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up with disease
when everything is treatable, normalcy becomes an aberration
by alicia coleman

There’s a good chance you're diseased.

If you feel anxious about meeting new people at a cocktail party, if you feel bogged down by the dreary winter temperatures – hell – even if you're menstruating, you may be suffering from a mental disorder. You may need serious treatment, expensive medications, and a lifetime commitment to a good health insurance policy covering much-needed pharmaceuticals. You just might need the immediate attention of a doctor. At least that's what the folks at the American Medical Association and American Psychology Association will have you believe.

The last time I checked, though, the above behavior amounted to shyness. A little seasonal slump. Oh yeah, and the pubescent physical curse requiring the aid of a training bra, while permitting for continuity of the human race.

But at the rate pharmaceutical companies have been turning out new prescriptions – including everything from Paxil to Zoloft, treating everything from "social anxiety disorder" to "premenstrual dysphoric disorder" – it's a wonder that any sort of human sentiment, which doesn't prompt one to sing like a choir boy or gleefully somersault down the street with the enthusiasm of a world class gymnast, remains as normal. Or at the very least, untreatable.

What's next? A pill that makes you feel like you have the perfect "cute as a button" nose, with ravishing eye-surrounding skin to boot, thereby encouraging you to make the most dazzling entrance into a crowded restaurant you would otherwise feel uncomfortable in? (Perhaps someone should have filled in Greta.) A vaccine that makes you seem taller, your "napoleon complex" notwithstanding?

Given our new pill-popping standards, the potential for even more outrageous "treatments" to deck the shelves of CVS does not seem that far fetched. Almost every emotion – every sad feeling, every ounce of nervousness – can be treated or cured. Assuming, of course, that the "patient" seeks professional help promptly.

But is this the right way to go about ridding Americans of their problems? Must every condition which does not inspire warm, fuzzy feelings be lumped into the "dysfunctional" category, elimination of which can be achieved only by popping three pills daily, with or without food, so long as one avoids direct exposure to sunlight?

Clearly not. And most M.D.s would never trivialize the matter in this way. (Even the ones who shove trial packages of Zoloft in your bag within the first five minutes of a visit.) Rather, most American doctors would argue that only those who suffer from severe depression or panic, most likely caused by a chemical disorder, should seek a prescriptive remedy. All others need not apply.

Yet I wonder if that’s how all these specialists operate. In a time when children are being prescribed Ritalin with the alacrity in which it takes the President to receive a "state of the union" standing ovation, the need to medicate – rather than merely treat – overwhelmingly steals the spotlight. Indeed, the pill-pushing doctor seems about as ubiquitous as a drug dealer in a needle-littered back alley. And his tactic is much the same, too: Hand out a month's worth of goodies (Prozac or methamphetamines, take your pick) at no cost, wait for the kid to start jonesing for her next fix, and then move in for the kill. End result? A junkie, er, patient for life.

To be sure, though, our Prozac Nation's children can't put all the blame on the willingness of their providers to refill those plastic orange vats – could this be our new "agent orange" era? – with mothers' little helpers each month. Those of us intent on a quick fix without having to work for it are just as culpable for our new drug dependencies. We pick up the phone to set up an emergency meeting with our analysts immediately after having run into an ex who's dating someone more attractive, or the moment we run out of Vicadin right before hosting a big party. We are, in the words of some right-wing Republicans, no longer responsible for our own well-being.

But shouldn't we be? No matter the cause of our problems, don't we have any solution other than that which, when mixed with alcohol, causes drowsiness and/or comatose stupors? With the exception of those who are severely or clinically depressed, can’t the majority of us pull ourselves up by the boot-straps, jump back on the horse, and get back into the saddle with relatively little effort?

