Store-Bought Neurotransmitters are Not Fine
consumerism + healthism = wellness? (no)
Against my better judgement, I have been going on Twitter lately! (Do not recommend.) The algorithm seems to enjoy showing me things that are the exact opposite of everything I love, and recently, it gave me this:
“If you don’t make your own neurotransmitters, store-bought is fine”
This is not the first time I've seen this catchphrase on social media; it's a play on something food bloggers and busy moms say about pie crust. But neurotransmitters aren’t pie crust, stimulants aren’t neurotransmitters, and consumerism is not the magic fix to all that ails you.
First of all, you do make your own neurotransmitters. If you didn’t, you would have a lot more problems beyond motivation. Dopamine is involved in all kinds of physiological processes, like motor function, lactation, sleep, reproduction - it’s not just the molecule that makes you want to do things.
Second, long-term use of stimulants causes the brain to downregulate dopamine receptors, which results in less sensitivity to dopamine, which would theoretically be the thing you do not want if you’re trying to treat a lack of dopamine. It doesn’t make a ton of sense to say that taking stimulants is akin to buying your neurotransmitters - that’s actually a pretty big misrepresentation of how stimulants affect the brain long-term.
Do stimulants help you get shit done? Sure, sometimes. But if you’ve ever taken Adderall and been scrolling Instagram when it hit instead of doing the thing on your To Do list, you know it’s not a magic bullet, because four hours later you have curated a fantastic IG story and had some very zealous chats in the DMs, but your To Do list remains extremely undone.
Stimulants don’t make you organized, but they do help you pay attention, feel confident, and give you energy - and those things can feel like better performance.
Several militaries did extensive studies on stimulants during World War 2 and found that they kept pilots awake and made them feel like they were performing better, even though, by objective measures, they weren’t. I am a big fan of feeling good, and I think that can be healing in itself. The pleasure we get from drugs is valuable, something we seem to have forgotten in our pursuit of “targeted” treatments that provide no high.
Informed and consenting adults should take whatever drugs they like that make them feel better - what I disagree with, and think is dangerous for a number of reasons, is the idea that drugs are a fix for faulty brain chemistry. Easy fixes are capitalism’s favorite, because they’re sellable, marketable, and profitable.
When a momfluencer says that store-bought pie crust is fine, she is leaning into the solution of consumerism to push back against the shame that many people feel about not making their pies from scratch. “Store-bought neurotransmitters” is a cheeky attempt to push back against shame, too.
The biomedical model of mental distress is often held up as the antidote to shame, blame, and stigma, but it doesn’t actually deliver on that promise, because the central message of the story is that you have a broken brain. That story has become popular because it sells products — not so good for you, but great for corporations!
Consumerism is woven into our healthcare system, telling us that the key to fixing our broken health is making the right choices and purchasing the right treatments. Healthcare is a market, and pharmaceuticals a multi-billion dollar industry, with ADHD meds in particular set to grow immensely over the next few years.
“The important thing is my brain is happy, healthy, and getting what it needs - so I can do what I need” sounds like ad copy straight out of a pharma commercial. While McCabe told the Washington Post last August that she has turned down money from pharmaceutical firms in order to remain unbiased, this post parrots pharma talking points and has the indirect effect of advertising for them anyway.
As Jonathan Leo and Jeffrey Lacasse summarize in their study of pharma ads:
“...the claims made in the consumer advertisements of ADHD medications are oversimplified, one-sided representations of complex medical and social issues. The major difference between the advertisements and the medical literature is that the advertisements portray these issues as having clear, straightforward answers, while the medical literature is filled with ambiguity, conflicting results, and an ongoing debate...the degree to which this advertising is shaping the public’s perceptions of the issues should not be underestimated.”
How does McCabe’s brain get what it needs? By purchasing a product, of course. We have learned to talk this way about our health because this is what’s been modeled for us; consuming-as-treatment is the only thing we’ve ever known to do.
“Suffering is the new bad, and failing to consume the right ‘remedies’ is the new injustice,” James Davies writes in Sedated.
Under neoliberalism, our focus is primarily on the self: “We are all independent, autonomous actors meeting in the marketplace, making our destinies and in the process making society,” sociologist Nicole Aschoff explains.
The autonomous self in the marketplace is called the consumer, and in healthcare, it’s a position that sits somewhere in between the wholly passive patient and the activist survivor, as Ewen Speed analyzes in De-Medicalizing Misery.
The consumer is allowed to choose their treatment, retaining some sense of agency, but still “invokes biology rather than social or environmental factors as the main causes of ill health, allowing for the persistence of deprivation and social inequality.”
Neoliberal healthcare pushes the philosophy of healthism - your health is your personal responsibility, and maintaining it is a moral duty you must pursue above all else. Alexis Shotwell calls this an “individualizing purity politics” and, because the possibility for managing one’s health is not distributed equally throughout the population, says we should “understand calls for personal responsibility for health as racist as well as classist.”
“It is an atomizing and individualizing process...Health becomes a commodity determined by lifestyle choices...rather than anything more enduring or extra-individual, such as an issue of social equity and social justice.”
“The consumer can be seen to work with rather than against the medical model. This means it has less capacity than the survivor model to resist the medicalization of emotional distress.”
Store-bought pie crust is fine, sure, but store-bought neurotransmitters are another issue entirely — an individualized solution to a complex systemic problem, one that reinforces the illusion that you are an island entirely separate from the society and culture around you, and all you need to do to feel better is buy the right products.