One Nation Under Medication

Clinical depression’s analogy to illnesses like heart disease or diabetes has been helpful to de-stigmatize it in our society.  It is a physical illness, regardless of its causes, and requires medical care and treatment.  But, in a very real sense, it’s much more than that.

Heart disease and diabetes do not affect our minds, personalities and emotional worlds like clinical depression.  Taking antidepressant medication, unlike other meds to open sinus congestion or plaque-filled arteries, changes how we see ourselves as well as how others see us.

Much about what drives how we feel about taking medication is driven by stigma; the dark cloud of shame which says that we’re weak or somehow “bad” for taking such drugs.  This nonsense continues despite the fact that 350 million people suffer from depression worldwide and that it’s the leading cause of disability on the planet.

In the book Undoing Depression, Dr. Richard O’Connor captures some of the irony of stigma:

“If [all of the statistics] are true, if depression is as dangerous and prevalent as I’m saying, you may well ask: Where’s the big national foundation leading the battle against depression?  Where’s the Jerry Lewis Telethon and the Annual Run for Depression?  Little black ribbons for everyone to wear?”

Looking back on my journey with medication, it was a rough ride but one in which I am glad I took.  I have been on medication for the past eight years and it controls my depression.  I don’t think that it’s the only reason why I’ve gotten better; I’ve done a lot of healthy stuff to recover too (e.g. psychotherapy, exercise and change in my diet).  But, at least for me, medication brought about a profound stability that I might not have otherwise achieved.

The fact that medication helped me and continues to do so doesn’t mean I don’t have my fair share of ambivalence about taking them; on the contrary.  Besides the unknown long-term effects on our brains from using these potent concoctions, there is also a change of identity that takes place when we start using them.

I sometimes miss the old, pre-antidepressant Dan that was wired and edgy.  When anxiety and depression really lit up  my nervous system, it was as if too much wattage was flowing through the power grid of my body.  The medication seemed to calm things down and even things out.  As I grew calmer, I was able to think through things more clearly – especially my depressive thought habits.  But there’s a struggle which waxes and wanes within me, even as I give the medication its due, about whether becoming a medicated person has been a good thing entirely. 

In his book, “Is It Me or My Meds?” Boston College Professor, David A. Karp writes:

“[P]eople’s self-esteem and sense of integrity are deeply connected to their ability to control their personal problems  The people I spoke with had difficulty accepting the idea that emotional illnesses are no different from physiological problems such as heart disease or diabetes.  It may be comforting to hear that antidepressant medications correct chemical imbalances in the brain just as insulin controls diabetes.  But most of those I interviewed assigned different meanings to mental and physical conditions. When asked directly, they affirmed that psychiatric drugs are far more likely than other medications to make them feel bad about themselves . . . .”

There is no doubt in my mind that we become different people on these drugs; there is the pre-antidepressant person and the post-antidepressant person.

In an article Dr. Karp wrote for the Lawyers With Depression website, he writes:

“While direct-to-consumer advertising has likely fostered an easier acceptance of these pills, most of the people I interviewed who suffer from major depression embark on a psychiatric drug career with great reluctance.  Typically my respondents turn to medications only when desperation leaves them without alternatives. 

This is understandable in terms of the identity line that one crosses by seeing a doctor, or seeing a diagnosis of depression and filling the prescription for anti-depressants.  One person poignantly expressed her identity dilemma by saying that, ‘When I swallowed that first pill I swallowed my will.’  Beginning a regimen of psychiatric medications is part of the traumatic transformation from person to patient; from being a merely troubled person to someone who has mental illness.  Crossing that boundary is hardly an easy step to take.”

I think Dr. Karp captures a good deal of the angst that goes along with taking meds.  Most people I know who take them can identify with what he says.  There is often a sense of shame attached with taking medication because we feel that we should be able to kick depression’s ass all by our sweet old selves.  What that blows up and we are left stumbling on depression’s playing field, we often turn to medication.  In my own life, I felt shame for a period of time.  But as my understanding of depression grew, I knew I didn’t have anything to be ashamed of.  It wasn’t my fault that I had depression, but it was my responsibility to get better.  Medication was part of that for me.