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Archive for February, 2010

Many people today are infatuated with the biological determinants of things. They find compelling the idea that moods, tastes, preferences, and behaviors can be explained by genes, or by natural selection, or by brain amines (even though these explanations are almost always circular: if we do x, it must be because we have been selected to do x). People like to be able to say, I’m just an organism, and my depression is just a chemical thing, so, of the three ways of considering my condition, I choose the biological. People do say this. The question to ask them is, Who is the “I” that is making this choice? Is that your biology talking, too?” The New Yorker, March 1, 2010: HEAD CASE: Can psychiatry be a science? by Louis Menand

I seem to have been in a downward spiral for the past few months. Thus the lack of postings. Miss me?

I can blame it on a lot of things. The weather. The news. The economy. Dick Cheney. The fact that I am forced to deal with bad brain chemistry without the aid of medication.

But whatever the cause, my depression, and the cause du jour, is not a CHOICE.

Yes, the pharmaceutical companies have gone astray and led their Mercedes Benz—home in the Hamptons—trips to Paris aspiring doctors along with them.

I don’t have a problem with people taking Paxil for shyness, Xanax for anxiety, or Wellbutrin for weight loss. But I do have a problem with people assuming that whatever it is that I take (used to take, actually) is a cop-out.

The decision to handle mental conditions biologically is as moral a decision as any other. It is a time-honored one, too. Human beings have always tried to cure psychological disorders through the body. In the Hippocratic tradition, melancholics were advised to drink white wine, in order to counteract the black bile. (This remains an option.) Some people feel an instinctive aversion to treating psychological states with pills, but no one would think it inappropriate to advise a depressed or anxious person to try exercise or meditation.”

For the record, there are those of us who are treatment resistant. But even if you’re not, why would anyone assume that you would choose to take a prescription medication if you didn’t have to?

Yes, we have entered the age of pharmaceutical advertising (TV, magazines, billboards) in which even the most obscure diseases and disorders are woven into our subconscious minds. Come to think of it, my legs do tingle from time to time—maybe I should be taking something for restless leg syndrome. I’ve also noticed I’ve been a little gassy lately—I’ll just bet I’ve got me a mild case of GERD. And even though I’ve no idea what Fibromyalgia or COPD are, according to recent commercials I have a number of symptoms for both, so…yeah, I’m going to self-diagnose (since that’s what those advertisements seem to be about anyway, and it doesn’t seem all that risky when you consider that “…psychiatrists reached the same diagnosis only twenty per cent of the time…”) and demand my doctor prescribe an assortment of pills and caplets for me to ingest that may or may not work, but that will certainly cause dizziness, nausea, constipation, tremors, dry mouth, blurred vision, weight gain, diminished libido (which in all fairness, may be attributable to the weight gain) and suicidal thoughts. Yeah, give me some of that.

Exercise? Diet? Meditation? All good options. IF you can drag your sorry ass out of bed.

We seem to be living in a very strange time (but then, when haven’t we?). Scientists discovered (in many cases, accidentally) that some drugs had a positive effect, on certain psychological disorders, in a few people, under certain circumstances. And, this being America, land of opportunity and quick fixes, we of course decided to take it one step further. Why feel good when you can feel great? My girlfriend just dumped me—give me a pill. My stock portfolio is in the toilet—better take a capsule. My favorite sitcom just got canceled—better up my dosage.

You know what, that’s what cocaine is for, not Prozac. And quite frankly, cocaine (the few times I consumed it years ago) did more for me than Abilify, Prozac, Zoloft and all of the others combined. WITHOUT impinging on my libido.

For those of you who are suffering from symptoms that are far more profound and harder to treat, and find any kind of relief at all in pharmaceuticals, I am truly happy for you. Whatever relieves you from some of the horrible effects and consequences of depression or bipolar disorder, ADHD or OCD, go for it. And I promise you, even though it’s not for me, I won’t be one of those people standing on the side-lines accusing you of copping out.

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“…studies show that the worse side effects a patient experiences, the more effective the drug. Patients apparently think, this drug is so strong it’s making me vomit and hate sex, so it must be strong enough to lift my depression. In clinical-trial patients who figure out they’re receiving the drug and not the inert pill, expectations soar. That matters because belief in the power of a medical treatment can be self-fulfilling (that’s the basis of the placebo effect).”

Perhaps I should explain the title of this post.

You’re all familiar with the philosophical riddle, “If a tree falls in a forest and no one is around to hear it, does it make a sound?” Well, an article in the February 8, 2010 issue of Newsweek magazine (“The Depressing News About Antidepressants,” by Sharon Begley) about antidepressants had me wondering; if a pill that is swallowed that is basically sugar, with no chemical component that might effect serotonin, works because we “believe” it works…does it “really” work?

“…scientists who study depression and the drugs that treat it are concluding…that antidepressants are basically expensive Tic Tacs.”

I’m a firm believer in the power of the mind. I’ve witnessed first hand how thinking can make it so. I do believe that, in some instances, there is such a thing as a self-fulfilling prophecy. BUT…

But, the chances of it working are about as good as your chances at the blackjack table in Vegas. Sure, sometimes you’ll draw an ace and a jack, and sometimes people get better because they believe they will, but not always. If just wishing could make it so, I’d have a brand new Maserati (GranCabrio convertible in Blu Oceano with a Sabbia interior) sitting in my driveway.

Here’s another question I had after reading the article: What happens to the placebo effect after people read an article like this one? Great! Now the pills that don’t really work, really don’t work because we’ve lost faith in them. Now what do we do?

The power of positive thinking has its place. In fact, it wouldn’t hurt to practice that in your daily life, pills or no pills. Accentuate the positive, as they say. But also, be realistic. But wait, how can you be realistic and hope to cure your depression with blind faith?

But then again…I’ll bet there are a number of Pharmaceutical sales reps out there who do have Maseratis in their garages because they visualized them. Because they held a picture of them in their mind and repeated a mantra over an over again while they fudged the test results and made promises to general practitioners that the pills couldn’t possibly deliver.

If placebos can make people better, then depression can be treated without drugs that come with serious side effects, not to mention costs.”

Hey, it’s worth a try. If you wouldn’t mind, I’d like to try an experiment of my own. Here’s a photo of the car.

If you would just stare at it for a few minutes and repeat over and over, “A Maserati in Marco’s driveway,” I’ll let you know what happens. If I go out there tomorrow and there’s a blue convertible, I’ll be first in line to refill my prescription for Zoloft.

But until then, I’m remaining drug free!!!!

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