I have no idea how many of my students are on medication, but the number is certainly significant. We live in a medicated society, yet we’ve never heard the stories of those who grew up taking medications.

“I’ve grown up on medication,” my patient Julie told me recently. “I don’t have a sense of who I really am without it.”

At 31, she had been on one antidepressant or another nearly continuously since she was 14. There was little question that she had very serious depression and had survived several suicide attempts. In fact, she credited the medication with saving her life.

But now she was raising an equally fundamental question: how the drugs might have affected her psychological development and core identity. (Coming of Age on Antidepressants)

During my brief stint in graduate school, I had a brief discussion with my adviser about the metaphysical connotations of such medications. These substances change the very core of what we think of as the soul, I said, adding that it brings up once again that old chestnut of the mind-body problem: what exactly is the connection between the “I” that I think of as GS and the brain/body? How can something physical change something we tend to think of as non-physical. If we throw out the idea of a soul, it’s an easy question to answer; if we want to cling to that idea, it’s somewhat more difficult.

Our discussion continued along these lines, moving to a discussion of how these medications tend to change things we used to think were personality traits. “How many Kierkegaards have we destroyed with Prozac?”

Indeed — think of all the creative geniuses in history and it’s almost shocking how many of them displayed characteristics that would now be labeled bipolar, for instance: Mahler, Van Gogh, and Kierkegaard all come to mind.

The possibility of changing personality through medication seems more likely when we think of people taking medication from age fourteen, before a solid “I” has formed. Who would these people have been without medication? In many cases, the answers is no one — they would have ended up as suicide statistics. But tweak the question a bit: who would they been if they had begun medication a few years later?

We’ll never know.

Nor will they.