Medicating the Jerkbrain and the Single Story of Mental Illness

Over at Greta Christina’s blog, there’ve been some.. interesting.. conversations recently around dealing with having mental illnesses that will probably need indefinite medication, and the responses other people have to that. Last week I talked here about my own experiences with having been on meds for my own jerkbrain and the things that allowed me to more-or-less recover.

I’m lucky. I don’t have to take meds anymore. But I can tell you that I’m a happy, drug-free person because I took my drugs when I needed them. I spent, all in all, the better part of a year on Lexapro, and while I’m glad I don’t have to deal with side-effects anymore (did you know Lexapro can make you need to pee all the damn time? Now you do.), those little pills gave me the leg-up I needed to get out of the worst of the maelstrom I was in and sort my shit out. I would not be in the place I am now if it weren’t for many things. One of them is those little pills.

It’s a crutch!

People talk about jerkbrain meds saying things like “it’s just a crutch”. They’re right. They’re a crutch. They prop up bits of your brain that aren’t working right now, just like a physical crutch stands in (seewhatIdidthere) for your leg when it’s too broken to take your weight itself.

Sometimes crutches are temporary. You’ve broken something badly and after a few weeks or months, a cast, and some moderately unpleasant physiotherapy you’re able to put it away and walk unaided. This is great!

Sometimes crutches aren’t temporary. You actually, really, genuinely, have a leg that is (now) intrinsically not able to hold you up while you walk, or that would lead to excruciating pain or balance difficulties or injuries if you did so. So you use the damn crutch, and you get from where you are to where you need to be, and that’s also great.

Sometimes jerkbrain meds are less like crutches than they are prostheses, correcting for things that your brain simply doesn’t do, bits that just aren’t there or don’t work the way you’d like them to in ways we can’t fix. And yeah, having a prosthesis is probably a lot more of a pain in the ass(/leg/arm) than having a limb that does the stuff without having to think about it. But that prosthesis? Is great.

The Single Story

There’s a lot that we, as a culture, don’t get about mental illnesses. We act like depression is the same as feeling down in the dumps, describe ourselves as ADD if we’re distracted one day, and bipolar if we’re hangry and need a snack to get back on the level.  One of the biggest things that we do, though, is act as if each of those labels actually describe just one thing- as if depression is like the measles, a specific thing that we can isolate and treat.

They’re not, though. I didn’t get diagnosed with depression after a bunch of blood tests and scans with fancy machinery. My doctor talked to me for a while, asked me a lot of questions about my life and how I was feeling, and ascertained that I was definitely suffering from the symptoms that we clump together with words like “depression” and “anxiety”. Having those words meant that I had a name for what was going on, and that we (me, my doctor, and the therapist he made an appointment for me with right there in that office, knowing that people you’ve just diagnosed with anxiety might not be people who are good at making scary phonecalls in a timely fashion) had a variety of tried and tested options to choose from for helping me to feel better. That was all.

There isn’t a perfect depressed person sitting in a vacuum in the Smithsonian. We’re not all shadows of the ideal depressed person flickering on the wall of Plato’s cave. Depression’s just a word we use to describe a phenomenon where some things happen together, and it varies as much as the people living with it.

It’s when we decide that mental illnesses (and for that matter, many physical illnesses) are one thing, that we start making harmful assumptions about what to do about  them. We all either are or know someone who had an unpleasant bout with a mental illness that they managed, after a hell of a lot of work, to get past. That doesn’t mean that all mental illnesses can be overcome with bootstraps and gumption, any more than it means that amputated limbs can be grown back because broken bones can heal.

Sometimes bones or minds are broken and heal up fine. Sometimes they can’t.

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Medicating the Jerkbrain and the Single Story of Mental Illness

5 thoughts on “Medicating the Jerkbrain and the Single Story of Mental Illness

  1. 1

    The last time I consulted my doctor about my mental health, I got my self-reportage of symptoms basically doubted. The last time I went to a counselor (with a student counseling service), I got told that labeling things “depression” and “anxiety” was A Bad Thing To Do, and that I wasn’t really depressed.

    After seven years, I have a raft of coping techniques for dealing with the inside of my own head, but I’m still angry about that.

    Fortunately, no one has taken my prescription for escitalopram away yet. I will fight tooth and nail to keep that one, because it’s been really useful in keeping me on an even keel. Or at least, a much more even keel than I was without it.

