It's o-week and I'm back blogging to coincide with my return to Woroni's illustrious pages. This year I will be trying to post fortnightly on average, though sometimes I might even go weekly! I'm feeling very ambitious this year. I'm studying again (economics) and its giving me some serious routine, and whenever I'm routine I'm busy and whenever I'm busy I'm productive. I have completed a book, some excerpts of which I might feature on this blog, and I've also prepared a bunch of articles, some for Woroni with longer versions for here, some short pieces for here, and some weird out-of-left-field stuff like the piece I'm currently brewing on Manic Pixie Dream Girls. But wait, there's more! Over the summer some friends of mine and I recorded a show on 2XX community radio called Left, Right and Centre. I will try and feature or link to some of the episodes here, and press the host to continue the show into the academic season. I think it is an outstanding show for students and something Woroni radio should be super keen on. If that doesn't work I'm also trying to get a show going called the academic (half) hour for academics and postgrads to showcase there research. Should be a busy year on the blog, which is good given that I've barely posted anything in months (granted, I did write a book). Sign up to the RSS and strap in for some high octane pontification on everything.
To kick off I'm posting an entirely re-written version of my first Woroni article for the year 'Stay off the drugs kids'. I intended to publish this version in Woroni but some wires got crossed at the editor's offices. I will be publishing a significantly longer version of this article in a fortnight or so. Please hold your flame mail (as if I get any mail) until you've read the whole story, which looks like it will be several thousand words at this point.
To kick off I'm posting an entirely re-written version of my first Woroni article for the year 'Stay off the drugs kids'. I intended to publish this version in Woroni but some wires got crossed at the editor's offices. I will be publishing a significantly longer version of this article in a fortnight or so. Please hold your flame mail (as if I get any mail) until you've read the whole story, which looks like it will be several thousand words at this point.
Stay off the drugs
kids
It is increasingly common for laypeople to understand
depression as a chemical imbalance in the brain. This understanding worries me
because it is professionally contested, disempowering, and can actually impede
healing.
The chemical imbalance thesis is extremely popular because
it reduces psychic activity to very measurable chemical factors. Science likes
this.
The problem is that all the founding schools of
psychotherapy—Freud’s, Adler’s, Jung’s and especially Frankl’s—all stressed the
importance of not seeing man as a machine.
Many neuroses arise from personality factors that cannot be
medicated away but must be talked out. For example, depression resulting from
an inability to meet parental expectations. Medication here cannot tackle the cause of the neurosis, only its symptoms. An existential therapy is
required.
The second problem is that conceiving depression as a
chemical issue disempowers the patient from doing anything about it. They have
no existential ability to objectify their problem and resolve it
psychologically.
Such an objectification is central to Logotherapy (the third
Vienna school of Psychotherapy). Consciousness—the defining quality of
humans—allows us to take a stand towards our neurosis and make of it a task to
be overcome.
If we are experiencing a neurosis that is directly related
to controllable factors, like the parental expectations case above, we can work
through our issue. We do not throw our arms up in despair and say: ‘the
chemicals in my brain are messed up; there is nothing I can do!’ We can
investigate our self-worth rationally and decide that our parents are wrong,
for example.
This kind of
soul-searching is difficult if our feelings are obfuscated by chemicals,
because communication between the unconscious and conscious elements of our
psyche is then inhibited. In this way, drugs can actually impede the
psychological processes required for healing.
Obviously drugs are useful and even necessary in some cases.
One example is anxiety disorder, where the patient’s fear of a panic attack
brings about panic attacks. Medicating away panic attacks here can act as a
circuit breaker for the neurosis.
But these cases are very different to the existential crises
that everyone faces at times in their life, especially in early adulthood.
Here we don’t need medication we need reflection—and
that is often impeded by drugs.
Many turn to drugs to remain functional. This is often
short-sighted. If a depressed person accepts a period of dysfunction in order
to rigorously engage with their neurosis they will often emerge a far more
functional person than the crippled one they are on medication.
Ironically, it is sometimes precisely what you are trying to
be functional at that is causing the neurosis. But you won’t discover that your
law degree is killing you if you’re too preoccupied medicating your way through
it to reflect a moment.
Hi Mark – congrats on showing an interest in mental health, it’s a worthy cause. Can I please suggest that you complete you research before advising impressionable youth to disregard best practice?
ReplyDeleteYou seem to have confused feeling sad with depression. Stress from parental expectations isn’t depression. People with depression may feel the stress of parental expectation but the expectation does not cause depression.
