December 18, 2009

Stimulus Packages and Prozac: The Unintended Consequences of Intervention

By Dr. Peter Breggin

A column written by David Wessel on December 17, 2009 was published in the Wall Street Journal with the title, “A Prozac Economy Has Its Costs.” Wessel warns against the potentially stultifying effects of economic control. He makes some good points that can be sharpened by a more precise comparison between the impact of Prozac on the brain and the impact of government regulation and stimulation on the economy. Prozac is the prototype for what became a whole slew of newer antidepressants including Paxil, Zoloft, Luvox, Lexapro and Celexa.

Initially, these newer antidepressants have the potential to cause an artificial euphoria that makes an individual feel temporarily elated. But the sense of wellness is unrealistic and can lead to poor judgments. The brief sense of euphoria too often drives the individual to try one drug after another in the hope of repeating or prolonging that evanescent glimpse of happiness. Worse, the euphoria can escalate into outright mania, a bubble that is bound to burst with ruinous consequences for the individual, his or her family, and even society. In the long run, drugs like Prozac, Paxil and Zoloft impair brain function and tend to produce emotional apathy and indifference.

Now consider the similar impact of artificial interventions thrust onto the economy. Initially, government stimulus packages engender an unfounded sense of confidence. Inevitably, this is mistaken for genuine economic growth and improvement, and thus the stimulation is increased in a compulsive attempt to make it last. Once again, we risk creating a manic-like bubble that will eventually burst. In the long run, the economy will become mired down in varying degrees of inflation and stagnation. Growth will be suppressed by distortions that were caused by the initial stimulations and by the government regulation that come along with them.

But it gets worse for both chemical and financial interventions.

Prozac was tested in clinical trials lasting a mere 4-6 weeks before it was approved by the FDA and unleashed on the marketplace. Although I predicted many of them in my book Talking Back to Prozac (written with my wife Ginger in 1994), the untoward consequences were unforeseen and then denied by advocates of the drug. The FDA-approved labels for antidepressant drugs now recognize some of these harmful outcomes. For example, by over-stimulating the brain, Prozac and its chemical cousins can lead to disinhibition or loss of self-control with violence, suicide and aggression. In my latest book about psychiatric medications, Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide, and Crime (2008), I describe how they can cause bizarre and horrendously destructive episodes of mania and disinhibition.

The equivalent to artificial interventions with the economy is apparent. In an effort to make housing available to the poor, the government encouraged and even forced banks to invest in subprime mortgages that created an enormous bubble in the housing market. The easy money policies of the Fed then enabled speculators and financial institutions to package these unsound mortgages into what would become “toxic assets.”

As I mentioned earlier, there is a long-term antidepressant effect that is finding its way into the medical literature and that I am seeing on a regular basis in my psychiatric practice. Patients find themselves becoming apathetic on these drugs. They lose their interest and involvement in their own lives. It happens gradually with a diminishment of emotional investment in sex, in love, in relationships, in creativity, and in work. In the words of one of my patients, “All of life becomes blah.” Time and again I hear, “I just wish I could get my life back.”

The road to recovery from psychiatric drugs can be long and discouraging. And there is a tragic analogy to current politics in America. With the increasing loss of our liberties, many of us will end up “longing for the good old days.”

Meanwhile, in a process I have identified as “medication spellbinding,” patients’ judgment and self-insight become so impaired that they rarely grasp what has befallen them until it is too late. The analogy to politicians spellbinding the public is striking. We must all wake up to the political dangers before it is too late.

In some ways worst of all, after enduring exposure lasting months if not years, people often find it difficult and sometimes impossible to stop taking antidepressant drugs. Withdrawal reactions are highly unpredictable, but include “crashing” into depression and suicidality, becoming over-stimulated into mania, and experiencing shock-like feelings in the head, a distressing sense of disorientation and imbalance, and various other neurological symptoms.

The analogy between pharmaceutical interventions into the brain and government interventions into the economy took on a new reality in the 1990s in regard to what Alan Greenspan called the “irrational exuberance” of Wall Street investors. Instead of an analogy, we had may have had a direct effect. I was not alone at the time in wondering if some of that investment euphoria was being driven by the widespread use of Prozac among these traders and speculators.

The withdrawal symptoms from economic stimulation are also a critical problem as the government struggles between the unpleasant choices of controlling inflation with higher interests or suppressing the economy with these same increased interest rates.

Why do we have so many unintended consequences from psychiatric drugs and from economic panacea?

The brain, like the economy, resists all artificial attempts to stimulate or control it. For example, newer antidepressants are intended to cause increased stimulation of the neurotransmitter system called serotonin. They are supposed to do this by blocking the removal of serotonin from its active sites in the brain, in effect flooding the serotonin engine with chemical fuel. But the brain immediately fights back by shutting down the production of serotonin, by increasing its rate of removal from these active sites, and ultimately by causing a die back of the receptors for serotonin. In manifold ways the brain resists the impact of any psychiatric drug. Animal studies show that distortions in the brain caused by psychiatric drugs can long outlast the exposure to the chemicals and may become permanent, including the development of grossly abnormal neurons or brain cells. The same risks are incurred with the use of all potent psychoactive substances, including recreational drugs.

There is a basic principle that applies equally to interventions into the brain/mind system and into the economy: They always result in unintended harmful consequences. Whether we are talking about a psychiatric drug or a street drug like marijuana or LSD, there are always serious adverse effects, many of them unpredictable, from both acute exposure and from long-term use.

Why is this true of both the brain/mind system and the economic system? To begin with, both are far too complex to be “helped” by artificial interventions. The human brain is the most complex system that we know of in the entire universe. Because of the subtle and elaborate complexities created by life, each individual brain is more intricate and complicated than the entire physical universe. Produced by a combination of the brain, environmental factors and individual decisions, the mind is even more complicated than the brain. The probability of an artificially introduced chemical improving this system approaches zero; the likelihood of that same alien chemical causing disruption and harm is nearly 100%.

The economy is even more complicated than the brain and mind of individual human beings, because the economy is the product of the activity of billions of human beings with their busy brains and minds.

Regardless of the underlying physical structure of the brain or the economy, its real life is mental — the product of individuals with free will who make their own subjective decisions about how to live. Our individual decisions direct our lives; put all together, these individual subjective decisions move society and the economy. As Ludwig von Mises described in great detail in his economic treatises, the subjective decision-making of untold numbers of people drives the economy. This aggregate of individual decision-making cannot be replaced by the top-down decision making of an elite or a dictatorship.

Put simply, the free will of individual people is the key to successful human life on both a personal and an economic level. Hence the importance of human liberty—providing the opportunity for people to exercise free will to the maximum of their ability. It is no coincidence that Adam Smith’s The Wealth of Nations and the Declaration of Independence both made their entrance onto the human stage in the same year, 1776. Both were the product of a growing realization that liberty provides the best opportunity for human life on all levels — personal, political, and economic.

Artificial interventions by know-it-all psychiatrists with their drugs, or know-it-all politicians with their economic bromides can never improve upon the activities of individual human beings pursuing their interests and their ideals in a free society.

Originally published on The Huffington Post