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127 Responses

  1. Andy
    Andy August 4, 2008 at 9:57 pm |

    Very well said.

    I try to get people to do a privilege check whenever they’re lambasting the homeless vets in our area. Many of them are mentally unstable because of their experiences and aren’t lucky enough to have family or friends there to help them get the care they need. They can’t afford the therapy (meds or talk) and the VA just isn’t doing right by most of them.

  2. Black Thirteen
    Black Thirteen August 4, 2008 at 10:03 pm |

    Did it ever occur to you, that perhaps people who are anti-medication are that way for legitimate reasons?

    Rather than attempt to hone your psychic prowess (or lack thereof) and tell them what they’re thinking, how about ask?

    Instead of assuming people who are anti-meds are these perfect, healthy people looking down on those that aren’t, figure that maybe these are people who understand the situation more intimately than you imagine?

    I have what would be considered incredibly bad depression? Do I take Prozac? No. Fucking. Way.

    Oh, but wait, how can this be? Someone WITH said condition, refusing said treatment? That sort of goes against your entire rant, doesn’t it?

    When they evince clear anxiety about how a certain drug meant to change their disposition might take over their personality?

    One only has to look at a person on (mental) meds when they’re on them, and when they’re off them.

    It’s like two different people. I’d say that changes their personality. Not to mention the rampant sexual side-effects of that completely useless line of drugs.

    Yeah, I said useless. Studies released recently, showed, amazingly enough (not really amazingly) that Prozac has no better of an effect than a placebo. Fancy that.

    I mean, is it that far-fetched to assume a drug company is telling people they’re depressed, and then telling them the only solution is this prescription?

    Oh, and you’ll also need this prescription for something to restore your libido, (which, coincidentally, is also made by the same drug company that makes your anti-depressant! How convenient! Prozac, Cialis).

    Moving on to more physical ailments, insomnia is a sign of a problem. For the most part, it’s a symptom, not the disease.

    Taking a pill for that is a bandage. It’s not going to cure the original problem causing it. Curing your symptoms won’t cure your problem.

    Plus, people who are anti-drugs are so, because as a society, the US, and most other major nations, are completely over-medicated. We have pills for fucking everything.

    People act as though society would grind to a halt without our multitudinous medications.

    Except, society went on for multiple millenia without these pills, and did pretty much alright.

    We have an over-reliance on everything from over the counter aspirin, to anti-depressants, to everything else. I mean, you name it, they make a pill for it.

    Rather than fix the actual problems, we’ve resorted to taking pills for our problems, and taking more pills to fix the new problems caused by the first pills.

  3. stnemmoc
    stnemmoc August 4, 2008 at 10:06 pm |

    I haven’t kept up with Feministe regularly for a while, but this piece expresses so well how people look at medication these days. In the case of depression, it’s “if I can’t see it without any additional understanding, it must not be there”. It’s just a relatively newly defined category of people that is safer to put down, so that’s what people do.

    A good related article from the NYT in one of their blogs is here: http://warner.blogs.nytimes.com/tag/big-pharma/
    From the article: there are very few people getting mental health services that don’t need them, and people have been self medicating for years any way; so if that’s what this is it’s hardly a new phenomenon, only now it’s safer.

  4. Lindsay Beyerstein
    Lindsay Beyerstein August 4, 2008 at 10:12 pm |

    You’re absolutely right about the irrational aversion to long-term drug therapy. We’ve got irrational aversions to drugs just because they’re drugs. If there’s a disease that has a good, safe drug cure, I say praise the lord and pass the spansules. On the other hand, we’ve also got a huge industry dedicated to defining diseases to fit the drugs we have (which aren’t always so effective or so harmless).

    Having written course materials continuing medical education company that made a good chunk of change hyping Ambien and Lunesta, I shudder at the thought that 1 in 5 Americans is taking sleeping meds on a regular basis. The amount of duplicity, pseudoscience, and greed involved in hyping sleep meds is simply staggering. Any time you hear from a sleep foundation, check to make sure it’s an independent research group and not an industry front posing as a group of researchers. There are so many of them.

    I quit in disgust because the industry knows perfectly well that longterm benzodiazepine therapy is of minimal objective benefit and considerable risk for the elderly and others with compromised health. I remember looking at dozens upon dozens of studies showing that the average insomniac with taking a BZ slept all of 12 minutes longer than those taking a placebo. It would just be more relatively harmless snake oil if it weren’t for the fact that seniors and people with disabilities comprise such a large segment of the market. For young, healthy people who have occaisional insomnia, these drugs are just about as good as the companies say. But if you’re older, taking other meds, or suffering from cognitive or mobility issues, BZ drugs can easily contribute to your death or further disability–through falls, drug interactions, cognitive impairment, etc.

    Even more depressing is the fact that OTC sleep meds, typically antihistamines, have even worse side effects

  5. whatsername
    whatsername August 4, 2008 at 10:16 pm |

    What is it, really, that people are trying to say, when they express distaste for teh drugzzz?

    I agree with my of your points but I also think you’re mashing together two issues here, which this particular quote emphasizes to me. There are a couple things people are “really saying” with a quote like this. For some, it’s exactly what you said.

    For myself, I have an extreme distaste for medications, yes. I think Big Pharama, as you said, is corrupt. I think they feed us a lot of stuff we don’t really need and act as though it’s vital. I think they do things purposefully to undermine alternative treatments to various diseases and ailments.

    For me it has nothing to do with a fear of disability, well, in a way…it’s a fear of dying early and miserably as a result of exposing my body to lots of various artificial and toxic chemicals I didn’t really need. My perspective on this was formed early when I realized if I didn’t treat the symptoms of my yearly colds, but instead helped my body recover from them (vit C + echinecea and/or astralagus versus you know, Advil Cold) my infections were cut in MORE than HALF.

    This early experience fueled an interest in learning more about medicine and the toxic chemicals in products I’d been led to believe were vital to my survival (toothpaste, shampoo, antiperspirant…) What I found is that Western medicine is gravely flawed in this regard. It is obsessed with symptoms instead of treatment of causes.

    Having to take medication to sleep? To me that’s a strong reinforcement to the idea that we are becoming more and more a seriously over stressed people. That the demands of daily life are too high. It has certainly been shown that stress and sleep are related. I don’t have a problem necessarily with people treating their inability to sleep with meds (though before popping pills I’d rather smoke a bowl…) it’s that we’re having a harder time sleeping that worries ME.

  6. Jeff Fecke
    Jeff Fecke August 4, 2008 at 10:22 pm |

    I have what would be considered incredibly bad depression? Do I take Prozac? No. Fucking. Way.

    Well I do, and I will state flatly — it’s probably saved my life, and it’s certainly improved it.

    You have the right to turn down medication if you wish, but don’t attack those who choose to use medication. All you do is other us, and set yourself up as morally superior to those of us too weak to handle depression on our own.

  7. Black Thirteen
    Black Thirteen August 4, 2008 at 10:29 pm |

    There are a huge variety of treatments available for people to try. Not everyone does well with drugs. Not everybody does well with talk therapy. Not everyone does well with stretching, or light boxes, or visualizing, or whatever.

    And all we’re saying, is the fact that there are tons of people on drugs that don’t need to be. In fact, most people don’t need to be.

    Problem is, too many people are too contradictory. “Oh, there’s plenty of treatments”, but depression is a problem with your “brain chemicals”, so you NEED drugs, etcetera. Talk therapy (also bunk, moreso than the mental meds kind) isn’t going to rewire your brain.


    At the same time, some people do great on some of those things — and I’m not particularly happy when I hear people’s knee-jerk reactions against treatments that make a HUGE difference in the lives of so many people, esp. things that hold up to scientific scrutiny.

    Except things like Prozac don’t hold up to scientific scrutiny. They aren’t making a difference in people’s lives, people are convincing themselves they are.


    Because all those little knee-jerk comments add up, and we hear them. And we get the message.
    This post is me dissecting that message to try to understand how all the little components that make it up work.

    Well, I’m just pointing out that the people saying them aren’t these ivory tower perfect specimens that somehow “fear” being like the “unwashed masses”.

    A lot of them are people like me, people who society says are bad/broken/need medication, and who refuse that BS definition.

    Like another person said, in most cases, people who stop taking cold medicines, end up getting sick less.

    Since I cut cold/flu meds out of my system entirely…I honestly cannot remember the last cold I had. It’s been a couple years at this point.

    I’m not anti-medication because I “fear” being “like those people”, I’m anti-medication because I (rightfully so) fear pumping my body full of drugs that even the companies selling them aren’t completely sure what they do, that I’m damn sure I don’t need. I’ve learned to live with how my brain is, every day, and I don’t need a pill to change who I am, to be more “acceptable” to society.

    Blah, sorry. It’s a subject I’m very outspoken about.

  8. Donna
    Donna August 4, 2008 at 10:31 pm |

    I think you might have picked the wrong example for this, because sleep aids are definitely one of the problematic meds out there.

    Is it the individual people who question whether a sleep aid is necessary? Or the ‘big pharma’ pushing doctors to overprescribe their latest wonder drug? Or our must-have-it-now-with-no-effort society (so let’s pop a pill for everything!)? I think it’s all three, but you seem to be most angry with the first, if it wasn’t for the other two then few would question if a med or treatment was unnecessary.

    I doubt if many are questioning whether there aren’t any people who need a sleep aid, I think what they are questioning is do all the people taking them need them and if not, what can or should be done?

    I’m on 5 prescribed meds daily, and go to the doctor’s office for another drug treatment monthly. I also have physical therapy, exercises, traction, heat therapy, a tens unit, and multiple rubs, lotions, ointments etc to manage chronic pain due to herniated discs, a bone spur, and neuralgia. Some of this stuff is a lot of work and to be honest, I’d rather have a miracle pill to take for the pain (vicodin) than to do my exercises or go to physical therapy for example. I’m sure the drug manufacturer agrees with me, but my doctors and physical therapists are trying to wean me off! Damn them! Oh wait, I consider this what good health care professionals do even if I want the easy way out by popping a pill.

    I do agree with you if we were discussing depression for example. I do think there are people who want to deny that depression is real. They think because they have had the occasional bad day that they understand what depression is, and that those who are depressed just have to think sunny thoughts and snap out of it, like they did when they had their bad day or two.

  9. Kristin
    Kristin August 4, 2008 at 10:43 pm |

    amandaw: Actually, many disabled communities and communities of color in the United States have legitimate skepticism of the medical industry in the United States because of a history of forced sterilizations both in secret and under state-approved eugenics programs (And, I’m sorry, but I do not believe that the pharmaceutical industry can be separated from the medical industry writ large.). Not to mention other instances of victimization, mistreatment, and abuse at the hands of the medical establishment.

    Suspicion wrt medical treatment is not, in fact, always related to privilege or of this generalized “fear of disability” that you suggest plagues us all.

    State-sanctioned eugenics programs were at one time approved in 33 US states and lasted well into the 1970′s–not that fucking long ago:

    http://www.medicalnewstoday.com/articles/51730.php

  10. painted dragon
    painted dragon August 4, 2008 at 10:43 pm |

    ah, yes. i’d have to agree with you, to a certain extent. altho i’d have to add insurance companies to the list of “people” who think that drugs are frivolous. i’ve had insomnia since i was very young (think 3 or 4 years old!). only since the more recent sleep aid drugs (like ambien) have popped up have i been able to deal with this effectively.

    unfortunately my medical insurance thinks this is frivolous & refuses to pay for it. (along with the “heartburn” meds that i need to control the *pain* caused by an ulcer) i have to rely on samples that my doctor gives me – which is a weeks worth per month. so i actually get some sleep *one week* out of each month.

    so i think that the reluctance to rely on drugs goes beyond just your “average joe.”

  11. Kristin
    Kristin August 4, 2008 at 10:52 pm |

    Also, I mean… Um, we’re skeptical because the FDA does *in fact* often approve medications that have not been sufficiently tested, over which there are serious safety concerns, and often because of their market potential. One that comes immediately to mind is the diet drug, Alli.

    I’m not against medication as such. I just didn’t really find your generalizations helpful.

  12. Jay
    Jay August 4, 2008 at 10:56 pm |

    Yes, Big Pharma )and my profession’s collusion with Big Pharma) feed into a demand for problematic meds. Yes, too many docs want to write a prescription instead of talking to patients and too many people are too overwhelmed by work and commuting and the other emotional demand on their lives that they end up on meds for symptoms that might have non-pharmacological solutions.

    And yes, at the same time people are living better, longer and more functional lives because of those very same medications.

    Donna, narcotics aren’t always the easy way out. For many people, regular doses of long-acting narcotics spell the difference between working and being on disability, between sitting in a chair and doing their own housework. The more we know about non-narcotic pain meds, especially NSAIDs, the better the narcotics look. I spend far more time trying to coax people who are limited by their pain into taking a narcotic than I do fending off people trying to get inappropriate prescriptions.

