Judith Warner: Overselling Overmedication

Of Warner, as Lawrence Welk would say, "Wunnerful, wunnerful!"

The Peter Kramer piece Warner linked to (and you linked to the other day, Therese) gave particularly sobering perspective in its closing paragraph:

"Likewise, there is risk in answering questions prematurely. Finally, how antidepressants interact with capitalism remains uncertain. We may — this concern was at the core of (Kramer's book) Listening to Prozac — be using medication to achieve the assertiveness and confidence that our society demands. Or, as Barber suggests, we may be numbing ourselves. But two other possibilities remain on the table. We may be doing pretty well with the imperfect medicines we have. Or we may still be failing to reach numbers of people with substantial mental illness."

Big Pharma is raking in the money, Warner is right (and bravo for her for getting the actual meds right, unlike Barber, BTW). But the fact remains that every scientific and medical study (and every right-thinking political leader, in Congress if not the Administration) has concluded that Americans DO NOT GET ENOUGH mental health treatment.

By a longshot.

PS -- And of course, part of the problem for Barber is credibility. He has OCD -- crippling OCD, and I have deep sympathy for him for that -- but it is NOT depression, and he projects his experiences onto those of folks who do have unipolar and bipolar conditions.

Barbara:

I agree with you, but remember that society is torn in its stigmas and prejudices about a lot of conditions.

Is alcoholism a moral problem or a disease, for example?

Barbara - I know people with OCD, and I know people who are uni-polar and bi-polar. The illnesses are brain-centered in nature, but they are way not the same. They offer very different challenges to the individual, and respond to different medications.

I liked the comment on people not worrying about the moral implications of Botox injections, liposuction and the like.

Larry - I don't see how consuming alcohol is a moral problem, if one's spiritual path accepts it, but if one is addicted to alcohol, that is a whole different bag of worms. Definitely an illness at that point.

One more though (trouble sleeping!) We also don't have public establishmnts on nearly every urban corner wher any individual who has attained a certain age can LEGALLY walk in,tell the proproetor what pharmcologcal they prefer and get it simply by laying a little money on the counter then get behind the wheel of their vehicle endangering the lives of EVERYONE on the road because of the medication'S effects on his/her driving abilty which adds,IMHO yet another layer to the onion that is the moral issue untertwined with alcoholism. Nor is ther ever social pressure to take anantidepressent or other psychotropic medication; in fact quite the opposite is true; hence this dialouge ! Try telling the families of anyone who's been killed by a drunk driver that alcoholism isn't a moral issue!(Of course, it's first and foremst a disease as all of us here on BB know)

