Meds

‘Club Medication’: The Top 5 Myth-Conceptions

 Enter the ‘Prozac Nation’ & the ‘Lithium Liberation Army’

“No I’m sorry Captain Zoloft and Colonel Paxil aren’t available for interviews, they’re in negotiations with the Prozac Nation and the Lithium Liberation Army” – from the play ‘Crazy for Life’

We’ve all heard of them, or at least some of them: Cymbalta, Wellbutrin, Effexor. And the most suspect culprit of them all: Prozac. Like a roll call of lieutenants on the Starship Enterprise or relatives of Cyborgs, they file into our minds carrying a string of preconceived, often inaccurate ideas of what ‘antidepressant’ means.

What is one reason people refuse antidepressants? The common yet subtle stigmas and moral judgments accompanying them. At least that was the case for me. Yes, side effects of these meds are sometimes worse than the symptoms of depression itself, but often it is the fear of the medicine, and the self-judgment of what it means to ‘have’ to take psychiatric medication.

Enter the ‘Prozac Nation’ & the ‘Lithium Liberation Army’

By Victoria Maxwell
Created Apr 30 2010 – 2:43pm

 “No I’m sorry Captain Zoloft and Colonel Paxil aren’t available for interviews, they’re in negotiations with the Prozac Nation and the Lithium Liberation Army” – from the play ‘Crazy for Life’

We’ve all heard of them, or at least some of them: Cymbalta, Wellbutrin, Effexor. And the most suspect culprit of them all: Prozac. Like a roll call of lieutenants on the Starship Enterprise or relatives of Cyborgs, they file into our minds carrying a string of preconceived, often inaccurate ideas of what ‘antidepressant’ means.

What is one reason people refuse antidepressants? The common yet subtle stigmas and moral judgments accompanying them. At least that was the case for me. Yes, side effects of these meds are sometimes worse than the symptoms of depression itself, but often it is the fear of the medicine, and the self-judgment of what it means to ‘have’ to take psychiatric medication

Now just to be clear, I am not a ‘psychotropic hedonist’, one whose immediate remedy to any of life’s unpleasantries is popping a pill. But I am also not ‘anti-medication’, if in fact taking said medication is the wisest choice for recovery. 

What is also clear is that I had enormous difficulty accepting I needed medication to stay well. It took a good (‘good’ isn’t quite the most accurate adjective to use, but anyway…) a good 5 years after my diagnosis before I would willingly take any medication. And by far it was due to the many ‘myth-conceptions’ I had about them that prevented me from adding an antidepressant and mood stabilizer to my wellness kit. But with shrewd counsel from my peer led support groups and my health team, I began taking them and take them today still. However, my recovery is maintained not only by medication, but also by the host of other wellness strategies I use.

Below are the ‘Top 5 ‘Myth-Conceptions’ I had about antidepressants:

Antidepressants are:

  1. addictive
  2. ‘personality changers’ and create a ‘high’ and artificial happiness
  3. for people who can’t cope and are weak-willed
  4. to be taken only until the depression lifts, and shouldn’t have to be taken for life
  5. not natural and therefore ‘bad’

 1. Are antidepressants addictive? No. (Haddad, 1999). Contrary to popular belief, this family of medication does not create a dependency whereby you need to keep increasing the dosage to receive the same effect, nor do cravings for them occur.2 Some people experience temporary withdrawal symptoms when they first stop taking certain antidepressants, but this doesn’t last nor does it mean an addiction has developed. As with any medicine, they still need to be administered and stopped under the care of a competent physician.

 2. Nor do antidepressants create a ‘high’, an unnatural happiness or ‘Stepford Wife’ demeanor. Simplistically speaking, they help rebalance neurochemical deficiencies in the brain, restoring and stabilizing natural mood. (Panzarino & Schoenfield 2003) A new personality isn’t eerily created; but with appropriate medication, the already existing personality, previously painfully submerged under the illness, returns.

A particular set of antidepressants: SSRIs (selective serotonin reuptake inhibitors) prevent certain neurons in the brain from re-absorbing the neurotransmitter serotonin too quickly. The ‘appropriate’ neurons can then receive serotonin, permitting healthy mood regulation.

3. Antidepressants are easy answers and for those who can’t cope with stress. This is no truer than saying a person with diabetes should forgo insulin and control their blood-sugar level with will power and a more positive attitude.

PET scans – ‘photo shoots’ of the living brain – show marked decreases in activity in the ‘depressed’ brain. (Yatham et al 2001) When the right medication is taken, the brain returns to healthy activity, and ‘normal’ levels of mood result.