    I think there are a lot of drivers of this attitude; fear of disability certainly drives a lot of doc behavior but I hadn’t thought of it as much with others. The sense that meds are “the easy way out” is another driver. Either way, it’s othering and it’s assuming without thinking or inquiring.

  13. Kristin
    Kristin August 4, 2008 at 10:56 pm |

    I mean… The more I think about this, the more it troubles me. When I think about hearing people complain about medications, the people I hear most often are *not* well-off people with good medical coverage who are simply ignorant of their privilege.

  14. other orange
    other orange August 4, 2008 at 11:02 pm |

    Do you think there’s an age separation with people who are anti- and pro- medication ?

    I was kind of curious about that, looking at the histories and feelings of family and friends and trying to find a pattern, but there just might not be one. I know a good number of older adults, and those of them who are on long-term medications are incredibly grateful for the advances in the last few decades. I also know younger people who are pro-medication because that’s how they’ve grown up- with a pill available for every possible symptom and condition, and the stigma in some ways has been taken off of seeking treatment (definitely a good thing.)

    On the other hand, there are people like my mother- experimental medical treatments in her youth (like being exposed to radiation for birthmarks) caused health problems for her and other people in her generation. (Not to mention her own personal history, involving long-term damage to her immune responses from steroid joint treatments.) She has a dislike of the pharmaceutical industry and of the HMO system and I would say it’s not entirely unwarranted. (And as a child of the 80′s, I saw Ritalin overprescribed in my peers.)

    I think there’s a balance somewhere- understanding and respect for people who choose to manage their health and wellness issues in their own way (whether drugs, therapy, etc.) but also a healthy dose of skepticism for the pharma-industrial complex.

  15. shah8
    shah8 August 4, 2008 at 11:28 pm |

    Well, it’s like this. You want to be on as few maintenance drugs as possible. No drug (except, ironically, cannabinoids and opiods among others) is truly safe. The drug companies want to put you on as many maintenance drugs as possible. There is an inherent conflict.

    Ambien, most certainly, is NOT a safe drug to take on a regular basis. This is not to say that people who get regular insomia shouldn’t treat it with Ambien if necessary, but really, and truly, find other ways to fix it if possible.

    In fact, *most* head meds much more complex than THC or amphetamines aren’t that safe to to take on a regular basis, which is why people should *always* seek a well rounded head treatment portfolio if they can–drugs, therapy, lifestyle changes…

    It’s actually pretty easy to make the distinction of what drugs to be wary of and what drugs you go ahead and take. It’s any maintenance drug that’s advertised on tv, for obvious reasons. It has to make money to pay off advertising costs. It’s visible to shareholders as a potential cash cow, so forth, so on. One would have missed out on Vioxx or Phenfen and other really bad failures.

    As for the thesis of the blog-post? I disagree. I think it’s the opposite. People look to drugs to save them from a lifetime of bad habits that has eventually caused a major health issue that ain’t gonna go away. For instance, look at the AIDS drugs’ relationship with the gay community. Or the various drugs for weight-loss (gain as well). Or Botox. Then there are some of the echoes of the Fountain of Youth with many of the perspectives surrounding Stem Cell research. It’s not a fear of disability, but the hope of that “good as new” feeling.

  16. denelian
    denelian August 4, 2008 at 11:29 pm |

    i am TERRIFIED of the meds i am on. always have been – i’ve been in chronic pain since i was 9, and until last year when i found out that *part* of my problem was displasia of the hip (just had surgery for it) i wouldn’t take something unless i was crying from pain. i had all these different meds (mostly flexaril, vicodin and ultram) that i WOULD NOT TAKE. because i was terrified i would become addicted to them.
    i have to take stuff right now (loooooooots stronger than the above, too) but as soon as i can not take them and function… bye-bye oxycodon and zanaflex!

    i want a pain med that TAKES AWAY PAIN WITHOUT IMPAIRING MY BRAIN. duragesic/fentanyl SORTA does this. a bit. why is that soooo much to ask?

  17. Tapetum
    Tapetum August 4, 2008 at 11:46 pm |

    It’s possible to be both aware of the incredible problems with the pharmaceutical industry and the FDA, and still believe that some medications are helpful or even life-saving. Some of what ails the pharms is the same thing that ails surgeons – when you have a hammer, everything looks like a nail – compounded with all the problems of corporate America.

    Which doesn’t change the fact that the three medications I take daily are a major factor in my not having to have brain surgery. I really appreciate this effect and seriously resent people who seem to think that sufficient (willpower? healthy eating? positive thinking?) would somehow magically fix things. Yes humanity survived all these generations without advanced medicine. Individual people, on the other hand, frequently did not.

  18. CBrachyrhynchos
    CBrachyrhynchos August 4, 2008 at 11:50 pm |

    *sigh* and some of us who are on psychotropic medication are skeptical of how its used.

    Quite seriously, submitting to that daily pill was a choice of last resort. Even with weekly group therapy and monthly individual CBT therapy it wasn’t working. CBT was great for helping me realize when my cognition was kinked and way off the rails. But it wasn’t doing anything to stop the shakes, tachycardia, and formication. In the mean time, I was self-medicating stress symptoms with toxic levels of tylenol, and hit a brick wall in regards to meditation practice.

    So yeah, after several years of trying talk, diet, exercise and meditation I started taking a pill. And yes, it does change my personality, some changes are better, and some are worse. And its not a cure, or a panacea, and I don’t magically feel good. And there is a constellation of symptoms that I accept because I know the pounding my body was taking from the anxiety disorder was killing me slowly.

    So it really bothers me the way battle lines are drawn on this.

  19. Sarah
    Sarah August 4, 2008 at 11:58 pm |

    I haven’t done any double-blind studies of anti-depressants myself, of course. :p But in my personal experience, saying that drugs like Prozac have only a placebo effect seems inaccurate. In my teens I tried out about 5 different anti-depressants over the course of two years, including Prozac, and all of them had slightly (or not so slightly) different effects. This suggests that there is not only a placebo effect, because it wouldn’t make sense for me to experience a *unique* placebo effect for each medication. (I don’t doubt there’s some placebo effect, but there is certainly a chemical effect as well –at least in some people’s brains.)

    I definitely agree with the basic premise of the post, about how a fear of disability/drugs can be harmful for people who could actually benefit from those drugs. I’d add that the fear of people’s *fear* of disability/drugs (ie, the stigma surrounding them) is a major problem as well; when I went on anti-depressants I was initially worried that they would change my personality, but now the greater concern is what a history of mental illness will look like for insurance/hiring/what-have-you.

    Not to make this a ridiculously long comment –sorry!– but the whole “don’t treat insomnia/symptoms, treat the stress/etc that causes it” is a great goal in an ideal world, but is often an unrealistic standard. (This too-high standard can prevent some very necessary symptom-treating, as well.) My friend has bad insomnia that is a combination of current circumstances and brain chemistry. Unless she wants to wait to get a good night’s sleep until she has gone through years of counseling and has managed to find the right medications to fix her brain, she needs to find a sleep aid. …Or else she can’t expect to graduate in the near future. So it *is* a temporary measure, but in more of a tourniquet-to-prevent-massive-blood-loss than a band-aid kind of way. Sleep loss is also a cause, as well as a symptom, of other problems, so even “forced” sleep can be preventative and beneficial.

  20. Kristin
    Kristin August 4, 2008 at 11:58 pm |

    Hi all–I take lots of medications myself. I am not against medication. I am simply saying… Marginalized groups have very good reasons for being suspicious of the medical establishment, and that fact was ignored in this post. And continues to be ignored.

  21. Kristin
    Kristin August 5, 2008 at 12:01 am |

    “It’s possible to be both aware of the incredible problems with the pharmaceutical industry and the FDA, and still believe that some medications are helpful or even life-saving. Some of what ails the pharms is the same thing that ails surgeons – when you have a hammer, everything looks like a nail – compounded with all the problems of corporate America.”

    Tapetum–Yes, of course, it is. I didn’t see anyone denying that.

  22. BeccaTheCyborg
    BeccaTheCyborg August 5, 2008 at 12:07 am |

    Awesome post. :)

    It is a very important point that there is a definite problem that so many people *need* to take medication to get sleep, rather than so many people *take* medication to sleep. And though Big Pharma is definitely problematic, so is the ridiculous attitude that some people have that people who use medications either are a)dupes who don’t know better or b)whiners who just need a set of Health Bootstraps to pull themselves up with. So I choose not to take medication for my emotional/mental issues, my friend N does. That makes neither of us the superior person. And people who do take medications are likely to have considered the ramifications of long-term medication. They just come to different conclusions.

    My own experience: I was offered by one of my specialists a medication for a condition that is currently only in small-problem stages, with the explanation of what it does, its effects, the side effects (among other things, lasting nausea). I turned it down for now, having weighed the options. I have a good enough chance of taking it down the road, should my condition worsen (the symptoms can be very, very unpleasant). If I need it, I’ll have to take it forever. I’ve explained this to loved ones, and there was a common reaction: distaste for the idea of long-term medication.

    Back to your point, people really don’t like to think that they might have that fragility all humans (and cyborgs) do, and often are willing to dismiss real people who remind them of this, in their work to remain well.

  23. Jeff Fecke
    Jeff Fecke August 5, 2008 at 12:30 am |

    So it really bothers me the way battle lines are drawn on this.

    Exactly. No drug’s right for everyone, and some drugs are going to be bad for people, even if they’re good for others. I’m not a drug evangelist. But I know for me, the drugs have worked. And so I get very tired of being told that Prozac is an evil conspiracy when I know for a fact that fluoxetine has had a definite, positive impact on me. That doesn’t mean it will for you — just as Wellbutrin and Lexapro didn’t work for me, but work for some others. And some people won’t be helped by SSRIs, some won’t be helped by drugs at all — but will be helped by talk therapy.

    Drugs are like any other tool — they’ve got good and bad sides, they can be overused, and they’re not the perfect answer. But for some people, they’re a good answer, and given where I was four years ago compared to where I am now, I’ll gladly, gleefully give money to Big Pharma. Your mileage may vary.

  24. Donna
    Donna August 5, 2008 at 12:36 am |

    “Donna, narcotics aren’t always the easy way out. For many people, regular doses of long-acting narcotics spell the difference between working and being on disability, between sitting in a chair and doing their own housework. The more we know about non-narcotic pain meds, especially NSAIDs, the better the narcotics look. I spend far more time trying to coax people who are limited by their pain into taking a narcotic than I do fending off people trying to get inappropriate prescriptions.”

    Jay, I definitely agree with you. I will probably need a prescription for vicodin or some other narcotic for the rest of my life at the very least for break through pain. I was mostly thinking of myself and not other cases. When you are in pain the idea of some types of treatments, therapy, or exercise, seems incomprehensible since in the short term it will increase that pain. You just want more of your pain med to manage it in the present. For me and me alone, this is the wrong way to go about it. I had hoped that I could have surgery and be pain-free, but my surgeon said no, that most of my pain wasn’t even related to the herniated discs at this point. It had more to do with the way I was sitting, standing, to try to ease the pain. In other words I had adjusted my posture in ways that weakened some muscles and strained others and it’s causing pain from that. That’s why the exercises and physical therapy are working for me and making me less dependent on vicodin. I’m taking a third of the dosage I was before I started.

    Anyway, I was only using my case as an example of someone whose first instinct was, “Just give me the pain meds and leave me alone!” but not trying to say that everyone who has herniated discs or chronic pain can or will benefit from my meds, treatments, or therapies. I know other people who have had surgery and it did nothing for them but make their condition worse, there is no treatment or therapy that will ease the pain, they will live with it for the rest of their lives and have to use narcotics to manage that pain in order to function.

  25. Panopticon
    Panopticon August 5, 2008 at 2:38 am |

    Thank you amandaw, it’s refreshing to see a post about medication from someone who isn’t throwing around tired cliches about people who seek pharmaceutical treatment for mental illness.

    I see nothing in at all in the post that implies other treatments don’t work for some people. They don’t work for everyone though, and yes, when people make assumptions about what treatment I, or anyone else should be pursuing, yes, that is your fucking privilege talking. When people say “have you tried yoga” or “you should try this instead, it worked for me” yes, that is fucking privilege unless I have solicited your opinion.

  26. Lauren O
    Lauren O August 5, 2008 at 3:07 am |

    This post is excellent! I am giving it a standing ovation right now!

    Certainly there are good reasons to be skeptical of Big Pharma, but most of the anti-medication folks I personally meet are rich white people who have not been the victims of the abuses described in this comment thread. I find that many rich white people are especially vicious about depression meds, and it seems to me to mirror the “poor people are lazy” meme. If you can think of poor (or depressed) people as lazy, then you see them as deserving of their problems. You don’t have to feel bad for them; in fact, you get to feel superior to them.

    Medication doesn’t work for everyone, and I definitely don’t want to force medicine on anyone who doesn’t want to take it, but my SSRI changed my life in a profoundly positive way. And yes, Black Thirteen, it did change my personality, and I am incredibly grateful for that. It’s not like my personality was so completely flawless that it couldn’t use any changes. People try to improve their personalities all the time. Taking Zoloft allowed me to talk to people without having to, like, hide under my bed and weep for a half hour afterward. It allowed me to stand up to people without feeling terrified and intimidated, which has been a huge catalyst in terms of adopting and fighting for feminism and other progressive causes.

