Sunday, July 09, 2006

Prozac. And the horse it rode in on.

Type in the annoying unreadable alphabetic script that Blogger tortures us with, hit “publish.” – and there it is, your very own Blurted Tactless Opinion, in print in the Comments section of another person’s very good blog.

I can be unreasonable on the subject of anti-depressants. And let me say, before I launch myself into no-man’s-land again, I have taken anti-depressants and been damn grateful for the relief. And I have many close friends who’ve fought their way to solid emotional ground through a combination of prescribed brain-altering chemicals and therapy. Let me be that fair, at least. Let me admit that sometimes people hit a point when they can’t pull out and some intervention is called for…

Let me also emphasize the part where the brain-altering chemicals are combined with therapy, with the process of learning to manage moods and emotional triggers, to understand them as something that did not drop mysteriously from the sky.

I don’t trust the pills. I haven’t trusted the pills since a psychiatrist diagnosed me with this mantra of the trade: “One depression – six months of anti-depressants; two depressions – a year of anti-depressants; three depressions – you’re on them for life.”

That was over ten years ago. I quite seeing the psychiatrist. I flushed the prescription down the toilet.

I had been thinking about a Native American belief that depression means you have lost your soul. I wanted my soul back.

At age sixteen, having lost my mother, having a father who absented himself emotionally on the better days and was downright abusive in his own grief on others, I became “depressed.” And the solution? Hospitalization, with shock treatment and a diet of tranquilizers to calm me down and speed to cheer me up. This was accepted medical practice at the time. Sound medical practice.

In what world, in what universe, I have to ask, do we medicate every grief? Do we medicate what Pema Chodron calls, “the genuine heart of sadness”…that human opening that allows us to feel compassion, understanding, acceptance?
In what world do we have so little patience with our own processes – and such high expectations of perpetual happiness that the natural lows of life have to be medicated instead of used as an alert that, possibly, something is wrong with reality in general – or at least our perception of reality? That we ignore the fact that life and mood is cyclical, that highs and lows are normal?

I am in full-rant here. And I have to apologize to anyone who is presently taking or has taken anti-depressants at the point when they could no longer put one foot in front of the other. I know. I know. And it isn’t that one-time intervention I’m furious with, but the assumption that our brain chemistry alters arbitrarily, with no reason. I’m furious with the doctors who pass it out at the first sign of depression, with no reasonable follow-up and no recommendation of therapy. I’m furious with the Canadian medical system for covering treatment by psychiatrists, but not psychologists, not alternative medicine.

At age sixteen, I was given to believe that I had a “condition”…some awful brain anomaly that made me different, made me inevitably sad. A condition which would make me a patient, a victim to my own chemistry for the rest of my life. I’m pretty furious about that, too.

I’m frustrated with a medical model that treats us like machines. I do not believe that there is no place for western medicine, no place for drugs, surgical and pharmaceutical interventions…but I despair of a culture in which it is not profitable to look into the why of disease, into what makes us healthy. I despair of a culture which has no room for the “genuine heart of sadness” common to us all, and which teaches us that it is unacceptable to be deeply quiet or have stretches of time when we are not all that damn perky and upbeat.

I have not put an anti-depressant in my mouth for many years and I assure you that I never will again. Have I been depressed? Yes. Here and there. Sad, too – which is a different thing. And I’ve been down at times because I needed to deal with things which hadn’t quite surfaced to consciousness – where I could have the realization I needed, or take the action required to ease the stress.

Depression, a very wise woman pointed out to me, literally means, “pressed down.” So it’s a signal. What is being pressed down? And when we’ve pressed that something down out of an instinct for self-protection, what strength have we buried with it?

And how do we ever find out if we medicate the signal away? How do we retrieve our souls?


Koru's Daughter said...

There was a time when I would have been your back up singer for his tune. Now I say that depression treatment is a suit that needs to be tailored to the individual.

I agree that the off-the-rack rules are not the best approach to depression management but perhaps we should not make rules about the rules. It just gets too complicated... Yaknow?

LJ said...

Not rules just POV, you know. And I've seen SO many people walk down this road incautiously and unquestioningly. Off the rack, as you say. Not though, I want to restate for the record, everyone.
Thanks for the comment KD.

Anonymous said...


When I was sixteen, I was heaved into the Happy Makers System.

There was no attention given to cause, just a blitzkrieg on symptom. Which was too bad, my depression was well-founded indeed.

Somewhere in all those soothing tones, I realized that it was simple application of formula. The "make 'em all better flow chart". Chide chide chide, dose dose dose.

"Fuck this", I think, "better to learn how to use it broken, than spend my life reliant on this shuddering calliope."

Ilga says "We're not supposed to feel great all the time!" Somehow this too is a great revelation to many. That, coupled with a fine sense of how every systems' (churches, medical fields, charities, schools, etc.) primary purpose is to sustain itself, function following later if there's time, has embued me with a robust suspicion of anyone who offers to "help".

Also kiddo, you mentioned that medicine treats us like machines; I'll further that it treats us like collections of mechanisms, none having a whole hell of a lot to do with any of the others. A total failure to see the forest. "Dammit, my business is trees!"

Blah blah,


LJ said...

I hate to rant alone. Thanks Marko. Really. Thanks.

Jess said...

Amazing, the way the world was run when we were sixteen, the things that passed for "right".

Now too, though. You've articulated the problem very well.

