It’s my birthday and I’ll rant if I want to

This is really very simple and it won’t take long and I just have to say it. So excuse my self indulgence.

There’s a letter to Cary Tennis from a person who is coping with serious depression. In response to Cary’s advice there are 185 messages. A good number of these messages address the issue of medication, and a lot of that discussion is negative.

Don’t go the pharmacology route. Stay away from meds, change your diet, your exercise, your sleeping habits and forget the pills.

Not all the responses are like this, but enough.  Now, I’ve written about depression more than once here. About my own history with it, about family history and tragedies narrowly avoided. I’ve done a lot of reading and thinking about all this, in addition to my personal experiences.  So I’m not going to repeat all of that — the links are in the near right hand column if you are really interested — but I am going to say this.

Unless you yourself have been diagnosed as clinically depressed, or have had a close family member who has had such a diagnosis, your opinion about medication counts for jackshit.  If you have been diagnosed and you had a bad experience with one or more medications, keep that to yourself when you are talking to people who need help. Just shut up. This is not the time to raise the issue of the questionable practices of pharmaceutical companies. If you know someone in a bad place, this is the time to listen. If you are asked for advice, provide names and numbers of medical professionals, but do not, do not, tell the person in question how to feel about medication before they ever walk into the doctor’s office.

Imagine a neighbor’s kid is diagnosed with diabetes of a particularly difficult and dangerous kind. Would you go over there and start up a discussion about the profit margins on insulin? Would you suggest that the kid try to do without? talk about the healing power of cranberry juice or ritual cleansing or  morning hikes? Would you ask if your neighbor had considered the fact that his kid will be dependent on insulin for the rest of his or her life, and if that’s a good thing? If you are such a person, my guess is that you’d get punched in the face, and deservedly so.

Depression has to do, at least in part — and maybe in large part — with genetics and brain chemistry.  They haven’t figured out the details, but there is a lot of data and some pretty solid conclusions to be drawn from that. But here’s all you need to know: depression is serious business that often requires medication.  It’s not a fad diet to be discussed over coffee, it’s a disabling condition, one of the invisible disabilities that can make an individual want to die. Any many do.

So when people raise the topic of medication for depression, when you’re asked for your opinion, here’s what you say: I don’t know. I have no idea. It’s too important and too complex a subject for casual tossing about of opinions.

And leave it at that.

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20 Replies to “It’s my birthday and I’ll rant if I want to”

  1. Happy Birthday Rosina!

    Also, as someone who’s been on Zoloft for about 3 years, I understand your aggravation. I too sometimes wonder if it’s a good thing to be “dependent” on drugs, but as my doctor once said “if you had diabetes, you would take insulin. If you had a thyroid problem, you’d take medication. Well your head is the same thing.”
    I am on meds for panic attacks and have never been diagnosed with depression. However, I just separated from my husband and I can feel depression creeping up. I would love to be able to fight it the “natural” way, but I also know that if I can’t, it doesn’t mean I failed. There’s obviously some chemical stuff that goes wrong in there. Anyways, I’m rambling…

  2. Anti-depression medication can be a life saver. The psychiatrist should be the one to answer the person’s questions and get the right regimen going – medication or talk therapy or both. It can be extremely hard to get the depressed person to go. Just one more part of the depression.

    Happy 39th birthday!

  3. And, while we’re at it, here’s my personal list of what NOT to say to someone who is depressed:

    *Get over it.

    *What do you have to be depressed about?

    *Cheer up

    *Look at all the wonderful things you have in your life.

    *What’s wrong with you?

    *Are you crazy?

    *I’ve had enough…call me when you are more pleasant to be around.

    I’ve been there myself so I know that none of these are worth jackshit, either.

    And, happy birthday, Rosina!!

  4. And, while we’re at it, here’s my personal list of what NOT to say to someone who’s depressed:

    Get over it.

    What do you have to be depressed about?

    Cheer up.