    I find the attitude that “society went on for multiple millenia without these pills, and did pretty much alright” rather problematic. Society also went without antibiotics for millennia, and how many people died of the black plague? Society went without modern childbirth techniques, and how many women died because of childbirth complications? How many people in developing countries still have problems like that because they don’t have access to modern medicine? Just because modern medicine isn’t strictly necessary for the continuation of the human race doesn’t mean it can’t vastly improve our existence.

    And if “popping a pill” is a quick and easy way to get rid of my depression, so fucking what? It has been totally rad to be able to get rid of my depression with a pill, and my insurance lets me buy it for 5 dollars each month. Should I spend hundreds of dollars per month on talk therapy or yoga classes or whatever so that I can earn not being depressed (assuming those things would even work for me personally)? Or should I not spend any money and just somehow muster up the mental fortitude to snap out of it? Why does it make people so angry that I can solve my problem easily?

  27. jess
    jess August 5, 2008 at 3:44 am |

    I think you are right on with this post, amandaw. I grew up in a liberal western town with “spiritually”-influenced friends who basically told me depression didn’t exist and that pharma was full of shit for making drugs for it. I don’t know if I will ever feel like I forgive them for that. I take two management medications for different conditions and I completely need them and I feel great about it!

    Someone said something about the superiority those who are anti-meds feel and I have experienced that and it pisses me off too. Hearing those privileged “knee-jerk reactions” make me want to kick someone in the face. If only you knew what it was like to live in brain-fogged depression for MONTHS AT A TIME. You have your occasional bad days? I went 4 years with occasional GOOD days. You are making yourself sound horribly ignorant, friends. Fuck you.

    I am disadvantaged by my health and anti-depressants were a life saver for me. With them I was able to form healthy relationships and other good patterns. It wasn’t an easy process. I had to try a few different kinds and the transitions were awful and most of them were not right for me with bad side effects. But I made it to the other side, and now I’m happy as a clam.

    I could go on, probably for a long time. But as you can tell this is a subjust I am terribly passionate about, and some of these comments make me want to bust heads.

    (..alright.. I’ll keep going:)

    I think it’s importatnt to hone in on the subject at hand- this is not about bandaid drugs like certain sleep aids and cold symptom relievers. This is about long-term chemical (drug) therapies for mental or physical disorders.

    I’d like to also note that alternative therapies are a great supplement to chemical ones! Acupuncture was another breakthrough to my well being. Taking prescribed vitamin supplements has been great. Anyway, I’m going to bed. :P

  28. Cara
    Cara August 5, 2008 at 7:35 am |

    One only has to look at a person on (mental) meds when they’re on them, and when they’re off them.

    It’s like two different people. I’d say that changes their personality. Not to mention the rampant sexual side-effects of that completely useless line of drugs.

    Yeah, I said useless. Studies released recently, showed, amazingly enough (not really amazingly) that Prozac has no better of an effect than a placebo. Fancy that.

    I mean, is it that far-fetched to assume a drug company is telling people they’re depressed, and then telling them the only solution is this prescription?

    You know, you’re right — my personality is totally different. I don’t break down in nonsensical crying fits multiple times a week, have a violent mood swing every ten minutes, yell at my husband for no reason and often feel like I don’t want to get out of bed and/or live. OH MY GOD TEH BIG PHARMA HAS TAKEN OVER MY POOR STUPID CONSUMER MIND. My mother’s too. She’ll freely admit that she used to have panic attacks every other day and do things like break plates when my father did something incredibly minor to piss her off. Now she rarely has panic attacks, is happy, has a good relationship with my father and can do every day tasks like driving on her own because there’s no real threat of her having a complete and total breakdown on the thruway.

    So you know what? Yes, we’re both like two different people. Previously we were both in our own ways totally emotionally out of control over-reliant on others and now we’re relatively happy, well-adjusted and independent people. I’d say that it was the mental illness causing the change, not the drugs.

    By the way, I never talk about any of this because there is such a big stigma from asshats like you, Black Thirteen! And even though I know it’s not, bullshit like this makes it feel like a personal failing and just aren’t good enough to heal myself or be a relatively happy functioning person all on my own. I’m talking about it now, even though I never ever do because this comment just pissed me off THAT FUCKING MUCH, in fact more than anything I’ve read in some time! And I read a lot of things that piss me off! Look at that, I can even still get angry and yell when I want to, despite my totally different zombie personhood! Maybe it’s because I just haven’t taken my evil happy brainwash pill yet this morning. (And if you come back with “I wasn’t talking about you” or “well sure they help some people but other people are total morons who don’t need them!” your arrogance will just piss me off even more.)

    So get fucked. Yeah, I said get fucked.

    And thanks to Jeff and Lauren O and others who more nicely said the same thing.

  29. Anna
    Anna August 5, 2008 at 8:08 am |

    I am an incredible hypocrit when it comes to drugs.

    I fully support the drug-therapies my husband is on, discuss side effects with him, assure him that he’s not “weak” for needing pain meds (omg) and after much discussion he’s going back to his doctor this week to discuss getting back on antidepressants because being off them has been bad for him.

    No force on this earth has been able to get me to even consider meds for my mental illness. None. I’m mortally terrified of them.

    They’re fine for HIM! He’s not weak! He’s really sick! (Marfan’s Syndrome, for those playing along at home, and part of the anti-depressants that help his chronic depression also help with pain management.) I’m not sick! I’m just… weak! Or something! And taking drugs will totally prove how weak I am!

    I know exactly how wrong I am. I know. But I still can’t get the will up to even talk to my doctor about treatment options.

  30. Cara
    Cara August 5, 2008 at 8:31 am |

    Rereading my comment I see that I’ve indicated that reliance on other people is a bad thing and there’s ableist connotations to that. My sincere apologies for that. I certainly do enjoy the increased independence, but my point was intended to be about dependence on the wrong people and things out of fear to get medical help that would significantly improve one’s quality of life, not about how relying on other people is always some horrible thing.

  31. Black Thirteen
    Black Thirteen August 5, 2008 at 9:10 am |

    By the way, I never talk about any of this because there is such a big stigma from asshats like you, Black Thirteen!

    Again, that sort of statement would work, if you were talking to someone who had no idea what said “condition” felt like.

    I do.

    The only people I think need to be on mental medications are people who are an immediate harm to others. Schizophrenics. Various other psychoses. People who are irrevocably nonfunctional, and don’t fit into society because they’re a threat to others.

    Also, like I said, studies have shown that Prozac is just as effective as a sugar pill. I could easily pull the news stories up, but, so could you. Just Google “prozac doesn’t work”. The first few hits should cover it.

    And as far as a different personality, did it occur to you that plenty of us LIKE our personalities? I like how I see things, how I deal with (or don’t deal with) people, and I like who I am.

    I don’t think that I need to entirely change who I am, via risky drugs, in order to fit some societally acceptable standard.

    Though, in the future, before you stand on your soapbox, remember, sometimes, you’ll be talking to someone who knows how it feels, has felt it longer than most people you might meet, and still says that pills are bullshit.

  32. Cara
    Cara August 5, 2008 at 9:17 am |

    Yeah, I read your comment the first time Black Thirteen. But thanks for at least having the integrity to stand behind your statement. Guess what, people who “know what it’s like” can still hold stigma against others who “know what it’s like.” I’ve seen the studies and gossip that says ‘prozac doesn’t work.’ Good thing I don’t take prozac. And if there’s a study/rumor that says the drug I do take doesn’t work, I wouldn’t really give a shit.

    So here’s a clue: we both “know what it’s like.” But I’m not telling you to go on drugs. I’m happy if you like your personality and like who you are. I love the insinuation that I don’t, though. I don’t think that “who I was” before the drugs is my personality. I think that was a mental illness wrecking my life and wrecking my personality — especially since I’m now like I was before all of that. Who is making assumptions now?

    I’m not telling you to go on drugs. I’m not telling you to “change who you are.” But you’re telling me that my drugs are bullshit and that I shouldn’t be on them, and that doing so shows that I don’t like my personality and am only taking them to fit some socially acceptable standard. Don’t take any fucking drugs if you don’t want to. That’s your choice and I couldn’t care less. I’m not going to sit here and call your choice bullshit and insult you because I made a different one. You’re the one doing that. So again: fuck you.

  33. roses
    roses August 5, 2008 at 9:41 am |

    One only has to look at a person on (mental) meds when they’re on them, and when they’re off them. It’s like two different people. I’d say that changes their personality.

    Studies released recently, showed, amazingly enough (not really amazingly) that Prozac has no better of an effect than a placebo. Fancy that.

    I’m intrigued… how is it that a pill has no more effect than a sugar pill and simultaneously completely changes people’s personalities? Magic!

    Yes, there are people who have medical conditions and have made informed decisions not to medicate for them. I’m not going to condemn them for that choice (if only more of them would extend me the same courtesy!) But there are also lots of people out there who have no idea what it’s like to live with a given medical condition, and yet still feel entitled to express opinions like: “This country is over medicated!” and “People with [x condition] should just buck up” and “Pills are the lazy way out”. I think Amanda brings up an interesting idea about those people – if depression (or whichever medical condition) is a personal failing rather than a legitimate medical condition, then they don’t have to worry about it happening to them.

    I don’t think that I need to entirely change who I am, via risky drugs, in order to fit some societally acceptable standard.

    Well then for goodness sake, don’t. Who here is telling you to take drugs? Amanda’s post was about the “Shock!Horror!Drugs!” mentality, not the: “I choose not to take drugs for personal and scientific reasons” mentality. And if you fall under both, try to keep in mind it’s the first people are condemning, not the second. Nobody here cares if you personally choose not to medicate, really, truly we don’t.

  34. roses
    roses August 5, 2008 at 9:44 am |

    Oh, and I love this:

    Should I spend hundreds of dollars per month on talk therapy or yoga classes or whatever so that I can earn not being depressed

  35. Broce
    Broce August 5, 2008 at 9:50 am |

    Moving on to more physical ailments, insomnia is a sign of a problem. For the most part, it’s a symptom, not the disease.

    Taking a pill for that is a bandage. It’s not going to cure the original problem causing it.

    Yeah, well try curing 70+ hour workweeks, pagers going off all night, financial problems for some, chronic pain…all of these things can lead to insomnia, and arent “curable” in the sense I think you mean here. Stress is a sleep killer, and for some of us, crushing stress just is not avoidable if we want to stay employed.

    So yeah…I take ambien some nights. And you can pry it out of my cold, dead hands.

  36. Black Thirteen
    Black Thirteen August 5, 2008 at 10:37 am |

    Yeah, I read your comment the first time Black Thirteen. But thanks for at least having the integrity to stand behind your statement.

    I stand by all my statements. Like I said earlier, I am very opinionated on the subject.

    I’ve seen the studies and gossip that says ‘prozac doesn’t work.’ Good thing I don’t take prozac. And if there’s a study/rumor that says the drug I do take doesn’t work, I wouldn’t really give a shit.

    Prozac is part of a family of very similar or identical medications. If one doesn’t work, all the generics based on it, or ones that do the same thing, logic would dictate that they don’t work either.

    I think that was a mental illness wrecking my life and wrecking my personality — especially since I’m now like I was before all of that. Who is making assumptions now?

    You are, sort of. You’re pointing out that the drugs change your personality, I’m pointing out that I don’t want my personality changed, because I like it. A change would make a new one that I might not like.

    You’re assuming I’m using some underhanded sneaky dig against you, which I’m not.

    Also, if we’re going on a “privilege check”, you might want to check the privilege that enables you to have health insurance and get said medications.

    I’m intrigued… how is it that a pill has no more effect than a sugar pill and simultaneously completely changes people’s personalities? Magic!

    Meaning, the effect it has on the actual condition is no better than a placebo, however, something designed to alter the brain can still change one’s personality, even while it’s not treating the actual condition.

    still feel entitled to express opinions like: “This country is over medicated!”

    The country IS over-medicated.

    if depression (or whichever medical condition) is a personal failing rather than a legitimate medical condition, then they don’t have to worry about it happening to them.

    Well, it happens to me, and I still consider it a personal failing.

  37. sara no h.
    sara no h. August 5, 2008 at 10:40 am |

    /shrug. While I’m glad there’s theoretically a pill for everything, sometimes it just seems to me that people would rather medicate than attempt to address the root problem. My father, for example, had the option of going on medication for various bits of his insides, or of drinking less hard liquor and eating fewer super spicy foods – which would eventually result in a lack of need for medication (for those bits, anyway).

    I guess I just don’t see the point in using medication as a kind of band aid to avoid treating the “real” problem. If you can’t sleep because you’re too stressed out, maybe you should change as much of the bits of your life that are stressing you out as you can, you know? As a stopgap measure in the meantime (taking meds to overcome depression so that you no longer have to take meds) makes sense to me though.

