Jed did buy a bed…

Jed did buy a bed Thursday night, and then we went and saw Shrek 2, lots of fun, and at points the jokes were going by far too fast to hear them. Will watch again on DVD at some point. Yesterday, took the train up to David's, had lunch with an old friend, Mahmud, who in the intervening eight years or so since I knew him has not only gotten an MFA at Mills, but has come pretty close to finishing a collection of stories. Cool. Ethiopian food -- yummy, but oh, so non-dietish. What's a girl to do? When Cafe Colucci calls, you must answer. In the evening, cooked some food for this weekend's various parties, hung out with David. This morning, will soon throw on clothes and go to the gym, followed perhaps by running a few shopping errands, then much socializing -- wedding celebration stuff at Dan and Nadya's, followed by birthday stuff at Susan's.

None of which is what I'm actually thinking about this morning.


A day or two ago, Jed and I were talking about drugs. Specifically, drugs like prozac and zoloft and paxil -- the kind that alter your brain chemistry and make you calmer or less anxious or more energetic, etc. I've never taken any such drugs, but lots of our mutual friends have, some after a lot of resistance. And we have other mutual friends (a few) who might benefit from such drugs but who also have a lot of resistance. And we were talking about that resistance. Some of it is just the fairly common smart people syndrome of feeling somehow like their intelligence should be enough to let them solve any emotional problems they might have. Goofy, but understandable, I guess. Jed has more sympathy for that position than I do.

That syndrome also leads smart people to resist therapy. ("Why should I think the therapist will be any smarter than I am?" "That's not the point, dummy," is my usual response, but somehow isn't as effective as it ought to be.)

But in any case, the primary reluctance seems to come from somewhere else. Something to do with a sense that taking such drugs will alter who you are, turn you into someone you don't recognize, and even worse, that the new person won't even realize they've radically changed, won't remember the parts that were valued about the old person. Something like that. I'm not sure I really get it. Feel free to explain it to me -- if you have a reluctance to try these drugs (and, presumably, some reason why they might be of use to you), what is that reluctance grounded in?

Because personally, I don't see it. Oh, I'd definitely get it if these were seriously addictive drugs, or if in any way they had a permanent effect that would last even if you immediately stopped taking them. But that isn't my impression of how any of them work. If they did, I'd steer way clear of them unless I had absolutely no choice. But as it is, it seems like you can try them for a month or two, see how they work, stop if you don't like the effects (or the side effects). No?

I've never taken any of these drugs -- I have a pretty stable base personality, generally cheerful and energetic. I've been very lucky with that. But what I do have is a thyroid problem. I'm hypothyroid, which means that my thyroid gland does not produce as much thyroid hormone as it's supposed to. That has a variety of effects -- thyroid hormone regulates the body's endocrine system, so it essentially controls how fast or slow your body is running. When you're low on thyroid hormone, you get cold, you gain weight, you're tired all the time. And sometimes, you get mood swings or depression.

I'm not sure when I developed my thyoid condition; late college, would be my guess. I gained around 10-15 pounds then, started feeling cold all the time, got progressively more tired. By six in the evening, I'd be exhausted -- I think that's why I was so content to spend every evening in front of the tv with Kevin when we were living in Philly. We watched something like 30 hours of tv a week, for two years. Astonishing. We were also having a roller coaster of a relationship -- we've never really fought, as such -- in twelve years, we've never yelled at each other. That's not our style. But we'd have these incredibly painful long discussions, where I'd end up weeping for hours and he'd try really hard to reason with me. Inevitably, these would happen at night, and in the morning, I'd feel fine, cheerful, have no idea what all the fuss had been about. Mood swings, is what I'm saying. Huge, mongo, exhausting mood swings. Poor Kev. The cheerful girl he'd fallen in love with had turned out to be a raving loon, at least at night. Must have been bewildering.

The second year we were in Philly, I was working as a secretary for an endocrinologist. I kept seeing all these patients who had gained some weight, were cold, were tired all the time. They were being diagnosed as hypothyroid, and given supplemental thyroid hormone. I wondered (after an astonishingly long time, in retrospect) whether I might be hypothyroid. I asked my boss, and she said it wasn't likely -- there were many reasons why I might have those symptoms, including simple non-chemical depression. But hey, I was there, it was simple enough to run a conclusive test. She ordered the blood work.

