http://chronicle.com/weekly/v49/i40/40b00501.htm

  The Chronicle of Higher Education
   6/13/2003

  Let's Not Medicate Away Student Angst
 
   By JOLI JENSEN
 
   My student told me that she was having trouble in my class
   because her doctor hadn't yet found the "right" mood
   medication for her. I had known something was up because she
   hadn't been the delightfully contentious student I had met the
   year before. This semester she seemed distracted and subdued,
   and she had been missing class. A few weeks after talking with
   me, she returned to attending class regularly, but mostly to
   listen while others spoke. The "right" medication for her,
   apparently, was one that made her no longer want to argue in
   class.
 
   A surprising number of my best students are on antidepressant
   or anti-anxiety medication. Both the student health center and
   their own physicians prescribe the drugs in response to
   complaints that seem to me to be normal, even necessary,
   aspects of young-adult life. None of these students previously
   felt themselves to be at risk; none were behaving in
   self-destructive ways. Many were initially surprised by their
   diagnosis of "clinical depression" or "social anxiety
   disorder." Yes, they were feeling self-doubt, uncertainty,
   insecurity, melancholy, as my best students always have, and
   as do I, still. But they accept the diagnosis because they
   find that the medications help them succeed in college, and
   they are grateful for their newfound calm.
 
   I'm not so sure. Are the characteristics of late adolescence
   -- and of life -- being mistaken for evidence of pathology? Do
   our best and brightest students now believe that they need
   drugs to handle class? And, in taking prescription mood
   medication, do they avoid, even stifle, the emotionality and
   zeal that feed intellectual growth and make the life of the
   mind worth living?
 
   Good students use college as a time to explore and experiment,
   to try on different perspectives, and to become different
   selves. Strong emotions, shifting commitments, and difficult
   relationships help all of us sort out who we are and what we
   believe. Emotional upheaval helps us figure out what matters
   and what doesn't. But for students focused on productivity,
   those developmental struggles stand in the way of what they
   define as academic success. It's hard to write good papers,
   study assigned material, join clubs, be a leader, do community
   service, and build a compelling resume if you are experiencing
   doubt about what it all means. Existential angst makes it more
   difficult to do the kinds of things that supposedly get you
   ahead in the world.
 
   My students have been told that their feelings of sadness or
   worry or fear are due to a chemical imbalance in their brain,
   and that the imbalance can be corrected by drugs like Prozac
   or Celexa or Paxil. A Newsweek cover story last fall featured
   a sad-eyed adolescent girl holding a teddy bear, and described
   an "epidemic" of undiagnosed mood disorders among teenagers.
   The article quoted a professor of child psychiatry warning
   parents that moodiness, oppositionality, and irritability
   aren't normal teenage traits and should be treated as symptoms
   of an underlying disorder.
 
   But those traits don't seem all that abnormal to me,
   particularly in academe. Frustration, hostility, anger, and
   resentment, as well as feelings of hopelessness and
   insecurity, have long been features of our common life.
   Oppositionality is our stock in trade. Another supposed
   symptom of mood disorder is absorption in particular
   activities (research? writing?) to the exclusion of an active
   social life. All the introverts, eccentrics, and productive
   intellectuals I know have those "symptoms," as do many lively,
   interesting teenagers and young adults. Does that mean we are
   all diseased and need medication? Or that, whether or not we
   are dysfunctional, we would benefit from taking mood-altering
   medication?
 
   Much is still not known about the biochemistry of emotion. The
   neuroscientist Elliot Valenstein notes in Blaming the Brain
   that there are surprisingly few long-term studies on
   mood-altering drugs, but quite a few troubling side effects,
   and even scary suggestions about permanent changes the
   medications may cause. Nonetheless, drug-company
   advertisements offer glowing images of confident, restored
   selves, implying that drugs bring the brain back to a
   naturally happy state.
 
   Does this matter? What my students (and increasing numbers of
   my colleagues) tell me is that they don't really care how
   their drug works, just that it allows them to function more
   normally. But who is defining normal? And for what purposes?
 
