Official Treatment: "Just Take This Li'l Ol' Pill and...Bibbity-Bobbity-Boo!"
- Are diabetics told, “Take insulin, but otherwise, eat all the popsicles you want”?
- Are lung transplant candidates told, “Just come in for the surgery, but no need to stop smoking”?
- Are cancer patients told, “Just do chemotherapy, but no need to cut down on unsaturated fats or cola or alcohol or Twinkies. It’s okay if you want to eat tons of white pasta and strawberry pop-tarts while avoiding apples and broccoli”?
- In general, do doctors ever say, “Eating more vegetables and whole grains while eating less sugar and refined carbs and getting a good night's sleep is nice, but that won’t make a big difference to your overall health”?
No, of course not.
Even the most conventional anti-alternative doctors also clearly recognize the effects of stress, sleep deprivation, and poor nutrition on physical health.
Yet when it comes to mental health, why don’t psychiatrists tell schizophrenics that along with their daily meds, they should also stop staying up all night playing graphically violent video games?
(Not all of them do that, of course, but quite a few of America’s famous shootings were carried out by people on psychotropic medication — or in withdrawal from such medication — who regularly played graphically violent video games. If someone already has issues with delusions, wouldn’t playing incredibly realistic & violent games be a problem?)
Why don’t psychiatrists at least tell their depressed patients to have at least one cup of leafy greens a day, get outside for a walk (or dance at home on rainy days) or prescribe a really good vitamin supplement (like vitamins B-12 methylcobalamin and folate) — at least in addition to the medication?
Why don't they recommend behavioral and lifestyle changes?
Look what happened to a boy on antidepressants who made no positive changes in his behavior or thought patterns:
In 2005, a 16-year-old boy growing up amid an unusually disruptive family life and living in poverty on the Ojibwa reservation in Minnesota shot to death his grandfather and his grandfather’s girlfriend in their sleep.
(This despite having a good relationship with both of them.)
Then he went to his school and within 10 minutes, he shot to death an unarmed security guard, a teacher, 5 classmates — and himself.
(Another 5 classmates were injured.)
He committed this crime while taking Ritalin and just after having his dose of Prozac (an anti-depressant) increased.
Online, he indulged his adoration of zombies, Nazism, and music that glorified suicide and murder.
He also created violent Flash animations. And rather than taking notes in class, he penciled sketches of people getting shot.
Yes...all while taking antidepressants!
Okay, that’s an extreme case.
But the point is that anti-depressants don’t negate a person's indulgence in dark activities, dark thoughts, or a depressing life.
No Such Thing as "You Just Take This One Little Pill Every Day for Life and That's All!"
(They also often present it as "It's just this one LITTLE pill..." As if the size of the actual tablet matters. Like if it was a larger calcium-sized pill, it would be worse?)
Yet these medications ALWAYS need re-evaluation at some point.
ALWAYS.
You cannot just take the same dose of Prozac or Ritalin or whatever every day for the next 30 years and never have a reaction or build up a tolerance that demands a change in dosage or even a change of medication.
This is true with medications for physical illnesses too. People with chronic physical illness do not just take the same medication at the same dosage for the next 50 years.
Adjustments are required at some point.
This means that at some point, the person is going to start acting out. That's an absolute certainty.
How do we know?
Well, how else can anyone tell if the medication or dose is no longer working as it should?
Only by a change in that person's behavior.
And this merely refers to the most ideal situation, in that the medication is basically working as predicted, but just needs adjustment.
Here's another example of when medication worked for a time, but then needed adjustment:
Leah had been on Ritalin for years when I noticed that she started displaying ADD behaviors, like impulsive interrupting, fluctuating high-pitched speech, getting distracted VERY easily, and things like that.
She’s very open about her medication, so I asked her as tactfully as I could whether she’d taken her pill that day.
“Why?” she squealed. “Am I acting FUN-nyyyyyyyyy?”
“Um,” I said. “Well, you’re little bit more, uh, distracted and, uh, energetic than usual.”
“Reallyyyyy?” she chirped. “Well, I guess I'd better check this OUUUUUUUuuuuuUUUUuuuuuuuut…!”
And she hung up without another word.
Oddly, I knew her for 3 years before she started taking medication, and she never behaved like that. And for one of those years, I was her roommate. I never saw this kind of behavior in her back then.
What’s going on here?
"And So It's Just a Little Pill You Need to Take Your Whole Life – Just Like How Diabetics Need to Take Medication Their Whole Life" – Not.
At his wife's insistence, family friend went to his doctor to receive a prescription for Ritalin.
The doctor, a regular mainstream family doctor, asked the man whether he was managing in life. Could he work normally? Was his ADHD behavior interfering with his life?
The man said no, it wasn't.
