Tom and Brooke

Theology mom writes about the Cruise/Shields feud over psychotropic meds. Look out all, great minds are clashing in Hollywood. I don't have time for a full post, but here's my two shiny lincolns on the whole psychotropic med thing:

with slight updates on second viewing a few hours later


for one, Tom is foolish to lump all mental illness into one category; schizophrenia, bipolar disorder, and postpartum depression, not to mention other forms of depression and the whole catalogue of anxiety disorders (of which I've had all, I believe) are not the same things.

two, Tom's description sounds like psychiatry in the 50's and 60's, maybe 70's, perhaps what Hubbard had in mind when he was writing and alive. Shock therapy now is not what it was then. And meds have advanced considerably for most forms of mental illness.

three, I don't know a thing about postpartum depression and I'm not going to pretend; it sounds like a time of tremendous hormonal changes which might seriously affect mood. This is not the same thing as depression or anxiety which result from trauma or abuse or neglect in some form, though these things could of course blend.

four, medication can be combined with therapy, and often this is the best course: if someone comes in with very heavy depression or uncontrollable panic attacks, meds can be one part of their road to recovery; hopefully, they will eventually work the deeper issues and no longer need the medication.

Now I've tried meds and done long term therapy, and I will say this: the latest batch of meds, the new ssri's, are overprescribed and used as a cure too often; they can mask underlying issues, though in most cases those issues can still be felt if the client looks; I don't buy the chemical imbalance model, that all neuroses results from chemical problems, that the drug companies are selling me, and I have ocd. I admit I was unable to tolerate any of the ssri's and never experienced their therapeutic benefits, and the tricyclics did little for me, though I think they helped some of the very worst depression and I have no regrets that I used them then. I did use xanax way back in the day, and it helped a lot, but now is frowned on as addictive and a band-aid cure (and the ssri's are different how? well, they alter mood in a much different way).

In my own case my depression really was anger and other feelings bottled up; my ocd really is driven by said feelings and mostly anxiety, even though I know it carves huge cables in the brain. And I found that conventional therapy, support groups, self-care, and spriritual work (what else do I call it) made huge changes in how I feel, really cured my depression for the most part; I want to share this story, but I'm such a slow blogger!

For ocd, though, I found that conventional feeling based therapy helps, but only after I did exposure and response prevention, cognitive therapy, though I resisted it so much and still don't do is as I should (but then, I had already done years of conventional therapy, and perhaps that set me in a place where the exposure could work; I'll never know). ERP works for phobias also: do what you're afraid of in little steps and learn to relax there; same with ocd: working with a therapist, expose the mind to gradually worsening scenarios regarding the core obsession, and breathe through it, learn to still, recondition the mental reflex. It was very hard to start, and will probably be hard to end, but it works wonders. As the underlying anxiety diminishes, the brain is retrained away from the obsession/compulsion. Sounds deterministic; it's just one component of my reality.

Now all this takes work and time, and if someone wants to take ssri's his or her whole life, fine (many people have side effects, but not all). They do poop out, but there are always new ones. I'm a fan of getting underneath, when possible, to the underlying feelings in the case of a chronic neurosis (which postpartum is not, though feelings surely play a role along with hormones). I think that's where the deepest growth occurs. Is social anxiety disorder a chemical imbalance? I don't believe it. The pill isn't the final answer for depression or anxiety, at least in my limited experience. Most people with some chronic phobia or other have a learned fear, or more likely, the transference of other, earlier fears, and this anxiety tends to increase over the lifetime if it is not treated and the fears are not faced (my mother, for example, is much more anxious now than when she was in her twenties, though the roots where there then).

So in part, tom has a very limited idea of what he's talking about and he's sticking to his religious beliefs or religious culture in spite of the evidence; in part also, he's right, though perhaps not about brooke as an individual example. Psychiatry is still figuring itself out. Perhaps someday there will be a pill to actually de-traumatize the original memories in the brain; then this will be a different discussion.

But the ssri craze, though I know these help many people and I'm not suggesting anyone who is reading to stop taking them will, in my view, one day be looked on as better than the valium era or the barbituate era or the morphine era (or for that matter, the cocktail era), but only by degree. The mind still holds psychic wounds, and final healing involves dealing with those one ugly chunk at a time; it can take years (in my case, nearly 15 now, though I took some time off from therapy and had some special setbacks and didn't discover erp until just over a year ago); it will take money for a professional therapist and hard work. Plus, every fluoexetine pill is exactly the same; not so with therapists, and finding a good one can be hard, though it's worth the effort (the toughest thing is that a hurting person can't tell who is good and who is marginal or even incompetent easily). So, if the ssri does the job, I'm not telling anyone it's morally weak to take the med. Life is short, and I've had no choice but to take the long route. But know that in many cases, though not all, if the med is discontinued, the beast still lurks. And it's hard for me to believe that the essential personality is changed as much by the med as it would be by the hard feeling or exposure work, the tough and long process of healing naturally.

Enough preaching. We all need to get through this life somehow. Many times I've wished the ssri's did work for me, though I haven't felt that way lately. Certainly my life might have been completely different if they worked for me at 20. Someday I imagine they'll understand why I have the reactions I do and find new meds which bypass even that. But the mind, in the presence of a safe environment and the technology of therapy, modern, eclectic and ethical therapy, not that idiot Freud whose work is constantly used to ridicule therapists (and all too often by the cognitive researchers)...the mind can heal in marvelous ways.

For schizophrenics or those with bipolar disorder, it may be another tale completely. I can't imagine schizophrenia is ever curable without meds, and those meds have a long way to go still though they continue to improve. There is always hope.

***

And that phrase reminds me of the classic Crystal Method tune, which reminds me of this: those of you who know me may see a familiar face at the band's website. Look under photos for the show on 5/19. I'm back a little in the crowd in a couple. Like I said, confessions of a barbarian. What a night that was. Sometimes the best cure is getting out when one can. Rave on.

My heart goes out to all who can't. 'Saying a prayer for the desperate heart tonight.'

t

Comments

twila said…
Seems like it's human nature to try to figure everything out, then try to change everyone else to fit into this neat little box we've created to ecplain it all. Why is it that we grasp and grab to find what works for us and then insist everyone else join us on our bandwagon? It's all about fear. It's all about spelling truth with a capitol "t". It's what bugs me about any religious extremist, Tom included. I feel kind of sorry for him. I imagine someday he will look back on his creepiness and cringe.
FunKiller said…
My tent is in your camp on this. I'm not sure what Tom is up to with all this but it is clear to me based on my limited knowledge on the subject that he has no ideas what he is talking about.

I love that second sentence:"great minds are clashing in Hollywood." Is that even possible? Peace, brother.
KMJ said…
Insightful post! I'll have to mull through your many points in the next few days... :) Peace and happy fourth of july!

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