Abstract
In this article, I discuss intimate practices of self-medication in relation to political preoccupations with the ethics of the pharmaceutical economy, and discursive constructions of illness. Partly self-ethnographic, the article draws from my personal experience of clinical depression, and the discomforts in thinking of myself as a ‘depressed’ subject who consumes medications. Intervening in debates on new materialism and affect studies, I offer an account of dynamics where the material and the discursive, the human and the non-human, the personal and the political converge. I suggest that the experience and performative effects of self-medication lie not only in the activation of chemical compounds, but in the conscious bodily animation of cognitive and affective relations with medications. In this analysis, I employ creative forms of writing, to find a language of distress that blurs the boundary between the material and the discursive.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
By ‘the pharmaceutical industry’ I refer to medication sales, direct-to-consumer advertising, money paid to psychiatrists, sponsorships and the financial support of patient advocacy groups and educational organisations (Whitaker, 2010).
In the past five years, an increasing number of celebrities, such as Angelina Jolie, Woody Allen, Hugh Laurie and Stephen Fry, have publicly revealed that they have suffered from mental health problems.
Cooper traces patients’ voluntary participation in the development of new drugs in 1980s AIDS activism, when activist-patients demanded a right to experimental and potentially high-risk drugs. In recent years, pharmaceutical companies have incorporated patients into the research process as a form of ‘innovation in practice’ (Cooper 2012, p. 26, emphasis in the original), where ‘user-generated innovation’ is a model of value production that employs networking sites based on the unpaid contribution of users, such as PatientsLikeMe. Within a shift from test to ‘distributed experiment’, Cooper suggests that such forms of potential innovation are expressions of embodied labour that also arise through ‘ingestion and metabolic self-transformation’ (2012, p. 22).
Thrift’s discussion is based upon Benjamin Libet’s experiment in the 1980s, where subjects were asked to carry out a simple physical movement and report the instant when they decided to perform it. Monitoring their brain activity with EEG electrodes, Libet concluded that an action is set in motion before the subject consciously decides to perform it, and the time that elapses between volition and action ranges between 0.8 and 1.5 s (see Thrift, 2004). Thrift focuses on this ‘half second delay’ as a re-evaluation of the preconscious, or an instance of ‘bare life’ upon which, for example, commercial strategies are engineered, such as the use of smells and sounds in retail settings ‘so as to produce impulse purchases’ (2004, p. 158).
References
Artaud, A. (1999 [1964]) Collected Works. Volume One. London: John Calder.
Austin, J. (1962) How to do Things with Words. Oxford, UK: Clarendon Press.
Bennett, J. (2001) The Enchantment of Modern Life: Attachments, Crossings, and Ethics. Princeton, NJ and Oxford: Princeton University Press.
Bennett, J. (2010) Vibrant Matter: A Political Ecology of Things. Durham, NC and London: Duke University Press.
Blackman, L. (2007) Psychiatric culture and bodies of resistance. Body and Society 13 (1): 1–23.
Blackman, L. (2012) Immaterial Bodies: Affect, Embodiment, Mediation. London: Sage.
Blackman, L. and Hardbord, J. (2010) Technologies of mediation and the affective: A case-study of the mediated environment of mediacity UK. In: D. Hauptman and W. Neidich (eds.) Cognitive Architecture: From Biopolitics to Noopolitics. Architecture and Mind in the Age of Communication and Information. Rotterdam: 010, pp. 303–323.
Blech, J.R. (2006) Inventing Disease and Pushing Pills: Pharmaceutical Companies and the Medicalisation of Normal Life. London and New York: Routledge.
Braidotti, R. (2010) The politics of ‘life itself’ and new ways of dying. In: D. Coole and S. Frost (eds.) New Materialisms: Ontology, Agency, and Politics. Durham, NC and London: Duke University Press, pp. 201–218.
Breggin, P. (1993 [1991]) Toxic Psychiatry: Drugs and Electroconvulsive Therapy: The Truth and the Better Alternatives. London: Harper Collins.
Broom, B. (2007) Meaning-full Disease: How Personal Experience and Meanings Cause and Maintain Physical Illness. London: Karnac.
Butler, J. (1993) Bodies that Matter: On the Discursive Limits of ‘Sex’. New York: Routledge.
Butler, J. (1995) Burning acts – injurious speech. In: A. Parker and E. Kosofsky Sedgwick (eds.) Performativity and Performance. London and New York: Routledge, pp. 197–227.
