Snap Out Of It!

Safety Neal points out this column by Mark Morford who I ordinarily adore for his passion and righteous, sensible rage.

But this But, wait, isn’t the angry-teen thing a part of life? Isn’t that a mandatory stage for just about every kid nationwide, right before they evolve past it and their skin clears up and they finally get laid and then get old enough to drink and buy a minivan and have kids and finally join AA like good Christian adults? makes me angry.

Look, depression is a serious illness. It needs serious treatment. Fifty years ago it was looked on as something you should just “snap out of,” as one profoundly unsympathetic physician told a close relative of mine. For years, if you suffered from fear and dizziness and nausea and tightness in your chest at the thought of sitting up in bed, if you were absolutely unable to function, if the outward manifestation of the tropical storm going on inside your mind was you being unable to button your shirt, I mean being unable to comprehend how you could possibly button your shirt, you were told there was something wrong with YOU. You lacked the gumption to pull yourself up by your bootstraps and get over this silly little thing. You could get over it any time you wanted and the only reason you didn’t is because you were malingering, lazy, undisciplined. You you you you.

A lot has changed since that time. There’s therapy now, to change behavior that leads to and exacerbates depression. And there’s drugs. Drugs that don’t make you happy. Drugs that make you sleepy, that make you put on weight. Drugs that make you wonder if it’s you that no longer wants to kill yourself, or if it’s the chemicals. Drugs that don’t shoot you through the cieling. Drugs that keep you from falling through the floor.

Drugs that saved my life when I was considering finding a high place to jump from after years, years and years and years, of telling myself that this dark mood was a) my personality and b) something I could just snap out of. Drugs I wish I didn’t need, that I’m still not used to after two years, but I know I wouldn’t be here without.

And yes, commercials for anti-depressants have told us in the last 10 years that not only is everybody depressed, but that it’s no big deal, and the drugs can fix it. Drug companies have pressured and rewarded doctors who prescribed these drugs, and doctors have convinced lazy parents to give their kids pills rather than treat them with the complicated combination of therapy, love and yes, medication that so far is the only known remedy for this nightmare.

Morford seems to think that’s a problem with drugs. I tend to look at it as a problem with commercials.

Look, commercials promise kids that if they drink the right soft drink, they’ll be popular. They promise if you get the right clothes, the right toys, you can all but fly. Commercials have never been a good measure of reality, so to look at commercials for anti-depressants as an example of their efficacy or even their promise is really, really stupid.

And saying that it’s normal for teenagers to be angry and sullen is just as dumb as saying they all need Prozac. The truth is, this is complicated. Putting someone on medication that alters their brain chemistry is a serious decision, one that should not be made without consulting numerous doctors and long family talks that should always, always include everybody affected by the depression, including the person who’s depressed.

Doctors have responsibilities here, not to bow to pressure from Eli Lilly and other drug makers. But you, as the person or guardian of the person who needs health care, have responsibilities, too. That responsibility is not, as Morford suggests, to diagnose yourself and treat yourself, whether that’s with drugs, alcohol, or, as he suggests, “love.” If you think you’re sick, you go to a doctor. Reputable doctors will not just “decide” you’re depressed and shove pills at you. If they give you a pill after seeing you once, that’s not the pill’s fault, it’s the doctor’s, and you should leave and find a new one. If they give you a pill without explaining other treatment options, without requiring that you monitor your reactions, without charting your progress regularly, you should dump that doctor, because he or she isn’t helping you.

I have absolutely no doubt that anti-depressants are prescribed to people — especially children — who don’t need them. But I have no less doubt that people — including children — who do need them often don’t get them. Fifty years ago, it was because their parents, their co-workers, their children, their friends, their doctors told them they should just snap out of it.

Today, it’s because a serious illness is being seriously trivialized in commercials that should be laughed off like you laugh off the commercial showing that GI Joe can fly, but are instead being taken as gospel because they’re about meds and not action figures. Today, people aren’t being treated because, as one very dear friend put it before chucking his lithium down the sink, “I don’t need pills. I’m stronger than that.” Yes, he is. He’s also miserable, and on the edge of something drastic and unbalanced, all the time. Concern about overmedication is good, and I’d take it more seriously if it was coming from people who truly had a cat in this fight. Morford’s snide, simplistic commentary plays into a dangerous trend, that of rejecting treatment out of some insane desire not to seem like a pussy.

Yes, Mark, of course parents should talk to their kids instead of just shoving pills at them. They should also talk to their kids instead of just shoving PlayStations at them, too, not to mention $500 sneakers, thanks, and at times, when talking to their kids doesn’t seem to be working, they should try to find out if this is a serious problem going on, and find ways to fix it, and should not reject any, ANY answer just because they’re uncomfortable with the idea. Saying, as Morford does, that “the angry teen thing is part of life,” makes it just as easy for parents to shrug off symptoms of depression as giving a teenager a pill does.

Overmedicating depression can kill.

So can ignoring it.