Take a Little Pill: On Psychiatric Medication

Lately it’s hard to go a day without seeing some think piece about how the United States is an overmedicated country – usually not referring to abuse and misprescription of antibiotics, for example, but rather to psychiatric medications. I’ve heard it all: psychiatric medications are prescribed for the wrong reasons, for the wrong disorders, are dangerous or immoral, are “unnatural”. They numb your emotions, cutting off access to “the real you.” According to David Breggin, author of the book Medication Madness, psychiatric medications cause violent behavior. There is apparently no end to the devastating ills of psychiatric medication.

I’ve gotten really tired of it.

Some background on my personal perspective on this issue: I have major depressive disorder, obsessive compulsive disorder, and quite possibly general anxiety disorder on top of that. I take medication for all of them, and have, in various types and quantities, for almost ten years. I have the privilege of knowing what I’m like when I’m not on medication due to the fact that my meds stop working after a few years, and sometimes in the course of a week or two I find myself dropping into ugly lows. Most recently, over the summer, I spent several weeks at a time struggling with the urge to stop existing, feeling out of control and constantly vulnerable – like my skin had suddenly gotten quite a bit thinner, and every little problem was a disaster of world ending proportions.

So this issue is a little personal.

While mental illness has become more widely accepted and less stigmatized than it once was, articles like Breggin’s seem to assume that we live in a world in which mental illness is, well, not that big a problem – the bigger problem is the drugs used to treat it.

An article by Julie Holland made the rounds recently called Medicating Women’s Feelings. Holland argues that women are prescribed psychiatric drugs because women are not permitted to have strong feelings. In her words:

[Women] are under constant pressure to restrain our emotional lives. We have been taught to apologize for our tears, to suppress our anger and to fear being called hysterical.

First of all, Holland’s article is a prime example of the kind of neurosexism dissected in Cordelia Fine’s excellent book Delusions of Gender: for instance, in the very first sentence, Holland states that “by evolutionary design, [women] are hard-wired to be sensitive to our environments, empathic to our children’s needs and intuitive of our partners’ intentions” – a highly dubious and mostly nonprovable statement. The idea of women being more intuitive and emotional than men has a long history rooted in sexism, dating back to Aristotle’s claims associating women with natural slaves because of their lack of capacity for rational thought.

Secondly, Holland assumes that the high number of women on psychiatric medication (compared to men) is because women are being subscribed medication unnecessarily. Isn’t it possible, instead, that women suffer mental illnesses more often (for instance, due to abuse and trauma, or environmental stress, due to the simple fact that being a woman is stressful)? Or that men don’t seek out psychiatric help because cultural conditioning tells men (even more than women) to be stoic and unemotional?

Holland’s core point, that women’s emotions are seen as something to be suppressed, is of course valid, but the trouble is that Holland’s argument – that what women who medicate are really targeting are their “natural” feelings, and a need to be more “in touch” with their emotions – all too easily sounds like (for instance) “you aren’t really depressed, you just can’t handle real emotion” – the last thing someone struggling with depression needs to hear. It becomes a damned if you do, damned if you don’t situation particularly for mentally ill women – if you medicate, you are suppressing your natural “female” emotions; if you don’t, you are a woman whose emotions are out of control, vulgar and hysterical.

Every so often I forget to take my medication, and sometimes even when I realize this it becomes a grotesque game of chicken with myself: do I really need this? (I do.) Am I really sick? (I am.) This cycle is one of the reasons the anti-medication articles make me so twitchy – because a part of my depression, and a symptom of depression and many other mental illnesses in general, is the conviction it’s not real, that everyone else feels this way and they’re just dealing with it better, that your failure to adjust is something wrong with you that you should be able to fix. Perhaps, as Breggin suggests in utter sincerity, with “courage, determination, self-discipline, and sound principles to face and overcome our personal problems”.

While I am far from denying the fact that medication isn’t the answer for everyone, and for some people it may be downright harmful, a lot of these articles paint with far too broad a brush for my liking. They reinforce the stigma that paints mental illness as a personality trait in need of adjusting rather than a chronic illness requiring treatment (in a common metaphor: who is going to tell a cancer patient that they just need a little more self-discipline?). While undoubtedly some people may abuse psychiatric medication, ultimately I fear the real people these articles are going to end up hitting are the people who might really, truly benefit from the use of psychiatric drugs. The people who will read them and think it’s all in my head, I should be able to do this on my own.

To close on a personal note: I do not claim that medication is a cure all. Nearly ten years of it hasn’t “fixed” me, after all. What it does do is enable me to live, day to day, and to work on finding coping strategies, and to recognize my own distorted thinking. It gives me the space to be a functioning human being, rather than leaving me to take all of my energy to do basic tasks like wake up and eat.

The message articles like Breggin’s and Holland’s send too often boils down, to people like me struggling with mental illness, to: your illness isn’t the problem. You are.

No, thanks.

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