I turned out to be noticeably hypothyroid (which surprised her, but surprised her less when we found out that my mother and four of my aunts were also hypothyroid -- it's apparently common among women, and runs in families). She started me on replacement thyroid hormone, and within a week, I was feeling so much better, I can't tell you. I stopped gaining weight, I stopped feeling so cold, and most noticeably to me, I had energy again! I could do things in the evenings! I could go out dancing...

And while my mood swings didn't go away entirely (I take my replacement hormone in the morning, which means that by bedtime, my thyroid levels are a bit wobbly again -- it's still not as good as a working thyroid gland, which would pump the stuff out in quantity as needed), they were much mellowed. Making me, and Kevin, and probably David and Jed, a whole lot happier.

The point of all this is that I've been seeing some parallels lately between the thyroid thing and the exercise-diet thing. (You didn't see that twist coming, did you? :-)

I've lost about twenty pounds in the last year, and I'm almost back down to my early college weight (six more pounds to go). In the process, I've rediscovered the shape of my back (which had been covered in rolls of flab), and the contours of my face (I have cheekbones! who knew?). I look at myself in the mirror, and I feel like I can finally almost recognize myself again. I think I set my mental image of myself in high school or early college, and it's been deeply distressing, for the last decade, to look in the mirror and not quite see myself. Who is this flabby stranger? Where did she put my face???

So for me, reshaping my body has had a very similar effect to taking replacement thyroid hormone -- both of those allowed me to get a little closer to my core, to whom I feel like I really am. Maybe I'll never be slender -- the last time I was actually thin was pre-puberty, when I was a kid and the fastest sprinter in third grade. But as a teen, I was reasonably athletic -- I played on the high school thirds soccer team (yes, there's a level below both varsity and jv :-), I biked around my neighborhood, I even (though I hated it) did Indian classical dance. I want that level of fitness again. I want to look like me again. This diet-exercise thing is getting me closer to that goal, and every day I do it, I feel a little better. Thyroid hormone let me feel like me again. From my point of view, they're very similar in their effects.

And I know that prozac and zoloft and paxil aren't the same as replacement thyroid hormone. They're not simply replacing missing hormones that other people's bodies normally generate (and yours used to). They're drugs, with side effects, and other unpredictabilities. But some of my friends seem so unhappy, seem less and less like themselves. And I worry about them, and wish that they'd at least try the drugs. Keep a record of the effects. Report back. Maybe the drugs (and therapy) can help.

Am I missing something obvious here? Is there a good reason for resistance that I'm just not seeing? Please let me know, if so.


Sidebar: I feel I should include an explanatory note that while it might be tempting to take extra thyroid hormone (or take it even if you don't have a thyroid problem), it's a bad idea. Sure, you lose weight, get thin, and have lots of energy -- the hyperthyroid patients who came in always seemed pretty happy, and they really didn't like taking medicine to bring them back down to normal energy levels. But it's a bad strain on your heart -- your body is running too hot, essentially, and you get anxiety attacks and heart palpitations. If it gets bad enough, you can give yourself a stroke. So, don't push your doctor to give you thyroid hormone unless your TSH and T4 levels actually warrant it, and if you are taking it, don't take more than you're supposed to. Or else you might kill yourself accidentally. Which would really counteract the whole getting thin, having lots of energy thing. This has been a public service announcement.

14 thoughts on “Jed did buy a bed…”

  1. Hmmm. I see your point Mary Anne, and it was one that I got to after years of resistance. I have a history of clinical depression since I was a young teenager (undiagnosed until I was an adult unfortunately), and I have Post Traumatic Stress Disorder. I’ve come to terms with taking the drugs as being the same as taking my blood pressure meds. Something that my body needs some help with via modern pharmaceuticals.

    I take Prozac. And have taken it on and off for years. I’ve also done psychotherapy on and off for years.

    I like being on the drugs and I hate being on the drugs. They help me keep more even (not completely even, I still have mood swings and flashbacks but the drugs greatly reduce them).