    At the end of the day though, you know: your body, your choice.

  38. Ismone
    Ismone August 5, 2008 at 10:56 am |

    I don’t avoid taking drugs because I want to feel morally superior to anyone else.

    I avoid taking drugs because they seriously fuck me up.

    I really, really, wish we could push more skepticism about taking drugs. Now, I’m not saying that there aren’t people for whom pharmaceuticals are an absolute godsend. But I am saying we have a society that tends to conflate normal sorrow (which can suck) with depression. This is bad for the people who are just sad (not that sadness can’t be debilitating) because it medicates a condition unnecessarily, but also for people with serious depression, because people then confuse it with normal sorrow, and do not understand the severity of what other people are going through.

  39. Sailorman
    Sailorman August 5, 2008 at 11:00 am |

    I have taken plenty of undergrad and graduate neuropharmacology classes and actually used to work on developing psychopharmacological drugs.

    I don’t get the “drugs are nothing” argument. Drugs not work? Of course they work.

    And there’s nothing wrong with using them.

    People’s levels of neurotransmitters can be (or become) imbalanced for many reasons, just like their joints can hurt and get swollen, and just like they can develop a lot of other issues. The imbalances may be considered “normal” in laymens terms insofar as they are “anecdotally unexceptional” but they are real and can have a lot of shitty effects on folks.

    Of course the brain is–duh–reeeeeally complex, and it is true that we still don’t have the brilliant targeting ability to hit exactly what we want (or to know, always, exactly what we want to hit, and how.) But we can still make some very good observations and design some good drugs and help people who are not happy. Unhappiness may be normal but it is not pleasant.

    I think, though, that it is a fear of changing personality rather than a fear of disability which makes people protest psychopharmacological drugs. Because they do change personality, insofar as you are defined by the electrical signals and neurotransmitter levels of a ball of meat in your skull. Still, that is an individual choice. Some folks don’t really like “who they are” on certain drugs, so they stop. Others don’t like it, but think the benefits are worth it. Others like the “new them” and view any other changes as just so much gravy. And any third parties are free to interact or not with anyone they see fit.

  40. vgnvxn
    vgnvxn August 5, 2008 at 11:06 am |

    I agree with whatshername and others who have mentioned that for many people, being skeptical of drugs is more a skeptism of the medical industry wanting to heap on “cures” for symptoms rather than problems. I have no issue with people taking medication- I just feel we as a society leap to drugs first rather than investigating what could be an underlying cause.

    I had extreme pain for a long time, and I was put on 6 painkilker pills a day. I then had to take 8 pills of anti-diarrhea medication a day to cope with the first medication…and started dropping weight. I was put on medications so awful they were recalled from the market months after release! Finally I went to a holistic doctor after my regular doctors refused to do anything but keep trying new pills. I’ve been without pain for years, without all the awful meds. That’s my issue. IF I can exist without putting serious drugs in my body, that’s what I want. That’s what the goal of our medical professionals should be, without stigmatizing those who need/prefer drug treatments. No pushing drugs that only treat symptoms, no stigmatizing those who need them as weak.

  41. annalouise
    annalouise August 5, 2008 at 11:12 am |

    I would say the opposite is more true: We live in a society that conflates depression as simply normal sorrow. Rather than people being unecesssarily medicated for depression (and other mental illnesses) it is significantly more common for people with severe mental illness to be untreated and unmedicated.

    Yep, these are two sides of the same capitalism-is-destroying-our-health coin. But I find that conversations that demonize medication or insist that there are vast numbers of overmedicated sad people who just need to take a walk or do some yoga, prevent us from having the other, more important conversations.

    In other words, the nature of the concern that too many people with access to both health insurance* and yoga are manipulated into choosing a over b stops us from talking about the horrible lack of access to mental health care for most people.

    *my anti-depressenats cost me $20 with my insurance, without they cost me over $150.

  42. the speculator
    the speculator August 5, 2008 at 11:19 am |

    There’s a hypothesis about auto-immune disorders that the immune system evolved to be able to handle a certain level of foreign intrusion. Modern first-world societies do not come anywhere near that level, so some individual’s immune systems, lacking concrete threats, begin to see threats in the body’s own cells. The immune system begins attacking those cells, causing rampant inflammation and eventually organ damage. There are medications for this (steroids to reduce inflammation, immunosuppressants to kill white blood cells), but some clinical trials have been showing that ingesting tapeworm eggs can have the same effect, but with fewer untreatable side effects.

    I wonder if there’s something similar going on with anxiety. i.e., our nervous system evolved to handle a certain level of stress, and in modern society we don’t have that stress—after all, most of us will die of old age, not of starving to death or disease or being killed; most of those who are diagnosed with anxiety disorders are not hurting for food or water or shelter; most of us can have kids that have a virtually 100% chance of living through childhood. So, perhaps lacking any of those pressures that wild animals deal with constantly, our nervous systems create responses to stresses that aren’t really there to the degree that they are in the wild (which is what our nervous system evolved to be able to deal with).

    I see that this could be interpreted as me saying that people with anxiety disorders are just imagining their problems, and I truly do not mean that at all. I’ve been diagnosed with social anxiety and I was on Paxil for about a year—it changed my life drastically, and for the better. (I’ve also been diagnosed with an auto-immune disorder and I’m currently taking immunosuppressants.) I know how real anxiety disorders are and how much they can affect your life. I’m just saying that the biggest influencing factor might not be deadline pressures or getting along with co-workers or any of the things that are commonly cited as proximate causes, but rather the lack of the types of stresses that our distant ancestors had to cope with daily and that produced the nervous systems we all have.

    This is purely speculative; I have no expertise whatsoever in medicine, the immune system, the nervous system, or anxiety disorders.

  43. Sarah
    Sarah August 5, 2008 at 11:35 am |

    “The only people I think need to be on mental medications are people who are an immediate harm to others. Schizophrenics. Various other psychoses. People who are irrevocably nonfunctional, and don’t fit into society because they’re a threat to others.” — Black Thirteen

    Of course. Killing *yourself* because of an imbalance in your brain chemistry, over which you have little-to-no control, is perfectly acceptable. And schizophrenics are of course always dangerous. And it’s okay to judge people as “irrevocably nonfunctional” instead of, you know, trying to find medications to help them…

    Having a mental illness doesn’t give you a right to say bullshit about other people and their choices any more than having a uterus would give someone the right to say “well, the patriarchy’s right about women being stupid sluts! It’s okay for me to say it, ’cause I’m a woman!” Just fyi.

  44. Black Thirteen
    Black Thirteen August 5, 2008 at 11:35 am |

    it is significantly more common for people with severe mental illness to be untreated and unmedicated.

    Except statistically, there are lots of people being overdiagnosed with it. The prescription rates for antidepressants are in the millions upon millions.

  45. shfree
    shfree August 5, 2008 at 11:46 am |

    I guess I’m one of the “lucky” ones that people generally agree that there is a need for me to take drugs, as I have epilepsy. But I actually could live without the drugs, I was unmedicated for years following my first seizure, and I wasn’t particularly concerned about them since they only happened once every two years, almost like clockwork. Then, after I had one in front of my toddler, I made the decision to get meds, since it wasn’t just me having to deal with my illness anymore.

    It has been a process finding a drug with side effects that I can live with, and I still have issues with the idea that I am going to be medicated for the rest of my life. But the idea of having uncontrolled seizures, even if they are only once or twice every few years, is more risk than I am now willing to take.

    I tend to believe that everyone who has a chronic condition, whether it be something like what I have, something that nearly the entire population agrees should be managed, or someone who is dealing with physical pain or depression which has a clear stigma, has made their decision to medicate or not medicate with much thought. To go around lecturing others about their choices is belittling and rude, as I think an individual is the best arbiter of what works for them to deal with a chronic illness.

  46. Holly
    Holly August 5, 2008 at 11:59 am |

    Well, it happens to me, and I still consider it a personal failing.

    As someone who’s also suffered from severe depression in the past (and, I should probably note, chose not to take medication for it) this statement makes me unable to take anything you have to say on this subject seriously.

    On top of that, millions and millions of people = overdiagnosis? Right. There are 300 million people in this country. I would not be surprised at all if far more than 1% genuinely struggle with depression or anxiety at more than a mild level. Whether they choose to take medication for it, what their health care providers (for those fortunate enough to have them) recommend to them, is a separate question from whether a condition is overdiagnosed. If anything, I suspect we are not taking mental health issues seriously enough in this country, although that doesn’t necessarily mean that medication or talk therapy or any particular course is the best or only answer for anyone.

  47. Cara
    Cara August 5, 2008 at 12:09 pm |

    Wow, until Holly’s comment I missed that entire comment by Black Thirteen. I kind of wish that I still had. Disgusting. But at least we now know what we’re dealing with and that it’s better to not bother at all.

  48. roses
    roses August 5, 2008 at 12:34 pm |

    I was dismissive of this statement before:

    I don’t think that I need to entirely change who I am, via risky drugs, in order to fit some societally acceptable standard.

    because, well, I thought this whole martyr-iffic “why are you trying to force me to take drugs!!” stance warranted dismissal, but I want to address something in it.

    I did not go on antidepressants to fit into a societally acceptable standard. I don’t fit into that standard regardless. I’m too spacey*, not sociable enough, I don’t have the right interests, generally I’m just too weird. I knew this and came to terms with it before the depression really hit. I went on antidepressants because I hated having depression. I hated every minute of it, from the helpless feeling of despair when I realised another bad spell was coming, to the days of laying in bed staring at the ceiling and wishing for sleep or death, to the hunger pangs that kept me up at night because I just could not force myself to eat, to the hysterical crying spells that I couldn’t control, to the way every minute I was actually okay was tainted by knowing that sooner or later another bad spell would come on. I hated living that way so much that I didn’t want to live anymore. I suppose I could just have killed myself, but instead I chose to get help. Not because I wanted to be more acceptable to society, but because I wanted to be happy and enjoy life.

    *Because it’s related: My spaciness meets the DSM qualifiers for inattentive type ADD, and I could probably go on medication for it. I choose not to because: 1) it’s an aspect of my personality I’m not sure I want to erase and 2) it’s not debilitating enough to be worth the risks that inevitably do come with taking drugs. That’s my choice. Other people choose to medicate, and that’s their choice. So, you know, I do get choosing not to medicate. I don’t get condemning other people’s choice to medicate just because you chose differently.

  49. Arnold Layne
    Arnold Layne August 5, 2008 at 12:39 pm |

    I have often wondered how many among the anti-medication folks drink coffee or beer daily, and/or smoke cigarettes or weed.

    I have to admit though, when I was on Risperdal, I got to thinking about it one day and said to myself, “Self? Why am I taking a medication to STOP hallucinations after all the acid I did in the 70s?”

    Well, that put a stop to that right then and there, let me tell you!

  50. shah8
    shah8 August 5, 2008 at 12:47 pm |

    Reading this thread just goes to show…People can argue for seemingly diametically opposed beliefs and still have both beliefs be correct. Excluding that thirteen guy (are you a fan of Richard Morgan or something?), who does seem a bit dogmatic, most people here have quite nuanced attitudes about drugs for their personal selves. What has an element of controversy is what “everybody else’s” feelings and motivations are. Why don’t some of use try and google for surveys about mental health attitudes?

  51. annalouise
    annalouise August 5, 2008 at 12:48 pm |

    @Arnold: Lol. I had a similiar realization about my good friend Marijuana and my good friend Wellbutrin, albeit with the opposite conclucions.
    “Wait a minute, self” I said, “You are jumping through inglorious hoops each month to get your hands on a very expensive medication to stop your lethargy, social disengagement, lack of motivation and tendency to eat everything you see. The least you can do to help this process is to say enough with the weed”

  52. everstar
    everstar August 5, 2008 at 12:52 pm |

    The only people I think need to be on mental medications are people who are an immediate harm to others.

    I wanted to repeat this. Before I was diagnosed (or, to be more precise, before I had an official diagnosis put on what was glaringly obvious to both myself and my mother), I never hurt other people. Ever. I slammed my head into tables and walls, punched myself in the head, and bit myself hard enough to leave marks, but I never hurt other people. I collapsed sobbing in the hallway outside my room because I was packing for a school trip and I had no socks and that meant I was an utter failure and the trip would suck, but I never hurt other people.

    I guess the fact that I was able to stop doing this after I started taking medication is just a placebo effect and the MMPI I took that pointed out clear depressive symptoms was a tool of big pharma. Oh well.

  53. Cara
    Cara August 5, 2008 at 12:55 pm |

    Word to everything Roses said. Virtually all if it is my same experience (up to and including the part about ADD, which I very strongly suspect that I have in a mild form but have no desire to medicate). *applauds*

  54. Broce
    Broce August 5, 2008 at 12:59 pm |

    If you can’t sleep because you’re too stressed out, maybe you should change as much of the bits of your life that are stressing you out as you can, you know?

    Now why didnt *I* think of that!! Erm…I wonder who is going to pay the mortgage and my son’s tuition when I quit my job, though.

