Drugs and Personal Responsiblity , a Riddle Wrapped in an Enigma

I have hesitated before publishing what follows, as it deals with a number of rather sensitive subjects. I would ask those who comment upon it to be thoughtful in their responses.

 

I think I may now know why Damian Thompson, the Daily Telegraph writer, has picked quarrels with me and made severely disparaging remarks about my position on the MMR vaccine. (By the way, my offer to him to make his case here in detail still stands, should he choose to do so).

 

I suspect that the reason for Mr Thompson’s passion is that he very much wishes to believe that the medical profession are pretty much infallible, which of course my attitude to the MMR strongly implies that they are not.  He rightly sees my attitude towards the MMR , and my attitude towards modern psychiatry and the prescription of antidepressants as being parts of the same sceptical view of what we might call the assertion of Medical Infallibility. Under the circumstances, his strong feelings are understandable, though of course that does not necessarily make him right.

 

For Mr Thompson has, quite courageously,  made it public that he himself takes ‘antidepressant’ pills. I had no idea. While I am sure that many people in public life do in fact take such pills, and I am equally sure that this greatly influences their attitude to many things, I can only guess at who might be affected in this way.  And, while puzzled by aspects of Mr Thompson’s behaviour towards me, I certainly never attributed them to this factor. And, now that I do, I am not saying that Mr Thompson’s pills have made him argumentative, but that his faith in them has made him hostile to scoffers against medical orthodoxy, such as I am.

 

In a recent column, Mr Thompson discussed the revelation by Stephen Fry that he (Stephen Fry) had made an attempt to take his own life . As Mr Thompson puts it  (partially quoting Mr Fry’s own account) ‘…he (Mr Fry) took “a huge number of pills” washed down with vodka, and convulsed so badly that he broke four ribs. If he hadn’t been discovered by a producer he’d be dead. This wasn’t a “cry for help”: it was a resolute attempt to kill himself that almost succeeded.’

 

 

If anyone is expecting me to sneer here, I am glad to disappoint them. Suicide, or attempted suicide, is actually a very complicated and serious issue. I am no friend of Stephen Fry, nor he of me. But I grieve that anyone should be so miserable that he behaves like this. Whatever you believe about death and eternity, seeking to bring about your own death is a particularly dreadful thing. Who could not sympathise with a person who does such a  thing, and who could not be sorrowful? 

 

Even so, if Mr Fry’s action was his own choice, then I still have to regard it as a wrong action.  Suicide, or attempted suicide, is an action which hurts many people, including the suicide or would-be suicide - and who can doubt that? Of course, if the person involved is in the hands of torturers or in some other way subjected to conditions of horror and despair, these doubts recede. Which of us can say he would not bite the cyanide pill once the Gestapo or the NKVD got to work? Not I, for certain. But this was not the case.

 

There’s another issue. Can one speak freely of and to a person in this state of mind? Mr Fry is not all that restrained in letting fly at people and things he doesn’t like ( he did so once at me, rather clumsily, and also famously spent an evening being rude about the Roman Catholic Church in a debate in Westminster) .  Naturally, It has seemed reasonable to me to reply equally vigorously. I have mocked him in public places, though my favourite jibe (which I won’t repeat)  is really an attack on his fawning battalions of admirers, rather than on him.

 

I don’t suppose he set out along life’s road actively wanting to be besieged by hundreds of thousands of slurping sycophants who seem to think he’s a combination of Einstein, Wittgenstein, Laurence Olivier, P.G.Wodehouse, F.R.Leavis and Oscar Wilde.  But if he’s so unhappy that he tries to end his life, should we all just shut up, let him be rude to us and scornful of what we love, from his many platforms?  The answer ought to be easy. But in fact I find it difficult.  I want to answer - and if possible defeat - my opponents, but not to trample them under my heel. On the contrary, I cherish the good relations I now have with many people I’ve clashed with in the past (though I don’t expect or seek to have good relations with Mr Fry).  And I certainly don’t want to add to anyone’s personal unhappiness. Could a little light mockery, and some robust exchanges,  do that? Perhaps, in some cases, it could. Very well, I’ll restrain myself from now on. No debating point is worth such a risk. But what a strange position we have now arrived at, when this is necessary. And yet, what else can the civilised human being do?

 

And what about the problem (relevant here) of ‘antidepressants’ and suicide? I often point out, and urge investigation of, the apparent correlation between the taking of such pills and suicide. Some of these pills are acknowledged by medical science as being capable of promoting involuntary suicidal thoughts in those who take them.