    But there are definite sacrifices. I have a really hard time with my weight. I gain easily and have to fight to lose weight (this is also a symptom of another drug I take to keep my endometriosis at bay so I get a double whammy there). And, because the Prozac dulls my emotions — to even the mood swings out — I don’t feel things very intensely. While it’s nice to have the lows be less low, it’s not fun to not be really happy when that is warranted. Especially since the nature of my disease means that I’m gonna feel lows no matter how medicated I am and I still feel them far more intensely than any highs. So this basically leaves me feeling less low, with not much along the lines of true happiness or contentment, because I just can’t swing past that line. (I hope that makes sense.)

    And, worst of all for me, my creativity is very, very blunted. I can hardly write at all. For me, writing seems to be a bit manic. On the drugs, I am unable to reach that manic high state I need to really write. Creative writing is a struggle, and since I committed myself to staying on the drugs about four years ago, I have not written more than a few hundred words.

    On the other hand, at least I’m not actively trying to commit suicide any more, so I guess they’re working okay.

    That’s it for me. I hope some others can give you better insight.

  2. In case it wasn’t clear, I can *totally* understand trying the drugs and then deciding that you don’t think the negative side effects (such as loss of creativity, weight gain, loss of sex drive, loss of ecstatic moments, whatever) are worth the exchange.

    It’s obvious that these drugs often are not an effective trade-off for many people — individual response to them varies so much, as do individual decisions about what people consider valuable in life. That makes total sense to me.

    What’s not clear to me are the reasons for the initial resistance, given that you can try them and then stop, if you decide they’re not for you.

    Maybe other people have pushier doctors than I do?

  3. One reason is quite simply that these *are* mood and personality altering drugs – that’s their point. And people who are depressed have a distorted perception, sometimes including actual paranoia, and may well be more worried about just how much of an alteration they’ll experience than someone who doesn’t need the drugs would be. Catch 22. 🙁

    It doesn’t help that in fact you can’t just try them and stop if you don’t like them – some of the side-effects do not go away immediately, they can go on for months or years afterwards. That includes the personality alteration – one of the known side-effects in SSRIs is triggering mania in bipolar people, some of whom had not known until then that they’re actually bipolar rather than unipolar.

  4. Hey MA,

    Yeah, I think I understood that point of yours, but for some reason I didn’t actually address that part.

    For me, and many others that I know on (or who should be on) mood altering drugs, there is a stigma attatched.

    It’s much harder to reconcile the thought that your brain isn’t working right than say that your pancreas isn’t working right. Maybe it’s centuries of misunderstandings (“The devil is in you, girl!”) that make it so hard to stomach taking mood altering drugs.

    Not to mention the fact that when a person is deeply depressed, the idea of a pill making you happier is just silly. When you are very depressed you don’t truly believe that anything will change that. So you must also make a leap of faith there, as well. It’s very hard to do when you are depressed. I don’t really know how to explain the deep feelings of helplessness that come with severe depression. But even when you are crying out for help, you still deep down have a part of you that doesn’t think there is any help.

    Also, it’s very difficult to just try out SSRIs for a short period. There is a real rebounding effect that comes with stopping them even when they are stepped down under a doctor’s supervision. I’ve been through that several times as I’ve fought to get back off of the drugs. There’s also the feelings when the drug is working, you feel better and so you stop taking them because you think you don’t need them anymore. This is a very common problem for people who take psych drugs, especially bi-polar patients.

    Your point about the sacrifices is well taken. I hope I didn’t come across defensive about that in my first comment. (!)

    I think the thing about the sacrifices is that no one knows what might be sacrificed. The drugs affect each person differently and no one can predict what will happen.

    My psychologist actually thought it might help my writing, because he thought I would be more focused and think more clearly. And, I am more focused and I do think more clearly, however, my writing turned out to be tied to my emotions in a way we didn’t anticipate. That’s why it suffered.

    Now, could I re-harness that creativity in another way and learn to write again without stopping the drugs and getting all pendulum person-y again? Now that I think about it that way: probably. I probably could find that happiness and that emotional high without waiting for it to just happen, like I did before.

