27 November 2007

Sadness vs depression

I love to read Sister Wolf's blog "Godammit.com" because she so often has a perspective that I haven't thought of before. For instance, she has passionate views on the ethics of surgically modifying children to appear more "normal" if they have congenital "deformities."

She recently wrote regarding a NT Times book review of three books on the pathologizing of common conditions like shyness and sadness.

During my annual visit with my primary care physician I told her what a crappy year I had had. Well, she asked. Foremost on my list of crap things were breaking up with the exMrStapler and my sister dying.

She was sympathetic - and then she offered to medicate me. I demurred. She pressed, saying, "Well, you know if it gets bad you can always call me and I will fix you up."

Memo to Doc: I'm not clinically depressed. I am grieving. Can I do that?

I don't know about you, but I don't think all pain can or should be avoided. To me, not feeling this pain and loss would actually be worse than feeling it. As I said in my comment to Sister Wolf, I think I would be a monster if I didn't hurt like this.

I wonder what Emily Dickinson's poetry would have been like if she were medicated out of her social anxiety. Van Gogh clearly could have used medication for his bipolar disorder, but...I'm too chicken to say this, but his art and his illness seem so bound up together. What would be the ethical thing to do with someone like him? Would it be better to end his suffering, if it ended his genius? (Please note: I'm not saying you have to be mentally ill to be a talented artist or that people who are on medication can't produce great art.)

When I was a kid, the 18-year-old son of our neighbors 2 doors down ran out of air while SCUBA diving, a dumb macho kid mistake. He got the "bends" which left him unable to feel his legs.

He could still walk, but his pain receptors were gone. This condition turned out to be very dangerous, because he often cut, bruised and sprained himself, even once broke a bone, without ever being able to feel it.

Is there a parallel in our society? Where there is pain, is there also necessarily illness? And what are the dangers that come with being chemically removed from our deepest feelings?

Edited to add: I just want to be sure that you know I'm not doing a Tom Cruise and saying that psychiatric medicines are unnecessary. I know that many people need them, just as diabetics need maintenance drugs, and that there should be as little stigma involved in both. I am concerned, though, that a family doctor would offer to change my brain chemistry after a 3 minute conversation because I mentioned being sad.


Blog Antagonist said...

Once again, you have voiced a thought I have had often. There are no doubt people who are clinically depressed and need pharmacological help. I'm glad that help is available for them.

But not every sadness is depression. When there are reasons to be sad, we should be.

Anonymous said...

You are absolutely right. How can you truly experience joy without understanding sorrow or pain. However, having just got my first urinary tract infection, medicine has its place -- and this is coming from someone who rarely, if ever, pops a pill.

meno said...

I have a brother who i just know would have been diagnosed as ADD or ADHD or some other initials. He's all grown up and fine, juat a busy active curious boy. It's not that i don't think these things exist for real, but we sure are eager to fix everything that causes distress.

gael said...

I asked a friend about his brutally vibrant political paintings. He's not so keen on war, Condi and Halliburton, to name a few... But he said that if he didn't work out his rage on canvas, he'd go crazy. I'd much rather have his art than tranquilizers. Thought provoking musings, thank you.

Julie said...

I share your feeling with this. Each time I see my Dr. he will offer antidepressants - to the point where I think he might receive some sort of bonus from the drug companies. (Each time I had valid reasons for feeling sad.)
I'm certain there are people who benefit from these drugs, but the physicians are being pretty careless with them.
We are Americans, we are supposed to be happy all the time.
I think they do it with everything: drugs to help with high blood pressure instead of telling people to take care of themselves.

Average Jane said...

I couldn't agree more. A few years ago when I was suffering from a lot of anxiety symptoms due to stress and probably too much caffeine, my doctor sent me home with samples of Lexapro. I read enough about it online to know that there was no way I'd ever actually take it. As soon as the root causes naturally subsided, so did the symptoms. I ended up throwing away the samples when we remodeled our bathroom and I'm really glad I didn't go that route.