 

How powerful these thoughts are, we cannot know unless we have experienced them. But there seems to be an alarming number of people who take their lives after being prescribed such pills (though withdrawal from them can, it must be stressed, also be followed by distressing side-effects, and nobody should so without seeking medical advice). Are they fully in control of their own actions?

 

It is a series of riddles within riddles, all to do with the real nature of human responsibility, made harder by the fact  that nobody really knows what effect SSRI pills do have on the human brain and body, and harder still by the fact that so many influential people have completely bought the ‘antidepressant’ theory (and taken the pills)  and so cannot really accept the case that such drugs might be dangerous.  Where does responsibility lie, when dealing with the actions of a person who is taking or has taken such drugs?

 

Does such a person cease to be responsible for what he does while under the influence of such drugs?

 

I’m not sure. Some cases are clearer than others. If such a person knowingly takes an *illegal* psychotropic drug, knowing it is illegal and that it is mind-altering, then it’s my view that his responsibility for what he does under its influence is total. This is also true for those who take the legal drug alcohol, in quantities known to have an effect upon judgement.

 

But if a person takes legal prescription pills, under the impression that they are a genuine treatment for a genuine illness, having been advised to do so by a qualified doctor, then can he be considered fully responsible for any wrong actions he takes under their influence? Obviously not.

 

But if that person is intelligent and informed , and aware of the controversy about ‘antidepressants’, and consciously rejects the doubts about them, that person is surely more responsible for anything that happens after he  takes such pills, than he would be if he did not know. Or he would be, if he accepted the validity of the controversy and took the criticisms seriously.  This may be why any doubts or criticisms expressed about ‘antidepressants’ are met with such strong objections, sometimes actual abuse, or are coldly ignored. I suspect that many prominent people in public life have taken, or are taking such pills. They want to believe in them. Even to treat criticism as reasonable is to undermine their faith.

 

 

What (by the way) about people who take illegal drugs and later become mentally ill? They are of course responsible for their illness, as it is hardly surprising that mind-altering drugs damage the mind (though it is far better-known that this danger exists than it was).  But it would be an absurd stretch to say they were then responsible for insane acts they later did, as a result of stupid or criminal actions they took when they were still sane. If they had become permanently mentally ill, then they would have, by definition, lost responsibility for their own actions. It would then have been up to others, including the state, to protect them from themselves, and us from them.  A society that lets mentally ill people wander unsupervised would, (and in my view does)  bear more responsibility for that than the individual involved.

 

Let me recap here on what do we actually *know* about SSRI ‘antidepressants’.  Double-blind placebo tests throw grave doubt on their efficaciousness, to put it mildly.  We also know that the theory on which their prescription is based, that ‘clinical depression’ is a physical illness caused by a Serotonin deficiency, is scientifically baseless.  Therefore if the pills do, as claimed,  ‘work’, then they either do so through a placebo effect, or through effects not understood by, predictable by, or measurable by scientific methods.

 

And what we also know is that many of these drugs are known (by recorded experience, not through supposition or baseless claims)  to have side-effects, which may – as it happens – be their only actual measurably objective effects. Many who take them have noted what might be described as a  general numbness in which all emotions, from grief to joy, are dulled by a grey fog of chemically-induced indifference. But that is hardly a precise or measurable effect, nor would it seem to be a condition that anyone would desire to experience, in and of itself.

 

So the really interesting thing about Mr Thompson’s article – and, as I say,  perhaps the key to his behaviour towards me is here:  ‘..where do we start, and stop, in the prescription of drugs to control moods whose instability is made worse by our environment?

 

‘I don’t know. But I can tell you that crawling out of bed today was made easier by 60mg of duloxetine, an anti-depressant that, so far as I can tell, suppresses the feelings of despair and meaninglessness that start in the pit of my stomach and colonise my whole body. That’s what depression means to me. I don’t have it badly, I could probably ditch the pills, but, to put it bluntly, life would suck. So, like many people I know – and, I suspect, a frighteningly large percentage of future generations – I’ll keep taking the tablets.’

 

 

I simply can’t argue with Mr Thompson about this. The nature of the problem is such that nothing I could say about it could be considered purely as a statement of fact and logic. Though he has bravely made it public, and though his doing so might be said to have involved the taking of a position, it is also far too personal to be debated in public with strangers.   It is, in the strictest sense, none of my business.  Mr Thompson is not a relative or a friend. He hasn’t asked my advice. I am distressed that he should feel the despair and meaninglessness that he speaks of, and hope that he soon becomes free of this burden. But I hope that all who read this, whether they agree with me or not, see the immense difficulties which arise from the prescription of ‘antidepressant’ medication by doctors, and the way in which increasing resort to such things is changing and will change our whole society.