    This whole thing is hard to understand because it deals with emotions and not insulin production. I don’t think that people really think of their brains as just another organ, we think of them as ourselves, and it’s hard to imagine altering yourself.

    Thanks for bringing this topic up, Mary Anne, it’s interesting and I’m glad to get some other viewpoints. 🙂

  5. I have an interesting perspective on this because thyroid medication is what I’m on instead of mood-altering drugs. That is, I had all the symptoms, knew the family history of hypothyroidism, got myself tested. But, I went through my general practitioner who ordered T3 tests (this was standard in mid-1990’s), and those were negative. Well, annoying symptoms kept cropping up and people in my family insisted I deal with it. We tested diabetes and blood sugar tests and overnight fasts. The next step was going to be anti-anxiety medication which I was fervently against. Well, because I was so against it, we continued to look – talked to an endocrinologist who asked the right questions, made the right diagnosis, could feel the goiter in my neck – told me he KNEW the answer, and when I said, “uh, I’ve been tested negative for that”, was stunned. Ordered the tests anyway, but he ordered the TSH and thyroid antibodies, which were sky-high. T3, if he had relied on it, was still normal. Go figure. That’s a big issue, I think, the sense that we might be trying to use Prozac or Ritalin to cover something more concrete/ obvious/ organic/ provable. Maybe you’re unhappy cause you’re in a bad marriage or a bad career or taking too many classes… It will still help, but is it the right answer? I’m NOT saying that’s true for your particular friends, but there is the image of the valium-housewives, taking sedatives because everyone has brainwashed them into thinking that they are the problem, when they weren’t.

  6. Okay, I do not (to my knowledge) have any reason to be on a SSRI type drug. So this comes from just thinking about it.

    I personally feel that Riddlin & Prozac are often times perscribed too much & too easily. This comes from watching many of my peers while growing up be diagnosed ADD and “solved” with drugs. I think it is a load of hooey and that in some cases they just needed better parenting. My own brother was one of these, so it is not from complete inexperience that I speak.

    So, if I were told that I needed a mood/personality altering drug, I would resist. I would check other things first, and try therapy and change my eating habits and whatever else before taking a drug. Is it silly? Yes. But there it is.

    Dawn

  7. Hm.

    So… when I was diagnosed a year or so ago, I had actually gotten to the “danger to myself and others” stage, for which most people are not only medicated, but institutionalized.

    I opted (with the support of family and friends and under the supervision of my shrink) to not only not check into a hospital, but to try a combination of herbs, therapy and meeting the depression head-on instead of trying to mask the sypmtoms, instead.

    You list three drugs–zoloft, prozac and paxil–and there are of course several more. They run the gamut in terms of what problems they are supposed to address, but unfortunately are often prescribed interchangeably, sometimes with disastrous results. I was not thrilled with the idea of being put on several different medications, dealing with the side effects and riding the roller coasters while a doctor tinkered with prescription and dosage. It’s not an uncommon story, and the more research I did and the more I talked to people–including doctors–the more it seemed like the norm in terms of experience… and not something I wanted for myself.

    Besides which, there was a perfectly good reason for the depression, and my moods (which have always been extreme) to get where they got. I knew the reason, and was fairly sure that my shrink, some time and patience from the people around me would get me through it.

    After a lot of consideration, and under the advice and supervision of my shrink (I’m going to keep saying it because I want it clear that I never would have recovered without her help or continuous, vigorous therapy), I started taking St. John’s Wort, with the idea that if it wasn’t working or I wasn’t recovering on schedule, we’d discuss conventional drugs again.

    I recovered in about six months, which is about the same timeline that people who get where I got take to get back to functioning and normal.

    The depression as I see it now was a necessary thing. I could not continue to live my life as I had; something was going to break eventually. I am, by nature, emotional and high strung. As Carol mentioned, my moods fuel my writing, and when they’re managed, are an important component of who I am. They make the world intense, and bright, and often painful, but also often exceptionally good and sweet. They force me to retreat, to sleep, to collapse when I’m overwhelmed with how much the world simply… is.

