Janie B. Cheaney: What chemicals can’t do

LINDSAY MAST, HOST: Today is Wednesday, September 4th. Good morning! This is The World and Everything in It from listener-supported WORLD Radio. I’m Lindsay Mast.

PAUL BUTLER, HOST: And I’m Paul Butler. WORLD Commentator Janie B. Cheaney now on where brain science ends and wisdom takes over.

JANIE B. CHEANEY: Once upon a time, medical science preached the theory that illness was caused by an imbalance of “humours” in the body, related to the four elements of earth, air, fire, and water. Treatment aimed at restoring balance. That was the rationale behind the widespread practice of “bleeding,” which persisted into the 19th century. Leeches never had it so good.

Fast-forward to the 1990s: Remember the Zoloft commercial with the unhappy blob under a raincloud? The blob represented depression, which might result, the narrator suggested, from a chemical imbalance in the brain. Substitute “chemicals” for “humors,” and we’re not that far from medieval medicine.

Six months ago my husband started taking Thorazine for psychosis, so I won’t complain about pharmaceuticals in themselves. But the chemical-imbalance theory has got to be oversimplified. That was the point of a recent podcast from Radio Atlantic called “The Mandala Effect”: how a shift from talk-based therapy, such as psychoanalysis, to chemical-based psychiatry in the 1990s created dangerous expectations about what drugs could do.

The central narrative of the podcast belongs to Cooper Davis, now in his 40s, who began taking Ritalin for ADHD in his late teens. The effect was immediate, and dramatic. Like a superpower, he says--“Like, it wasn’t fixing my brain; it was making my brain even better than the average brain.”

In time, though, he became dependent—not on the drug, but on the conviction that if he wasn’t feeling 110% all the time, something was wrong. Anxiety in college led to a prescription for Ativan, to be balanced by stimulants like Adderall in ever-higher doses. The crash came with his first real job at a local paper, where his erratic behavior and missed deadlines led to “You’re fired.”

Cooper explains that he’d convinced himself he was under intolerable pressure. But that wasn’t the case: “What I really had was a lack of maturity and an inability to manage my time.”

Why exercise self-discipline when he had superpowers?

Maturity barged in when his girlfriend told him she was pregnant, and he began to think seriously about fatherhood. Drugs were not the villain, he realized; his son might need low doses of Ritalin to get over a rough patch. But he would also need a realistic view of himself and his abilities. He would need to fail at times. He would need to be challenged, not superpowered.

The optimistic notion that chemistry was the key to depression, ADHD, and all forms of mental illness has hit a wall. That’s because the brain is more than physical matter. It houses a mind, with a profound spiritual dimension that chemicals can’t touch. In a way, our brains are still reeling from the Fall; as the Preacher says in Ecclesiastes, there is a time to weep.

We can be grateful when “uppers” and “downers” serve their purpose. But sadness and failure have a purpose too, especially if Jesus walks us through.

I’m Janie B. Cheaney.

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