Sure, there’s always alcohol to put the spring back in your step. (And as an Irish Catholic I’d be hard-pressed to suggest that we altogether eliminate that panacea from the feel-good medicine cabinet.) But there are other alternatives, too. In addition to the help of friends, family, rabbis, philosophers, and writers (just steer clear of the Russians when in a funk), we can each rely on good ole' fashioned self-determination and gumption. Instead of stewing or obsessing about a feeling or problem, it's best to get off the duff and start moving. Go for a run, write a poem (yes, even a melodramatic, teen-angsty sort of ode), or whip up a batch of your mama’s chicken stew and distribute it on the street to as many homeless persons as you can find.

Depression, sadness, and anger – no matter what the cause – can muster up some of the most creative enterprises and ideas. And no pill, even at the temporary expense of mental health and happiness, should stifle them. Reliance on the prescription, or so it seems, may deter one from tackling and resolving issues or, more importantly, may numb one to the point of apathy. It may, create a dependency such that one reaches for the labeled goods at the onset of a twinge of nerves, regardless of whether it is caused by an actual attack or an innocuous case of butterflies in the stomach.

But on the flip side, medications, when absolutely necessary, might enable one to see through the darkness and pain and thus prompt one to action and initiative. The same goes for therapy and analysis: When one is properly guided and treated by a professional, the chances that she will conduct her life productively and happily are upped.

The problem, then, is not that we simply seek professional help but that we, (or at least a good number of Americans), rely too heavily on it. We look to the prescription to altogether eliminate a problem rather than accept the discomfort or pain – depression, anxiety, panic, etc. – as a means to a different end, as a way to catharsis, improvement, and – best of all – creation.

After all, some of our most productive and celebrated minds achieved what they did not in spite of but, rather, because of their pain or madness. So, for those of us who experience these feelings on a smaller scale, it appears as if only good can come about when we use certain unpleasantries, no matter how despairing they may seem at the time, to push us into doing something which we may not have considered otherwise. For heavens' sake! If it weren’t for that prompting goad of depression and anxiety, the world would have been a much more boring place. No movies about bumbling neurotics pining for lost loves. No pithy poems about one's tyrannical father. No dripping, splattering paintings done in a mad rage.

Trying to make ourselves silly and happy all the time seems just that, silly. And doctors and companies that, through provision of an avalanche of medications, seek to turn every emotion which doesn't make one sing from the rafters are encouraging both abnormal and unrealistic behavior. Because, as it just so happens, anxiety, panic, and, yes, the dreaded depression are normal reactions to normal events in a normal life. Sad and desperate things may happen; sad and desperate reactions may follow. Yet that doesn't make us sad and desperate people who throw up their hands in insuperable despair while reaching for a multi-colored assortment of head candies. It just makes us normal folks. And that category shouldn't have to be relegated to the outskirts.


more about alicia coleman


matt morin
3.22.02 @ 2:22a

Spoken like a person who has never been around someone with depression or a social anxiety disorder. Those, and many more disorders, are much more than just "the blues" or being "shy."

It's terribly naive to believe it's as simple as just pulling up bootstraps, getting back on the horse, or getting back into the saddle with "relatively little effort."

It's also terribly self-centered to suggest people who suffer from these conditions should just put up with it so they can create some great work of creativity for your entertainment.

What's silly isn't that people want to be happy. Silly is people needlessly suffering because others trivialize what they're feeling. Silly is not getting treatment because they're afraid or ashamed that they'll get a reaction like this column.

juli mccarthy
3.22.02 @ 7:50a

You're certainly entitled to your opinion, Allegra. However, I would strongly suggest that this particular opinion is very misguided, at the least.

