“I’ve grown up on medication,” my patient Julie told me recently. “I don’t have a sense of who I really am without it.”
At 31, she had been on one antidepressant or another nearly continuously since she was 14. There was little question that she had very serious depression and had survived several suicide attempts. In fact, she credited the medication with saving her life.
By RICHARD A. FRIEDMAN, M.D.
NVDL: Personally, while I feel they [antidepressants] have their place, far too many people are on them, and far too few people question this as a matter of course.
If you have a mental disease or disorder - like bi-polar or mania - then there is definitely an argument for the use of anti-psychotic drugs etc. I am not sure whether a lot of people ever learn to manage their moods. I've seen people who go through break ups go on anti-depressants. A mental diet is just as important as a physical diet, and who decides what we habitually think? We do. Who decides what we eat (and eating as a way to enhance our moods)? We do. That same person and decision process has to be reversed, and it is tough. Taking medication is a 'crutch-philosophy', which treats and symptoms, and fosters dependency. I have discovered the most violent critics of statements such as these are people who have defaulted their decision making process to something their shrink told them, and a lifetime subscription to medication.
I believe people are not only worth more, they are capable of more. They need to be asked - often - to try, to try to manage their own recovery process. I also feel that an indictment can be made against those who decide/default to go on anti-depressants long term. If they have given up on themselves - in a here and now sense - ought we to take them as seriously as they demand to be taken, given that others apply higher quality standards to their own lives and loved ones? Are those that are not on permanent medication (I mean those who volunteer to treat ordinary depression with long term courses of anti-depressants) really meant to take their mood swings, moodiness and lifelong living apoplexy as the real person communicating with us, or are we really dealing with a drug induced, iffy, half-baked daywalker?
One of the best ways to approach this problem - the problem of depression - is by exercising. In starting to exercise the individual has to begin to own their low motivational levels, and find the resources to get themselves moving and activated. It is a very real, pertinent and necessary question: why? why should I do this? why should I do anything? The answer is just as simple, and makes just as much sense as the question: because not doing anything is worse. Happiness is in doing something, and preferably according to a purpose and a design that is of your own invention, one that you recognise as meaningful and necessary (but not necessarily).
Exercising addresses a host of chemical, psychological and self image issues. If you are depressed and you want to change your life for the better, ask yourself to go for a run, and then stand in the mirror and listen to the arguments why this is not a good idea. This is the source of your pain.