Dear Dr. Brilliant Cliché,
I just read an article titled “Ketamine the Next Big Thing for Depression?” Isn’t this a rave drug? Are doctors now giving out street drugs?
Dear I. N.;
At this point ketamine isn’t approved for depression but doctors are starting to prescribe it and, yes, it is a problem. The current idea is that small amounts won’t produce the high that street use does. The drug works amazingly fast and amazingly well thus the risk of abuse is justified.
Unfortunately, this misses the big picture. Sure it works but so does a hammer- except after hitting yourself with a hammer you probably won’t do it again. In our culture, suffering is greatly misunderstood and the treatment is backwards. Psychiatry is not surgery. We cannot reformat people’s brains.
In psychiatry any drug that works too well and takes symptoms to zero is not a good thing in the long run. The body is built to handle anxiety, sadness and other emotions. Removing all of it throws off the balance and feedback mechanisms our brains need in order to live in realistic conjunction with our environment.
The best examples of how medications can make one’s life a lot worse by making one feel better are Xanax and Valium.
I can’t tell you how many people I see daily who are in crappy relationships and want Xanax because they are anxious. Many doctors give it to them. The patient feels immediately relieved… and does nothing to change their circumstances. Eventually their relationships further deteriorate, and their symptoms become even worse as they build tolerance to medication and develop withdrawal symptoms.
I once saw a woman who had a mean, abusive and manipulative child who was eating away at her self-esteem. She was taking antidepressants and Xanax prescribed by her former doctor and she made no effort to discipline her kid at all. Her indulgence increased his demands and accelerated her panic and depression. Her medications facilitated the dynamic as it lessened her inclination to control the situation.
Anxiety is a body’s signal that something is wrong. People need to learn to deal with their problems rather than recruiting their enabling doctors into suppressing their anxiety so they can continue their dysfunctional behavior. It’s no different than an alcoholic’s spouse providing alcohol so that they don’t have to deal with their partner’s unpleasant mood instability from withdrawal.
Ketamine is yet another in the series of denial medications that works so well it will perpetually keep you out of sync with your environment. In the short run the operation will be success- but the patient will have died.
Dr. Brilliant Cliché
Granny says: I think Dr. Brilliant knows how I feel about medications.
Pharmaceuticals don’t create balance in the body. They substitute an artificial equilibrium for actual balance. The big advantage is that people can still go to their jobs and earn money to buy stuff and contribute to our capitalistic society. We live in a country where big business refuses to let environmentalists take steps to prevent global warming because it might hurt profits. The big joke will be that after the planet is destroyed, there won’t be anything left to buy.
The best street drugs have always been pharmaceutical grade. What made them street was that doctors weren’t prescribing them. Now that doctors are, I guess we can’t call them street anymore. But we can still call them stupid.