Yamerra
You are absoutely,INHO,correct! That was what i was tring in vain to express in my comment that our meds are not routinely sought after in the same way that alcohol, narcotics and the like! Nor do they, as I stated cause withdrawal symptons when the patient forgets a dose or stops taking them altogether as the others also do. anyone who has spent time around an alcoholic or drug addict during the process of withdrawal knows that there are debilitating symroms while the body tries to detoxify. I had one uncle who shook so badly when giving up alcohol for a mere forty=eight hours that he almost seemed to have palsy And his hallucinations truly gripped him in terroreven while completely awake! An acquaintenance of mine from a long time ago related that in order to manage withdrawal from heroin actually had shis brother tie him up and lock him in his bedroom because he had become so violent that he feared he might hurt himself or worse yet, his children which is precisely why professionals recommend hospitalization when trying to "kick" those kinds of addictions. most depressives I've known who needed hospitalization were trying to kick the depressionITSELF, not the meds they take/took to help manage it. It was the state of mind that made them dangerous to themselves or others, not the lck of their "cocktails(pharmecutically speaking, of course. The couple of times my own father tried to quit booze he became so mean that he was like a totally different person in addition to resembling the proverbial "bowl full of jelly". (He was way not a "jolly old elf",) however. another friend of mine who's in law enforcement states unequivocally that the "drunk tank" at the county jail is more of a nightmare than Joe or Jane citizen can even FATHOM with so many individuals experiencing withdrawl at the same time and in the same place. It's why he now actively advocates incarcerating those individuals in a mental health facility rather than the jails.Most law enforcement people don't have the kind of training to monitor even a SINGLE person experiencing withdrawl, let alone a room full of them! he's gotten so that he avoids "disturbing the peace complaints as much as he possibly can. although it's not always the case, DTP complaints frequently, maybe even usually involve someone under the influence and locking them up in a cell automatically means they'll be "going cold turkey" and quite likely becoming increasingly violent in the process. Tragically, one individual in our own county jail killed himself by repeatedly bashing his head against a concrete wall convinced that it was crawling with cockroaches as big as his hand! The "pink elephants of tired jokes don't seem to be what most of these poor people see; their hallucinations are FAR from amusing/harmless! i've never(nor, even more telling, has HE seen or heard of a depressive stopping his/her meds experiencing SImILAR levels of Hell. If they DO kill themselves, it's usually a more carefully planned and deliberate act rather than a violent reaction to detoxifying Still suicide, I know, but somehow less frightening for the wiTnesses and more easily monitored by measures like confiscation of belts, shoestrings and sharp objects or other things that could easily be utilized in ending one's own life. An individual who's in control of his/her senses is FAR less likely to see head-butting a concrete wall as a desireable method and even if s/he DOES, the physical pain involved is more likely to end the attempt before death cOULD happen. My friend's BIGGEST fear is that one of these pour souls will try to start enough trouble to commit "suicide by cop" when he's responsible for monitoting them. since there are SOME behaviors a guard/matron CANNOT ignore or take lightly.He's been fortunate in that as a twenty-yeat-veteran he has yet to be put into the position of drawing his weapon but many of his colleagues haven't been so fortunate, and it literally HAUNTS him that one day he, too will have to use either his gun or tasar on an out-of-cobtrol inmate. Since he underwent being tasared himself as a part of his training to carry one, he's well aware of the pain/damage these sophisticated weapons can cause. His description was that it "felt like an elephant had sat on his chest"! as he struggled to regain control of his breathing and muscles afterwards. Perhaps tasars are less gory, but they're DEFINITELY weapons and capable of bringing even a well--built grown man down! And to think thereareactuallyschooldistrictsthatwant to trainteachersand/orsecurity personnelto carry them! Scary! I certainly would neverhavewanted to be required to have on in my classroom! nor would I want my child attending a school equipped with "stunners" I know, i know, SOMETHING must be done to stop all the violence in our schools, but I know of not one educator who chose our profession expecting to teach as a fully-armed "peacekeeoper."Besides, as much as I hate to say it, there are "bad apples" in EVERY fieldwhich is a big part of the reason corporal punishmentin schools has been abolished in nost if not all states. paddles were still in use when i first began teaching, and that was MORE than enough for me to see! There simply HAS TO BE ANOTHER WAY! Sorry, I KNOW I've gone off on a tangent; I'll get out of the way now. but, let's GET REAL, folks! anridepressants and/or mood stablizers CANNOT/SHOULDNOT be lumped in with alcohol or narcotics in terms of regulation; SICK people depend on them!

For the record, some of our meds ARE actually addictive -- if we take benzos (as I do with Klonopin). The "controlled substance" tag is always on the label from the pharmacy.

Lap and Babs:

I was not meaning to challenge Barber's difficult experience with OCD. I was meaning to challenge his PROJECTING that experience onto people with unipolar depression and bipolar disorder.

(BTW, Lap, I'm not a Southern Baptist, as you well know! Even though I don't imbibe myself, I'm no Carrie Nation. I was just referring to the fact that many people who are not ultra-religious, including myself at an earlier time in my life, treat alcoholism/drinking to excess as a moral fault, and not a disease.)