    When I was depressed, really severely depressed, I had visions. You could call them hallucinations, but I prefer to think of them as part of the reason I went on that particular journey. My shrink (who is amazing and wonderful and beloved) responded to my telling her about these visions by helping me decode them, understand them. Her willingness to look at where I was at from a spiritual standpoint meant that now I carry much of what I learned with me.

    Things you could see as gifts, including the ability to now know my limits, my fragility, and my need to shut down and retreat.

    I could take the drugs and might very well be more functional.

    But in the end, I’m not sure I’m really interested in that kind of functionality.

    I’m OK–in fact better than OK–with this.

  8. This is all really informative and helpful guys — I’m so aware of how clueless I am on this topic. Please keep the responses coming…I am paying a lot of attention and pondering.

  9. An excellent topic to have raised.

    There are clearly cases where the Paxil, etc. family of drugs (serotonin reuptake inhibitors, is that what they are?) make a huge difference; I’ve seen it in friends and family. They save lives, and help people feel right again. They are an enormous improvement compared to what the previous generation had — the image of the Valium-addled housewife has a lot to do with the limitations of barbituates, which _are_ very addictive.

    However, I also think Kate and Mr. A are on to something with the idea that the drugs can mask the causes of unhappiness rather than treating them. We in our culture like to stamp out unhappiness — it’s deviation from the correct emotional state. I always loved the description of how madness is handled in the Utopian society of Marge Piercy’s _Woman on the Edge of Time_ — it’s “going down”, and there are places set aside where you can be taken care of while you do it, and it’s considered an important and healthy thing that everyone should do. There’s a lot to be said for that.

    And I also was going to say what Dawn B. said about these drugs and kids. Ritalin for ADD seems to me to be *massively* overprescribed in America — both in comparison with other countries, and with reality. I worked at a day camp for many years in the 80s and 90s spanning the period both before and after the widespread use of Ritalin for ADD. There were a lot of kids who used to be just difficult, demanding, and needing a lot of attention, who became suddenly diagnosable. Some kids really do need the drugs, don’t get me wrong — but a lot of times it’s a substitute for changing the kid’s circumstances, or parenting practices, or whatever. (Which is always easy for someone other than the parent to say!)

    Bodies and minds seem to be homeostatic in all sorts of important ways. I think there’s a real risk that by supplementing too quickly supplementing the chemistry of a growing brain, you can mess it up in subtle ways. Some of these kids may just be late in developing the self-control that Ritalin supplies; one wonders if the Ritalin taking its place also hinders its development.

    Of course, one has to ask what the alternative is. If the alternative is the kid long-haul self-medicating with alcohol or ecstasy or heroin, bring on the Ritalin!

    Anyway, I think I understand your friends’ reluctance. Personally, I’m very superstitious about drugs. I’m reluctant even to take aspirin when I have a headache. I even avoid homeopathic medicines, despite being 90% convinced that the fact that they are, chemically, just sugar, means that they are just sugar. I need to be very convinced my body is broken before I mess with it.

    I guess the question about and for your friends is, do they want to get happier? If they do, what are they doing instead of Prozac? Is it a convincing program? Is there some timeline to measure the results?

    I think if I was bitterly and ongoingly unhappy, after I checked out all the overt medical things (brain tumor?), I would make some kind of deal with myself, like, if this isn’t better after a year of therapy and life changes, I’ll try the happy pills.

    And there are different kinds of therapy, too, which is important for people to know. There’s the spiritual what-does-this-all-mean kind that Kate talks about. There’s the behavioral what-if-tomorrow-you-get-up-off-your-butt-and-do-this kind, which is not interested in causes and meanings. There’s the kind whose purpose is to just talk about what is until you cry or laugh your ass off, after which you can’t help but feel better. Different kinds may work for different people differentially.

    (You are also right in saying that being smart has monumentally little to do with it; your limbic system does not care how clever you are.)

    There are also times I’ve wanted to be unhappy — or needed to be unhappy. Unhappiness can sometimes be an important creative state, or is an appropriate response to your life. I’m basically happy and I like that. But sometimes being unhappy is a gift. Obviously, I’m not talking here about soul-crushing, suicidal depression. I just mean that one valid answer to the question “what are you doing to stop being miserable?” is “I need to be miserable now — please keep me safe and keep loving me while I do so.”

