Thirty-five years ago, I received a phone call from my friend Lily about a car accident involving a mutual friend of ours, Terry. The three of us had graduated from UCLA three weeks earlier. Terry, along with her sister, brother-in-law and niece, had gone on a graduation trip to the Colorado River. En route, along a two-lane highway, another vehicle tried to pass them and the line of cars ahead. The driver mis-calculated the distance and as a result, a semi-truck coming from the opposite direction swerved to avoid the passing vehicle, struck our friends' car and instantly killed Terry's sister, brother-in-law and niece. Terry survived but suffered severe and irreparable brain damage.
I had given up my apartment following graduation and was briefly staying with my parents before leaving on a long trip. When I came out of my room after the call, deeply upset and in tears, my mother immediately went to her bathroom and returned with a blue, 10 mg Valium which she pressed into my hand. Her response to my grief was to offer me the same medication she used to keep her own pain sedated. I hadn't thought about that incident in years, but recently, in considering some of the wrong reasons people take antidepressants, the memory came back to me.
I believe that antidepressants have their uses, especially in the short-term, but I also believe they are grossly over-prescribed by unqualified physicians and medicating psychiatrists who run prescription drug mills. This criticism lays most of the blame at the feet of the medical profession, but a conversation with an old friend from Los Angeles reminded me that insistent patients are also a part of the problem. Many people choose to take an antidepressant in order to avoid dealing with a problem they might otherwise have to confront.
My friend -- let's call him Peter -- has worked in the film industry for more than 30 years and knows everbody. Peter told me that he's close with quite a few women who (in his opinion) are on antidepressants because their married life would be otherwise unbearable to them. They're married to wealthy, powerful men in the industry who they don't love; divorce would mean giving up a financially privileged and superficially glamourous style of life they don't want to relinquish. So they take SSRIs ... NOT because they're depressed but because those drugs make tolerable an emotional situation they wouldn't otherwise be able to bear. Peter says this is not an unusual Hollywood story.
A mutual friend of ours is quite candid about using an antidepressant for similar reasons. She has a child growing up with Asperger's, and the very low dosage of her medication makes life bearable. She tried getting by without the meds but found she just couldn't cope. This friend is not struggling with depression per se but with an extremely stressful life situation. Her drugs "take the edge off," numb her out just enough so that she can manage.
Another friend of ours, after her divorce, decided to become an elementary school teacher, despite the fact that many of us felt she was by temperament ill-suited to the profession. Ignoring some judicious advice, she went ahead with this career change and suffered a nervous collapse during her first year of teaching. With mostly sleepless nights and several panic attacks, she wound up in the emergency room more than once. Instead of reconsidering her career choice and trying to find something more suited to her, she opted for anti-depressants instead.
Medication might be the right choice for our friend with the Asperger's syndrome child; after all, as his mother, there isn't much she can do to change her basic lot in life. But in the case of our friend who chose drugs over a career change, it seems to me she's using antidepressants to avoid confronting something dysfunctional in herself and in her life. Likewise, the Hollywood wives who take SSRIs rather than file for divorce are surely using those drugs in ways for which they were never intended.
One of the primary rationales given for using antidepressants is that they may get a depressed mind "unstuck" when psychotherapy is making slow progress; meds are often seen as an adjunct to talk therapy, helpful in promoting insight and understanding for the psychotherapy client. But those Hollywood wives and our friend who made a disastrous career choice are using medication for just the opposite reason; they don't want insight so they can understand themselves better and confront important choices. Instead, they are using those drugs in order to avoid confronting their problems.
Depression, like pain, can be the body's way of telling us that something is wrong. If we listen to our pain and our depression, we might understand what's wrong and over time, figure out what to do about it. But if we reach for the little blue pill as my mother did, numbing the pain instead of confronting it, we'll remain stuck and never move forward.