To put this in perspective, let's imagine a time when there were no eyeglasses for the nearsighted - then someone discovered that specially cut lenses could help people to see better. At that time, I would imagine a whole bunch of people suddenly found out they needed glasses. I am sure that, to those who did not understand what it was like to suddenly be able to see clearly, eyeglasses may have seemed like an affectation, or a fad, or a means to get attention. And it's possible that, had Monet worn glasses, he would not have created the kind of paintings he did -- but how do you think Monet would have felt if suddenly, his world snapped into focus? We'd be deprived of his art, sure, but I'd bet it's a price he would have paid willingly.

mike julianelle
3.22.02 @ 9:22a

I don't think Allegra was trying to belittle people with serious issues, she is just bemoaning the fact that too many people run too quickly for synthetic solutions to problems that aren't necessarily in need of such drastic measures. Noone denies that depression is real, or that social anxiety disorders exist, but I certainly agree with Allegra that people look for quick fixes these days a hell of a lot more than they attempt to weather the storm, or at least give it a shot before succumbing to the latest pharmaceutical panacea. Sure, there are people who need Prozac and all that, but the world functioned just fine before it was around. And you can't tell me that so-called ADD and the like are anywhere near as prevalent as we are lead to believe. Not every hyper kid needs Ritalin, and jumping to such conclusions in a haphazard attempt to calm your kid down, or unleash his hidden potential by loading him with drugs is "potentially" harmful to say the least, and stiflingly so in many cases. Sure, there's a need for a lot of these new drugs, but they should never be a quick fix, and should only be a last resort after all other avenues are explored. Taking drugs, over the counter or not, can change your mind/body, and I for one would prefer to find other ways to feel better before I go running for Mother's Little Helper.

tracey kelley
3.22.02 @ 10:20a

While there is indeed a case against those who look for a quick fix rather than face a problem, I can say with certainity that the exact opposite is more true.

I am currently doing field research for the Univ. of Michigan on the National Study of Health and Stress. I can assure you, without breaking my confidentiality agreement, that there are literally thousands of people who have conditional or even serious mental and emotional disorders who not only do not rely on medication, but do not seek needed professional help because of the perceived notion that they are "lazy" or "crazy."

Consquently, there are thousands of others who are very aware that their fear of snakes or crowded places or speaking in front of a group of people is irrational, and manage to "pull themselves together" to deal with it - or, in most cases, avoid these particular situations altogether. And some people who have panic attacks or depressed episodes are aware they can "snap out of it" and do so most of the time. More often than not, however, they have a valid reason for feeling this way. And those who are aware of their schizophrenia will be the first ones to say their life is meaningless, but more controlled, because of their medication.

I have personally interviewed hundreds of total strangers who trusted me and the study's purpose enough to share their trials and tribulations dealing with emotional, mental and stressful occurances - and I assure you: it is

tracey kelley
3.22.02 @ 10:21a

con't... wrongfully judgemental for any single one of us to:
1) evaluate how someone is dealing with "it" and deem that action right or wrong.
2) believe that "it" is only a manifestation and nothing of true consequence.
3) think that "it" can't happen to any one of us.

Because it just might.


sarah ficke
3.22.02 @ 10:22a

You're right, Matt, those disorders do exist, and I don't think Allegra was denying that. What she does point out is that the line between the disorders and the emotions tends to get blurred. It's important to draw the line between pain you should work through and pain you should be medicated for because sometimes it is just a passing thing that can be cured in non-medicinal ways. I think Allegra's piece is about not taking the easy way out and thinking your decisions through, not putting down people with serious problems.

juli mccarthy
3.22.02 @ 10:41a

If that is the case, Sarah, she needs to work on her tone. This particular piece comes across as judgemental and very demeaning.

And Mike? Go ahead and get me started on "so-called" ADD.

mike julianelle
3.22.02 @ 10:43a

Rev it up, baby.

And what good is an opinion if it's safe and middle of the road? I'm glad Allegra's column is incendiary. We need some controversy.

russ carr
3.22.02 @ 10:51a

A moment of lighthearted commentary:

