FORESTS, AND CASHEWS, AND MEDS, (AND LOBOTOMIES), OH MY

There's a person in here, somewhere.

There's a person in here, somewhere.

Play along.

Imagine you’ve been diagnosed with a mental health condition. Then live, for a while, in the world. Hang out online. Be present for social media. Facebook, Twitter, what have you. It’s hard to avoid those platforms these days. Especially if you are involved in any sort of field where you have to put yourself out there.

What I think you will find, dear play-actor, is that there exists a wealth of people, some wholly unrelated to you, who would like to tell you what to do.

There are the people that insist that all mental illness is exactly like a physical illness, with roots in biology and genetics, and that, therefore, psychotropic medication is the only appropriate treatment.

On the other side of the spectrum—actually, not quite, because I’m skipping Scientologists—are the people who can’t open their mouths without screaming: BIG PHARMA!!

In between are the people who maybe are not totally opposed to meds, you know, in the case of people who really need them, but who nonetheless like to post memes about how the reason so many people are depressed is because, I don’t know, they aren’t spending enough time in forests. Or, maybe a daily portion of cashews would help.

Perhaps you’ve seen some of these. Perhaps you’ve shared them.

When you do, I kind of roll my eyes. On the other hand, I see your point.

Here’s me: at some point in my twenties, and into my thirties, my personal world experienced a series of rather terrifying collapses.

Bring on the string of diagnoses: first bipolar disorder, which was in vogue at the time, then temporal lobe epilepsy, then, d’oh, not epilepsy, rather PTSD, but, nope, not that either, let’s go with schizoaffective disorder. (Schizoaffective disorder is kind of bipolar disorder and schizophrenia, meeting somewhere in the middle). I spent about a decade in various forms of therapy (though never the kind of intense weekly therapy where I could actually talk about my deep-seeded issues), in different support groups, and on all kinds of meds. Mostly mood stabilizers and antipsychotics. I remained a mess. A messy mess.

I have a lot of feelings about all of this. Of course, there were all kinds of people telling me what to do. Sometimes, I even listened.

Later I ended up on different health insurance, and had regular therapy sessions, a whole year’s worth, with a Jungian-influenced depth psychologist. We talked, week after week, about the real stuff. The stuff that was breaking me. The stuff, that if I stared down, might stop breaking me. More than anything, I guess, this is how I became a bit more whole.

It’s not like my life is perfect now, because whose is, but I consider myself mostly recovered. (I’m not even in therapy.) I take a minimal amount of medication, which my body is dependent on (more on this in another post), and practice self-care. You know, the basics. Exercise, healthy diet, the occasional adult coloring book. I safeguard my personal time and always make sure I have an hour or two, once in a while, to do nothing.

By which I mean absolutely nothing. Maybe I’ll lie face down on the sofa and daydream. Okay. Technically, daydreaming is something. But, hopefully, you see my point. I put no stock in being busy. To my mind, busy is a luxury.

Onward.

As I’ve gotten better, I’ve become rather curious about the system that shaped so many years of my life. I have a lot of questions, and I’ve read a few books. My interests include the history of the system itself. Psychiatry. How, I want to know, have we gotten to the present point?

First I read Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker. I would say it counts as a polemic. Definitely more anti-meds than I think a lot of people who take meds might find comfortable. What I remember most about the book is the rather convincing case he made that the rise of bipolar disorder diagnoses in youth was linked to the prevalence of Ritalin prescriptions (or other drugs like it) in cases of ADD/ADHD. Put a kid on speed, I guess, and see where that takes you. Or, at least, that seemed to be his point.

I next spent some time with Richard Bentall (who I’ve recently come back to). This guy is kind of a hero of mine, and I’ll spend at least an entire future post talking about him. For now I’ll say that his basic argument seems to be that mental health professionals should focus on treating symptoms, not diagnoses. He also argues for what he terms judicious use of medication. (He started making these arguments years ago, and I’m happy to report, that at least in some quarters, his ideas have been adapted.)

In February of this year, I read Andrew Scull’s Madness in Civilization: A Cultural History of Insanity. What became clear to me after reading this book, in rather stark terms, was this: viewed through the perspective of history (whole centuries of it), those who have taken on the role of treating the mentally ill have rarely gotten it right. But, and this is important, what they’re doing often seems right at the time, or at least is the best they can do. Sometimes, what’s not right is even celebrated as innovative and groundbreaking. It’s probably worth mentioning that Egas Moniz received the Nobel Prize in Physiology or Medicine in 1949 for developing prefrontal leucotomy. In other words, a form of lobotomy. So, maybe in the end, not so great. (In what may be one of the biggest cases of karma coming round, Egas Moniz was later shot in the leg by a patient.)

Suffice it to say, I view mental health professionals (and their advice) with a dose of what I think is very healthy skepticism. Kind of like, okay, maybe meds, for now. Until the next better thing. Whatever that might be. Hmmm. Can’t wait to find out. (A big part of me hopes this might involve high quality, affordable therapy available for whoever needs it, when they need it, but you won’t catch me holding my breath.)

Essentially, my take on mental health treatment revolves around the idea that no one can put themselves into anyone else’s shoes, so we should all do what feels right for us. (And I’ve met enough people who really seem to experience life a bit better on meds. Better enough that the cashew/forest walk people should maybe hush up. Why? Because some people are allergic to nuts, and none of us can really live in the forest.) This may mean accepting that mental health and/or illness need not be all one thing, or have one cause. Widespread, overarching theories, perhaps, need not apply. One-size-fits-all ideas could take a flying leap out of the nearest window. Those who struggle with mental illness might, for a change, be regarded as unique individuals, with their own vastly different, but highly relevant personal histories, and treatments tailored specifically for them.

I think that would be nice.

Till next week.