(The truth is, this guy has a whole load of behaviors he refuses to work on, which is why his wife finally pushed him toward Ritalin. She gave up on him ever loving her or being compassionate toward her. She at least wanted his impulsive, hyper behavior and his frequent outbursts of rage to stop. But he honestly felt fine because he didn't see anything wrong with those behaviors. Unfortunately, according to her, he felt good when he behaved that way.)
Anyway, the doctor shook his head and said that Ritalin and similar drugs were contraindicated at his stage of life.
"How old are you?" asked the doctor.
"Fifty," said the man.
The doctor shook his head. "Ritalin causes an upswing of heart problems from the age of fifty. We don't like giving Ritalin at your age. For fifty and up, we only prescribe it when the person is not able to function without it."
He told his wife, his wife told me, and I told my husband (without names, of course).
We were all shocked to hear this common drug, promoted as something some people simply need to take for the rest of their life, was actually considered dangerous to take one's whole life.
So I don't know why so many doctors, publications, and people so blithely promote it as a medication to take one's whole life when it can actually shorten one's life.
With physical illness (like diabetes), the medication is intended to prolong one's life, not shorten it.
Can Taking Psychotropic Meds be Just Like Taking Regular Meds?
Why?
Apparently, her husband—who was difficult even in the best of times—would gang up on his wife with his mother during these visits.
The wife, Etti, wanted to remain calm and nonchalant, especially with their children around, and also because any upset response on her part would be greatly exaggerated and spread by her mother-in-law throughout the family with ensuing phone calls from Flying Monkeys — I mean, from the concerned and well-meaning relatives who wanted to smooth things over and make sure that Etti was sufficiently empathizing with her hard-working & long-suffering mother-in-law.
Here's Etti's side of the story:
After an exhausting Shabbat visit, during which Etti strove to be calm and pleasant no matter what, Etti needed to sleep after cleaning up and getting the kids ready for bed.
But after the house was neat and the kids in bed, Etti's mother-in-law suddenly wanted to start cooking anew for a full-stop melaveh malka.
These cooking sessions also always demanded that Etti be her mother-in-law’s drudge.
When Etti pointed out there were plenty of tasty leftovers from Shabbat, and apologetically said that she just didn’t have the energy and was actually planning on going to bed, her mother-in-law got all huffy and Etti's husband started yelling at her.
Frazzled, hurt, and at the end of her rope, Etti finally snapped back at her husband, who then joined his mother in the kitchen with his brother, where they also Etti heard their anger whispers and grumbling, positive they were enjoying a self-righteous lashon hara extravaganza at her expense.
Etti didn't expect much from her not-very-religious-or-knowledgeable mother-in-law, but she never understood why her husband always stooped to his mother's level.
Yet Etti went to her bedroom anyway, feeling so stressed-out and full of dread, she knew she wouldn’t be able to sleep.
So she took one Xanax.
She knew that this was all from Hashem and that ideally, she should say Tehillim or talk to Hashem in some way, but her nerves were shot at this point and she simply couldn’t make any more mental or emotional effort on her own.
Yet she knew how important proper sleep was, especially in such stressful situations.
After all, tomorrow would be just as bad — if not worse — and she wanted to make things as easy for her children as possible.
On a side note, I had a friend who smoked hashish every time her mother came to visit. (Her mother thought her daughter was smoking regular cigarettes.) I’m not in favor of that, but having met her mother, I understood my friend’s reasoning just as I understood Etti's reasoning.
Hard-core enthusiasts of alternative medicine will still insist that if only Etti (or my hashish-smoking friend) would inhale some lavender oil or drink a strong brew of chamomile tea or engage in deep breathing exercises, or give her mother-in-law and husband the benefit of the doubt, Etti would be just fine.
But at that moment, Etti felt like she just needed something that not only worked, but worked fast without any effort on her part.
(On Etti’s part, she wanted to daven to Hashem to help her relax and go to sleep, but she was too emotionally & physically exhausted to do that.)
This situation occurred once or twice a year, meaning that Etti only needed to take the sedative at its lowest dose for 2-4 days a year.
So what’s wrong with that?
I don't see anything wrong with that.
Furthermore, I’ve given birth surgically and believe me, I did not inhale essential oils or say Tehillim for pain relief—I took Epidural before they cut my stomach open!
So yes, there is a place for medication in our lives — both for physical pain and for mental/emotional pain.
However...
Let’s turn the above situations around to as if they were physical illnesses:
- What if a person was constantly plagued by headaches?
- What if the only way they could make it through the day was to pop Advil around the clock?
- Or what if they felt they couldn’t make it through the day without Epidural?
Wouldn’t that signify a deeper problem?
Wouldn’t a responsible doctor search for an underlying cause?
Of course!
So why is it that when someone feels they can live a life free of depression or paranoid delusions or hallucinations or anxiety only if they take a pill, then everyone is just fine with that?
Why not search for an underlying issue rather than writing out a prescription?
Especially since scientific research shows that the whole theory of “chemical imbalance” — as the prime & only cause of mental illness — is nonsense?