    Ben

  10. VERY interesting to me that Ben feels like he can tell the difference between kids who need medicine and kids who need better parenting. Not sure if this is as clear without the parents in view?

    I was talking to an emergency-room psychologist who felt the same, that the distinction between “in a bad situation and acting out” versus “out of touch with reality” etc. etc. were obvious to her within a half-hour conversation.

    I think there’s truth to that, too. There may be gray areas, but generally not. But, I think people want there to be a gray area. I don’t mean to offend anyone with psychological problems, but I think it’s like living in an abusive situation. Maybe everyone else can SEE that the situation is out of control and preventable and so on, but you’ve been living it so long and it’s a kind of frog in the boiling water syndrome. And there may be good days. Plus, with mental illness – the sense is that the people who don’t know you, can’t add up all the evidence to say. But the people who do know you – are biased. At least in my family, there’s a lot of the blame-game being played, and if someone wants me to be or do something that I don’t want to be or do, they’ll suggest I’m crazy for not wanting what they do. You never know what someone else’s agenda is – maybe it’s to make a quick diagnosis and get you out the door, or maybe it’s to keep you as a long-term patient. I think that’s nice about the ER person I met, that she has plenty of exposure but little at stake.

    There are at least two people I wished she could meet, diagnose, talk to – because I also felt the weight of authority in her manner. I think, at least, if she told me that these people were not crazy, I would feel much comforted. And if she said they were – she would back it up with solid reasons in a way that would help convince them. Or me, or the parents, enough to respond to their problems in that particular light.

  11. I cannot personally diagnose mental illness. (My wife can, though — she’s a psychologist — and it is awfully comforting to have someone like that around, who can say without a shadow of a doubt, “she’s just upset; she’ll be fine.”)

    I didn’t mean to say that I could absolutely tell, in the case of any individual kid, if they needed meds. I was partly talking about the broad trend — in 1986, the camp was full of crazy, high-energy kids, some of them destroyed property or hit each other, but, y’know — we dealt. Given limits, attention, and motivation to do something else (like learn Logo), they would calm down and get with the program. They were fine.

    The same *population* of kids, five years later, was on Ritalin. In some cases it may have been called for — but barring some theory of ADD as infectious epidemic, it couldn’t have been absolutely necessary in *all* those cases.

    I strongly suspect the kids, taken as a group, hadn’t changed any. What changed was the definition of “needed meds” — partly based on what meds were available. And I fear this was, at least often, to those kid’s detriment.

    It’s like with C-sections. I can’t tell if any given C-section is medically necessary. I just know that if the US has like a 23% rate of C-sections, with the attendant complications and risks, and the WHO puts the acceptable rate at 10-15%, something is amiss.

    (I also want to say that “better parenting” is highly loaded. Maybe in some cases, it’s better for all concerned to put the kid on Ritalin, rather than deploy a lot more resources for interacting with the kid in a structured and supportive environment — a parent quitting work, or private school, or something. Not everyone can afford those options. Sometimes “better parenting” is making do with what’s available, and maybe that means Ritalin. I’m not asserting all or most kids on Ritalin need “better parenting”. I am saying — and I’m not like an expert or anything, this is just gut feeling and layman’s self-education — that probably for a lot of kids, you could replace Ritalin with the teaching of behavioral skills, a different environment, and/or different parenting practices. Whether that’s better, depends.)

  12. I doubt I have anything to add, but… on the one hand, I’ve never been clinically depressed or anything like that. On the other hand, stress and anxiety are often issues, and there have been a couple of times when therapists — I’m almost perpetually in therapy — have raised the possibility of medication… upon which I’ve made it clear that there is no way I’m willing to consider it, and they’ve backed off.

    This is partly because I’m resistant to elective medication of all sorts; like Benjamin, I don’t even take aspirin under most circumstances. It’s partly because I don’t really believe my problems can’t be handled without resorting to messing with my brain chemistry. (It probably helps that I’ve been right about that so far.) It’s partly because my mind being the way it is is about the only thing in this world I have going for me, and I’m not about to risk it. (Creativity is essentially a mild form of insanity, after all.) And it’s partly because of what to me seems the obvious flaw in the “you can try them and then stop, if you decide they’re not for you” argument; it assumes that, if they turned out not to be for me, I’d still be me, and make the decision I might make if I hadn’t gone on the meds in the first place. It’s possible that my current thought processes aren’t as rational as I think they are, but at least they’re consistent and homegrown.

