A client recently shared how frustrated and hurt she was with all the pressure she was experiencing from family and friends. Her loved ones kept telling her to stop relying on medication and do the work to overcome her mental struggles. These individuals may be well-meaning (benefit of the doubt), perhaps worried about the big business of pharmaceutical companies or the trends of over-diagnosing disorders like ADHD. While no system is perfect, we need to remember that individuals suffering from a mental health issue are hurting and impacted so much that they struggle to function, work, and even make mundane decisions. This advice belittles the amount of pain, how the body and mind are impacted during these times, and the risks involved. In the end, the naivety is shaming and recklessly dangerous.
Let’s highlight some commonly held myths:
- Disorders like depression can be taken care of with positive thinking and healthy choices. Dr. Joseph Wegmann, a doctor of pharmacy and a regular presenter for the APA, says there are many causes for clinical depression:
- Reactive: rearing patterns, social environment, or a shattering emotional experience are the main issues. One may have inadequate coping strategies or be unable to process something that is extreme and traumatic. Even though these are environmental, research has shown that they can cause biological changes in the brain.
- Medical: culprits like hypothyroidism, diabetes, and chronic pain are shown to contribute and cause clinical depression.
- Biological: this is when the chemistry of the brain is out of balance. In the case of depression, there are specific chemicals (serotonin, norepinephrine, and GABA) that send neurological messages to the brain that say, “I feel good; I’m satisfied.” For those with biological issues, the message never arrives because the sending neuron calls back the courier before the message can be delivered. In such a situation the brain is much more vulnerable and impacted by life events, not having the benefit of built-in protection.
- Structural: Kay Jameson Redfield added an additional category, noting structural differences in the brain. PET scans revealed that bipolar patients exhibit an enlargement of the amygdala, the part of the brain responsible for activating the fight-or-flight system, an increase in white-matter lesions which affect the water in the brain tissue, and severe depletions in glial cells which provide growth factors and nutrients to nerve cells. (p. 193)
Imagine telling someone with diabetes to wish themselves into increased insulin, a cancer sufferer to pull up their boot straps, or telling a veteran who’s experienced unimaginable horrors that s/he just needs to move on. These struggles are real and hard! Anyone who believes that all this would disappear if people would stop being so passive is delusional! No one can change these factors by wishing it to be so. If it were that simple, people would have done it long ago.
2. Everyone has down times. This is just an extreme reaction. Depression is complex, often a blend of numerous distressing emotions that have deep roots. Other times, it can emerge for no observable reason whatsoever. Where downtimes pass, depression/bipolar enters a person’s life without invitation, and hangs out like an unwanted houseguest that can last for years. The overwhelming experience is debilitating, taking away previously enjoyed activities, motivation, meaning, and energy.
3. This ailment means I’m crazy or weak. It is not about age, intelligence, gender, or economic status. These disorders can strike at anyone. Some of the most capable people I know have struggled with a mental health issue; and to me those people who are willing to face it head on are some of the bravest.
Seeing the suffering first-hand, I am dedicated to helping my clients feel better and I will utilize any tools that could help. After all, the consequences are too costly. Consider the following statistics:
- 45% of all suicides were inflicted with depression
- The strongest risk factor for suicide is depression, 20 times that of the general population.
- Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44. (3)
- In the United States, people with mental illnesses have one of the lowest rates of employment of any group with disabilities – only about 1 in 3 is employed.
For a significant number of people, medication makes a major difference. 55% report relief with the first treatment attempt. 80% of people that seek treatment for depression are treated successfully and the most effective intervention is the combination of medications and therapy. Do I recommend this for all my clients? No, but if there are significant difficulties dealing with life, if there is no ability to experience joy, if it is life threatening, or is causing major life consequences, it’s negligent to not encourage medication.
The path is not easy. As mentioned above, 45% of people will not find relief when they have their first medical trial. Even when it does work, it usually takes a week for there to be a noticeable difference and often six weeks for the full effect to be felt. On average, people have to go through seven attempts before the right combination is found for significant relief, enduring undesirable side-effects, multiple doctor visits, and endurance to keep trying.
Please, don’t make the journey harder by limiting the options with messages of shame. This only compounds their plight and erodes hope. Support yourself, your friends and your family in their efforts to get well. Help them consider all the options and encourage a well-rounded treatment plan that works with them to find relief. Most of all, love them with all you can give. As John Holmes stated, “There is no exercise better for the heart than reaching down and lifting people up.”
Resources:
http://www.save.org/index.cfm?fuseaction=home.viewPage&page_id=705D5DF4-055B-F1EC-3F66462866FCB4E6
http://www.suicidology.org/c/document_library/get_file?folderId=232&name=DLFE-157.pdf
Jamison, K. R. (2000) Night Falls Fast: Understanding Suicide. New York, NY: Vintage Books.
Katz, N, and Katz, O (2007) Presentation: Achieving Remission in Depression. Institute for National Resources.
Wegmann, J (2013). Presentation: Psychopharmacology: What you need to Know about Psychiatric Medications. CMI Educational Institute.