Are all these pills necessary?

By Edward “Ed” Garren, MA, LMFT

You see those ads on TV, “If your anti-depressant alone isn’t enough, maybe you need (an extra pill).” The other one, from a local health research company asks the same question, “If you’re taking an anti-depressant and not finding relief, call (name withheld) Research to see if you qualify for a free clinical research study.”

When I moved here lots of people commented on the “Seasonal Affective Disorder” (rain related depression) and it’s legendary contribution to the Portland lifestyle.

“Your practice will dry up in the summer, everyone is out having fun. As soon as the rain returns, your phone will start ringing” offered one friend, a veteran of the Portland mental health care delivery system.

After I started seeing clients, I began to realize something else, something more cultural might also be a factor.

The week I opened my practice, I had three clients who came within a week, all of them had taken anti-depressants for years and wanted to get off of them. All three reported that they just weren’t working anymore, and all three of them were natives of the Pacific Northwest.
What became apparent over the course of treatment were three things. None of them had ever learned how to express their anger, and in fact, were very uncomfortable with any display of anger, including their own. The culture had taught them to stuff their anger at all costs. They felt trapped in lives of duty, service and politeness. When a situation, or a person ticked them off, they didn’t know what to do, until they exploded, and that scared them.

As they learned some assertiveness, and shed some of their “put everyone else first” beliefs, the need and desire to keep taking those pills evaporated. Within a year, all were off the pills, and a lot happier, finding much more satisfaction in their relationships.
I still have a core of folks in my practice who are getting off their anti-depressants, and so far, with the same predictability.

Anger turned inward becomes depression. What are you angry about?

When I was in high school, there were a lot of “future doomsday” books, with titles like 1984, Brave New World, Level 7, Soylent Green, On the Beach, and later, one of my favorite movies, THX 1138 (George Lucas’ Master’s film for UCLA.) In most of them, part of the Brave New World was the routine ingestion of sedatives, so that the humans would become more like robots, or androids, simply performing their functions, in an efficient and soul-less manner. At the time, it was unthinkable to me that a civilization would offer up it’s very soul in order to have order.

Yet, in 2005, anti-depressants became the most prescribed drug in the United States.
http://en.wikipedia.org/wiki/Antidepressant – Controversy

By some estimates, over 30% of the population is now taking them. The use of them doubled during the last ten years. Most of these new prescriptions are not being made by psychiatrists, but my general practice doctors who have no psychological training. Often, they do not refer the patient for additional counseling, so the patient is just taking pills and hoping things get better.

What is also interesting is that in the last ten to twenty years, more and more people have lost any semblance of control over their lives. The disappearance of good paying jobs, escalating living costs, exaggerated consumer credit interest rates, and other factors have all flowed into the “American way of life” and fewer and fewer people believe they have much control over their future or destiny. And now we have an economic depression as well, further fueling that sense of powerlessness.

I want to be very clear here, I’m not suggesting you flush your pills down the toilet. I’m also not suggesting you make a unilateral decision to stop taking your medication.

But I am asking you to think it out. Has taking medication improved your life? Are you any happier on the meds? Are you also seeing a qualified therapist for counseling? Are you taking an honest look at your life, and what you can do to be more happy and fulfilled? And finally, do you easily connect with your anger inside, and feel comfortable expressing it appropriately when someone violates or offends you?

The decision to take or stop taking any medication is an important one and should not be made without appropriate consultation with your doctor AND a psychotherapist with whom you have a comfortable and honest relationship.

Edward “Ed” Garren, MA, LMFT

*Ed Garren is a psychotherapist in private practice. He has been a Social Justice activist all of his life. In 2008, he ran for Portland City Commission, seat #2