People with family histories of alcoholism tend to have lower levels of endorphins- the endogenous morphine that is responsible for many of our pleasure responses- than do people genetically disinclined to alcoholism. Alcohol will slightly raise the endorphin level of people without the genetic basis for alcoholism; it will dramatically raise the endorphin level of people with that genetic basis. Specialists spend a lot of time formulating exotic hypotheses to account for substance abuse. Most experts point out, strong motivations for avoiding drugs; but there are also strong motivations for taking them. People who claim not to understand why anyone would get addicted to drugs are usually people who haven't tried them or who are genetically fairly invulnerable to them.

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Since I am writing a book about depression, I am often asked in social situations to describe my own experiences, and I usually end by saying that I am on medication.
“Still?” people ask. “But you seem fine!” To which I invariably reply that I seem fine because I am fine, and that I am fine in part because of medication.
“So how long do you expect to go on taking this stuff?” people ask. When I say that I will be on medication indefinitely, people who have dealt calmly and sympathetically with the news of suicide attempts, catatonia, missed years of work, significant loss of body weight, and so on stare at me with alarm.
“But it’s really bad to be on medicine that way,” they say. “Surely now you are strong enough to be able to phase out some of these drugs!” If you say to them that this is like phasing the carburetor out of your car or the buttresses out of Notre Dame, they laugh.
“So maybe you’ll stay on a really low maintenance dose?” They ask. You explain that the level of medication you take was chosen because it normalizes the systems that can go haywire, and that a low dose of medication would be like removing half of your carburetor. You add that you have experienced almost no side effects from the medication you are taking, and that there is no evidence of negative effects of long-term medication. You say that you really don’t want to get sick again. But wellness is still, in this area, associated not with achieving control of your problem, but with discontinuation of medication.
“Well, I sure hope you get off it sometime soon,” they say.
Andrew Solomon
depression