    Look at all the wonderful things (life, job, money husband, children) you have in your life.

    What’s wrong with you?

    Are you crazy?

    I’ve had enough — call me when you are more pleasant to be around.

    I’ve been there and I know these aren’t worth jackshit, either.

    Oh — and, happy birthday, Rosina!!

  5. While we’re at it, here’s my personal list of what NOT to say to someone who is depressed:

    *Get over it.

    *What do you have to be depressed about?

    *Cheer up.

    *Look at all the wonderful things (husband, children, job, money, health…) you have in your life.

    *What’s wrong with you?

    *Are you crazy?

    *I’ve had enough — call me when you’re more pleasant to be around.

    I’ve been there and I know all of these aren’t worth jackshit, either.

    Oh — and happy birthday, Rosina!!

  6. While we’re at it, here’s my personal list of what NOT to say to someone who is depressed:

    *Get over it.

    *What do you have to be depressed about?

    *Cheer up.

    *Look at all the wonderful things (husband, children, job, money, etc) in your life.

    *What’s wrong with you?

    *Are you crazy?

    *I’ve had enough — call me when you are more pleasant to be around.

    I’ve been there and I know these aren’t worth jackshit, either.

    Oh — and happy birthday, Rosina!!

  7. If it wasn’t for the medication I take every day, I don’t know what would’ve happened to me. I’m not the sort of person who takes medication for every little thing, but the pills are the difference between living a happy, normal life, and dealing with lows where the depression is so crushing it takes everything in me to even get out of bed, and highs where I am ultra-creative and social, but also make the dumbest, most irresponsible decisions.

    And on that cheerful note, Happy Birthday! I know more people who have birthdays today than any other day of the year: my husband, one of my closest friends, my sister-in-law, and two of my co-workers.

  8. I’d sing happy birthday, but then your comments would explode. So imagine me lip-synching in the background.

    Being a former medical professional and thereby tainted by many years of association with physicians, I’m not going to comment on the disturbing anti-medication advice portion of the post. This is also so that my head doesn’t explode.

  9. Happy Birthday! I hope you have a lovely, relaxing day. Eat some great food and drink too much wine.

    As to the depression and medication topic, I think the problem is two-fold:
    1. There is an outdated stereotype about anti-depressants and the people who need them. I really think it’s the lack of education and information available to the general public. We’re misinformed and misguided. These are meds that address the root of the depression and work to correct the problems. No, it’s not an exact science yet. But we know alot more now than we did 20 years ago. We’re not talking about lithium or happy-pills here people.
    2. Opinions agains anti-depressants are usually expressed by people who have lived untouched by severe depression or other mental illness. In my personal experience, opinions about anti-depressants are radically altered once you have experienced severe depression or other mental illness for yourself or in the life of a loved one. When your world is crashing down around your ears, and your life is rocked to the very core, excercise, vitamins or estrogen cream aren’t even an option any more. In cases of mild depression, those are options to explore and try. Reality for those in desperate times is that you HAVE to address the medical, physiological issues immediately, and then you can supplement the medical treatment in other, more natural ways.

    Having come from a family where the very idea of anti-depressants suggested personal weakness, I thought I had an opinion on this topic. That was until a year and a half ago when two members of my immediate family had what many people refer to as a “breakdown”. In one case it was the buildup of over 25 year of intense stress and pressure which caued a what we were told was a “mental break.” In the other case, the individual was diagnosed (by a psychologist) with rather severe OCD. Our world was in COMPLETE upheaval. Desperate to the point of thinking life would never, ever be the same. Both of these family members were and continue to be treated with anti-depressants in combination with anti-anxiety meds. The treatment and medications literally saved our lives. Our eyes were opened. We’ve been educated about how these meds work, how they CORRECT the imbalances and “misfiring” of the brain.

    We live organically, believe in naturopathic medecine, seek treatment from acupuncture – and now firmly believe that sometimes you need to be treated medically for mental health issues.

    There! My 2 cents.