  55. hydropsyche
    hydropsyche August 5, 2008 at 1:06 pm |

    some clinical trials have been showing that ingesting tapeworm eggs can have the same effect [as medications to treat auto-immune disease], but with fewer untreatable side effects.

    As a person with an auto-immune disease who has also studied invertebrate zoology, can I just say I am much happier taking my medications, side effects and all, than infesting myself with a tapeworm. But if you want to have parasites, go for it.

  56. shah8
    shah8 August 5, 2008 at 1:12 pm |

    Ah, and roses, I don’t know if you know this, but I take adrafani for my inattentive disorder. It might not work for you, but adrafinil and modafanil are typically much better drugs for us inattentive types than the amphetamines and the antidepressants used for ADD. At any rate, one reason I appreciate adrafanil was that I could not tell it was working. I’d just come back later and find that I did a better job.

    What is truly infuriating to me about inattentive syndrome is that I am not actually aware that I’m not paying attention. It also makes it difficult for me to write or explain things NOT in a stream of conciousness and thus easier for others to understand. It has put limits on what I could achieve just as thouroughly as someone who have recurrent depression.

    I don’t hate myself, and I do like my own spacy personality, but there are limits. In any event, the norandrenergic drugs mentioned above has *very* little psychotropism–less than caffeine, actually. While I am not in your shoes, and cannot hope to understand your situation all these electrons away, I would definitly encourage you to perhaps think about seeking treatment for inattentive ADD. While it’s true that this is a much less understood version of ADD, there are still some psychs that know what they’re dealing with.

  57. XtinaS
    XtinaS August 5, 2008 at 1:17 pm |

    sarah no h: If you can’t sleep because you’re too stressed out, maybe you should change as much of the bits of your life that are stressing you out as you can, you know?

    Honestly, this kind of response drives me the most nuts, because it falls right into the category of “Clearly you have never thought of this obvious thing, so allow me to show you it”.  I get wicked insomnia sometimes because my anxiety means my brain consumes itself at night.  I really seriously had someone tell me to just not worry as much.

    …gosh, if only I’d thought of that!

    It’s like people think that if you have [some mental disorder], clearly it also means you’re a gibbering idiot.  Pah.

  58. Ledasmom
    Ledasmom August 5, 2008 at 1:21 pm |

    ” If you can’t sleep because you’re too stressed out, maybe you should change as much of the bits of your life that are stressing you out as you can, you know?”

    Certainly! And after I’ve dropped the children at the nearest orphanage and traded in the husband for an illness-free one, I shall sleep like a baby, I shall!

  59. sophieblue
    sophieblue August 5, 2008 at 1:23 pm |

    Thanks for this post. Thanks, so much. I have been scarce on this community since another post a few weeks (or months?) ago in which the author casually dropped a really offensive assumption about people who take anti-depressants into an otherwise really sharp article… then, when called out on it, simply refused to back down.

    I was starting to feel like I was on the Twilight Zone the way people’s- private medical choices were judged and stereotyped (in a feminist community!), and the author’s hurtful attitudes about mental illness and medication were flat-out denied.

    Bottom line? A choice to take medication is a choice between a person and his or her health care provider, PERIOD. I never knew why people feel like they get to stereotype those decisions, but I think it does make sense w/ able-ist attitudes…

    Anywa, thanks again- this is really thought-provoking and I’m going to take that thought with me.

  60. roses
    roses August 5, 2008 at 1:24 pm |

    Thanks, Cara =)

    I don’t hate myself, and I do like my own spacy personality, but there are limits.

    Oh, I didn’t at all mean to imply that people who choose to medicate for ADD are self-hating! That was actually kind of the opposite of my point… I’m not good at making myself understood either :P I cut out part of my ramblings because I felt my comment was long enough already, but I was going to say something along the lines of: “Some people may choose to medicate for ADD because it’s more debilitating to them than mine is to me, or because they’ve read up on the drugs and don’t consider them dangerous, or because an inability to concentrate for more than 10 minutes is not a part of their personality that they’re fond of… or some combination of the above.” Thanks for the drug info though, I’ll look into it.

  61. XtinaS
    XtinaS August 5, 2008 at 1:26 pm |

    (a) Man, I really typed “sarah no h”, I lose at typing.

    (b) Hot button issue of mine – I don’t think you personally think I personally am an idiot, I just don’t think people think through what they’re saying when they say things like “Don’t worry so much” or “Hey, try finding the source of your sleep problems!” or “You should just focus more”.  (It’s really like people telling me I should reboot when I talk about having computer issues.  hffhyau;45twi NO WAI.)

  62. Crys T
    Crys T August 5, 2008 at 1:39 pm |

    Jeezus, can we not deplore the fact that society is so fucked up that people need to take medication to get enough sleep without being happy about the drug-taking? Is there something wrong with thinking that the real solution would be to change the way we live in order to make the majority of that drug-taking unnecessary?

    I’m currently on anti-depressants and they work for me, but that doesn’t mean that I insist they’ll work for everyone. They actually do fuck some people’s lives up.

    And I’m also not going to blind myself to the fact that any long-term drug use is going to have consequences, possibly quite negative ones. I just have to weigh the benefits and the drawbacks and decide, but that doesn’t mean that I’m going to chirp on about how drugs are 100% A-Ok. They have a serious downside and it’s completely irresponsible to gloss that over or minimise it.

    There is a massive difference between saying that people who need drugs to function properly should not be demonised and giving a blanket “YAYY DRUGS!!!”

  63. Feministe » PSA
    Feministe » PSA August 5, 2008 at 1:42 pm |

    [...] commenters touched on the subject in my previous post and I wanted to open up a thread to talk about that [...]

  64. Tapetum
    Tapetum August 5, 2008 at 1:43 pm |

    sara no h. said: /shrug. While I’m glad there’s theoretically a pill for everything, sometimes it just seems to me that people would rather medicate than attempt to address the root problem.

    Well, yeah. Considering that “addressing the root problem” for me would entail having someone crack my skull open, I’m pretty damned happy to have a pharmaceutical alternative. The day the neuroendocrinologist said, “You don’t have to have brain surgery” counts as one of the happiest of my life.

    Also note that the root problem can be unaddressable for a ton of other reasons – the necessary job, the relative you have to live with, the life trauma that isn’t going away – sometimes digging up the roots will harm you worse.

    Why calling medications “bandages” or “crutches” is considered an insult is pretty bewildering to me. Bandages and crutches are useful, necessary items. I have friends who wouldn’t be able to walk at all without crutches. Bandages can keep you from bleeding to death, or developing an infection while something heals. I was profoundly depressed for better than a decade. Curing that involved a massive change in my thinking habits, which required a good deal of energy and commitment – which logically enough, I couldn’t summon while profoundly depressed. Going on antidepressents was exactly like having a crutch – one that let me walk the marathon I had to cover instead of crawling it with a broken leg.

  65. Cara
    Cara August 5, 2008 at 1:45 pm |

    Crys T — did I miss something? Who said “yay drugs!!!”?

  66. FashionablyEvil
    FashionablyEvil August 5, 2008 at 1:50 pm |

    Could someone around here to cite some actual sources? I keep hearing over-medicated! over-diagnosed! under-diagnosed! under-treated! without any actual evidence to support these claims.

    I think Amanda’s point is well taken though: that all of the handwringing about people taking drugs distracts us from the real problem, which is how can we ensure that people get the help they need (pharmaceutical or not)?

  67. William
    William August 5, 2008 at 1:52 pm |

    The only people I think need to be on mental medications are people who are an immediate harm to others. Schizophrenics. Various other psychoses. People who are irrevocably nonfunctional, and don’t fit into society because they’re a threat to others.

    Do you know how uncommon it is for schizophrenics or people with psychotic disorders to actually be dangerous? The vast majority of people with those kinds of severe mental disorders aren’t a threat to anyone, its just the bullshit media Law & Order tropes that give you that impression. Sure, maybe it makes you feel better to imagine that an entire class of people needs to be medicated (because, after all, you can define yourself out of that class and give yourself all the justification you need to attack medication without actually upsetting your world view), and it does make for good television, but its still a steaming load of bullshit. Worse, its those kinds of views that lead to the oppression and stigmatization of people with mental illness in our society. Do us all a favor and don’t make broad generalizations about people who aren’t you, especially when you don’t have the knowledge to speak on the subject.

    The fact of the matter is no one should be required to use medications the don’t consent to. Period. Full stop.

    The other side of that is that no one ought to be criticized or shamed for choosing to use medications. Period. Full stop.

    You’ve got serious depression and you don’t like to take meds? Good for you, I’m glad you’ve found a way to deal with your illness and I’m glad it works for you, but don’t imagine for a second that somehow your way is right for anyone other than you, much less better. We’re all different people with different needs, values, and priorities (thats what “individual” means). Leave your narcissism at the door, kay?

    I’ve got serious depression too. For years I dealt with it on my own, going through the dark stretches and just gritting my teeth, living through it. Eventually I decided that it was too much goddamn work and I had better things to spend my energy on so I went on meds. I researched, made informed decisions, read the actual studies, looked at my family history to figure out what the likely biological component of my depression was, and then went to a friendly doctor and told them what to proscribe. My life is better for it, and I’m not really interested in being shamed for that. Yeah, I take bupropion to mitigate my depression. No, it hasn’t changed my personality beyond banishing the asshole who showed up every eighteen or so months and turned my life into a living hell for six. If I had the money I’d take Provigil to reduce my need for sleep, various nootropics to boost my memory, HGH to sculpt my body, amphetamines to sharpen me up during periods in which I need to be unusually productive, and anything else I might find that I believe might improve my life. Thats my choice.

    See, the issue here is choice. You have the right to choose what is best for you without anyone shoving pills down your throat or telling you you’re wrong for taking the path you believe is right, and I have the right to amp up in any way I see fit without anyone telling me I’m wrong. At the end of the day we are the only ones who can choose for ourselves. For you it’s learning to manage your symptoms, for me its better living through chemistry. Raging at others for daring to make a different choice than you just makes it look like maybe you aren’t quite as confident as you’d like us to believe. “The lady doth protest too much” and all that…

  68. NancyP
    NancyP August 5, 2008 at 1:59 pm |

    I agree with the premise of the post – I had a distinct aversion to being on antidepressants long-term, but changed my mind when I had the nth relapse and decided that I would do anything to not feel suicidal, etc again. It probably didn’t help my attitude that the first one I tried (during a long-ago episode) was pre-SSRI and had marked side-effects and only partial efficacy at best. Another episode and I tried the then new Prozac – again, partial efficacy at best. Forward 15 years – a severe episode – I was resistant for about 6 months, since I figured that if you weren’t hospitalized, you didn’t need drugs. I gave in, tried several drugs, and landed on one that within 2 to 3 weeks made a dramatic difference – it was like turning on a light in a dark room. It also helped me adhere better to the non-pharmaceutical aspects of mental health care – exercise, proper diet and sleep patterns, light box. As for taking it long-term – I think there is reasonable evidence to suggest that individuals who don’t take drug for at least a year suffer relapse at a higher rate.

    I suspect that in 10 to 20 years, the treatment of depression may be greatly assisted by genetic tests that would suggest the best drug or other approach to use, but at the moment it is a crap shoot. All studies seem to indicate that a combined talk (cognitive therapy) – lifestyle (exercise, diet, sleep, light box if needed, meditation or prayer if desired) – drug or electrical stimulation approach is best. If you can get a good effect with healthy living, mindfulness, and the tools gained in a short course of cognitive therapy, great! Some poor souls can’t get relief by any means. There is great variability in unipolar depression response to treatments, and what works for one person may not work for another.

    Re: sleeping pills. I don’t think much of them except in very limited use in difficult environments. Shift workers have significant problems. The vast majority of the rest of the insomniac population need to exercise, eat appropriately, avoid caffeine late in the day, stick to some sort of schedule, and make an attempt to deal with stress (do something constructive during the day to lessen the problem; learn to meditate or do mindful prayer; pay attention to a pet cat or dog; or whatever).

  69. Anna
    Anna August 5, 2008 at 2:24 pm |

    Ledasmom, I hear you. I don’t sleep sometimes because my brain weasles are going hell-to-leather (or whatever that phrase is) re: how am I going to pay for my husband’s medications this month?

    I also grind my teeth because I read the internets way too much.

    I do the best I can, but sometimes I take an anti-nausea pill at night because it has sleepy-effects and because we have buckets of them around because of the side effects of all of his meds.

  70. Sarah
    Sarah August 5, 2008 at 2:40 pm |

    I absolutely agree with Tapetum, about medication as a “crutch” in the best possible sense of the word. Until I went on anti-depressants, I didn’t even realize I *was* depressed. My mom basically had to force me into counseling, and my counselor had to coax me into trying medication. I thought constantly talking about death and suicide was normal, I didn’t realize that napping for several hours everyday was unusual, and I had literally *forgotten* what it felt like to feel joy. My counselor asked me what the last time I’d been happy was, and I managed to dredge up a vague memory of a sleepover several years previous. I was too listless to talk to my counselor, too disinterested to do my homework, and I had no reason to fight towards being healthy again because I could not remember a time when I *wasn’t* depressed.

