Medication and Self Control

Notice, I said “medication AND self control”, not “medication OR self control”.

I think of putting medicine into my body as a method of improving my ability to achieve something I want. Analogies include putting on glasses to focus my vision; wearing shoes to protect my feet; using pencil and paper/ calculator/computer/cell phone to enhance my cognition or communication.

Objections to this line of thinking are that messing with the brain with chemicals is wrong and different from the above. Also, that harm can be caused. We always want to balance risks against benefits. If we have medications that rearrange some connections among brain synapses, with the goal of reducing suicidal thinking or incapacitating depression, is it worth it? How about the goals of getting through school, reducing anger, keeping a job? We have medications that reduce alcohol consumption, decrease nicotine dependence, eliminate the need to seek Percocet or heroin.

You can also change brain synapses (and thereby change behavior) by reading about self help ideas or listening to new information from friends or therapists. Or belonging to groups. Your self control of behavior is improved by being aware of laws and speed limits and punishments: these all change the brain connectome.

There is a lot of room for philosophical conversation in the above comments, and my patients don’t seem afraid to ask difficult questions or to disagree. My goal is to present options for the best ways to improve brain function and results. There are many things that can help improve self control in addition to medication, and I want to share what I know of the pros and cons of various methods.

POSTSCRIPT: I will resist the temptation to do more than just mention recent work on machines that think, transhumanism, and memes.