Butler, J. (1999) Gender Trouble: Feminism and the Subversion of Identity. New York: Routledge.
Carter, R. (2004 [1998]) Mapping the Mind. London: Phoenix.
Clough, P. and Halley, J. (eds.) (2007) The Affective Turn: Theorizing the Social. Durham, NC and London: Duke University Press.
Conrad, P. (1992) Medicalization and social control. Annual Review of Sociology 18 (1): 209–232.
Coole, D. and Frost, S. (2010) Introducing the new materialisms. In: D. Coole and S. Frost (eds.) New Materialisms: Ontology, Agency, and Politics. Durham, NC and London: Duke University Press, pp. 1–43.
Cooper, M. (2012) The pharmacology of distributed experiment – user-generated drug Innovation. Body and Society 12 (3–4): 18–43.
Cvetkovich, A. (2012) Depression: A Public Feeling. Durham, NC: Duke University Press.
Diedrich, L. (2007) Treatments: Language, Politics, and the Culture of Illness. London and Minneapolis, MN: University of Minnesota Press.
Dumit, J. (2003) Is it me or my brain? Journal of Medical Humanities 24 (1–2): 35–47.
Dumit, J. (2005) The de-psychiatrisation of mental illness. Journal of Public Mental Health 4 (3): 8–13.
Fee, D. (2000) The project of pathology: Reflexivity and depression in Elizabeth Wurtzel’s prozac nation. In: D. Fee (ed.) Pathology and the Postmodern: Mental Illness as Discourse and Experience. London: Sage, pp. 74–99.
Fisher, M. (2009) Capitalist Realism: Is There No Alternative? Hants: O Books.
Foucault, M. (2007 [1972]) Preface. In: G. Deleuze and F. Guattari (eds.) Anti-Oedipus: Capitalism and Schizophrenia. London and New York: Continuum, pp. xiii–xvi.
Foucault, M. (2009 [1961]) History of Madness. London: Routledge.
Franklin, S. (1998) Embodied Progress: A Cultural Account of Assisted Conception. London and New York: Routledge.
Glynos, J. (2012) Body, discourse, and the turn to matter. In: S. Bahun and D. Radunovic (eds.) Language, Ideology, and the Human: New Interventions. Farnham, UK: Ashgate, pp. 173–192.
Healy, D. (1997) The Antidepressant Era. Cambridge, MA: Harvard University Press.
Healy, D. (2004) Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression. New York and London: New York University Press.
Hewitt, J.P., Fraser, M.R. and Berger, L.B. (2000) Is it me or is it the prozac? Antidepressants and the construction of self. In: D. Fee (ed.) Pathology and the Postmodern: Mental Illness as Discourse and Experience. London: Sage, pp. 163–185.
Horwitz, A. and Wakefield, J. (2007) The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Oxford: Oxford University Press.
Illich, I. (2002 [1975]) Limits to Medicine: Medical Nemesis: The Expropriation of Health. London and New York: Marion Boyars.
Jenkins, J. (ed.) (2011a) Introduction. In: Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology. Santa Fe, NM: School of Advanced Research Press, pp. 3–16.
Jenkins, J. (ed.) (2011b) Psychopharmaceutical self and imaginary in the field of psychiatric treatment. In: Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology. Santa Fe, NM: School of Advanced Research Press, pp. 17–40.
Kane, S. (2001) Complete Plays. London: Methuen.
Kosofsky Sedgwick, E. (2003) Touching Feeling: Affect, Pedagogy, Performativity. Durham, NC and London: Duke University Press.
Kramer, P. (1994 [1993]) Listening to Prozac. London: Fourth Estate.
Kutchins, H. and Kirk, S.A. (1999 [1997]) Making Us Crazy: DSM, the Psychiatric Bible and the Creation of Mental Disorders. London: Constable.
Laing, R.D. (1990 [1967]) The Politics of Experience. Harmondsworth, UK: Penguin.
Law, J. (2006) Big Pharma: How the World’s Biggest Drug Companies Market Illness. London: Robinson Publishing.
Leader, D. (2009 [2008]) The New Black: Mourning, Melancholia and Depression. Minneapolis, MN: Graywolf Press.
Leys, R. (2011) The turn to affect: A critique. Critical Inquiry 37 (3): 434–472.
Luther, M.H., Gutman, H. and Hutton, P. (eds.) (1988) Technologies of Self: A Seminar with Michel Foucault. Amherst, MA: University of Massachusetts Press.