Psychiatrist, Dr. Ron Remick, from St. Paul’s Hospital in Vancouver, BC explains using the term ‘Pharmacological Calvinism’5 (a phrase coined by Dr. Gerald Klerman in the ‘70’s). “Some people”, he says, “incorrectly believe medications are an easy way out. Instead of pills, they believe people should get to ‘the root of the problem’. Meaning uprooting a personality problem or weak temperament.” 6

People fail to understand major depression is, in part at least, a physical illness needing medical attention, which very often includes medication. It is a biologically based ailment that expresses itself in behavioral, emotional and personality changes. A person with severe depression will benefit from learning better stress management skills and therapy to be sure, but rarely is it enough to eliminate the depression completely.

4. People mistakenly believe once a depression lifts, medication can be discontinued. As with diabetes where insulin is needed on a daily basis, so too in cases of chronic and severe clinical depression, medication is usually needed to manage the condition. Contrast this to a person suffering from a headache, where when the pain has ceased aspirin is no longer required. When a person living with chronic depression starts to feel better, this doesn’t necessarily mean the course of treatment should stop, on the contrary – it means the medication, along with the other wellness strategies are working well.

Only you and your doctor can decide what the best choice is. Depression varies in both type and intensity, with an individual’s history playing a pivotal factor, all of which influences the direction of treatment. For some, staying on an antidepressant long-term is the wisest choice, for others medication is only needed for a limited period of time.

 5. ‘I want a natural approach,’ people with depression may say (myself included).  I spent years in therapy, trying different kinds of herbal medicines and alternative therapies prior to accepting traditional antidepressant medication.

With mild depression, an herbal remedy such as St. John’s Wort or Kava sometimes can be enough. Counseling combined with exercise is also a good form of treatment. But often, especially in cases of moderate to severe depression like mine, medication in combination with therapy and other management tools is required.

Taking a prescription for any condition can never replace the benefits of healthy lifestyle choices and good psychotherapy. In fact, antidepressants combined with these other two approaches statistically produce the most effective treatment. (Panzarino, 2003)

The more educated we are about antidepressants, the more we remove its disabling shame. Accurate information means more objective decisions about treatment. Medication should never be mandatory, but up-to-date, stigma free information should be. Making decisions based on facts, not fallacies and fears allow those of us living with depression and other psychiatric illnesses to increase our chances of recovery and level of well-being. This is our right, not an option.

 © Victoria Maxwell 2010

Victoria Maxwell BFA, BPP* is creative director of Crazy for Life Co. a conference and corporate training/educational company offering keynote performances and workshops on a range of mental health topics. Her acclaimed solo shows about her personal experience living with bipolar disorder and psychosis, tour internationally. Contact her at: [email protected] or visit at http://www.victoriamaxwell.com/

*Bachelor of Fine Arts / Bi-Polar Princess

References:

1 Haddad P. Do antidepressants have any potential to cause addiction? J Psychopharmacol.1999; 13(3):300-7.

2 www.rcpsych.ac.uk/mentalhealthinfo/problems/depression/antidepressants.aspx

3 Panzarino P, Schoenfield L. What treatments are available for depression? 2003;   www.medicinenet.com/depression/page6.htm    

4 Yatham L, Liddle P, Shiah I, Lam R, Adam M, Zis A, Ruth T. Effects of rapid tryptophan depletion on brain 5-HT(2) receptors: a PET study. Br J Psychiatry. 2001 May;178:448-53.

5  Bringle M. I Just Can’t Stop Thinking about It: Depression, Rumination, and Forgiveness. Word & World 1999; 16(3): 340-46.  “The term ‘pharmacological Calvinism,’ coined by Gerald Klerman and popularized in Peter Kramer’s best-selling Listening to Prozac, aptly names a widespread suspicion of the use of medication to treat “mental” or “emotional” disorders. Pharmacological Calvinists see drug use as a facile way out of the hard work of spiritual discipline, a cheap substitution of pill-popping for prayer-without-ceasing. Such criticisms verge on…denying the involvement of the body (including brain chemistry) in…health.”

6  Personal communication. 2004

 

Links:
[1] http://www.victoriamaxwell.com/shows-crazy-for-life.asp
[2] http://en.wikipedia.org/wiki/Borg_(Star_Trek)
[3] http://www.victoriamaxwell.com/
[4] http://www.victoriamaxwell.com/services.asp
[5] mailto:[email protected]
[6] http://www.rcpsych.ac.uk/mentalhealthinfo/problems/depression/antidepressants.aspx
[7] http://www.medicinenet.com/script/main/art.asp?articlekey=18518
[8] https://www.psychologytoday.com/Leslie J. Schoenfield,
[9] http://www.medicinenet.com/depression/page6.htm
[10] http://www.psychologytoday.com/files/teaser/2010/04/hppypls_0.jpg

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