I've tried just about all the antidepressants there are, at some point or other in my life, and don't believe I ever benefitted from any of them. It's always been a matter of coming out the other side as time passes and life goes on.

LJ said...

Jess..I got to thinking about all the stuff that passed for right. The wholesale handout of valium, the overuse of antibiotics etc. We won't even talk about thalidomide or the recent quick yanking of an anti-inflammatory drug I was taking for arthritis. And how about those hormones?
It's no bloody wonder we get a little gun-shy and suspicious. And then, for every study is a counter-study.
And I think so too...about coming out the other side. It takes the time it takes and the process - one way or another.

Koru's Daughter said...

Marko, have you ever read the Thoreau quote: "If I knew for a certainty that a man was coming to my house with the conscious design of doing me good, I should run for my life."

It is medicine being run like a corporation that I want to rant about. Hell, any public service being run like a corporation - universities, medicines, plus all the systems marko listed.

chuck said...

That we lose facets of ourselves as we self-medicate is oh-so-true...had friends over for paella and wine tonight, so...I am a little self-medicated as I write.

You got me thinking...Thanks.

AntiElvis said...

I agree with you to a certain extent. What we have in Canada isn't a health-care system, it's a sickness system - treat the symptoms of the illness and don't look at preventative measures that might avoid the problem in the first place.

That being said, it's kind of what Winston Churchill said about democracy - it's the worst system out there, except for all of the others.

LJ said...

Hey Chuck...Yeah. I thought about the self-medicating thing. Especially cigarettes. But I figure I have enough ways to lose facets without adding anything else.

Anti-elvis. Long time. LOVED the Winston Churchill quote.

Anonymous said...

That Thoreau, funny guy...

I see it all as a logical extension of several important principles from the Big Book of Marko.

1. The second most destructive thing in the world is a human being attempting to help* themselves.

2. The single most destructive thing in the world is a human being attempting to help* others.

3. Bureaucracies are inherently autistic.

4. Miserable? Good, now you have something to do.

Dogs bite people who are trying to help* them because they have fine instincts.

*by help I mean "make better", not "assist".


Handy Girl said...

pills treat the symptoms, therapy treats the cause. disease? dis-ease. hmmm...i'm not a fan of the pill pushing...a young woman i know was having a bad week and went to the psychological services department of her university and the doctor wanted her to take pills even when she insisted she didn't want them...jeezus h, she just needed someone to talk to...this is a book i pull out when something's wrong with my body, mind or soul: you can heal your life, louise hay...oh ya, i also think extreme lows are counter-balanced with extreme wisdom....

LJ said...

Marko. Show up on my phone sometime. We can add to the list.
Handy girl. Word. I'm sayin' the word.
Spell away!

Handy Girl said...

by the stroke of midnight, it will be done...

herhimnbryn said...

I wrote a long comment to your post yesterday! Pros / cons/personal experiences/ loved ones experiences. The dog then tried to get on my lap and put a paw on the delete button!! I couldn't believe it. Clever dog? Intuative? I laughed and he wagged his tail.
I hope I am not sounding flippant. I have had the 'pill' experience, albeit briefly. I was fortunate, I found a wise and experienced psychologist, who expected me to 'work' at the problem. I shall remain ever thankful for her support. I wish it was available fto all who wanted it in time of need.

zhoen said...

And exercise is as effective as the drugs. The least effective, drugs+therapy.
I finally figured out I had a tendency to anxiety, but because I cry, it was seen as depression. A doctor compared antidepressants to antibiotics, insisting that I take the right drug for the right diagnosis, in my case, in her opinion, antidepressants. Which I knew to be wrong, and it was not like she could culture out my emotional difficulties and see what drug killed what was growing, then give that to me. Bull.
Exercise and moderate alcohol, and I have been doing much better for years.

I could rant more, but this is enough.

LJ said...

Glad to hear your rant, Zhoen. And I agree that exercise & no (other) depressants helps a lot. I've got a fair amount of respect, also, for cognitive therapy - in that it gives people the tools to help them out of the echo-trap that negative thinking sometimes is. It isn't a cure-all, but it's useful.

Meditation isn't a bad tool, either...

Best help I've had has been a Zen approach. Coming back to now, to being present. What color are your socks?
The other thing is not getting scared.
Feeling depression come on no longer leaves me with the awful sensation that I'm doomed to be depressed for life.

Antibiotics, huh? Geez. My Doctor compared me to a diabetic. "It's just that your brain doesn't produce the right chemicals. And this is no different than a diabetic taking insulin."

I think not.

Therapy has been a mixed blessing for me in the past. A good therapist, at the right time, can help you ask yourself the questions that move you towards a more amiable agreement with yourself, I think. A bad therapist - whose aim is not to put the tools in your hands - is a disaster beyond medication.

Appreciate your comment very much.

AntiElvis said...

Well, I neded up getting a motorcycle to combat my depression. Nothing seems to work better than a 90 km/h blast down a twisty country road on a bright yellow screamer...

I've had two occasions to use therapy. One was through the employee assistance program with my former employer, and she wasn't terribly useful. The second was someone who said, essentially, "Alright, you have a problem. Here's how to fix it." We didn't spend so much time on looking at the issue so much as looking at ways to spot when it was about to happen and give me ways to combat it. One of which turned out to be the aforementioned motorcycle.

Anyway. Enough about me. Let's talk about me some more! ;)