Martin, E. (2007) Bipolar Expeditions: Mania and Depression in American Culture. Princeton, NJ and Oxford: Princeton University Press.
Massumi, B. (2002) Parables for the Virtual: Movement, Affect, Sensation. Durham, NC and London: Duke University Press.
McRae (2008) Antidepressants taken by millions of britons ‘Do NOT Work’, major new study reveals. The Daily Mail 26 February.
Metzl, J. (2011) Gender stereotypes in the diagnosis of depression: A systematic content analysis of medical records. In: J. Jenkins (ed.) Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology. Santa Fe, NM: School of Advanced Research Press, pp. 145–159.
Metzl, J. (2003) Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs. Durham, NC: Duke University Press.
Michael, M. and Rosengarten, M. (2012) Medicine: Experimentation, politics, emergent bodies. Body and Society 18 (3–4): 1–17.
Moerman, D. (2002) Meaning, Medicine, and the ‘Placebo Effect’. Cambridge, UK: Cambridge University Press.
Mol, A. (2008) I eat an apple: On theorizing subjectivities. Subjectivity 22 (1): 28–37.
Oneinfour (2014) Homepage. http://oneinfour.info, accessed 14 March 2014.
Orr, J. (2006) Panic Diaries: A Geneaology of Panic Disorder. Durham, NC and London: Duke University Press.
Papoulias, C. and Callard, F. (2010) Biology’s gift: Interrogating the turn to affect. Body and Society 16 (1): 29–56.
Parker, A. and Kosofsky Sedgwick, E. (eds.) (1995) Performativity and Performance. New York: Routledge.
Pollock, D. (1998) Performing writing. In: P. Phelan and J. Lane (eds.) The Ends of Performance. London and New York: New York University Press, pp. 73–103.
Reynolds Whyte, S., Van der Geest, S. and Hardon, A. (2002) Social Lives of Medicines. Cambridge, UK: Cambridge University Press.
Rose, N. (2004) Becoming neurochemical selves. In: N. Stehr (ed.) Biotechnology: Between Commerce and Civil Society. New Brunswick, NJ: Transactions Publishers, pp. 89–128.
Rose, N. (2007) The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century. Princeton, NJ and Oxford: Princeton University Press.
Scarry, E. (1985) The Body in Pain: The Making and Unmaking of the World. Oxford, UK and New York: Oxford University Press.
Seigworth, G. and Gregg, M. (2010) An inventory of shimmers. In: G. Seigworth and M. Gregg (eds.) The Affect Theory Reader. Durham, NC and London: Duke University Press, pp. 1–25.
Smith, R. (2002) In search of ‘non-disease’. British Medical Journal 324 (13 April): 883–885.
Sontag, S. (ed.) (1976) Antonin Artaud: Selected Writings. New York: Farrar, Straus and Giroux.
Sternberg, E. (2010) My Brain Made Me Do It: The Rise of Neuroscience and the Threat to Moral Responsibility. Amherst, MA: Prometheus.
Thrift, N. (2008) Non-Representational Theory: Space, Politics, Affect. London and New York: Routledge.
Thrift, N. (2010) Understanding the material practices of glamour. In: G. Seigworth and M. Gregg (eds.) The Affect Theory Reader. Durham, NC and London: Duke University Press, pp. 289–308.
Thrift, N. (2004) Bare life. In: H. Thomas and J. Ahmed (eds.) Cultural Bodies: Ethnography and Theory. Oxford, UK: Blackwell, pp. 145–169.
Van der Geest, S., Reynolds Whyte, S. and Hardon, A. (1996) The anthropology of pharmaceuticals: A biographical approach. Annual Review of Anthropology 25 (1): 153–178.
Whitaker, R. (2010) Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. New York: Crown.
Wight, G. (2007) Blue cheer. In: S. Turkle (ed.) Evocative Objects: Things We Think With. Cambridge, MA: MIT Press, pp. 93–100.
World Health Organisation (2008) Global burden of disease – Disease incidence, prevalence and disability. http://www.who.int [2004], accessed 25 November 2012.
World Health Organisation (2012) Fact Sheet n. 369, October. http://www.who.int, accessed 25 November 2012.
Acknowledgements
I would like to thank the anonymous reviewers of Subjectivity for their comments on the earlier drafts of this article.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Trivelli, E. Depression, performativity and the conflicted body: An auto-ethnography of self-medication. Subjectivity 7, 151–170 (2014). https://doi.org/10.1057/sub.2014.4
Published:
Issue Date:
DOI: https://doi.org/10.1057/sub.2014.4