The sense of suffering: subjectivities of depression and the neurochemical imbalance narrative
(University of Leipzig)
Paper short abstract:
My aim is to analyze the relationship between the neurochemical imbalance narrative and subjectivities of depression in Kerala. I argue that subjectivities are fractured and that patients engage non-medical discourses to make sense of their suffering.
Paper long abstract:
The narrative of depression as a neurochemical imbalance in the brain or, more precisely, a deficiency of the neurotransmitters serotonin and norepinephrine - largely produced by commercial interests of the international and national pharmaceutical industry and spread globally by international diagnostic systems - has found its way into the offices of biopsychiatrists in Kerala. In the clinical encounters, social, economic and existential suffering is thus transformed into a medical condition, treatable with pharmacological means. On the one hand, the setting of a psychiatric OPD largely shapes the way depressive patients express their subjectivities. On the other hand, the diagnosis (and explanation) of depression as neurochemical imbalance in and the prescription of drugs influences the way patients experience their suffering. Drawing from Jenkins' notion of "pharmaceutical selves" and from Rose's "neurochemical selves" and using several ethnographic examples, the aim of this paper is to analyze the relationship between the neurochemical imbalance narrative and subjectivities of depression in the context of clinical encounters in biopsychiatric institutions in Kerala. Subjectivities of depression are, I argue, much less coherent than ambiguous and fractured, unstable and fragile and engage accentuate and sometimes merge different, often contradictory discourses. Moreover I argue that it is because the neurochemical imbalance model of depression, though quite popular in Kerala due to the literacy rate and the numerous awareness programs in the state, doesn't provide patients with existential or religious meaning of suffering, that most patients seek other models to help them in making of their suffering.
Constructing diagnosis in 'mental health': the negotiation of categories, the encounter of subjectivities in South Asia