    When I tried the first medication, it brought me up a tiny bit (nowhere near where I should have been) but I was astonished. At one point, I even had a day where I didn’t hate everyone I knew, and where I didn’t hide in the bathroom at school, and where I didn’t fall asleep out of pure boredom and apathy when I got home after school. It was only because of medication that I even realized there *was* an alternative to feeling numb and miserable, and that realization that I *could* be happy and successful was enough to keep me going through years of therapy, medication, and crappy side-effects. (I didn’t have a libido until I was 20, for example. That was weird.)

    Now I’ve been off my medication for a little over a year, no problem. But without that initial boost, I might not even be alive right now to enjoy this-omg-is-that-what-a-libido-is? and what having a good day or even *week* feels like? My leg’s better, but only ’cause I finally stop hiking around on it long enough to get a cast and let it heal. Without medication I’d still be crawling around wondering what hurt so damn much.

  71. Luna
    Luna August 5, 2008 at 3:02 pm |

    I have a kid with ADHD and an anxiety problem. We resisted drugs for her for a long time, trying every other possible solution first. I didn’t want her to have to rely on drugs. It wasn’t so much fear of a disability (I have a disability), because I already knew she had one, it was fear of the side effects.

    Anyway, now that she’s on them, she’s a different kid. Happy, able to have a conversation, able to play games, meet new people, go to school, remember things from day to day. She’s happier and healthier because of two meds: Concerta (delay-release Ritalin) and Prozac. She also takes Melatonin to help her sleep – the Concerta keeps her up.

    I do appreciate how some people are against Big Pharma. They piss me off too. But seeing what a difference this makes in her life, and seeing how she reacts if she forgets her meds (yow. I can tell by 11 AM if she missed her morning med – and don’t give me the placebo shit. Placebo effect wears off eventually. She’s been on these meds for a year now), I have to say I’m glad she’s taking them. I am also glad we tried other things, because some of them helped a little, and continue to help a little. Counselling, diet modification (hell, we figured out she had Celiac Disease because of that!), therapy of different sorts, all helped to a minor extent. But now, she’s “normal”. Not that “normal” is the be all and end all, but it’s made her happy, and what more can any parent want for their kid than happy and healthy?

  72. CBrachyrhynchos
    CBrachyrhynchos August 5, 2008 at 3:17 pm |

    Speaking of libido, I think there is a profound privilege that comes up from time to time that assumes all problems with sex within a relationship can be fixed through politically enlightened conversation and possibly sex toys, and that relationships without frequent mutually orgasmic sex are doomed to failure. It excludes the possibility that some people might have cognitive or medical reasons for not being sexual or orgasmic, but still should have the right to pursue intimate relationships.

  73. puggins
    puggins August 5, 2008 at 3:28 pm |

    I’ve mentioned to friends of mine that I believe medicine is the present generation’s version of “new fangled technology that we don’t wanna need.” Our parents had computers, we have modern medications. I’m betting that my daughter and son won’t think twice about poppin’ a pill or two.

    I have exactly two concerns about medications though, and they’ve been mentioned several times- they don’t all have very good price to performance ratios, and there may be extremely serious side effects that we may not know about. Combine the two and I think that it’s best to avoid medication if your quality and length of life isn’t significantly and obviously improved. Of course, the medications that amandaw is talking about definitely fall into “obviously improved” territory.

  74. sara no h.
    sara no h. August 5, 2008 at 4:55 pm |

    All right, I am full of internet fail. My personal apologies to all those whom I’ve offended. I’d give you the line about not meaning it, but I think we all know that intent isn’t what matters in discussions like these.

    Sitting down and shutting up now.

  75. Lorelei
    Lorelei August 5, 2008 at 4:55 pm |

    WOW THANK YOU BLACK THIRTEEN FOR TELLING ME ALL ABOUT MY LIFE.

    what the hell? i can tell you just fine myself whether meds and talk therapy have done good things for me or not without you speaking for me and everyone else.

    you have got to be purposefully playing dumb, acting like SSRIs are the only antidepressants. what about wellbutrin? that’s not an SSRI. what about tricyclics? what do you have to say about those?

    PROZAC IS NOT THE ONLY ANTIDEPRESSANT FOR FUCK’S SAKE.

    prozac nearly killed my boyfriend. wellbutrin xl, however, works very well for me. i’m not about to throw out all my fucking pills and swear off meds that work for me because of the adverse effects wellbutrin had on my man.

    @@

  76. Tapetum
    Tapetum August 5, 2008 at 5:02 pm |

    sara no h – you are also full of awesome. It’s very hard to get handed your ass and simply apologize and listen. Thank you.

  77. XtinaS
    XtinaS August 5, 2008 at 5:12 pm |

    sara no h:

    Dude, no worries, and I apologise if I came off harshly in my first comment.  Thank you for coming back and apologising.

  78. sticking my foot in it on the internets. « Sara Speaking

    [...] August, 2008 this is what happens when I don’t stop to think before I write. Someone writes a post about medication, I write off some half-assed comment about my rather uneducated and entirely experience-based [...]

  79. scamps
    scamps August 5, 2008 at 5:18 pm |

    I take offence to the assumption that my personality is shot for shit because I’m on meds. I take Zoloft, Invega and kolonopin on a daily basis. While they have improved my state of mind greatly, they have not altered my entire personality. I hold the same beliefs and personality traits that I have held since day one. I am still the same person that I have always been. I do not see suicidal tendencies, irrational fears, noises and sights that aren’t really there and violent outbursts (all in my case) to be “personality traits”. To many, medication is a tool to help control biological issues that get in the way of treatments to control behavioral issues that CAN be treated with cognitive therapy (which I know way more about than I care to, having been on cognitive therapy since the age of two).

    Especially to a certain somebody in the thread, it’s fine to be opiniated about a topic. It’s NOT fine to verbally assault people for making their own life choices. You are merely doing what you accuse the other side of doing.

    Maybe the “Church” of Scientology has an opening.

  80. jessilikewhoa
    jessilikewhoa August 5, 2008 at 5:51 pm |

    y’kno, even with the shitty side effects of the paxil i was on til recently, like drastic weight gain and electric shock like zaps (which arent supposed to happen til you stop the drug, but i guess nobody told my brain) i am so fucking greatful for the changes the paxil made in my life, along with the buspar for anxiety and the ortho-cyclen for pmdd. in fact, the paxil had such an amazing effect that if the wellbutrin im trying now doesnt work, ill go back to it, and be the living definition of fat and happy.

    i tried everything, ive been in and out of talk therapy since i was 7 years old, so for the last 20 years. ive meditated and ive been hypnotized and ive self medicated with copious amounts of marijuana and none of that helped enough to make it so i could leave the house, so going to the gas station to get cigarettes wasnt terrifying, so i could get out of bed and take a fucking shower.

    im still not perfect, but i dont need to be. i just want to be ok.

    oh, and i totally dont have insurance, i researched meds myself, talked to my primary care doctor who thank goddess only charges me $80 dollars for an office visit, and found meds with affordable generics. the target list is a godsend, my buspar is $4 a month, my ortho-cyclen is $9, my paxil was $8 which was great. my wellbutrin is $32 which kinda sucks, but still costs less than my fiances co-pay for his generic allergy meds even with insurance. and if i wanted to go to 2 pharmacies i could pay 20 dollars to walgreens for a years membership in their discount program and get 3 months of my wellbutrin for $13.

    so for people claiming that meds are the bastion of the privileged with insurance, i say “nuh uh!” you just gotta use the google. i will never be insurable, having had 15 kidney surgeries, ptsd, depression, anxiety and pmdd, but ill be damned if thats going to keep me in bed afraid.

  81. Danakitty
    Danakitty August 5, 2008 at 6:06 pm |

    I actually found this topic really relevant. About a week ago, I went to the doctor for some knee pain I’ve been having while sitting down for long periods. He prescribed physical therapy and these pills called diclofenac, which is a supposed pain-killer/anti-inflammatory.

    The first day I took them I had HORRIBLE cramps and other gross bodily function-type stuff, and decided to look up information on the subject. Turns out about 20% of people on the pill have that particularly nasty side effect… not to mention ICE is an anti-inflammatory that would work just as well on my knee. In fact, that’s what my physical therapist used.

    I understand this drug is incredibly helpful to people with chronic pain (like arthritis) but for someone having occasional pain that could go away with ice, I thought the drug was not only unnecessary but more pain (literally) than it was worth.

    And I really wish that more doctors would consider that they are possibly over-prescribing drugs to people who don’t need them. Lots of drugs are helpful (yay Midol!), but many are also unnecessary or could be substituted by natural remedies. Also — I wanted to add that with how expensive health care is, someone who may not have insurance could be hurting their wallets too by taking drugs they don’t need.

  82. scamps
    scamps August 5, 2008 at 6:13 pm |

    Why is it only up to the doctors? If you don’t feel you need a certain medication, you DO have the right to refuse.

  83. Crys T
    Crys T August 5, 2008 at 6:23 pm |

    Cara: “Crys T — did I miss something? Who said “yay drugs!!!”?

    No, I think I’m the one who missed something. For some reason, when I read the post earlier today, that’s what I got out of it. However, after reading your comment I read it again and I’m somehow getting a totally different message from it this time round.

    Can I just use this to apologise and say that I’m feeling very, very stupid just now?

  84. Cara
    Cara August 5, 2008 at 6:24 pm |

    It happens :)

  85. Eva
    Eva August 5, 2008 at 7:30 pm |

    I don’t know, maybe this is one of those situations where people on both sides of the issue feel oppressed, but as someone who’s been told she should be on meds for bipolar disorder, in response to having what I think are very normal and healthy, if intense, emotional reactions to the fact that things in my life since I was a kid have been pretty much equal parts awesome and awful, and as someone who has seen schools attempt to bully and force parents into putting kids on meds, thretening expulsion if they don’t comply, I don’t really see where the stigma is working *against* people on meds. It often seems like most people are on meds, to the point that I call a friend in the immediate aftermath of a legitimate crisis and want to talk, and the minute I get emotional, the person is all, have you thought about antidepressants? Umm, no, I thought I would call a friend and talk about what’s going on in my life and maybe express an emotion about it? What the helll are meds going to do about the fact that my mom’s getting evicted and I can’t stop it and am not in a position to help? Why are people so hell bent on acting like every time I cry or express sadness– in spite of being a person with a mostly functional life, ie, I have a job, I support myself, I get out of bed most days– it is a symptom of clinical depression? My resentment towards meds is that I feel like my natural personality and normal reactions to life are being characterized as pathological, that people I love are being forced into lifelong drug dependencies as young children because some overhwlemed teacher or guidance counselor can’t deal with the root of the problem and doesn’t have the energy to deal with the symptoms, and that as a woman of color I have absolutely no faith in the medical establishment’s interest in my well being. I don’t go around judging people for voluntarily being on meds, but I wish people would stop judging me for liking who I am. There’s certainly some grey area between who “needs” meds and who is being overmedicated– obviously some people are nonfuncitonal without them. But at what point is pain normal? It’s not clear cut even with physical pain– it’s often a cue that something serious is wrong, and a painkiller is only going to delay treating the real cause, allowing it to do more damage in the meantime. Is insisting that a kid with an abusive mother who leaves him locked in the apartment for days at a time because she’s too cheap to pay for babysitting, an absentee father who occasionally pops into his life and promises to fight for custody, then vanishes again , and an extended family who tells him he’s stupid and ugly because he’s so dark skinned go on ritalin or get expelled from high school doing him any good? He’s not chemically unable to pay attention in class, he’s not paying attention because he has other stuff to deal with, and no one is interested in helping him– they just want him to be able to sit down and shut up during the schoolday. Is a guidance counselor insisting a girl who has three crying breakdowns in school during a year when her mother is in and out of the hospital, twice near death, and she’s, as a teenager, testifying against both an abusive ex boyfriend who’s been arrested for an act of violence, and the adult family member who she’s recently come forward and told the family was mosleting her go on medication a solution? If she weren’t breaking down in tears after all that, she’d be a sociopath. I don’t care who wants meds on their own, I just wish the pharmaceutical companies would stay the hell out of doctors offices and schools and workplaces and stop forcing their meds on people exibiting normal human behavior, and writing off the root social causes.

  86. William
    William August 5, 2008 at 7:52 pm |

    Amandaw re: Black Thirteen-

    I’m hoping this hits the moderation cue, if it does feel free to hold it back as it really isn’t contributing directly to the discussion you’re trying to foster here.

    I understand your reasoning for holding back their post, and I’m pretty sure I can guess what they were saying and why you thought it was harmful or counterproductive. Obviously, you’re the one with mod powers so its unequivocally your right to decide how far is too far and how you foster safe space. I’d just like to ask you to reconsider letting their post through, even if it is ugly.