  2. 2

    I’ve asked myself this question many times with regard to medicating “depression”, “anxiety”, “ADD”, etc., and I now pose it to you: How is it moral to prescribe chemicals for a person for whom there is no physiological diagnosis? As you yourself explained, depression is not a medical condition. It is not a thing. Depression is nothing more than a name for various symptoms. What actually CAUSES those symptoms? Is it a hormonal or chemical imbalance? A neurological glitch? The medical industry does not care, because as long as they can convince to you take medicines that the huge pharmaceutical companies make billions of dollars from then the doctors who are repeatedly bribed by these companies will continue to prescribe them.

    If taking the drugs makes you function more rationally, it’s fine with me. What you put into your body is your business and none of mine. But I can’t and won’t put blinders on and pretend that the system is actually treating whatever is the root cause of your emotional distress.

    The more I read about the “mental health” industry, the more arbitrary and victimizing it appears.

    Shutting off these factual stories to make it feel better taking drugs from big pharma doesn’t make the stories false and doesn’t make the facts go away. Now in any given case I’m open to the idea that there are actual physiological problems that there may be appropriate drugs to treat (though I personally believe that in the vast majority of cases the science would uncover nothing but someone who’s gotten into a pattern of not thinking clearly).

    In your particular case, the reason that you feel you personally function better with these drugs may be that there is in fact a specific, objective neurological dysfunction that the drug chemically compensates for. If medicine could actually get to the level where we could talk objectively about those chemical processes as a means of understanding “depression” etc. then I would be all for whatever objectively correct chemical treatments could be made available. But to say that telling a doctor how you feel and having them prescribe something with absolutely no idea of what’s actually causing you to feel that way and having it miraculously work and calling this medicine is the intellectual equivalent of taking us back to the Dark Ages, and I won’t stand for that.

    Respectfully yours, in love of reason and liberty.

  3. 3

    Tiffany, and, M. cozy, but mostly Tiffany.
    It is not really accurate to say that mental illness cannot be diagnosed with blood tests and checking for chemical imbalances and the like, only that doing so would be complex and prohibitively expensive. (Which would kinda make you wonder why doctors, who are taking bribes from one group of companies flat refuse to take them from another, the group who make diagnostic equipment).
    Depression is a measurable chemical imbalance. It correlates strongly to a person’s behaviour and outlook so it’s easier to diagnose it from those flags than from expensive tests to prove beyond doubt (particularly since there’s always some doubt). Going back to the physical examples given in the OP, if you turn up at the doctor and one of your legs won’t work they’ll make an educated guess what’s wrong. If they’re reasonably sure it’s a sprain they won’t send you for an x-ray, because it would be expensive and useless. However, they won’t send you for an MRI either, no matter how much extra certainty that would give, because it would be about a hundred times the cost of the treatment.
    So, hopefully now, according to your own assertion in your last paragraph, you are all for treatment of brain chemistry illnesses with appropriate drugs. Even if they are being proscribed by people who work with a collection of maybes to make a decision on a probably.

    1. 3.1

      Thanks for your thoughtful and respectful reply. Your analogy about the scans would make great sense IF those in the psychiatric industry truly believed or cared that depression and other trendy mental situations are chemical phenomena that can be tracked by science. Sadly, I cannot possibly agree with that premise. When the very definition of ADHD is nothing but a list of petty behavioral symptoms that could be linked to practically anything, medical or otherwise, I can’t somehow believe that the so-called mental health profession approaches mental conditions the same way that medicine approaches broken bones. It’s not comparable.

      I’m going to publish this piece in about 6 hours which has an excellent section related to drugging kids and the effects of prescription drugs for “mental health”. I’ll give you the link early – check back soon:

      Wishing you the best as your loyal follower.

  4. 4

    Hey, as someone who has suffered similarly, and has also been on meds I have a different take.

    First and foremost, I’m not anyone’s doctor, if something is working for you or even when it isn’t, I don’t have the right to say anything about your case. It’s between you and the people that take the responsibility of your care.

    Secondly, we’re not just talking about you and me, we’re talking about everyone with depression, and for that we need more than personal experiences, we need independent data that will tell us definitively what any given psychiatric medication does and doesn’t.

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