include each of these aspects in their
theories.
I claim that a self is a person as the object of reflective and introspective thought.
It is the result of a collection of things that make up and affect the way we view
ourselves. In addition, a self depends on our ability to reflect on our existence and
differentiate our existence from that of others. As such, a self is subjective and personal;
only introspection affords us access to it, and no other person can experience, or define,
that particular self. Although the self is open to outside influence, its subjective nature
renders it essentially unknowable to others. If someone were to tell me that I am funny,
this could likely impact my view of my self; however, I may also disagree with that
assessment. Even if all my friends think I’m funny but I disagree, I am unlikely to truly
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believe that I am funny because I don’t feel it within myself. I may be flattered by the
compliments and allow them their opinions, but if I don’t find myself funny, I can’t
change that by will. However, this conception of myself may change as I come to find
myself funny. In this case, my self would be funny after this change in self-perception
occurred, and not funny before. I can’t define myself as funny without actually believing
that I am funny. Conversely, I may think I’m hilarious, but if nobody else laughs at my
jokes, my conception of myself could change as a result. But whether or not my self is
funny is the result of my own thoughts, feelings, and ideas, and though other people may
have an idea about my wit or lack thereof, how they see my humor is a part of their self,
not mine.
In this way, our own thoughts and feelings create the self. These thoughts and
feelings manifest themselves in the brain and the brain is an integral part of our existence
and consciousness. Based on this knowledge, our self is an idea deeply connected to, if
not embedded in, the brain, which houses memories, genes, physiological processes,
emotions, thoughts, sensory perception, and almost endless information. It is important to
note, however, that people can be wrong about their self in certain respects. For example,
how would an alcoholic who believes that his drinking is under control fit into this model
of self? He may be engaged in self-deception here, but the self is not completely formed
by one’s own self-view. The self is formed and affected by multifarious influences.
Without delving into mereology, I claim that the self is a single, cohesive person,
but with many constitutive parts. One’s genes, physiology, experiences, and culture are
part of the self, as well as one’s past, present, and future. The self remains unified
throughout one’s lifetime, and one’s past is part of the self because it happened to this
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unified self and it affected the present self. One’s future is part of the self in the way that
one imagines it. Thinking about one’s future is a present activity that affects the present
self, but it also impacts one’s future, often in significant ways. Because the self is an
entity unified through time, the past, present, and future are all important to it.
This leads me to the next section of conceptualizing the self: what affects it?
Many things have the capacity to affect the self because everything we experience goes
through the brain. I will expand on several key factors that affect the self: genes, culture,
physiology, and experience. This list is by no means exhaustive, but it outlines what I see
as the main points of importance.
Genes affect many of our dispositions and personality traits that in turn influence
how we view ourselves. Although genes do not determine behavioral traits, they increase
the likelihood of the manifestation of those traits. Our behavioral traits, of course, affect
the way we see ourselves. I may view myself as careful, angry, or intelligent, and these
traits all have implications for those who either carry them or see themselves that way.
Genes can also affect the self in a more indirect way. They affect physical traits such as
skin color, which can influence how we view ourselves in several ways. Skin color
determines our susceptibility to skin cancer, which may affect our behavior in the
sunlight, which may also lead us to believe that we are cautious or careless or carefree.
Skin color also, when mixed with American culture, has significant implications on how
others view a person, and how one views oneself. Stereotypes accompany every race and
can be psychologically damaging.
The way a culture views an individual impacts that individual’s view of their self
significantly. To use a broad example, Western culture promotes individualism while
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Eastern culture tends to promote communality and collectivism. Thus, Americans tend to
think of themselves as individual people with their own personal goals and will go to
great lengths to achieve them, even at the expense of friendships, family, romantic
relationships, and the community at large. On the other hand, someone from the Eastern
world is more likely to identify themselves in relation to those in their community, and
priority goes toward the group rather than themselves.
Physiology undoubtedly affects the self as well. Since antidepressants and the self
are the theme of this paper, I will use antidepressants to show how they affect the self
physiologically. Depressed people may think of themselves as, for example, pessimistic
because of the constant dissatisfaction in their lives. But taking antidepressants can alter
the brain’s chemistry in a way that allows a depressed person to see more positivity in the
world, thus changing their outlook not only on life, but on their self as well. Broadly
speaking, eating and exercising can also physiologically alter a person, even if only
temporarily, and can change how one views oneself, if only temporarily. One’s physical
appearance influences the self as well (this also applies to the genetics section), whether
one is indifferent to or heavily invested in it.
One’s life experiences and memories also affect the self, and the other people in
one’s life constitute a significant portion of this category. One’s upbringing, for example,
has a significant impact on the self, often into adulthood. Growing up in an abusive
household may damage one’s psyche and self-esteem; children whose parents teach them
good manners may adopt a polite disposition; travelling abroad may change one’s values;
being cheated on may make it hard to trust another; and an impoverished childhood may
instill frugality. All of these effects may last only a short while or last a lifetime, but they
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all affect our self-conception, whether by affecting how we perceive our roles, our self-
worth, our values, or our traits.
Finally, a good theory of self must include the self’s relationship to time. On this
note, I argue two things: that the self is very susceptible to change, and that its essence
always remains the same. My explanation of the four factors above, I hope, have
effectively shown the malleability of the self. It is so malleable, in fact, that the ideal of
authenticity becomes irrelevant because changes are so frequent, natural, and often
unnoticed. The ideal of authenticity rests on the assumption that we have one permanent,
enduring self that has essential, unchanging properties. But the self’s essence does not
come from having certain traits that vary from person to person. Even though my tastes,
traits, appearance, genetic expression, and even my name may change, I still firmly
identify as the person who experiences the world as I do. With time comes many
changes, but through time the essence of the self is permanent; our memories and our
ideas for the future create this permanence through all of the changes the self endures.