   Academic life is indeed stressful. There are many good reasons
   to be moody and irritable. Others may imagine a relaxed and
   contemplative work environment; we know a demanding,
   all-too-corporate existence, replete with competition, status
   anxiety, politics, and chicanery. There is a risk, I believe,
   in seeking ways to thrive cheerfully, no matter how toxic our
   situation. If the pills work, we can believe that we, not
   circumstances, create "the problem." If the pills work, we may
   give up the chance to learn from our persistent or recurring
   melancholy and discontent. If the pills work, we won't have to
   think about our collective beliefs that we should publish or
   perish, or lecture at alienated students, or train graduate
   students for nonexistent jobs, or be at peak performance all
   the time.
 
   For our students, in particular, who are in a period of life
   when they have both the energy and the mandate to question and
   transform, pills can be a tragic deflection. Not only do the
   students lose the chance to struggle with what is true and
   right for them as individuals, but they also quench the
   discontent that fuels the desire to make a difference in the
   world. Discontent is volatile, but it is also a necessary
   catalyst. Our students are being told that their unhappiness
   is about their brain chemistry, not their situation, and that
   they should address their unhappiness with medication, not
   action.
 
   In my media-studies classes, we read social critics who warn
   about the ways mass culture deflects social change by
   semi-satisfying the discontents that modernity creates. Many
   cultural critics contend that we keep going back to popular
   culture or shopping or work, seeking but never finding what we
   really need. As Theodor Adorno and Max Horkheimer put it, we
   are being given the menu, but never the meal. What is
   especially worrisome is that we don't even realize the switch
   has been made; we keep expecting the menu to feed us.
 
   Adorno and Horkheimer's claim that we are being duped into
   meeting capitalism's needs rather than our own usually hits
   home with at least a few of my most contentious students. They
   understand that what pleases them right now may not be what is
   best for them in the long run. Such students can often get
   their classmates to see how easy it is to fall for stories
   that serve the interests of those who are doing the telling.
   This semester, however, the class consensus seems to be "so
   what if we're being duped, as long as we're happy." Few
   students argue for the value of "seeing through" myths in
   order to challenge them and come up with something better. Why
   make yourself unhappy for no reason?
 
   I've always felt a little uncomfortable with my pedagogical
   role as the skeleton at the feast. Much of my professorial
   energy is spent getting my students to at least consider the
   possibility that the very things that give them solace and
   pleasure -- like television and shopping -- may not be giving
   them what they need to lead a meaningful life. Part of my
   obligation as a professor is to demonstrate the nature and
   worth of being an intellectual. And I assume that the value of
   the life of the mind is that it takes nothing for granted
   without interrogating it for consequences.
 
   So I think that it is our responsibility to help our students
   become more alert, more contentious, and yes, more troubled.
   I'm not arguing that medication is never appropriate. Just
   that it may be given too easily, and taken too unthinkingly. I
   want students to be motivated to recognize what is absent or
   being hidden in contemporary culture, and to become familiar
   with alternatives from the past, and from points of view other
   than their own. In the end, I want them to seek ways to
   imagine themselves more as citizens than as consumers.
 
   Unfortunately, many of my students (and colleagues) subscribe
   to what I'm starting to call "psychic Taylorism." They are
   willing -- even eager -- to trade messy, inefficient doubt and
   worry for neat, effective productivity and cheer. Just as
   Frederick W. Taylor, the father of "scientific management,"
   found ways to eliminate the idiosyncratic movements of
   individual workers so that they could perform their repetitive
   jobs more efficiently, my students and colleagues are willing
   to eliminate their idiosyncratic emotional responses in order
   to become more resilient and productive workers. But messy,
   inefficient, troubling angst is the very stuff of creative,
   productive, challenging intellectual life. It wakes us up. It
   shouldn't be medicated away.
 
   Joli Jensen is a professor of communication at the University
   of Tulsa.