    In these kinds of conversations a lot of prejudice and implicit attitudes tend to pop up, things that a lot of people tend to accept without thinking about them. Those kinds of attitudes only change if they are challenged publicly. Black Thirteen’s mind might not be changed, but I’m sure there are plenty of people who read the comments here but who aren’t posting (or aren’t vocalizing the same feelings) who will be lead to think about those kinds of beliefs. I know its painful, and I know its ugly, and I know its incredibly enraging, but the best way to challenge ignorance and hate directed at the mentally ill is to drag it out into the light and show it for the bullshit it is.

    I’ve got an MA in clinical psych and I’m working on a PsyD. My current placement is with a chronic mentally ill population, many of whom have psychotic symptoms. I know the hate and fear that is directed at these people because of their mental illness, and I feel that it needs to be challenged directly for these people to find any measure of acceptance within the community. People like Black Thirteen are why the mentally ill are stigmatized, their willful ignorance, arrogance, and narcissism are largely to blame for the terrible scape goating that the mentally ill have suffered under for the bulk of human history.

    Even if you don’t want this thread to become the battleground (which is completely understandable) I think it might be valuable to open a thread up on the subject at some point. I always like handing bigots a mic because if you give them enough time and make it an open forum they always end up looking like the ignorant, hateful little creatures they are.

  87. William
    William August 5, 2008 at 8:14 pm |

    Amandaw: and thats totally OK. Its your space and you’re the one who gets to decide what the rules ought to be. I totally get not wanting every single space to become a battle ground, and I understand the need for safe spaces. Just my (admittedly idiosyncratic) two cents.

  88. Lauren O
    Lauren O August 5, 2008 at 8:34 pm |

    Jessilikewhoa – oh my goodness, yes, the birth control and the PMDD thing. I started taking it just as a contraceptive, but all of a sudden, the intense PMS (possibly PMDD) disappeared. The week before my period used to consist of me canceling my day’s activities to stay home and cry in bed, alternately yelling at and begging for emotional comfort from my loved ones. Of course, nothing they could say would comfort me, because I felt like I was in an inescapable bottomless black pit, and even if they were saying the most positive and true things in the world, I could not bring myself to believe them (which is why comments like Eva’s about calling a friend and expressing an emotion do me no good). The ortho tricyclen alleviated that period-related depression, and the Zoloft alleviated the rest of the general depression.

    I still tend to cry more often right before my period, and I still have some glum days, and I still get sad when sad things happen. I’m just not an automaton with my switch always turned to “miserable” now. Thanks, medicines!

  89. shah8
    shah8 August 5, 2008 at 8:47 pm |

    Bartender, a request?

    I’ve actually been learning things from your posts and the commenting has been stellar, really, all told.

    So, anyways, I have had a thought and comment 91 reminded me of it. It’s a meta question about insurance…

    I think the concept of insurance, who has it, and who doesn’t, drives the narrative discourse in the public about how they feel about drugs. For example, RU486′s contribution to the public awareness had quite a bit to do with government insurance providing it. The homeless who are psychotic because they have no insurance or care drives the image of mental health through calvinist lenses such that mental health is derived from class, and anyone who looks normal otherwise is being a lazy and not so tough person.

    What is also important is that the cost of drugs are much easier to shift to other parties than other therapies as part of an insurance regime, especially one that is not paid by direct health outcomes. There are two consequences…One, if people aren’t paying for the full costs of a medication, then “How effective is it for the cost?” narratives are diminished. The other is that drugs will always have a bigger mindshare than any other therapies, especially since only a smaller group of people with better insurance and easier access to knowlegable doctors will have access to the full pallette of therapies available. One, somewhat tertiary aspect of the second consequence is that fewer people have a chance to try out different therapies and fine tune things. Hence the disbeliefs in the benefits of therapy (z).

    So as a result of all this, I think we tend to talk about different issues…personal, social, mental health policy through the lense of drugs first and formost, and that tends to confuse everyone about what the actual issues are…even if the actual issue is drugs as well. Think people looking at frames, and mistaking it for the object inside a *different* frame.

  90. NancyP
    NancyP August 5, 2008 at 9:17 pm |

    The main reasons that I see for being cautious about medication are 1. interaction with other required medications 2. possible side-effects 3. cost. I am all for avoiding drugs if another strategy works for that person. But I am pragmatic – if you need a drug, use it! The personality change issue is likely to not be an issue for the unipolar depressed – it’s a relief not to be depressed – but some bipolar patients really miss the less intense parts of the manic phase. Most people are concerned about relationship effects of sexual side effects.

  91. romham
    romham August 5, 2008 at 9:26 pm |

    if i dont take certain pain meds, i dont walk. its pretty basic. yes, i have a huge problem with the pharmaceutical industry, and yes i know that when this fucked up western civilization finally crumbles(yay!) im gonna have to figure something else out (which might involve getting out of this whole racket because i cant handle the physical pain any more, or may involve opportunities to find alternatives, who knows?), but until then, im gonna keep taking this stuff, keep myself as mobile as possible, keep doing the shit i love, keep fighting, loving, sharing, learning. if it takes a fricken pill to do that, so be it. someone else can make whatever decision they need to to be ok. i just want to be able to do that in peace, without being told im either being duped or propping up bigpharma. whatever happened to “our bodies ourselves”?

  92. jessilikewhoa
    jessilikewhoa August 5, 2008 at 9:29 pm |

    well, im not amada, but i am comment 91, so ill pipe up uninvited. i think youre dead on about access issues. i have an amazing therapist who actually discounts the cost for my sessions to about half of her normal rate becos i dont have much money and my mother is retired and on a fixed income so she cant afford much either. however, the last session i had with my therapist was in the fall, becos i cant even afford the discounted price, at least not often enough to attend on a regular basis, and while certainly a single session can help in a crisis time, going once every few months isnt really contributing to my long term healing.

    meanwhile i can afford my monthly meds. but im not sure someone who lived in the middle of nowhere could afford the same regiment of drugs im on, as the drugs are only affordable for me becos of retailer discount programs. if theres only 1 pharmacy in a reasonable distance to travel for medicine, and that pharmacy isnt part of a large corporation that can afford to do these discount programs, youre probably S.O.L.

    sorry if i typoed or didnt make sense, the paxil withdrawal means im having constant zaps, trouble focusing, and some pretty nasty headaches. repeating my statement from before tho, i dont at all regret my paxil experience becos it helped me start to live again.

  93. NancyP
    NancyP August 5, 2008 at 9:35 pm |

    BlackThirteen said in response to this:
    …if depression (or whichever medical condition) is a personal failing rather than a legitimate medical condition, then they don’t have to worry about it happening to them.

    “Well, it happens to me, and I still consider it a personal failing.”

    To consider depression to be a personal failing is a very common EFFECT of being depressed. One becomes moralistic about depression and beats oneself over the head for being “weak”, “selfish”, “making too much of it”, etc. I have done this during depression, and it is completely counterproductive. Much better to muddle through the best that you can at the time, and work on finding better strategies (non-drug and drug), than to spend time blaming oneself. Depression just IS. Depression is not a punishment for any and all sins. Guilt and depression get conflated by the depressed sufferer, but they aren’t the same thing.

    FWIW, I regard having been depressed (and recovered) as a useful asset. I think it has made me more compassionate than I might otherwise have been.

  94. William
    William August 5, 2008 at 9:52 pm |

    So as a result of all this, I think we tend to talk about different issues…personal, social, mental health policy through the lense of drugs first and formost, and that tends to confuse everyone about what the actual issues are…even if the actual issue is drugs as well.

    Thats certainly true, but I think thats just a symptom of the overall medicalization of mental health. We like to think about mental health like it’s an extension of physical health. If you have an infection you take antibiotics, so it would stand to reason that if you have depression you’d take antidepressants. I don’t think its a coincidence that a lot of insurance companies only cover physical or occupational therapy marginally better than they cover psychotherapy. We think about health as a matter of quick fixes, you take a pill or have a surgery. Treatments that take a longer time (and especially treatments which require the active participation of the patient) are less valued because they don’t fit the ideas we have about what causes healing.

  95. William
    William August 5, 2008 at 10:02 pm |

    . Why the fuck are these things shoved off to the side like they aren’t a part of our overall health? Why is it so hard to get decent care on these issues?

    Because mental health makes us uncomfortable. To admit that therapy is useful and valuable is to admit that human beings are more complicated than we like to believe. It is to admit that one might have their own problems, that the “healthy” people might not be as healthy as they think, that all those times they’ve done things they can’t explain or hurt for no reason might mean theres something wrong with them. Providing decent therapy means opening yourself up to the idea that we aren’t as objective as we tell ourselves we are and that there is an entire area of our environment that we not only aren’t in control of but are only dimly aware of.

  96. Tomis
    Tomis August 5, 2008 at 10:29 pm |

    I think that a lot of psychiatric survivors etc. would find all this rather surprising. Traditionally, the concerns surrounding drugs and disabled people have been directed towards the opposite problem: the massive scale on which powerful and dangerous antipsychotics have been administered–often coercively–to the most vulnerable people, and the willingness of doctors, families and society in general to accept this in the pursuit of more easily managed and normal-looking individuals.

    Nor has this issue been left behind in some grim 1980s institution. The newer neuroleptics are a staple of care homes, and are currently being prescribed to ever younger children on dubious scientific and ethical grounds, often for utterly frivolous reasons. I agree that there are huge problems with attitudes towards medication and the blurry lines between illness and disability, but it does seem slightly remiss to write about this without mentioning the terrible treatment of children and old, ill, and disabled people who are not in the position to make, let alone defend, informed choices in the first place.

  97. Eva
    Eva August 5, 2008 at 11:32 pm |

    Lauren,

    To be clear, I didn’t intend my comment to mean that all anybody ever needs is to talk it out. I was just expressing that that’s often all I need, because my depression tends to be triggered by specific incidents, and even when it isn’t, all I usually need to feel OK is to be heard and know someone cares and understands what I’m going through. I wouldn’t begin to tell you what you need, or judge you for doing what works best. I just resent being told, when I’m reaching out to someone in a crisis, that I should look into drugs, as if by crying at a close friend during a crisis I’m somehow behaving unnatrually or putting some terrible inappropriate burden on them. That is why I resent the drug companies– they’ve stigmatized emotion and made it seem irresponsible and inconvenient to break down every once in a while.

  98. Cola Johnson
    Cola Johnson August 6, 2008 at 2:54 am |

    While I hardly consider myself one to judge others for their personal medical choices (or, you know, needs) I am in the class of Americans terrified of admitting that I need medication. However, I personally don’t think I’m afraid of disability, so much. I’ve had an easy enough time admitting to my disorder.

    Somehow, though, I’ve learned throughout my life that medicating my (personal) problems fails to solve them. Although I taught myself to swallow pills as a little kid by swallowing my Flintstone’s Chewables, I still grew up thinking that even Ibuprofen was to be avoided.

    I think that I largely came to this conclusion because I was worried about overuse of medication, and over prescription. I was one of those “problem kids” that my teachers preferred to see medicated when, according to the opinion of outside professionals, I was perfectly normal. I was just bullied at school, and had no friends, and read a lot, and drew. My mom refused to put me on ritalin. I can’t say if that was the best choice. I think it probably was for me. I guess that’s the point, isn’t it?

  99. Lauren O
    Lauren O August 6, 2008 at 3:16 am |

    Eva, I see where you’re coming from. Maybe the corollary to privileged people looking down on people on depression meds as lazy or flawed is privileged people who don’t want to have to deal with the completely valid emotions of others and therefore recommend pills.

  100. William
    William August 6, 2008 at 11:44 am |

    I think that a lot of psychiatric survivors etc. would find all this rather surprising. Traditionally, the concerns surrounding drugs and disabled people have been directed towards the opposite problem: the massive scale on which powerful and dangerous antipsychotics have been administered–often coercively–to the most vulnerable people,

    Actually, I think the misuse and the coercive use of drugs is exactly why people have this “you shouldn’t take X” mentality. Doctors have in the past so abused their authority that a lot of people who have seen the ugly side of psych medications simply decide that medication is just a means of coercion, something to ensure compliance and batter down their personality until it is more manageable. It actually becomes something of a double bind. As a kid I was diagnosed with ADHD and later child bipolar (at 7, now theres a talented clinician) and given powerful drugs that caused a lot of problems for me. As I hit my early teens I was diagnosed with depression and was again faced with a bad proscription because of a sloppy doctor. My response was to just say fuck it, I don’t want therapy, I don’t want meds, I just want to be left alone. The problem was that I really was depressed. Now, a little over a decade later, I wish I’d been able to take advantage of therapy when I could afford it and I am taking meds, but it was a really hard decision.

    The end result of doctors being lazy/incompetent/sloppy is that patients with real needs begin to see medicine not as something that can help them but as something that will control them so that others aren’t as disturbed by their problems. That means patients end up having to struggle with their symptoms, suffer through them, and stumble without relief because bad doctors have forced them into a place where they simply don’t trust the treatments that could help them.

