Posted by KenB on October 22, 2000, at 13:42:22
Greetings,
Regardless the best intentions of many researchers, it remains uncertain if a one-size-fits-all description of depression will soon, if ever, attract a genuine consensus among all practitioners. Even if a consensus opinion excluded practitioners considered “fringe,” informed patient/clients would likely continue to bring forward effective challenges to the one-size model.
The ways many clinical practitioners administer anti-depressants might seem to suggest that the medications are “happy pills,” but Athena’s suggestion ( http://www.dr-bob.org/babble/20001022/msgs/47062.html ) is consistent with the research. The medications usually are offered in hopes of satisfying a person’s hedonic needs. They are not offered, or at least not tested and marketed as recreational or self-improvement remedies intended to raise the person’s “hedonic set-point.”
There is a school of thought that suggests a change in philosophy toward use of medications for self-enrichment. Debate over prohibition of the popular illegal drugs properly includes discussion of whether the drugs are used as alternative remedies to normalize a person’s hedonic status, and whether it is appropriate to use medications, or anything else, in an effort to elevate the hedonic norm.
Although the discussion about the propriety of "happy pills" is interesting and relevant to the practice of medicine and the treatment of mood complaints, it might be appropriate to first reconsider the idea of a “hedonic set-point” that describes a person’s reasonable expectation of happiness.
Rather than an individual hedonic set point, it might be that we have instead an individually unique hedonic range. Some individuals might have a high tolerance for broad hedonic fluctuations. Some might tolerate either downward deviation (“depression”) or upward deviation (“mania”) or both, while others might be uncomfortable, unprepared or unable to handle fluctuations in either or both directions.
Granted, the research at this juncture suggests a set point rather than a range. Yet research and hedonic expectations alike are easily influenced by cultural and personal expectations. Mass communication, advertising and entertainment programming likely tend to elevate hedonic expectations. A rapidly changing technological and cultural environment might produce varied hedonic expectations among subsequent generations and among diverse cultural groups. “Low sex drive” for example might be considered evidence of a hedonic affect, but cultural expectations, especially in the United States might not be consistent with inherited drives. On average, U.S. adults reportedly have intercourse more frequently than those of any other nation, which might suggest exaggerated expectations rather than a disorder among individuals who are celibate or who practice intercourse less frequently.
These are merely hypotheses, and this is probably not the best place to develop or defend them, but perhaps these ideas can help advance the way some readers here look at various mood affects. A well-considered discussion of the current (primarily western) research on affective problems is available, at least for now, at:
http://www.medscape.com/Medscape/psychiatry/TreatmentUpdate/2000/tu03/public/toc-tu03.html
The "stress-diathesis model" is summarized in one section of the above article. This section also seems to suggest, as I have here, a wide range in hedonic expectations or tolerances among people who otherwise seem to exhibit similar risk factors for affective complaints:
http://www.medscape.com/Medscape/psychiatry/TreatmentUpdate/2000/tu03/tu03-03.html
Several articles suggesting that “happy pills” might be used to elevate, rather than to normalize, hedonic set points are available at:
xxx
In conclusion, the same considerations of nature/nurture factors relevant to discussions of hedonic set-points are also relevant to discussions of a hedonic range, and why some individuals are more or less tolerant of varied hedonic conditions. Further, in discussing “nurture” factors, it is important, especially in a diverse multi-cultural society, to consider how cultural expectations contribute to hedonic expectations.
For your consideration,
Kendall Baize
poster:KenB
thread:47078
URL: http://www.dr-bob.org/babble/20001022/msgs/47078.html