I remember when the only ads I'd see on television for any kind of medicine were for Anacin, Excedrin, Sine-Aid, and occasionally, if I was at home when Mom was watching Days, Pamprin. These days during prime time, I think I see more commercials for prescription medicines than I do for beer and fast food! And while some might argue that by advertising these drugs openly it's removing some of the stigma around "mental illness" and encouraging those who have it (or their loved ones) to seek treatment, I have to wonder if they're not casting their nets a little too wide, and perhaps ensnaring other people who just want that "new day" feeling.
Think about it -- even beyond medicines for depression, we've got NASCAR driver Mark Martin urging guys to ask their doctor for a 6-pack of Viagra. The relentless message is, "Take this, you'll feel better!" And in advertising these panaceas to the masses, they're breeding a generation of chemical dependents, not because they're sick, but because TV said they need it. "A gramme is better than a damn," to quote Aldous Huxley.

mike julianelle
3.22.02 @ 10:54a

I was going to bring Huxley, and Brave New World, and SOMA into this before. But I didn't. So there!

adam kraemer
3.22.02 @ 11:36a

I think that it's likely that for every person out there who needs medication but isn't being treated, there's probably someone who's on medication but doesn't really need it. Every time doctors say that they've discovered a new aliment, people line up around the block to get meds for it because - surprise - it turns out this is what they're suffering from.

I don't think anyone out there, including Allegra, would argue that for people who need the medication it's nothing but a godsend. But human nature being what it is, lots of people tend to look for the easy answer or the quick fix. And I think that's what Allegra was railing about.

Oh, and I'm pretty sure that glasses were invented by the time Monet was alive. Just not lasic surgery.

matt morin
3.22.02 @ 12:24p

It's all in the way Allegra wrote it though. Take this example of what she wrote:

But at the rate pharmaceutical companies have been turning out new prescriptions – including everything from Paxil to Zoloft, treating everything from "social anxiety disorder" to "premenstrual dysphoric disorder"...

Now substitute another disease or disorder:

But at the rate pharmaceutical companies have been turning out new prescriptions – including everything from Protease Inhibitors to Chemotherapy, treating everything from "AIDS" to "Cancer"...

See how something as simple as putting quotes around a disorder belittles it? Alludes to the fact that it's not real?

matt morin
3.22.02 @ 12:27p

With the exception of those who are severely or clinically depressed, can’t the majority of us pull ourselves up by the boot-straps, jump back on the horse, and get back into the saddle with relatively little effort?

That's like telling a gay man, "Come on, can't you just be sexually attracted to women? How hard can it be to like women?"

lee anne ramsey
3.22.02 @ 12:33p

This column is certainly thought provoking. On both sides of the issue.

On one side, I have someone very close to me who takes a littany of drugs to simply get out of bed in the morning. He's tried (and continues to try) everything from changing his job to alternative herbs to exercise to feel better. He has been chemically depressed for the last 40 years, and only recently has he been able to find drugs that actually help. And those drugs are a godsend. But there are still good days and bad days and I think that may continue the rest of his life.

On the other side, I hate the fact that we are giving kids Ritalin so they "behave" in school. I used to act out in class all the time because I hated sitting still at my desk for hours on end. (Still do, by the way.) Instead of labeling me "hyper active" my parents put me into a different kind of school (montossori) where I had more freedom to move around. That doesn't mean that some kids aren't hyperactive, but the ADD thing... I find it interesting that it is a condition rarely diagnosed outside of the U.S.


lee anne ramsey
3.22.02 @ 12:40p

I was considering taking out the quotes in the second paragraph, to Matt's point.

I guess I didn't realize how incindiary quotation marks are until it was pointed out. Some people (me) use quotation marks in order to highlight a word so that the reader has further clues as to how the writer intended the sentence to be understood.

You have to admit, Premenstrual Dysmorphic Disorder is definately not as well known a condition as Cancer.

adam kraemer
3.22.02 @ 12:41p

Actually, the concept of PMS vs. PDS annoys me. Like women needed another excuse to be bitchy once a month.


lee anne ramsey
3.22.02 @ 12:42p

What IS PDS, if I can ask?

adam kraemer
3.22.02 @ 12:44p

Premenstrual Dysphoric Disorder. For those who suffer from PMS, but want to make a big deal out of it.