  10. Having had a history of depression (and having been on several meds and having had some serious side-effects with a med change – including becoming suicidal) I too say the best advice to give to someone is to tell them this illness is like diabetes and you can’t “will” or “exercise” yourself better – they need to go to a doctor – and reinforce that over and over b/c I have had friends be in denial over how bad they’re depression is including thinking it was “SADS” – and I pointed out that no it wasn’t b/c they didn’t get blue every time of the year when winter started – if you have to, push your loved one to get help – a doctor first – and tell them you will check back with them to see if they went and what did the doctor say – again I know from experience that it’s easy not to go to the doctor to address this issue – and I know that the only reason one of my friends went for help was b/c I told her I would check up on her the day of her appt. Also tell your loved ones it is also important to get counselling – wonderful social workers correctly diagnosed me with depression – my doctor thought it was just anxiety and burnout b/c I was exhibiting the male attributes of depression – anxious, angry, irritable and I could still function somewhat – as soon as my social worker counsellor said I was depressed I told my doc, he changed the meds and I began on the road to wellness. Yes, it is crucial that people with depression take medication and get help – you can’t just do it by sheer willpower. I agree with Rosina – and unfortunately the people who suggest you can fix yourself by working out etc dont’ help at all – b/c it just keeps making you feel that you can’t cope and everyone else seems to be able to. I also concur with Rosina that until you have had, or had a family member/loved one, with depression you CAN’t have a valid opinion re the meds – you’re like Tom Cruise suggesting Brooke Shields shoudn’t have gone on antidepressants to handle her post-partem depression. Tom – ever given birth?? Ever had postpartem?? Ever had anyone you love go thru it? Then quit running off at the mouth about nothing you know. (Sorry but I concur with Rosina – and having a history and loved ones who have gone thru it – there’s nothing like people giving advice on something they don’t have the correct information on) And Rosina is correct – people die without meds. I would have committed suicide without the meds, my doctors and my counselling – and the meds and my counsellor telling me I would get thru this were the only things that got me thru.

  11. Here, here!

    I am a big proponent of the diabetes metaphor. There is just such a misunderstanding about mental health.

    and Happy Birthday. I hope your year is filled with many moments of joy. (And may you get to eat a wonderful dessert, too to help celebrate.)

  12. Happy Birthday Rosina- and wishing you many more.
    I have a very dear friend who had her life completely turned around (in a good way), by a proper diagnosis and use of the right meds for her.
    I love the way you express yourself, and the way you make me think about things.
    Keep it up ;)

  13. Firstly Rosina — Happy Birthday and may you have a wonderful year!

    Secondly — as someone who has suffered from clinical depression (or a chemical imbalance of the brain) – it is a medical condition and I think you have covered everything so well that I applaud your post. Very, very well said! I know my chemical imbalance wouldn’t have corrected itself with walks and diet……I’d be dead.

  14. I do hope you’ve had a wonderful Birthday and wish you many more to come.

    I agree with you on the depression meds discussion. I’ve been there, and in my lowest moments (in the hospital mental ward after a suicide attempt) the way depression was described to me was like diabetes. It made sense. Some people have “mild” cases that can be managed with nutrition and exercise, others have deeper cases which need meds. No one sitting on the outside of this type of situation should inflict their opinions upon others. It is a matter of life and death that only the patient and their doctor should figure out. No one should couch-coach someone else’s care.

  15. If you have been diagnosed and you had a bad experience with one or more medications, keep that to yourself when you are talking to people who need help. Just shut up.

    Actually, I would like to respectfully disagree with this portion of the post. My father in law was prescribed a certain medication by his GP (not a psychiatrist) and several weeks later attempted suicide. This med now carries a warning on the insert because of the number of similar cases it has caused. (And I would still like to stomp this GP’s foot.)

    In light of that, I’d think it important to let the person in question know there may be side effects, and if possible, be a source of support in case they happen. It may well save a life.

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