Posts Tagged ‘psychopharmacologist’

NYT Sunday MagOf course, none of the drugs work conclusively, and for now we are stuck with what comes down to a refined form of guesswork — 30-odd pills that operate in not completely understood ways on neural pathways, on serotonin, norepinephrine, dopamine and what have you. No one, not even the psychopharmacologists who dispense them after considering the odds, totally comprehends why they work when they work or why they don’t when they don’t. All the while the repercussions and the possible side effects (which include mild trembling on the one end to tardive dyskinesia, a rare condition that causes uncontrollable grimacing, on the other end) are shunted to the side until such time as they can no longer be ignored.”  “A Journey Through Darkness,” By Daphne Merkin / Sunday May 10, 2009 New York Times Magazine. 

Another quiet Sunday on the sofa, a cup of French roast coffee, George Winston on the piano (on the stereo, not in the living room) and the mandatory perusal of the New York Times.  But again, today, as in recent Sundays, my mind is not allowed to drift and contemplate budget tapas in Barcelona or the latest Denis Johnson novel, “Nobody Move.”  No, today I must once again confront the topic of depression.  Seems there is no getting away from it these days. 

The cover story of The New York Times Magazine is “A Long Journey in the Dark: My Life with Chronic Depression,” by Daphne Merkin.

Ms. Merkin’s experience of a hospital stay at the New York Psychiatric Institute, prescription drugs, and the decision of whether or not to try ECT (electro-convulsive therapy) to manage a particularly bad bout of depression, is beautifully told, heartbreaking, and all too familiar. 

The article is worth reading for many reasons.  For one, she covers a lot of ground: therapy, drugs, suicide, and relationships.  For another, while the story may not be a unique one, her ability to use language to make a point or to describe an emotion, is almost painfully beautiful and right on target. 

In some way, the quiet terror of severe depression never entirely passes once you’ve experienced it. It hovers behind the scenes, placated temporarily by medication and renewed energy, waiting to slither back in, unnoticed by others. It sits in the space behind your eyes, making its presence felt even in those moments when other, lighter matters are at the forefront of your mind. It tugs at you, keeping you from ever being fully at ease. Worst of all, it honors no season and respects no calendar; it arrives precisely when it feels like it.” 

My only issue with the essay is the ending.  For a woman who has “…not been free of psychotropic medication for any substantial period since [her] early 20s,” and admits to gobbling down a “…medley of pills — Lamictal, Risperdal, Wellbutrin and Lexapro,” she seems content with the idea that Abilify is the answer, albeit a temporary one. 

While I am always happy that someone has even momentary relief from the pain of depression, I can’t help but have that feeling overshadowed by disappointment at the fact that these stopgap measures are our only, short-lived, salvation. 

How long will we have to play prescription Russian roulette, wasting precious months, even years, as we wait to see what combination will work for us, all the while knowing that the solution is never permanent?  Never a cure.  While Ms. Merkin’s essay tries to end on a positive note, it is at best, a bittersweet one.

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Once over the line, we can’t go back.  We “have” depression.  We can recover from episodes, we can modify our lifestyles to prevent or moderate future episodes, but we “have” depression.”Undoing Depression; What Therapy Doesn’t Teach You and Medication Can’t Give You,” by Richard O’Connor, Ph.D. 

Mayo Clinic

“Bipolar disorder is a long-term condition that requires lifelong treatment, even during periods when you feel better. Treatments and drugs” by Mayo Clinic staff. 

After several web pages that define what bipolar is, that it “requires lifelong treatment,” the Mayo Clinic staff writers go on to say that “Recovery from bipolar disorder can take time,” if you “stay focused on your goals.”  How exactly does one recover from a lifelong illness?  They seem to be contradicting themselves here. 

The most disconcerting thing about their website is their attempt to address the issue of alternative medicine: Under the title, Alternative Medicine, the Mayo Clinic staff writes:

Some people with bipolar disorder turn to complementary…treatments to help manage symptoms, improve mood and reduce stress. These treatments may include prayer or spiritual healing, meditation, and vitamin and herbal supplements.”  

That is all they have to say on the matter.  They are almost dismissive in their insinuation that there might be alternative therapies to drugs.  While others may not have been “cured” of their disorder, there are certainly numerous enough cases out there of people who have tried yoga, acupuncture, SAMe and other holistic products and exercises, either separately or in conjunction with each other, and found some degree of success. 

I believe it is this blatant disregard for all things non-pharmaceutical, from clinics, from therapists, from traditional media, that keeps us both trapped and stigmatized. 

I would venture a guess that more money is spent by Coca-Cola and Banana Republic trying to figure out what motivates us psychologically to spend money on their sugar water and chinos, than is spent by all of the corporations and all of the labs combined searching for ways in which we can shift our thinking and alter our lifestyles so that the effects of mania and depression are, if not eliminated, significantly diminished.  

Our brightest minds should not be sentencing us to a life of pharmaceuticals (antidepressants mixed with antipsychotics, alternated with anti-seizure pills and mood stabilizers.)  For too many of us, pills don’t work.  And we only find this out through trial and error (each trial taking anywhere from one to three months) all the while suffering from the terrible side effects of each, and in some cases (my own included) suicidal thoughts. 

Read the blogs.  Do a search for bipolar/depression/suicide/mental health.  For every person typing away with glee that the latest in a series of medications has finally begun to give them some relief, there are ten or twenty others who can’t get out of bed, who are cutting themselves, who are quitting school, ending marriages, contemplating suicide.  For too long psychiatrists, psychopharmacologists, and pharmaceutical companies have held out false hope, and we bought it. 

What else have you got????

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