Women are diagnosed with clinical depression at twice the rates as men. Treating depression through psychotherapy or medication both focus on changing an individual, rather than addressing socioecological influences or social roles. In the current study, participants read of systemic inequality contributing to differential rates of depression in either American men or women, or in two fictitious Australian First Nation groups. Participants then considered the acceptability and efficacy of treating depression through psychotherapy, medication, or social change. When socioecological inequities and (...) unequal social roles were presented through an unfamiliar foreign lens, participants were more likely to recognize the systemic unfairness, and endorsed social change more than psychotherapy or medication as a treatment strategy. However, when identical social inequities and social roles were presented through descriptions of American men and women, social intervention was less likely to be endorsed, and psychotherapy or medication gained in acceptability. Participants of color were also more likely to recognize and endorse social change as a strategy for treating depression, while those reporting a history of psychotropic medication for affective disorders rated medication as more effective and acceptable. (shrink)

This paper utilizes the enactivist notion of ‘sense-making’ to discuss the nature of depression and examine some implications for treatment. As I understand it, sensemaking is fully embodied, fundamentally affective, and thoroughly embedded in a social environment. I begin by presenting an enactivist conceptualization of affective intentionality and describing how this general mode of intentional directedness to the world is disrupted in cases of major depressive disorder. Next, I utilize this enactivist framework to unpack the notion of ‘temporal desituatedness,’ and (...) maintain that the characteristic symptoms of depression result from a disruption to the future-directed structure of affective intentionality. This can be conceptualized as a loss of “online intelligence” and a shrinking of the field of affordances. Then, I argue that two of the standard modes of treatments for depression, medication and cognitive behavioral therapy, are not fully sufficient means of restoring online intelligence, and that these limitations stem partly from the approaches’ implicit commitment to a brain-bound, overly cognitivist view of the mind. I recommend expressive arts interventions such as dance-movement therapy and music therapy as important supplementary treatment methods that deserve further consideration. Insofar as they revitalize subjects’ bodies and emotions, cultivate an openness to the future, and promote self-insight and social synchrony, these treatment modes not only reflect key insights of enactivism, but also offer great potential for lasting healing. (shrink)

In this paper, I offer one moral reason to eschew antidepressant medication in favor of cognitive therapy, all other things being equal: taking antidepressants can be a form of self-objectification. This means that, by taking antidepressants, one treats oneself, in some sense and some cases, like a mere object. I contend that, morally, this amounts to a specific form of devaluing oneself. I argue this as follows. First, I offer a detailed definition of “objectification” and argue for the possibility of (...) self-objectification on this definition. I then explain why this form of self-objectification is morally problematic. (Morally problematic does not mean morally impermissible. It means, instead, that there is a moral reason opposing the activity in question). After, I describe how taking antidepressants can count as self-objectifying. Finally, I defend my thesis against a key objection offered by Levy. Thus, assuming that antidepressants and cognitive therapy are equally efficacious, and that all other things are equal, the self-objectifying character of antidepressants is a compelling reason to regard cognitive therapy as a first-choice treatment for depression. (shrink)

There is a sense in which antidepressants are feminist drugs, liberating and empowering …A lot of things have been said about Prozac.1 We have been instructed both to "listen" and to "talk back" to Prozac (Kramer 1993; Breggin 1994), Prozac has been called a wonder drug (Schumer 1989; Cowley 1990), it has been described as capable of dramatically changing selves and dramatically changing our conception of what a self is (Kramer 1993), it has been accused of dulling our artistic drive (...) (Berlin 2008), of diminishing our authenticity (Elliott 2000) and has been called a modern-day Soma, à la Brave New World (Weisberger 1995, 72; PCBE 2003, 258). It has also been called a "feminist drug." It is this last claim that we .. (shrink)

Prozac has been lauded by Peter Kramer for instilling potentially “liberating” personality traits in women such as assertiveness, resilience, and confidence. Witnessing these effects, Kramer declares that there is a sense in which antidepressants like Prozac are “feminist.” In this paper, we scrutinize Kramer’s claim from myriad angles. We evaluate putatively “feminist” uses of antidepressants in both women who are diagnosed with clinical depression and women thought to use them instead for “enhancement” purposes. We conclude that there are, indeed, some (...) ways in which Prozac is feminist, and some ways in which it is decidedly antifeminist. (shrink)

This paper aims to provide an account of the relationship between self-esteem and moral experience. In particular, drawing on feminist and phenomenological accounts of affectivity and ethics, I argue that self-esteem has a primary role in moral epistemology and moral action. I start by providing a characterization of self-esteem, suggesting in particular that it can be best understood through the phenomenological notion of “existential feeling.” Examining the dynamics characteristic of the so-called “impostor phenomenon” and the experience of women who are (...) involved in abusive relationships, I then claim that self-esteem fundamentally shapes the way in which self and others are conceived, and the ethical demands and obligations to which they are considered to be subjected. More specifically, I argue that low self-esteem—which in the experience of women may be rooted in particular assumptions regarding gender roles and stereotyping—can hinder autonomy, make it difficult to question other people's evaluative perspectives and behaviors, and attribute to others responsibility for their actions. (shrink)

Most of the literature on the ethics of psychopharmacology has focused on the question of whether altering our emotions by using drugs is somehow inauthentic. In this essay I argue that this focus on authenticity is misplaced and that the more important question concerns the nature of the emotions themselves. I show that what one takes the emotions to be is possibly the most important factor in deciding whether or not psychopharmacology is morally problematic and, if so, why. I illustrate (...) how theories of the emotions determine the ethics of psychopharmacology, but deliberately take no stance on what the correct theory of the emotions is. My aim here is not to reach firm conclusions about the issues anti-depressants and similar drugs raise, but to set the terms for a more fruitful debate about these issues. (shrink)