Actually, they're claiming that it's a different animal than PMS, though brought on, in both cases, by menstruation. I'm still trying to figure out the difference between a syndrome and a disorder.

lee anne ramsey
3.22.02 @ 12:46p

Wouldn't it be PDD then?

alicia coleman
3.22.02 @ 1:22p

wow. first of all, matt, feel free to comment on my opinion. that could very well be wrong. but you know absolutely nothing about me and absolutely nothing about my life (and absolutely nothing about whether i've been depressed).

Secondly, i never said that those with legitimate psychiatric disorders shouldn't seek treatment. why don't you try re-reading the column if you really care to comment. i said that people are being overprescribed medications when medications are not necessarily the right solution. i've got some shrinks to back me up on that too.

alicia coleman
3.22.02 @ 1:26p

by the way, michael, thanks for nicely summing up the problem in one paragraph. you seemed to hit the mark far better than i did in my long-winded way.

adam kraemer
3.22.02 @ 1:26p

Lee Anne - yes, it would. I'm acronymically impaired.

Allegra - I think they're trying to drive you to take pills. Fight the powers that be. Damn the Man.

matt morin
3.22.02 @ 1:37p

Actually, it's PMDD. I just looked it up.

Allegra, no, you didn't say that people with legitimate disorders shouldn't seek treatment. But the whole tone of your article suggested that most of what people feel isn't legitimate. From the discussion, I'm obviously not the only one who read your column that way.

And no, I don't know anything about you or your life. But I would assume that if you'd been around people with these disorders you'd be a lot more sympathetic than you were in your column, or at least focus your writing more so your point wasn't so easily misconstrued.

michelle von euw
3.22.02 @ 1:43p

Russ hit a good point with the TV commericals -- in fact, Allegra's second paragraph is very reminiscent of the ads we've gotten during the past few years. Of course, most of the time, it's impossible to figure out exactly what the pills are meant to cure, but basically, if you aren't dancing in a field under a bright sky right now, you should ask your doctor if Antiac is right for you.

ADD is extremely over-diagnosed today, and the fact is, there are a whole lot of kids in this country who are on Ritalin and other behavior-modifying drugs than need to be, because it's seen as a "quick fix" for "hyper active" kids, as Leanne and Mike have mentioned.

alicia coleman
3.22.02 @ 1:51p

well don't assume, matt.

adam, i think i'll prescribe us a couple of buds. true.

matt morin
3.22.02 @ 1:57p

My apologies Allegra. How about this:

But I would hope that if you'd been around people with these disorders you'd be a lot more sympathetic than you were in your column, or at least focus your writing more so your point wasn't so easily misconstrued.

adam kraemer
3.22.02 @ 2:01p

Given, we are talking about a column written by a girl whose first name is an allergy medication. Coincidence? I think not.

alicia coleman
3.22.02 @ 2:08p

forgive me, matt, for having too much faith in the human race and in its ability to actually deal with life. i know it can because i've seen it.

lee anne ramsey
3.22.02 @ 2:18p

I'm obsessed with this PMDD vs PMS thing. Matt, when you looked it up, did it differentiate the two?

jennifer grant
3.22.02 @ 2:19p

Adam, I would have to agree. Clearly the girl has a thinly veiled vendetta against the drug companies. Oh and the mentally ill. And "puppies". I could tell because of the incindiary punction that ran rampant through her vitriol.

matt morin
3.22.02 @ 2:31p

Lee Anne,

From Webmd.com:

PMDD is characterized by severe monthly mood swings and physical symptoms that interfere with everyday life, especially a woman’s relationships with her family and friends.
PMDD symptoms go far beyond what are considered manageable or normal premenstrual symptoms. 
PMDD is a combination of symptoms that may include irritability, depressed mood, anxiety, sleep disturbance, difficulty concentrating, angry outbursts, breast tenderness and bloating. The diagnostic criteria emphasize symptoms of depressed mood, anxiety, mood swings or irritability. The condition affects up to one in 20 American women who have regular menstrual periods.