  13. A point I wish to clarify (I see some people touch on it here and I want to add to those thoughts): The best method for SSRI drug therapy *includes* psychotherapy.

    The help with general mood level that the SSRIs gives a depressive person strengthens the mental capability to deal with working on their problems in psychotherapy. Most people who are severly depressed just don’t have the ability to cope with going through psychotherapy. I know I didn’t. And I went on the drugs this latest time at the suggestion of my psychologist because of where we were going with the therapy. He did not prescribe them for me, my GP did after I went to him and asked for them. When I asked, my GP verified that I was in therapy and that the drugs were warranted (I was evaluated years ago by a psychiatrist — who are also MDs, IIRC — who, because of my personal and family history felt that SSRIs were warranted. When we tested that, I got better. I later stopped taking the drugs on my own — after I stopped seeing the psychiatrist and the LSCW — and crashed far enough again to seek more counseling. Which led to going back on the drugs which I was told that I was going to need for the rest of my life in the first place.)

    Anyway….*I* think the difference is in how the usage of the drugs is handled and I think that is born out by the comparison to the valium housewives of the past. Sometimes people take the drugs without the therapy. These two things need to be used together. That’s not to say you must be in therapy everyday you take a pill, but they are meant to work with each other. From what I know about the valium housewives, they were only being prescribed a drug, no therapy. (And I won’t even get into the facts of the times and the repression of women during that time period due to the Women’s Movement.)

    The unfortunate thing is that people — including well meaning MDs — think that SSRIs and their sister drugs are a panacea. Take the happy pill and everything is fixed.

    The truth is our world is getting more complicated and people are failing more within it (for both phsiological and psychological reasons).

    And there is always a spectrum of reactions to any given invention, and let’s face it, it’s the ones at the ends of the spectrum that receive the most press. (Also don’t forget that the largest outcry about Prozac when it was first prescribed came from the Church of Scientology. Not exactly an authority on modern pharmacueticals.)

    Well, I think I lost my point here. Sorry! 🙂

  14. I’ve been keeping quiet ’cause I don’t actually know anything about any of this stuff, but I’ve been fascinated by y’all’s comments.

    Ben’s and Carol’s latest comments in particular remind me of the diet/exercise thing. If you (generic you) want to lose weight, you can decide to go on a diet—but if you don’t also make other changes (such as exercising more), things will go back to the way they were as soon as you stop the diet.

    Or to put it another way: complex causes may call for multifaceted solutions. But as Carol noted, starting on one facet of a solution may help make the other facets easier.

    …On another note, I too have (like Ben and Shmuel, though perhaps for somewhat different reasons) a strong resistance to taking drugs of any kind. In the past few years, I’ve gradually learned that taking painkillers to deal with headaches doesn’t actually dilute the Purity Of Essence of my precious bodily fluids or anything, and suffering through a headache doesn’t actually make me any nobler. But I’m still resistant to even things like painkillers and caffeine and alcohol; I think part of me superstitiously believes (for myself, not for others) that Natural is Good, and Artificial is Bad, and that taking drugs to deal with problems is Artificial and therefore Bad. Also something mixed in there about strength, and not wanting to admit weakness by revealing that I can’t deal with something on my own. Also, I don’t like change, and drugs do cause changes; and I hate the idea of being dependent on and/or addicted to a drug, even if it’s a beneficial one.

    All of which I think is related (for me) to mind/body duality; some part of me hates the idea that physical factors like food and sunshine can have a tremendous effect on my mood. I think if I were more willing to admit that my personality is changing in small ways all the time based on physical and chemical factors (among other factors), I would be more willing to use physical methods such as drugs as part of a toolbox of tools to shape myself into who I want to be. (Note how I use “myself” to refer to the mind part…and the difficulty of determining, as Shmuel noted in a different way earlier, who the “I” is who gets to make such decisions.)

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