Friday, April 18, 2014

Happy Pills: Overmedicated or Overly Cynical?

Prozac people.

I thought I knew about them.  They were the timid folks who wanted to live in a chemical haze to insulate themselves from anxiety and pressure.  Either that, or they were so crazy that if they didn't take their medication, they'd have to be fitted for a straitjacket.

When my Greenwich Village psychotherapist, and then my Upper West Side psychologist, both told me I needed to go on Prozac, I resisted.  The stigma of having to take a happy pill seemed almost as unbearable to me as the mental darkness that was cascading over me like unending buckets of black paint.  But my therapist - at the time, the only practicing evangelical mental health professional on the entire island of Manhattan - had already told me that if I didn't agree to be medicated, her further work with me as her patient would be pretty futile.  She'd notify my parents that she was absolving herself of any liability for my safety.  I'd been on a suicide watch, but while I didn't take that very seriously, how was she to know that I didn't?  Or wouldn't?
So I jumped on the happy pill bandwagon, and I've been there ever since.  I wasn't on Prozac for very long, however, before my doctors found some better medications to which I've responded more successfully.  A couple of people have asked me what I'm currently taking, and for privacy reasons, I'm won't provide that information on the Internet.  But I'll allow that I'm on a fairly high dosage, partly because I'm overweight.

And yes, I'm overweight partly because antidepressants usually prevent people from losing weight.  I stay on them, however, because I'm living proof - literally - that they can work.

Nevertheless, when critics of antidepressants respond to testimonies like mine, I can't disagree with at least part of their argument.

The pervasiveness of clinical depression in our society has indeed become a cause for legitimate concern, and not just for people who question whether medically-related depression really exists.  Just today, a remarkably candid article came out in the New York Times by Dr. Doris Iarovicia, a Duke University psychiatrist who's troubled by the fact that nearly a quarter of all incoming college students are taking prescription antidepressants.  And she believes many of these young people are being overmedicated.

To their own detriment, and to our society's.

Should all these people being diagnosed with clinical depression really be getting that diagnosis, or are doctors and therapists creating a huge market for their services to justify their own professional existence?  Has our health insurance industry, as Dr. Iarovicia suggests, inadvertently created an artificial dependency on antidepressants because pharmaceuticals are cheaper to insure than psychotherapist visits?  Are we all simply being enablers, allowing validation for somebody else's weaknesses because of our own weaknesses?  Are we more eager to hand-hold, instead of butt-kick?  Or has our society become so complex and complicated that some of us have discovered the limits of our endurance, tenacity, and persistence, and are unprepared to cope with not being able to compete with people boasting a greater tolerance for problems?

Personally, I believe that a little bit of all of that is at play in this discussion.  However, I also suspect that all of the man-made chemicals we've been pumping into our environment over the past century or so have had a negative impact on our physical and mental health.  I also suspect that as North Americans have become so sophisticated, and the nuclear family has fragmented so much through divorce, cross-country relocations, and our unique opportunities for social mobility, that the community structures God designed to help people cope with stressors have disintegrated.  Social scientists have already tried to prove as much, on both counts of ecology and community, but their results have never met with much approval from skeptics - most of whom are conservative, and consider themselves religious.

The very people who say they believe in a Deity they can't see or measure.


Meanwhile, the physical sciences have yet to prove that clinical depression is as real as broken arms are.  And if they ever do, it will be after overcoming a big credibility gap that exists between what patients should be able to handle, what they actually can handle, and the reasons why they can't.  After all, some people really are just wimps.  Some people really are simply lazy.  Some people truly believe they're entitled to a fun-filled, stress-free existence.  Some people live in denial regarding the fact that nobody can "have it all."  Some people are enablers.  Some of us need to make ourselves feel and look better by helping people we perceive as being more helpless than we are.  Yes!  I'm sure all of this is part of North America's depression saga.  But how does it get measured and quantified?

Hey, I'm a cynic, and I was a big cynic about antidepressants.  It took my going on them myself for me to begrudgingly admit that they can actually work.  However, if personal experience is going to be the only way to justify the efficacy of antidepressants, then people who don't need them will likely never understand why other people may.

Instead, it's much easier to deride North America's recent, widespread, and indelible embrace of mental health advocacy as so much humanistic pablum.  Too much coddling, and not enough personal responsibility.  Too much faith in feelings, instead of faith in God.  Just another way for pharmacy companies to make money.  All this medicine to treat something invisible!  Aren't we creating a society full of people who simply don't want to face reality?  Life can be hard, sad, painful, confusing, and unfair.  So what?  Buck up, force a smile on your face, and carpe diem!  That's the rest of us have to do sometimes.

So:  we have all of this doubt and ambiguity.  And the best way to respond to this doubt and ambiguity is flatly assume that clinical depression isn't real?  Or, if it is, that it's inherently a sin issue?

Now who's being unrealistic?

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