It sounds like PMS+.

jennifer grant
3.22.02 @ 2:35p

Matt, besides my intense dislike for your attitude, I have a few problems with your arguement. [That's like telling a gay man, "Come on, can't you just be sexually attracted to women? How hard can it be to like women?"]

First of all, Allegra's arguement begins with "With the exception of those who are clinically depressed."

Secondly, YOU throw gay men into the argument. Allegra didn't compare "gayness" to a disease, you did. Spoken like someone who doesn't know any.

mike julianelle
3.22.02 @ 2:36p

Allegra, thanks yourself!

This is easily one of the most interesting and best discussions I've yet to see here. And I'm not just saying that because I like fights.

matt morin
3.22.02 @ 2:50p

I wasn't comparing homosexuality to a disease. I was trying to illustrate that depression, or any of these other disorders, aren't just a simple case of mind over matter, like Allegra contends.

There are many people who think you can reprogram a gay person to think like a straight one. We all know how ridiculous that is. Just a little more ridiculous than thinking someone who is depressed should just pull themselves up by their bootstraps and be happy.

Like I said before, I am aware that Allegra stated "with the exception of those who are clinically depressed." But the entire tone of the article is that most people's depressions, fears, etc. really aren't that serious.

PS - I live in San Francisco. I do the AIDS Ride every year. I know, work with, and am very good friends with a lot of gay and lesbian men and women.


matt morin
3.22.02 @ 2:58p

Oh, BTW: My attitude comes from knowing a guy in college who was depressed. And instead of his friends supporting him, and suggesting something was wrong, they thought, just like Allegra's article contends, that he was overreacting and just being sad. They too joked that he just needed to get back in the saddle and gave him shit for being such a mope.

So instead of going to a doctor and taking a pill that could have helped him, he took 45 sleeping pills and killed himself.

You can have an intense dislike for my attitude all you want. But if it makes just one person not feel stupid to go see a doctor, then it'll be worth it.


jennifer grant
3.22.02 @ 2:58p

Wow. What a grossly inappropriate assumption on my part then. I can't believe how insensitive it was to make that pronouncement.

lee anne ramsey
3.22.02 @ 3:39p


Not to assume that everyone should think as I do... but can we MAYBE all take a deep breath? I think this is a really interesting topic Allegra has brought up, and it's really interesting to hear sides of the arguements that I wouldn't have thought of.

But why does this have to turn into a pissing match?

mike julianelle
3.22.02 @ 3:49p

I agree completely. This is a great discussion, but it's getting a bit too rowdy.

russ carr
3.22.02 @ 3:53p

I didn't think that hellspawn like you had limits, Mike.

adam kraemer
3.22.02 @ 3:54p

Besides, Jennifer's right. Matt is a doo-doo head.

matt morin
3.22.02 @ 3:55p

Aww...Mom, Dad, can't we stay out and play just a little bit longer?

Hey, on the bright side, the site finally got significant action on a Friday.


mike julianelle
3.22.02 @ 3:56p

Yeah, you're right Russ. Keep it coming, ladies! (I'm talking to Matt and Adam.)

matt morin
3.22.02 @ 3:58p

OK, Mike.

Adam, I think you're overreacting to your "testicular cancer."

I'm SO in trouble for that one...

russ carr
3.22.02 @ 4:01p

Hey, on the bright side, the site finally got significant action on a Friday.

Unlike Adam.

matt morin
3.22.02 @ 4:03p

Russ, I can always count on you.

russ carr
3.22.02 @ 4:07p


mike julianelle
3.22.02 @ 4:07p


We know return to our previously interrupted calvacade of sarcasm and insults. Soon we'll get back to movies. Sorry, Allegra!


juli mccarthy
3.22.02 @ 4:15p

Nope, I'm not backing off here. I don't intend to add to a pissing match, but Allegra's response to disagreement ("you don't know anything about me or my life so you can't possibly judge me" to paraphrase) is in direct contrast to the tone of this column. Allegra seems perfectly content to make a judgement of anyone who is on such medication. Yes, she makes an exception for those who are severely or clinically depressed, but by whose standards?

