Compassionate mental health: if we treated anti-depressants like any other drug

I grew up in what you might call a science-minded family. We appreciated traditional remedies for some things, such as lemon juice for sore throats and vinegar rags to bring down fevers if you couldn’t digest the anti-inflammatories, but for the most part, we deferred to medicine whenever someone was sick. We had no choice – as children, both my brother and I fell sick a lot, and our parents couldn’t afford to wait on us hand and foot while our bodies fought the infections by their lonesome selves.

That was the world I grew up in, and for the most part, that was how I believed the world was – people went to the doctor if they got sick, they got a precription, they took their pills as instructed, and they got better (after spending a few days watching soap operas from the couch and calling their friends for their homework). I didn’t know what homeopathy was, and when I did learn about it, I pretty much adopted the attitude of “good for other people, not for me.”

I didn’t realize how much of the “let nature do its healing work” attitude I had, or how much ableism I had internalized. Because for all my family’s belief in the power of medication for other physical ailments, we all drew a big line at anti-depressants.

It wasn’t until I found myself approaching this line that my own attitudes came into stark light.

Two years ago, I first sought help for my disordered eating and my compulsive exercising. The therapist was understanding, but she also asked me to speak to the university GP about my options. I was offered some information on SSIs to take away and read, and then come back and discuss.

I approached the leaflet with skepticism. I read the list of side effects and dismissed it immediately. At the time, I was still an undergraduate (in name if not in actuality), I had a crush to occupy my mind, I had a job and goals and mostly a rosy outlook on the future. I was depressed, but highly functioning. If people didn’t know any better, I looked normal.

I convinced myself I was normal – just a little down, and also with a tendency to moralize food choices and beat myself up, and also place way too much value in the subjective preferences of people who didn’t really know me. So I decided to stick to my daily activities and talk therapy and leave it at that.

Fast forward two years, I’m not working on a Ph.D., shouldering more responsibility as a self-led researcher. I haven’t  got a crush and my future prospects aren’t great, and my outlook on the world is grim as Hell. I’ve just been benched from a volunteering position because my orthorexia is flaring up. I feel angry, upset, and betrayed – I felt comfortable sharing about my struggles, and I was being punished for it. My doctor refers me to a counselling service and gives me a perscription for a mild antidepressant.

I wish I could say it was then that I realized that maybe I needed to re-examine my own attitudes towards medication geared towards improving your mental health, but no, I dragged my heels for another two months, first getting more depressed, then experiencing an unexpected high after going on holiday.

And then several things happened, convincing me in quick succession that my attitude towards perscription medication could be wrong:

I experienced persistant, distracting ringing in my ears. My doctor, finding nothing wrong physiologically with my ears, told me to take my antidepressants. It hadn’t occurred to me prior to that moment that I might be experiencing a psychosomatic manifestation of my illness. I just thought I’d finally overdone it with the loud music.

But bodies are weird. Illnesses are manifest through different means, as anyone who has seen an episode of “House MD” knows. I hadn’t thought this might happen to me, but you know what they say about plans, right?

My mood lifted after a long period of sadness. That was before I started my medications, by the by. If you have been struggling with low mood for a while, you will recognize how moods a cyclical – highs following lows following highs and lows again. Sometimes a high coincides with a major change of pace, like a holiday, or a breakthrough in a professional project. In the past, I always assumed that as soon as my life got better, my mood would stabalize, too. I just had to grit my teeth and get through to the next stage.

Can you see the flaw in that thinking?

Much like somebody who laments their teenage years in their twenties, or their twenties in their forties, I learned the hard way that youth isn’t some sort of slow progression towards an adult utopia, and that birthdays mark little more than the adding items on the list of things you need to worry about. You can hold a stiff upper lip, but for how long? You can spend your entire life waiting for things to get better, and they may never would.

I didn’t want to be a slave to my brain, to the very arbitrary flow of hormones in and out of my glands. I wanted my mood to be stable so that I could get on with my work. The realization made me move forward.

I realized I did not want to die. I’ve never been actively suicidal, but I didn’t want to wait until I was until I sought help.

I also began to question the reason behind the stigmatizing of antidepressants. Yes, overperscription is a thing. Yes, it’s difficult to get regular appointments with your GP to track your progress. Even as I write this now, I feel anxious because I need to have my prescription refilled and I’m not sure if I’ll be able to get it before I run out of my current ones. Yes, talk therapy is important and access to it is very restricted.

But there is a difference between being critical of the system in general, and refusing to explore an option regarding your own personal health because of what you think other people will say. One is a necessary part of being a productive member of society. The other is just plain dangerous.

Despite my fears about side-effects, I had no idea how antidepressants would affect me before I started taking them. I knew that therapy was good to me, but I couldn’t always access it. And like I said, I didn’t want to be a slave to my brain.

When I took away my own personal fears about side-effects, all that was left, I realized, was internalized ableism. And anti-depressant related ableism is oppressive and classist, as this Everyday Feminism article demonstrates. Like the author, I also tried a lot of “natural” remedies for my stress and depression – exercise, healthy eating, St. John’s wort. But while I discovered my own athletic abilitiy and began to take pleasure in moving my body, I also discovered food moralising, internalized fatphobia, orthorexia, and using exercise to “earn” nutrients, the consequences of which I am still trying to cure myself of.

Yes, antidepressants are cheap(ish) and maybe too-widely prescribed. Yes, it sometimes takes a lot of adjusting to find the right combination, if there is one at all, to help a specific person. In an ideal world, everyone would have access to regular therapy and check-ins with their GP to make sure their healing is going well.

But when we stigmatize a widely-available mental health support tool, like SSIs and other antidepressants, we are also supporting a system of ableism and class-related shame. We impose a hierarchy of need, a hierarchy of compassion. Drugs are the “lazy” way out, while people who make an example of their “healthy” lifestyle and talk openly about their struggles with therapy and processing are seen as “inspirational”.

The truth is that there isn’t a hierarchy of need. One person’s mental illness is no less deserving of compassion than another’s just because of their chosen method of coping with it. I believe that everyone deserves to have free choice of options, and an acess to a support network that helps them discover what works and doesn’t work for them. I believe mental illness is just as complex and varied as physical illness and thus needs to be treated with every individual’s needs in mind. I believe that people should be allowed to make decisions about their own health without stigma or ableism hamstringing them.

Imagine for a second if we approached the taking of antidepressants the same we do with antibiotics or other pharmaceuticals. If we acknowledged that people react differently to them, but in general they serve a purpose. If we didn’t ascribe cultural meanings of goodness and badness on the sufferers. If we treated mental illness with compassion rather than an embarrassing problem.

Wouldn’t it be nice?

 

 

 

 

 

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