Treatment versus Enhancement
The concept of “treatment” is based on a “biomedical” model of disease. In this model, illness represents a breakdown of the physical constituents of the body, leading to a functional loss of a capacity to perform typical activities of the organism. The proponent of the “enhancement” approach to the therapy of depression comes at the problem from other disease models. Any of the alternative non-biomedical models imply the conclusion that therapeutic interventions in depression should seek to enhance the functioning of the individual, rather than simply to permit redress of loss of functioning. Therefore, besides using psychotropic drugs for treatment of symptoms, many patients and clinicians seek psychotropic drugs to enhance normally variable psychological traits. This enhancement approach to practice appears to be most active in relation to the use of amphetamines to heighten attention, energy, and libido, as well as to lose weight. The use of psychotropic agents for such nonmedical uses raises some ethical questions, as well as contradicting the Hippocratic tradition of focusing medication treatment on diseases.