Yesterday I wrote about the pros and cons of psychotropic medicines; basically, I’m all for drugs that make people feel better quickly. But the physical, mental, emotional and financial costs of these drugs as currently prescribed so often outweigh their benefit. Yesterday after I clicked “publish”, I started thinking about a couple things I wanted to say – you know, like coming up with the perfect comeback in the shower, six hours after you could’ve used it. Most of these short points center around the idea that learning to “feel better” without medicines is a difficult and lengthy process for people diagnosed with mental illness. And so for many of us the question become whether we try to feel better quickly with drugs in a process that may or may not have worthwhile results, or whether we do the painstaking work of learning to feel and act closer to the ways in which people without a diagnosed mental illness would feel and act, without drugs. Again, what is right for you or the person you love may vary. But here are a couple things I’ve been thinking about on my own long and winding road toward majority culture cognitive and emotional processes:
1. If feeling is something you are unaccustomed to, how can you learn to feel?
Feelings can be pretty scary things. Trust me: after disconnecting from my emotions for a very long time, learning to live with (and love them along with the information they bring) was a terrifying journey. It took lots of time, and lots of work, and I am pretty sure that as far as I have come, I have that far to go again. But for me, the payoff is worth the price: the world of emotions is a rich, juicy, complex one worthy of a life of difficult learning. No matter how many emotions we learn about—their names, where others feel them in their bodies, under what circumstance, and how those others manage these emotions, there are still more emotions – more names, more situations, more difficult and sometimes confusing management. If you wanted a quick “how-to” for learning to experience and manage emotions, I’m sorry to disappoint; but through hard work I’ve come a long ways and I know that I’m not that unique – sorry for the glib bow tied on this package, but if I can do it, you can too!
2. If exercise is the best intervention for depression, what keeps us from exercising more?
Think about this as a bigger question: if some sort of hard work is the best medicine for a diagnosed mental illness, why don’t we do it? Well, it terms of exercise and depression, sometimes it’s not having any company while doing so. Sometimes exercise is inconvenient. Sometimes it’s frightening to be outside, or inside, or anywhere. Sometimes it goes back to #1: moving means feeling and feeling is terrifying. But eventually, every person I know wants to feel—it’s just that some want to feel differently. As terrified as we are to feel, depression is a feeling too and we’re stuck in it. The question is whether we’re more terrified (and immobilized or comfortable) in the mental health diagnosis or more terrified of the state of feeling that hard work could bring for us. The people I know who take big psychotropics don’t want to be “crazy,” and they don’t want to be shut down by their medications, either. In some cases, “hard work” interventions – like exercise for depression – might work. But darn does it take courage to find out the alternative…
3. If medication works for you, why not use it as a tool?
It’s a great premise: we know medication changes brain pathways so why not use it to grow the brain pathways that would make us feel better? One of the most gifted clinicians I ever worked with asked a group I was in of childhood trauma survivors to go on very low-dose antidepressants for a year, while we also did work to learn how to feel happy (which many of us never had). In that year, not only did we do expressive work, we also did somatic work, and cognitive restructuring. Other than the fact that I was only able to tolerate the medication for six months, it was great. I learned a lot. I practiced hard. I achieved an optimal level of happiness that served as a great baseline for the rest of my life – though I couldn’t always fly at that altitude, I always had something to shoot for and I knew it was there. If you can use meds as tool while you learn, great. If it becomes a long-term support, okay. But when meds stand in the way of real development, and potentially a means of social control in which clinicians or others medicate away different, valid ways of being in favor of the great ugly blanket of “normalcy”, I get nervous.
So there you go. Those are the little addendums I wanted to add to yesterday’s post. The thing is, there are thousands more points to be made about this delicate balance of medicines versus difficult work in this crazy thing society calls mental health (pun intended). I would love to hear about your experiences. What are the factors you take into account when choosing for yourself, your loved ones, and the people in society with a diagnosed mental illness? With meds, there’s all there’s nothing and then there’s careful nuance. What’s your opinion of the best use of these medications?
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