In the 1950s and 1960s a pharmacological revolution produced an array of drugs for use in disorders such as schizophrenia, depression and anxiety which enabled psychiatry to move closer to the paradigm of physical medicine of administering specific cures for specific conditions. Consider the following statistics

In the UK the use of antidepressants increased by 234% in the 10 years up to 2002 (1).

In the USA 11% of women and 5% of men now take antidepressants. (2)

What can be causing this explosion in the demand for prescription antidepressants? It cannot be possible that in ten years the number of people suffering from depression in the UK has more than doubled.

Here are some of the possibilities:

In recent years we have been encouraged to view more and more problems that were previously considered to be normal and manageable parts of the human condition as mental diseases that require treatment.

The boundaries of well known disorders have been broadened. Psychiatric diagnoses are very changeable and what counts as a disorder is highly dependent upon prevalent social norms and beliefs. We are now inclined to medically characterise the ‘problems of living’.

Lesser known disorders such as panic disorder and social phobia have been publicised. These disorders can have a substantial overlap with normal experience. When this is the case the condition is then expandable, which allows the drug companies may claim that they abhor the inappropriate over-prescribing of their drugs safe in the knowledge that this will almost certainly occur anyway.

Drug treatment has started to colonise areas where it was previously thought to be unhelpful such as substance misuse and personality disorder.

Depression as a diagnosis has been promoted by drug companies, especially after the advent of Selective Serotonin Reuptake Inhibitors (It has been suggested that pharmaceutical companies turned their attention to antidepressants after the collapse of the market for benzodiazepines following the discovery of their addictive potential (3)

It is more acceptable to admit to being depressed

Antidepressants have become household names and books about them have become best sellers.

There are social advantages by being depressed. A ‘depressed’ person can be seen as less responsible for their behaviour and can lay claim to the sympathies of professionals, the resources of the welfare state and the language of victimhood.

Although we are living longer, our modern lives are becoming increasingly uncertain. The comforts of the welfare state are less, our working hours increased, job security decreased and pension schemes uncertain. We are actively encouraged by the media to be in a semi-permanent state of mild dissatisfaction in order to fuel consumer spending and are constantly fed a diet of soundbites fortelling imminent doom.

Why is this important?

Medications cost a lot of money. This money might be better spent elsewhere and could go towards other non drug based therapies

A society which has been convinced that it is ill is less likely to look for other solutions to tackling misery for example that their social conditions are caused by wanting Government policy and will be unable to mount an effective challenge.

Psychiatric illness is poorly understood and the ‘biological hypothesis’ of this sort of disease is unproven.

We disempower people by informing people that their only form of relief of their mental distress is via medication.
The idea that problems that were previously considered a manageable part of human existence are now only to be addressed with the help of professionals is likely to reduce personal coping stratgies (4) and reduce our self confidence’

Medications have side effects, some of these can be very serious and there have been allegations that pharmaceutical companies have sought to play down the harmful effects of their products. Many psychoactive medications have a deleterious effect on sexual function, something about which patients are seldom asked.

Ben Goldacre has made available an interesting podcast entitled ‘More than molecules – how pill pushers and the media medicalise social problems’ - in which he argues that the media are locked in a ‘Miracle cure/sinister hidden scare’ model and that pharmaceutical companies seek to sell us preparations which they invite us to believe can cure complex social problems.

1 National Institute for Clinical Excellence (2004) The Treatment of Depression in Primary and Secondary Care. London: NICE
2 Stagnitti, M. (2005) Antidepressant Use in the US Civilian Non-Insitutionalised Population, 2002. Statistical Brief #77. : Rockville, MD: Medical Expenditure Panel, Agency for Healthcare Research and Quality.text
3 Healy, D. (1999) The three faces of antidepressants. Journal of Nervous and Mental Disease, 187, 174-180.
4 Moncrief, J. (2003) Is Psychiatry for Sale? Maudsley Discussion Paper

There is no exact and agreed concept or definition of ‘person’ in either common usage or philosophy. Instead the word ‘person’ has numerous uses. The English word is said to come from the Latin persona. This word was used to refer to the mask worn by actors in dramatic performances and also variously to the person speaking through the mask. It has been suggested in turn that persona is in itself derived from per-sonando (‘sounding through’). This murky beginning may account in part for our current ambiguous usage.

With this in mind, when we discuss the question of ‘personhood’ we are in fact attempting to give a more or less vague term a degree of precision by locating it within a set of terms which constitute the vocabulary of a scientific or philosophical theory. It is therefore misleading to speak of a particular philosopher’s theory of persons for there is no previously agreed definition of what this should a theory of. We must instead talk of the philosopher’s use of ‘person’ as a semi-technical term in his or her system. There must be some connection between this philosophical term and the ordinary concept otherwise there would be no justification for using this term rather than any other; but we cannot criticize a philosophical use of the term by citing certain facts about persons that the theory in which it is used fails to account or accounts for incorrectly. We may criticize it only by showing that its rules of usage are incoherent or that there is nothing in the world that satisfies the characterisation of ‘person’ as given by the theory.