    I agree that there are huge problems with attitudes towards medication and the blurry lines between illness and disability, but it does seem slightly remiss to write about this without mentioning the terrible treatment of children and old, ill, and disabled people who are not in the position to make, let alone defend, informed choices in the first place.

    Hold on a second, do you see what you just did there? I know I did. Think for a second about what you’re saying. On the one hand you’re saying “vulnerable patients are routinely medicated in order to make them more compliant because they do not have the power to say no” on the other hand you’re saying “we need to think about how WE can help THEM because THEY are unable to make informed choices.” Lemme be the first to step in and say, while I know you’re coming in with the best of intentions, you’re trading one form of paternalistic control for another.

    The old, the ill, the young, and the disabled are only rarely unable to make informed decisions about their care. We imagine they are because of their status, but thats more for our comfort than for theirs. There are plenty of schizophrenics in this country who hate the side effects of their antipsychotics but are forced to take them because choosing not to take them means they are no longer considered compitent to make their own decisions. If someone has the ability to signal consent/refusal, whether that means saying “no” or turning their head to avoid medication, then they’re able to make an informed decision. Once you start substituting your preferences and desires for theirs, even if you think its for their own good, you’re doing the same the as the ward nurse who gives the loud/difficult patient a little something to calm them down.

    What Amandaw was talking about, and what most of the people in this thread have been talking about, is the right to choose your own course of care. This discussion has focused on choosing to opt into treatments rather than to opt out, but plenty of people have brought up both sides of the choice. No one here is saying that drugs are the only way, all anyone has said so far is that patients ought to be free to make their own decisions without anyone else sticking their noses in.

  101. Panopticon
    Panopticon August 6, 2008 at 12:55 pm |

    Actually, I think the misuse and the coercive use of drugs is exactly why people have this “you shouldn’t take X” mentality. Doctors have in the past so abused their authority that a lot of people who have seen the ugly side of psych medications simply decide that medication is just a means of coercion, something to ensure compliance and batter down their personality until it is more manageable. It actually becomes something of a double bind.

    I think what also feeds the mistrust of mental healthcare providers and psychiatric drugs is that a lot of people can’t get treatment when they need it. I don’t know what other people experience, but I have had times when I’ve desperately needed mental health care, and have found that there is no way to get immediate, or even timely care short of hospitalization. I’ve been lucky enough to avoid hospitalization so far, but I’ve known people who have been hospitalized, and most of them probably wouldn’t have needed it had they been able to get the treatment they needed in the first place.

    I guess it’s hard to trust a healthcare system when you have to get locked up in order to get treated.

  102. Tomis
    Tomis August 6, 2008 at 6:25 pm |

    William, I’m afraid you seem to have read a lot of stuff into things I did not even come close to saying. My comment was intentionally limited to specific kinds of people and specific classes of drugs, essentially:

    1.Lots of disabled people have been dreadfully abused by the irresponsible use of antipsychotic medication.
    2.When you start making generalizations about society/medicine/disability, it is inappropriate to do so in ways which exclude these people once again.

    That was it: nothing more; nothing less. Individual and general attitudes towards a range of conditions and treatments have been more than well covered throughout the rest of the thread.

    On the one hand you’re saying “vulnerable patients are routinely medicated in order to make them more compliant because they do not have the power to say no”

    Yeah…

    on the other hand you’re saying “we need to think about how WE can help THEM because THEY are unable to make informed choices.”

    Umm… no. I’m not quite sure how you managed to arrive at this from the word “mentioning”. If you are really going to accuse someone of advocating “paternalistic control” by putting invented quotations into their mouth, I’d recommend reading the original more closely; this kind of carelessness borders on insulting. For a clue towards my personal opinions in this area, see the reference to the Psychiatric Survivors’ Movement on the very first line.

    amandaw, sure—and thanks for acknowledging this point.

  103. William
    William August 6, 2008 at 7:11 pm |

    Tomis: Sorry, the issue of consent and individual sovereignty in medical contexts is a touchy subject for me. You mentioned people who were unable to make or defend an informed decision, thats what I was responding to. I’m not really sure who you’re talking about, as I can’t really think of too many people who are incapable of making an informed choice. Sure, there are plenty of people who aren’t allowed to make a choice, plenty of people who make a choice and are ignored, but not a whole lot of people who are unable to make a choice. Thats what I was reading as paternalistic, the idea that some people are unable to make their own choices and need to be protected/defended/controlled for their own good.

    If I misunderstood your intent, I apologize.

  104. Tomis
    Tomis August 6, 2008 at 8:24 pm |

    Sure, there are plenty of people who aren’t allowed to make a choice, plenty of people who make a choice and are ignored, but not a whole lot of people who are unable to make a choice.

    I fully agree, which is why I originally wrote “not in a position to…”, rather than ‘unable’ or ‘incapable’.

    If I misunderstood your intent, I apologize.

    It’s fine–no harm done :)

  105. KT
    KT August 7, 2008 at 2:28 am |

    Okay, I haven’t read most of the comments so I may be beating a dead horse/off topic here, and if I am I apologize, but I blew a gasket over the comment about psych meds changing personality. I’ve dealt with pretty severe, debilitating depression for the past 7 of my 24 years, and low grade depression since I was a preteen. You bet my personality is fucking different on my meds, now that I’ve found a couple that work. But it’s not the MEDS that change my personality, its the depression. It’s hard to be yourself when you can’t get out of bed/brush your teeth/shower/answer the phone/do anything other than curl up under the covers & stare at the ceiling and shake with nameless fear and agitation. I find it insulting that anyone would even imply that the person I was in that state was anything other than the result of the toll an intense illness (yup, a real freaking illness) took on my entire being. I’m sure people thought my personality changed when I finally found drugs that worked, because they only knew me as I was when dealing with or covering up the depression. Still, it’s infuriating to me that anyone would think the drugs made me someone I’m not. If someone is in agonizing pain for years and the pain remits because you invented a fantastic new anesthetic, the person would act differently–you wouldn’t say the drug gave the person a new personality, but rather that the drug removed the pain that was a barrier to the person’s true self. Psych stuff isn’t any freaking different. (Conceptually, I’m not saying that mental/physical pain are the exact same thing.)

    The whole drugs-as-an-easy-way-out trope pisses me off too. Finding meds that worked was no small task–if this was the easy way out, I can’t imagine the hard way. There’s nothing easy about going through the wringer of praying the new drug will make me feel one iota better, titrating up, dealing with side effects, realizing the new drug is a failure, weaning off, going through more side effects and finding the will to do it again 15+ times over the course of 3 years, and I know plenty of people never get lucky enough to have a psychiatrist that persistent or find a drug that actually works.

    (Though I will say, even with my in-defense-of-psych-meds rant, that the best thing for my depression has been dealing with some awful shit in regular ol’ talk therapy. Unfortunately, I was completely incapable of engaging in any sort of useful therapy until I was medicated enough to get out of bed and stop obsessing about death.)

  106. Sarah
    Sarah August 7, 2008 at 2:43 pm |

    “The old, the ill, the young, and the disabled are only rarely unable to make informed decisions about their care. We imagine they are because of their status, but thats more for our comfort than for theirs.”

    I agree with the objection to “paternalistic control” on principle, but I’m not sure how much this applies to some forms/degrees of mental illness. For me, a certain amount of outside influence was exerted against my preferences, and it was very beneficial.

    (I am *only* going to point out my own experience here, and I am *not* trying to universalize it, ’cause that could go horribly wrong in about a nanosecond. This is just one example of how maybe not everyone is %100 fit *all the time* to decide their own welfare.)

    When I was a kid, I descended into depression very gradually over a period of years. By the time I was a teenager, I was full-on clinically depressed but couldn’t tell because it felt normal to me. When my mom told me that there was something wrong, I got angry and didn’t believe her, and could not remember a time when I felt different.

    My parents pressured me to go to therapy, which I did very reluctantly. We were advised to try an antidepressant, but I thought it would change my personality or make me artificially happy in a terrible rotten tragic world that wasn’t worth living in. :p I thought that *not* being miserable would be, like, a betrayal of all the people who suffered and died every day. Long story short, I refused to try anything.

    My parents kept sending me to different therapists to try and find one that could convince me that I was depressed, and constantly gently pressured me into trying medication. Eventually I *did* try an antidepressant, and it made me a teeny bit better. After improving my condition slightly, I was able to realize that no, my personality hadn’t changed, and no, there was no reason for me to punish myself emotionally for the state of the world, and yes, feeling good was *okay*. I agreed (after the fact) that going on anti-depressants was *exactly* what I’d needed, and from then on I was given full control of what I tried, how long, what my goals were, etc.

    To summarize: I was not initially fully fit to make informed decisions about my own health, but with a little bit a treatment I *was* fit to make informed decisions, and then I did. (Obviously, applying this to everyone requires a perfect world with truly benevolent parents. This would be a somewhat less practical if done by an *institution*…)

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  108. William
    William August 7, 2008 at 7:03 pm |

    I was not initially fully fit to make informed decisions about my own health, but with a little bit a treatment I *was* fit to make informed decisions, and then I did. (Obviously, applying this to everyone requires a perfect world with truly benevolent parents. This would be a somewhat less practical if done by an *institution*…)

    I totally get what you’re saying, and I’m glad things worked out for you. I think the way things worked for you are a great model of how people who care about someone who is ill should behave. No one threw you into an institution, shoved drugs down your throat, or otherwise negated your ability to make decisions. You were resistant, and others pressured you, but at the end of the day you went to the therapists your parents dragged you to. You chose to take an antidepressant. You might not have liked it, you might have resented the pressure, but at the bottom you still retained your agency.

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  110. Meg Thornton
    Meg Thornton August 9, 2008 at 1:03 pm |

    [Overall context note: Australian, living in Australia, not dealing with the US health system.]

    Lauren O @30 said:

    I find the attitude that “society went on for multiple millenia without these pills, and did pretty much alright” rather problematic.

    Ditto. Mental health medications in particular are the ones which a lot of people appear to regard as “unnecessary”. I’m something of a part-time history geek. I can sum up the attitude to mental health throughout those multiple milennia without pills quite easily: mentally ill people weren’t considered part of society. Instead, they were segregated away from the society they were born into – they were mad, after all. If you were lucky enough to be born into a wealthy family, you might be locked up in a private wing of the house, with just a few attendants to look after you. If you were middle class, it was off to the asylum with you, and nobody spoke of you ever again. If you were poor, it was Bedlam, or the poorhouse, or begging on the streets. If you were really lucky, you could turn your insanity into working in a freak show as some kind of prophet or seer.

    Oh, and that doesn’t take into account the ones who were ostensibly part of society, but self-medicated with alcohol, sex, opiates, food, or anything else they could get hold of in order to keep their personal demons down.

    Thanks, but no thanks.

    “The only people I think need to be on mental medications are people who are an immediate harm to others. Schizophrenics. Various other psychoses. People who are irrevocably nonfunctional, and don’t fit into society because they’re a threat to others.” — Black Thirteen, comment #35

    That’s a lovely view. There’s only one smallish problem with it: it doesn’t take into account the following factors –

    * Some of the most destructive psychological dysfunctions are personality disorders, such as narcissism, antisocial personality disorder etc, which are not (so far as I’m aware) presently able to be treated, either by medication or by any form of behavioural therapy, alternative medicine, or surgery.
    * Your definition of “harm to others” could do with a certain amount of refining. For example, I grew up with two depressed parents, and wound up with depression myself. I spent a lot of my young life being very angry with both of my parents for not being there for me emotionally, and it wasn’t until I got treatment for my own depression that I was able to forgive them for it. (For my own part, I’m taking the Larkin solution to the problem[1].) Were they causing me harm? Well, it depends how you define “harm” – physically I was fine, but emotionally and psychologically I was damaged.
    * You also need to define “irrevocably nonfunctional”. Does this mean “unable to beg in the streets”? “Unable to break into houses and steal?” A lot of homeless people are mentally ill. So are a lot of drug addicts. There are a lot of people who are unable to function in society, but who are also not a physical threat to others.

    Your overall picture of mental illness appears to be positively mediaeval. I’m surprised you’re not recommending exorcism as an option for the psychotics, just to make sure the demons are gone.

    Oh, and just for the record: in the grip of my worst depressive spasms, I would hit myself over the head, cut myself, and attempt to dislocate my fingers and toes. I would scream, yell, cry hysterically, and spend at least three days afterwards completely and thoroughly mentally and emotionally numb, cleaning up the debris. I stressed out my partner, and I probably caused him a lot of hurt emotionally. But I don’t recall ever hurting anyone else physically.

    [PS: for anyone who wants a good way of explaining just how damn annoying the whole "cheer up" thing is for someone who's depressed, my analogy of choice is that it's the equivalent of saying "breathe water" to someone who's drowning. Yes, that *will* solve the problem. Good thinking, Poindexter. Now how the blip do I *do* it?]

    [1] “… get out early while you can, and don’t have any kids yourself.” (Philip Larkin, “This Be the Verse”)

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