Recently, my psychiatrist told me that I had what was termed a "double depression", that my depression was not only biological, but situational as well. The biological component of my depression can and is being treated by the Effexor...and now Adderall...but the situational component cannot be changed using medication.
Basically, if my job is sucking the life out of me (which it is) and finances are an issue (which they are) and there exists other discouraging life issues (yup), I'm pretty much on my own for any depression that occurs as a result.
I said all that to say this: The Adderall seems to stir the down around (props to Willam Gibson on that phrase) as it were; the funk is still there but separate from that is a sort of engine or catalyst that keeps my brain humming along...thinking of solutions, getting mundane essentials done...in spite of the funk. This is good, especially since the alternative is a numb lethargy, but it's also sort of eerie. I experience a distinct awareness of separate me that comes on when the Adderall takes effect.
This leads to all sorts of posits about my identity and the veracity of it. Are these chemicals altering my true personality? If they are, and I function better with this new personality construct, then what does it mean when they wear off (and they do wear off; I have a strange metabolism that goes through amphetamines like an unsupervised kid through Halloween candy). Are these drugs (Adderall specifically) changing my neurochemistry to what it always should have been had I not been struck with depression, or are they forcing my brain to assume thought patterns and neurochemical structures that it wasn't meant to have.
My psychiatrist, the last time I presented him with a similar conundrum, put forth the analogy of a heart patient that takes meds. Is the patient without the meds the real person or is the one with the meds. Apparently it doesn't matter, since the patient without the meds will cease to be sooner rather than later. I told him it wasn't the same thing, and he insisted (I think) that it was; depression is a disease just as much as cancer or heart failure. I still don't think it's the same thing...hearts and cancers are physical elements within the body that can be removed, cut into, excised, whereas personality and mood are intangibles...but it was concede the point or be locked in a discussion that would take longer than the time I had for the appointment.
I wish I had an answer, but I don't...and I haven't the time to wade through what probably would be volumes upon volumes of research to figure one out.