Juliness said...

I am lucky enough to have a Doctor of Osteopathy (D.O.) as my primary care physician. He treats the whole person; mind, body and soul - and I love that.

If horrible things happen, I want to feel shocked or sad or angry, not numb. If I need help to sleep, I want to figure out what in my life needs to change so I'm not as stressed.

I am not opposed to meds at all, if they are necessary, the can save lives or make them measurably better. I just don't want to be offered a persciption right off the bat for something that requires only a bandaid.

Great, thought-provoking post!

one smarmy mama said...

I get it.

We have some *think* in our culture that makes it a bad thing to be in pain, even if the pain has a purpose. I think the pain of a loss serves a purpose. But we live in a "Oh, you deserve to feel good ALL THE TIME no matter what" society......

Lawyerish said...

I totally agree. As human beings, we are built to experience a wide spectrum of emotions, some of which are not pleasant but are a part of life. Is it really better not to go through the agony of grief (as distinct from the long, bludgeoning lethargy of actual depression)? I don't think so. It's a bit disturbing that your physician was so quick to offer to "fix you up." Jeez.

MsLittlePea said...

yeah! I agree with you. Meds can be a wonderful tool to those who truly and chemically need them. My own father is bi-polar and his meds have balanced him. I wish he had them when I was growing up.

But I find it shocking that doctors are so quick to offer meds without suggesting speaking to a therapist as well. I wonder why people think there's something wrong to 'feel'. We have to feel. Are we supposed to be robots?

lizgwiz said...

I totally agree with you. It's not normal to never feel pain. I have a couple of friends who are on antidepressants--and SHOULD be, let's be clear--but they sometimes think that means they should never be unhappy. I have to remind them--being human means hurting sometimes. Everybody has highs and lows, and it's normal. No drug should take away every bit of that natural arc of life.

Jhianna said...

Not much to add to what you and the other commenters (why does my spell checker refuse to believe that's a word? Have I made another one up?) have said.

Except, I've had that same thought about Van Gogh and artists before. Intense artistry so often seems to come with intense emotional and mental processes. It makes a piece of beauty so much more poignant when you know that the artist went through pain to bring it forth. (Not that I want anyone to suffer, yada yada yada.)

QT said...

This reminds me of my first visit to my doc (a woman) after I filed for divorce. She went through her usual list of questions, and when she was done she said "So, anything other than smoking, binge drinking and unprotected sex I should know about?" We both laughed. She told me if I still felt the same way in 6 months, to call her.

I am just glad it is a subject docs are willing to broach now - certainly I agree not everyone needs drugs - but at least they are talking about it.

Hilly said...

before i say this, i just want to go on the record as saying that i take pills for depression and anxiety.

now then, i actually agree with you. i think there is a huge difference between real depression and situational depression and we should FEEL situational depression. i like the fact that the meds i am on just even me out, but i still cry and hurt and feel when it is real and necessary.

Andrea said...

I'm in complete agreement. Some things SHOULD be felt, and how can we know the utter beauty in happiness and joy if we don't know the utter beauty in sadness? Not every unpleasantness needs to be medicated away.

That being said, however, I wonder if your doctor is going on the assumption that if you didn't want the medicinal boost, you wouldn't have answered her question truthfully. I once asked my doctor for a little help with some anxiety I was feeling (quite unnecessarily, I thought) and it took a lot to work up the courage to even mention it to him. So maybe your doctor is thinking that if you went so far as to say it (even though she asked and you were just being honest), that maybe you were asking for help so she was offering in the kindest way she could, by opening the door to you for it should you ever decide you want or need it. Maybe some of her other patients haven't known how to ask, so if she offers when they say they're down or have had a rough time of it, she takes away some of the discomfort and they get the help they meant to ask for anyway.

Or maybe she's getting kickbacks from the drug reps and really wants a new pair of pricey shoes or something.