The self is like a planet: though the earth constantly rotates and changes, it nevertheless
remains the same earth, though changed, as its location in time and space changes. I am
not suggesting that our change or movement is cyclical, but the metaphor shows how a
person can change and move while remaining essentially the same. To carry the metaphor
further, just as Earth has a center of gravity that holds everything together, our “center of
gravity” is our reflective and subjective introspection. Our ability to continually think
about ourselves, remember our past, and project our future allows for our continuity.
Even if that experience changes, I do not forget my past experiences, and the anticipation
of my continued existence propels my self into the future. “I will get married one day” is
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quite a different statement than, “The person that I will be one day will be married, but I
will not.” The former is a projection of one’s continued self into the future, and the latter
discredits any connection between a present self and a future self, and regards change in a
Humean way. Because we typically say the former and not the latter, I am inclined to
believe that this way of thinking of the self comes habitually to us. Whether or not one
believes in life after death, the self continues at least throughout one’s lifespan on Earth;
the connection we feel with our bodies binds us to the physical world, and our brains
illuminate our essence as thinking things. Our consciousness may cease with death and
resume in a different form, but the self as we know it within the context of our lives on
Earth exists only with the body and ceases with the body.
Antidepressants are of some consequence to its users within my conception of self
for several reasons. For one, they will notice a change, for better or worse, in their
dispositions and moods; but this change can quickly grow. Though several categories of
things affect the self, they are all intimately connected with one another; for example,
with antidepressants typically comes an improved mood, which often results in an
improved outlook, which creates changes in ideas, perceptions, opinions, and demeanor,
all of which alter one’s experiences. Antidepressants create a chain reaction, and the
process begins physiologically. But this change, though perhaps greater in magnitude, is
no different in nature from, for example, eating a meal. A meal alters our physiology and
can improve our mood, and even the whole trajectory of our day, as can exercise or
meditation or a headache. We constantly undergo physiological change, and taking an
antidepressant each day is just part of that process for people with depression.
Furthermore, authenticity does not exist for selves because, as I showed earlier, it is
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impossible to act inauthentically, so worry of inauthenticity as a result of this
physiological change is unwarranted.
Like any philosophical theory of the self, mine probably has its ambiguities. But
like any other philosophical idea, the self is elusive and difficult to define. The biggest
possible problem with my conception of self that I can see is that an antidepressant user
might say, “I feel inauthentic, like I’m not myself.” Although it is difficult to deny
another’s subjective experience of themselves, and although they may really feel this
way, they are actually misinterpreting their feelings. The antidepressant user simply
experiences a version of themselves, or a particular combination of the factors that affect
the self, that they find unpleasant. Because people have often spent many years feeling a
certain way (clinically depressed) before they began taking the medication, they feel
estranged from their previous self—the self they are used to experiencing. This novelty of
experience can be unsettling, but it usually passes. Antidepressants can take up to six
weeks to fully work, and in the meantime, the effects on the user’s mood are often quite
unpleasant and exacerbate the problem, so people often quit before the real positive
changes happen because of the discomfort they feel. The self, though a singular and
continuous thing, can go through drastic changes with antidepressants, creating the sense
of being a ‘new person;’ and because the self so easily changes, we may say that we have
different ‘versions’ of ourselves. These are not actually different selves: the
antidepressant self still has the same memories of childhood and of depression, but it has
greatly changed. I am not arguing that antidepressants are for everyone. Some people
truly prefer feeling the way they felt before, and that is fine. The point is that it is a matter
of preference, not of authenticity, and of choice, not of morality.
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In this paper I have posed a problem: people often feel guilty, anxious, and
confused about their ‘authentic self’ and the decision to take antidepressants. In
researching this topic, I found a surprising lack of clarity in most writers’ definitions of
self when discussing antidepressants. This creates a general incoherence in the discussion
and provides little help to someone with these concerns. Furthermore, expressing these
concerns often poses the issue as a moral problem (the ethic of authenticity), when it is
actually a definitional one. I have shown the ethic of authenticity to be irrelevant when
we properly define the self. The real problem is having assumed, vague, and inarticulate
conceptions of self that do not allow for a proper understanding of antidepressants, which
no doubt partly results from the inadequate clarity in the discussion. In treating five
definitions of self before explaining the effects of antidepressants on those selves, I have
shown the clarity that becomes possible in discussing this issue. Descartes, Hume,
Heidegger, and Taylor present theories of self, however, that range from incomplete to
inaccurate. My definition of self is comprehensive and allows peace of mind for the
segment of antidepressant users who are concerned with authenticity.
Understanding my conception of self, antidepressant users may come to feel no
guilt, shame, anxiety, or confusion, especially if these concerns come from accepting the
ideal of authenticity, which they often do. This conception of self can allow
antidepressant users to critically assess their situation with depression and antidepressants
and make whatever decisions they feel are best for their own self without the concern of
authenticity muddling their decisions. My conception of the self can alleviate concerns
about authenticity because I have shown authenticity to be irrelevant; it is impossible to
be inauthentic, no matter what we do. Depression is a biological, physiological, and
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perhaps genetic, condition that is authentic in and of itself, and seeking relief
understandably appeals to its victims. Depending on one’s personality and how their self
has been affected throughout their life, one may or may not choose antidepressants as a
solution. But in the event that one does choose this route, concerns about authenticity are
baseless because antidepressants are merely another physiological influence on the self.
The decision to take them is as understandable and authentic as any other action we take
to seek a happier self.
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