Philosophers have mainly concerned themselves with two issues regarding personhood.

• What qualities must a ‘person’ possess?
• Are ‘persons’ essentially physical or mental entities?

With regards to the first question Boethius regarded rationality has been an important quality. Writing in the sixth century he said:

[a person is] an individual substance of a rational kind (naturae rationalis individua substania)

This rationality approach was echoed by Locke who said that the term ‘person’ should be applied:

Only to intelligent agents capable of a law and happiness and misery (An Essay concerning Human Understanding, Book II Chapter 27)

And that a person is a:

Thinking, intelligent being, that has reason and reflection, and can consider itself as itself (Ibid.)

In his Introduction to the Metaphysics of Morals Kant made a similar point:

A Person is the subject whose actions are capable of imputation

Kant wished to make a distinction between ‘persons’ and ‘things’. He felt that ‘persons’ as contrasted with ‘things’ are of an
unconditional worth and that ‘respect’ is an attitude which has an application to ‘persons’ only and never to ‘things’. In view of this, ‘things’ may be pre-empted for our own purposes; their value depending upon the degree and kind of service that they may be to us in the execution of our aims. Persons may not be used in this way. They are ‘ends-in-themselves and sources of value in their own right’ (Kant)

By this view a person simply is any being having legal rights and duties. But not every human being is legally a person and not every legal person is a human being (a corporation is considered to be a judicial person). A slave by definition is used as a means to another’s ends. In ancient legal tradition slaves had no rights in the eyes of the law and were therefore not regarded as persons. Aristotle regarded them not as human beings, but as ‘[living]instruments for the conduct of life’. In Aristotle’s vew to be a ‘person’ such an entity must take part in the community of which he or she is a member. However, as in the case of slaves, not everyone who might be a member of the community is recognized as being fit to play a role in its public life. So, in the view of Aristotle, a ‘person’ is required to meet certain criteria of enfranchisement; satisfaction of these criteria constitutes someone a person or citizen.

Finally commonly a necessary condition for having rights is being responsible for one’s acts. Rights may be ascribable only to persons and accordingly persons alone are responsible.

With respect to the mental/physical debate Locke and Strawson have made major contributions: Locke wrote again in An Essay Concerning Human Understanding:

In the ordinary way of speaking, the same person and the same man stand for one and the same thing.

Yet Locke himself believed that these two expressions stand for two distinct ideas: ‘person’ having to do with the rational self, and ‘man’ having to do with a certain physical shape. A rational parrot, he argued, would not be called a man, nor would a non-rational human being be called anything but a man. The former however might be a person, while the latter, failing in rationality, might not be. A person then is not a rational man since ‘man’ has reference to corporeal form and
it is not, as he saw it, part of the meaning of ‘person’. Then Locke inferred that ‘person’ must denote something incorporeal and invisible. This deviates from common usage as a standard dictionary definition states ‘person’ means ‘the bodily form of a human being’. For Locke the identity of a person was simply the identity of consciousness, so that I remain the same person if I am conscious of being so even though my body could drastically change or indeed cease to exist at all.

For Locke persons were essentially non-corporeal simple entities. A difficulty with this is that it becomes difficult to distinguish persons from metaphysical selves. If we follow their reasoning in ascribing rights and responsibilities to human beings we are implicitly referring to some bodiless entity.

P. F. Strawson adopted a term for ‘person’ for philosophical use which is much closer to the common usage. A Strawsonian person is understood as distinct from a material body. For Strawson, a thing, or material body is a basic particular specifically in the sense that a physical body can be identified without reference to any other particular than its physical existence. He states that we are not our physical bodies, but does not follow the Lockian path that we are then immaterial entities.

Strawson chooses to introduce two terms: M-predicates and P-predicates, applicable respectively to material bodies and to persons. There is an overlap in that some M-predicates are applicable to persons, but there are some P-predicates that we would not be able to apply to material bodies (for example, states of consciousness). Persons therefore are distinct from material bodies but they are not therefore immaterial bodies or incorporeal nonbodies. A person has states of consciousness as well as physical attributes and is not merely to be identified with one or another.

Strawson’s concept is close to the whole concept of a person in ordinary usage. However, relative to the known laws of physics and chemistry, persons are indeed primitive and irreducible entities. A person is a body; is an appearance, is self conscious and rational; is the source and object of rights and obligations; is that which takes roles and discharges functions. In this sense then the dual nature of a person resembles the quantum mechanical particle neither a being a particle nor a wave but rather different things depending on how one might choose to observe it.

The Encyclopedia of Philosophy Volume 6 pg112-113; Paul Edwards
Editor: Collier-Macmillan Ltd London 1967.
A Dictionary of Philosophy Pan Books Antony Flew Editor 1979

Wikipedia
The Internet Encyclopedia of Philosophy