Most people can’t conduct heart surgery or apply radiation therapy but that doesn’t mean that we lie to the patients to try and convince them they have some control in the treatment of their disease. Just because a chemical imbalance doesn’t suit your neat and tidy model of brain healing doesn’t make it true.
Medication will not make a significant difference to people feeling sad and is probably inappropriate. People who are clinically depressed may be at risk of suicide or acts of violence without medication. Yes, there is a risk that medication will increase suicidal thoughts for a minority, but years of professional research has calculated that the risk of side affects is less than the risk of injury without medicine. We should be promoting harm minimisation first, and your hippy dippy brain healing ideas second. All the personal insight in the world wont bring back a dead person.
Freud et al may have said those things but I think you should focus on 21st medicine research. Newton described gravity and then went on to devote his life to bogus alchemy. And like Newtown, Freud possessed some remarkable insight and then went on to fixate on poppycock and cocaine. You have taken a snippet of information and extrapolated a bunch of Scientology nonsense.
Stressed university students are a vulnerable bunch and they shouldn’t be exposed to your propaganda. Why not promote all your reflection ideas as complimentary to best practice medicine, rather than persuade people not to follow doctor’s instructions?
Thanks for showing me the respect due anyone with a brain Tom. I will refrain from commenting too extensively and just direct you to the longer version coming out in a week or so, but in the mean time, I would like to note three things:
ReplyDelete1) Freud is conspicuously absent from my examples above. I tend to use Frankl much more, a DOCTOR working in the late 20th century who was held in extremely high regard by the medical community. Coincidentally, Frankl specialised in therapy for university students and advocated extensively for a non-reductionist understanding of the mental health of youth. As a preview for my longer piece, I offer the following quote: "In all these cases, to take psychotherapy in a narrow, traditional, psychologistic sense would mean simply to repress the 'metaphysical need'. It could easily amount to nothing short of education for 'metaphysical levity'. A somatotherapy of this kind would not only repress the metaphysical need, but try to DROWN IT IN TRANQUILISERS'.
2) Frankl stresses absolutely the patients ability to affect the healing process. His research was empirically validated, repeatedly, both in and out of laboratory conditions, in randomised controlled testing and in his concentration camp experiences.
3) In the longer version I specifically stress that my beef is not with psychiatrists who know the difference between 'sadness' and 'depression', but with psychology students who understand depression as 'nothing but' a chemical imbalance in the brain, and doctors who prescribe anti-depressants at the drop of a hat. My girlfriend once went to the ANU health service complaining of fatigue and was offered anti-depressants on the spot. In any case, I SPECIFICALLY MENTION THAT PEOPLE IN A SELF-HARMING SITUATION SHOULD TAKE MEDICATION SERIOUSLY.
4) One more for fun: Frankl made it his mission to educate doctors about the difference between feeling sad and depression, AS TOO MANY PEOPLE WHO WERE 'SAD' (SUFFERING FROM EXISTENTIAL VACUUM) WERE DIAGNOSED AS DEPRESSED WHEN THEY SHOULDN'T HAVE BEEN. This is PRECISELY what I am trying to communicate. I direct your attention to the third last paragraph. I'll do my research if you read the article more attentively.
Regards
Mark
A single paragraph within a rant of anti drugs messages doesn’t really present a balanced debate. Nor does quoting the research of a single doctor no matter how good that doctor may have been. I’m sorry, but I’m not convinced.
ReplyDeleteIt’s disappointing that your girlfriend got bad advice; but one anecdotal account shouldn’t cast a shadow over an entire branch of sciecne. I have a long list of anecdotal stories of people who have turned their lives around thanks to anti depressants. But the plural of anecdote isn’t evidence.
If you’re concern is for people acting out of ignorance, such as psychology students self diagnosing, then aren’t you just as guilty? You’re offering medical advice without qualifications.
Mental health is a tricky game. If we knew the exact cause of mental illness then psychology and psychiatry would be replaced by neuroscience entirely. But we don’t know. So we continue to do the best we can with the knowledge available at the time. I sincerely congratulate you on taking an interest but I really think you’re being irresponsible if you try to influence medical opinion without qualification or evidence.
Dissent is a great thing but power should be used wisely. Why not lobby for more funding for the ANU health clinic so that the doctors have the time to make a full diagnosis? Or get a grant to do some research into how frequently doctors incorrectly prescribe medicine? Otherwise you’re just adding more confusion to a problem that you describe as confusing.
Info is out of this world, I would bang to see more from your writers.
ReplyDeletelegal high