Dear Dr. Brilliant Cliché,
My friend is in a bad way. Her marriage has not been going to well and now her mother is dying of cancer. She is not taking it all well and she went to see a psychiatrist who diagnosed her with major depression. He started her on antidepressants and wrote her out of work saying she is temporarily disabled. I know she is having a tough time but isn’t it normal to be depressed given her situation? Why is it being diagnosed as mental illness? Is my friend really disabled?
This is not an easy question. Contrary to what the American medical world would have you believe, mental illness can not be defined by hard facts. Genetics, chemical imbalance, or anatomy are all components, but the mind isn’t the brain. There are many roads that lead to the same point and lumping your friend in with all depressed people is not useful. This general category includes people who burned their brains out with extensive drug use and also those who have a history of suicide that goes back three generations. This is due to the DSM5, the diagnostic manual for mental illness which doctors are forced to use in our medical system. It causes a great deal of confusion and misinformation in the psychiatric field.
Your friend is suffering and will be for a long time. In our culture protracted suffering is seen as an abnormal state and thus meets the criteria for being classified as mental illness. We are also expected to “leave it at the door” for work which is an unrealistic expectation.
Other cultures approach mental and emotional problems differently and probably wouldn’t label your friend as having a mental disorder; ours does. Other cultures have a different set of work expectations and policies. Your friend is failing to meet the work expectations of our culture; this is why she is seen as disabled.
Reality isn’t black and white. There are good and bad consequences to any treatment. No medication will make your friend happy but antidepressants do help in giving some distance from an overload of emotions. Too much distance would be a bad thing as grieving is natural and suppressing it would only prolong the inevitable. Medication should never be used to tolerate a bad marriage or suppress grieving but they may help by supplying some objectivity.
Dr. Brilliant Cliché
Granny says: I think it’s a big mistake to medicate people who are grieving. This is a very vulnerable time in a person’s life, but it is also a time when important realizations and epiphanies are found. A drug is a drug. The fact that a doctor is prescribing it doesn’t mean it isn’t a drug and it isn’t numbing out your emotions. It sends a message- this isn’t normal, you shouldn’t have to handle it without drugs. How is this any different than drinking or turning to street drugs? Does the doctor imagine that the patient will be better able to deal with the emotions in three months? Does postponing them make them more palatable? Please! That’s like putting off losing 20 pounds. It’s never going to get easier. You just have to do it. Postponing emotions is only more confusing, because now the source of the emotions has become history and the person feels a sense of removal from their importance. You can’t process an event that happened in the past. Memory is faulty and time has a way of twisting reality, especially when it has been padded with Prozac.
If a woman’s husband, parents and three children all die in a fiery car crash while she is driving, this is a situation that is outside the realm of normal grief. I can understand why the surviving woman might need some removal before she can process the situation. But a bad marriage and a mother with cancer is a scenario that occurs often in life and could possibly continue for some time. If medication is introduced, at what point is it removed? When the mother dies? No, that’s just another excuse for medication. When the marriage falls apart? No, there’s another excuse.
The fact is, if we don’t learn how to process difficult situations we will have very narrow, small lives. I know of at least one marriage that went kaput BECAUSE the wife went on antidepressants. I think that your friend’s doctor is an idiot. Just an opinion.