"That's the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it's impossible to ever see the end. The fog is like a cage without a key."
---------------Elizabeth Wurtzel (from her book Prozac Nation)
I recently posted about depression and medication. I currently work as a psychiatric social worker in a inpatient hospital/therapeutic treatment facility. Day after day I work with amazing individuals with mental illlnesses. Day after day I attempt to put myself in their shoes. Day after day they humble me. They are my teachers and they have no idea.
Winston Churchill called it the black dog. The term was made famous by Britain's World War II leader Sir Winston Churchill as he referred to his own depression.
President Abraham Lincoln suffered from it so badly that he said "I am now the most miserable man living."
I often wonder why depression has no bias. When depression aims it does not miss. It hits the brilliant and the lame.
"There is a classic moment in The Sun Also Rises when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, 'Gradually and then suddenly.' When someone asks how I lost my mind, that is all I can say too."
----------Elizabeth Wurtzel (from her book Prozac Nation)
Depression is widespread in this country. What is the fix? Well, hopefully anyone who enters a psychologist, psychiatrist or clinical social worker's office will do so with the idea of therapy in mind before the notion of medication truly enters their head. While some individuals may be suffering so intensely that they desire medication right away, I most often prefer medication to be a last resort. If one can reap the benefits of therapy without medication I say bravo.
This is not to say that I am against the use of anti-depressants. This is only to say that I often feel that some doctors prescribe medication with little hesitation.
I have seen the positive affects of medication. While there is no such thing as a happy pill, sometimes when a person begins taking medication the result is like day and night.
Let me again emphasize that there is no quick fix and "happy pills" do not exist. Even when medication assists a person so that they are not feeling as dreadful, the medication has only helped a person to an extent. It has given them enough energy (and by energy I do not mean pep) or rather capability to function on a higher level than they were before. Perhaps now the individual is able to get out of bed without physical and emotional pain. Perhaps the individual can actually laugh at a joke or find themselves less irritated by the smallest things. But most of all medication may assist the person so that they can truly examine their problems. Medication is not an end but a new beginning.
That being said...why is it that there are still so many who take medication but get nothing from it? A recent article in Science Daily, states that according to the Northwestern University Feinburg School of Medicine the symptoms of depression are often oversimplified and some anti-depressants aim at the wrong target.
Eva Redei, a David Lawrence Stein Professor of Psychiatry at Northwestern's Feinberg School, found evidence that squashes the long held belief that stress is a major cause of depression. Her research reveals that there is almost no overlap between stress-related genes and depression-related genes.
"This is a huge study and statistically powerful," Redei said. "This research opens up new routes to develop new antidepressants that may be more effective. There hasn't been an antidepressant based on a novel concept in 20 years."
Redei states that anti-depressants treat stress, not depression. She says another reason anti-depressants are often ineffective is that they aim to boost neurotransmitters based on the popular molecular explanation of depression, which is that it's the result of decreased levels of the neurotransmitters serotonin, norepinephrine and dopamine.
"The medications have been focusing on the effect, not the cause," she said. "That's why it takes so long for them to work and why they aren't effective for so many people."So, now what? Redei doesn't tell us. I can only hope that if her theories continue to prove correct that positive changes will be made.
So, what about those who do benefit from medications?
There are a lot of opinions about medications and I'd say the most advertised opinion in recent years was that of actor Tom Cruise.
Matt Lauer interviews Tom Cruise on the topic of psychiatry and anti-depressants
I will agree with Tom that there are abuses and there are some doctors who are too quick to prescribe meds. And to be honest there have been moments when I have asked myself why it is that there are sooooooooo many people who experience depression and why it is that anti-depressents make up such a marketable industry.
"Sometimes it feels like we're all living in a Prozac nation. The United States of Depression. "
----------Elizabeth Wurtzel (from her book Prozac Nation)
However, I understand that depression is much different from situational gloom, hormonal blues, or teenage angst (none of which I take lightly or trivialize). Depression is a state where one cannot function. Small issues become big obstacles to overcome. A worry turns into full blown anxiety, irritation turns into anger, and uneasiness turns into unbelievable sadness. And then a person is expected to handle a daily routine. How is this possible?
That's the one thing I want to make clear about depression: It's got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is in an altogether different zone because it involved a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature's part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.
---------Elizabeth Wurtzel (from her book Prozac Nation)
I can't speak for everyone but I hardly think that there are many who enjoy having to take medication for any reason. Who wants to pay to take medication and to have to continually see a doctor? Who actually wants to be sick? And who wants to have to deal with the acceptance or lack there of, of their own illness and the fact that medication may be necessary?
"Homesickness is just a state of mind for me. I'm always missing someone or someplace or something, I'm always trying to get back to some imaginary somewhere. My life has been one long longing."
--------------Elizabeth Wurtzel (from her book Prozac Nation)
The process of medication is a journey. I actually feel quite blessed to know that anti-depressants (and anti-psychotics) exist. I think those who have never worked in a mental health environment, those who do not have a friend or relative or lover with a mental illness, those who have not experienced it for themselves, have no idea how fortunate we are to have these medications.
But even if medications work for some, it is entirely possible that the medications that seemed like such a blessing may cease to opperate as they once did. Or even if the medications do their job continually the individual must continue to work on the areas that the medication does not touch. Additionally, one must accept that medication is now a part of their lives. One must reconcile any personal stigmas they undertook or stigmas pushed onto them.
So, to the Tom Cruises of the world, I hope it is understood that the mind is oh so complex and beautiful. And at some point you may just run into an individual who's mind is far more complex and far more beautiful than yours. Do not presume to know how to work it.
No comments:
Post a Comment