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Showing posts with label There's No Pill for This Kind of Depression. Show all posts
Showing posts with label There's No Pill for This Kind of Depression. Show all posts

Saturday, March 14, 2009

There's No Pill for This Kind of Depression

When you start a PhD program, the first thing you learn is that there is a world of difference between journalism and social science, and that difference begins with the way you write. Journalism is wet. The goal is to sell newspapers, to get to readers personally, to capture their interests, hearts, and emotions.

A lot like blogging for some of us.

And social science is dry. Research is dry. It is steeped in exacting, replicable findings, appeals to the side of the brain that demands significance, validation, logic. Science.

Some of us like both, and I happen to love Peggy Noonan, a political journalist for the Wall Street Journal. She is the Catholic sister I never had. I have Catholic sisters, Lutheran sisters, Episcopalian sisters, Muslim sisters, Korean sisters, Jewish sisters. We're all seriously middle-aged and own a perspective, a way of seeing we earned while toiling at books, people, and life. We've lived so we get to talk about it.

Generally Peggy spins a yarn as only she can (see last week's on the octuplets, just great) but today she dropped a stitch, providing me an opportunity to spleen about what to expect from medication and what not to expect. As a journalist I can't blame her for throwing her thoughts out there, for they're really easy going down, as always.

but they're wrong.

There's No Pill for This Kind of Depression
is the title of the essay, page 9, section A, Saturday-Sunday, March 14-15, 2009.

Her metaphor about the economic blows we're suffering are perfect to a fault.
The heart-pumping drama of last September is gone, replaced by the drip-drip-drip of pink slips, foreclosures and closed stores. . . .

People sense something slipping away, a world receding, not only an economic one, but a world of old structures, old ways and assumptions. People don't talk about this much because it's too big, but I suspect more than a few see themselves, deep-down, as "the designated mourner," from the title of the Wallace Shawn play.
Ms. Noonan asked a friend of hers, a psychiatrist, if he sensed pervasive anxiety, as if everyone is "on thin ice," and he answered in the affirmative. We've talked about that here.

She goes on to tell us that the sale of antidepressants and anti-anxiety drugs is widespread. (Big news, here). She feels that drug seeking behavior has become more common in New York since 9/11. Where she gets her statistics who knows. She doesn't need them, this is journalism, and opinion, no less. And you, the reader, should believe her, this goes without saying. You read it in the Wall Street Journal.

Fine, fine, fine. No harm done. But the following, Peggy, forgive me, begs an argument. As my sister, the one I can't wait to read on Saturday mornings, you should have called me, seriously, before writing this, referring to psychotropic medication as a cause of the crash.
We look for reasons for the crash and there are many, but I wonder if Xanax, Zoloft and Klonopin, when taken by investment bankers, lessened what might have been normal, prudent anxiety, or helped confuse prudent anxiety with baseless, free-floating fear. Maybe Wall Street was high as a kite and didn't notice. Maybe that would explain Bear Stearns, and Merrill, and Citi.
It would make a nice dissertation thesis, perhaps. But honestly, ill-conceived.

What would Ms. Noonan suggest? The half-glass of bourbon that Denny Crane and Alan Shore (the hot shot lawyers on Boston Legal) make look so psychologically appealing? America's favorite drug? Because that's so safe, after all.

Allow me this.

(1) Anti-depressants don't get you high. If you're lucky, when you take these medications properly, the weight sitting on top of your head disappears and you can get out of bed.

And suicidal people? They're less likely to shoot themselves in the head on anti-depressants, and less likely to take others down with them. Caveat here, of course, for some anti-depressants, taken by some people, can trigger manic episodes. But a real physician, one who performs an extensive evaluation before prescribing anything to anyone, knows this.

(2) Anti-anxiety medication that is taken as prescribed, does not interfere with reality testing. People who are on these medications as prescribed are still anxious, they still think about things that worry them. They still worry. But they can get to work. They learn, in therapy, not to obsess about what they cannot control, and we teach them how to do that. But prudent thought is not disabled with medication. And if you're on medications like these you are discussing what is prudent, what is not, with your therapist.

That's all I want to say. Depression, anxiety-- crippling disorders. Medicine helps people function, helps them manage their emotions. Therapy can, too. Together it all goes a little faster, is all.

I will grant that it's possible that the dayans of Wall Street may have used amphetamines and crack to stay awake, to keep up the energy necessary to be a mover and a shaker, a Master of the Universe (Ms. Noonan refers to Tom Wolfe). This will mess with a person's judgment, cocaine and dex, derivatives of amphetamines, anything that increases mania and a sense of omnipotence.

And hey, that's interesting, too, and sells newspapers.

But it might not pull at you, might not reach as large an audience, pull at as many heart strings, as only Peggy can.

therapydoc

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