Alex Elliot said...

I completely agree. When I was meeting with a therapist a while back, my goal was to be able to deal with pain, not to not be able to feel pain.

Staci Schoff said...

I didn't know your breakup with ex-MrStapler was so recent. You have had a tough year!

I think that psychiatric medicine definitely has its place, but surely if every third person you meet is on it, it's being used to treat behavior and feelings that are NOT "abnormal."

Like boys who used to be dismissed as "hyper" and sent outside, are now all sick. (I'm not suggesting that ADD doesn't exist or that some children don't need treatment, I'm just saying that being annoying to adults is part of being a boy and it doesn't need to be medicated.)

Your sadness is understandable, and I hope it fades soon.

Anonymous said...

I cannot understand how anyone who is "normal" could ever push for people who are "different" to stay just the way they are. Its that "god made you that way" bullshit that is dangerous. As a child born with a severe facial deformity, no one can ever understand the self hatred, the childhood teasing, the feeling of always being different, that Ive felt. I am 26 years old and children still stare at me because I look different. When a guy looks at me, I wonder if its because he thinks im cute, or because he wonders whats wrong with my face. My parents put me through 13 surgeries before I was 18. After that, I choose to have 7 more. And still, I know I will never look just like everyone else.

Sharkeysday said...

I so totally agree with you. My husband died when I was 29 and the first thing people wanted to do (everyone...not just dr's) was to medicate me. Why do we medicate to get through the natural things in life. OF COURSE THEY'RE SAD. Duh.

Count Mockula said...

I mostly agree, but I want to back up Andrea, too. I think many people are scared to ask for things, and so the doctor offering is a proactive step. I also know that now every doctor asks how you're feeling. I have never had one ask, actually. So cut her some slack -- it seems to me like she's on the right track.

Mrs. Swizzle said...

As someone currently medicated for depression, I completely agree with you.

I believe that, right now, this is what I need. But this is different from what you are talking about.

I agree with others that your doctor is probably just making sure that you know that help is there if you need it. It took me weeks to even make the appointment to ask.

Suzanne said...

I have polycyctic ovarian syndrome (PCOS) and a common symptom is depression. I went to see an endocrinologist and he almost would not let me leave his office because I refused a prescription for anti-depressants. Big problem in our under-insured society.

mothergoosemouse said...

What Hilly said. And I agree wholeheartedly with the importance of therapy in conjunction with meds.

WkSocMom said...

While I agree you should not be medicated just because you are feeling bad, I think sometimes medication for situational depression is okay, if it makes you feel better, artificial or not.

If you aren't functioning very well meds can help you enough to address the problem. Also your brain can adjust itself whether it chemical or situational and meds can help stop that permanent change (spoken as a totally unmedical person so I probably didn't say that very well.).

Ironically of course my family think I'm totally anti-therapy and medication since I don't think they work for me.

SIster Wolf said...

Well, you already know what I think.

But when I ponder the Van Gogh question, I wonder whether he himself would have judged his mental suffering to be worth it.

I used to think that the grit of suffering was what produces the 'pearl', so to speak. For most of us, there's no pearl, though, just the grit.

xxoo Sister Wolf

Chantel said...

I've fallen into a clinical depression a couple of times in my life. The meds helped. Then I hurt my back and have been experiencing chronic pain for a year, and my doctor thought I was depressed and put me on meds again. Those meds gave me weird side affects after they quit working; she gave me more. By the end of the year I was on 3 different psychotropics; FOR BACK PAIN. I quit taking them and I've never felt better.
Next time my back hurts I'll take an advil.

Kizz said...

I hear you on this. If I need medication I think I'd get it but I don't want to have it be plan A. I also wonder about the parallel between genius and madness and medication. I think that Robert Downey Jr. and Savion Glover and Aaron Sorkin (and scores of other people I'm sure) self medicate to help relieve the constant pressure of the creative input their brains give them.

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