I am in total agreement that there are people who are looking for a quick fix, and that some of them probably should be able to work out some of their problems without the use of drugs. But that is not what I read in this column...what I read is a complete dismissal of several legitimate conditions that do not meet Allegra's standards for "illness."

adam kraemer
3.22.02 @ 4:25p

Okay a) it was an easy joke; b) if I'd been paying attention, I would probably have said it first.

adam kraemer
3.22.02 @ 4:27p

Well, if you're not clinically depressed, then you don't (or shouldn't) really need the drugs, should you? Popping a prozac because you had a lousy day at work isn't the answer. I think that's what Allegra was saying.

juli mccarthy
3.22.02 @ 4:29p

My point, Adam, is that it could have been said better. The tone of this is insulting, period.

And don't talk to me about PMDD, either.

adam kraemer
3.22.02 @ 4:33p

Oh, and anyone who says that the pharmeceutical companies aren't basically in it for the money is being naïve, I think. Just look at all of the medications that were pushed through the FDA only to be proven dangerous later on. And even then, not necessarily recalled.

matt morin
3.22.02 @ 4:37p

True. There are many people who take drugs who probably would be OK without them.

But take for example when you break up with a significant other. Most people feel some degree of sadness. Then they get over it and move on. But therin lies the danger. Because then, when there's someone who really is seriously depressed after a breakup, you have a whole group of people thinking, "Oh come on! It's just a breakup. Snap out of it. Go be happy." When in reality, it's both emotionally and physiologically just not that easy.

And what you end up with is a person who gets convinced they're just being silly or stupid, when in reality something's seriously wrong and they should get treatment.

matt morin
3.22.02 @ 4:40p

Of course the pharmaceutical companies are in it for the money. But that doesn't mean their medications aren't helpful or even unnecessary.

adam kraemer
3.22.02 @ 4:42p

That happened to my roommate. He's now on Neurontin and doing great. I can say without equivocation that he really needed the meds. But for some, it's a crutch. And having worked in pharmeceutical PR, I can tell you that it's not out of question for the big med companies to exaggerate the effects of a health problem in order to get more people to buy their product that counteracts that problem.

matt morin
3.22.02 @ 5:36p

Adam, here's (part of) the copy in the latest Paxil ad for Generalized Anxiety Disorder:

If you're one of the 10 million people who live with uncontrollable worry, anxiety, muscle tension, irritability, restlessness, fatigue and sleep disturbances for 6 months or more, you could be suffering from Generalized Anxiety Disorder.

Later in the copy they say, "Anxiety from everyday stresses usually does not need medication."

I'd call that pretty responsible advertising.

tracey kelley
3.22.02 @ 6:05p

I'm curious how one is able to recognize the giant chasm between having a "bad day and pulling yourself up by your bootstraps" (not quoting Allegra, btw) and clinical depression when you're in the throws of it.

I am currently struggling with hypothyroid-induced depression. (y'all thought I was joking, didn't you?) I have an appointment with both my physical doctor and a counselor next week to beat this shit. Why? Because even though I am fully aware that my depression is a side effect of my thyroid condition (which at least 9 million people in the US have, btw) that doesn't change the fact that I have it. Yes, there are some other factors contributing to my "not feeling my best" but the physical imbalance does not help.

Since I've been told I will have to be on medication to regulate my T-3 and T-4 levels for the rest of my life (but we'll see about that) that absolute LAST thing I want right now is more medication.

But I also don't want to feel this way every time my thyroid hormones get off-track. I've been through far more devestating problems than what I'm going through now, and, although depressed, I managed to pull through fine. I recognize the difference: now, there is something unusual about the way my mind and body responds to things.

I'm fortunate I have the presence of mind and wherewithal to battle this and can see the difference. But what about those who truly can't?


tracey kelley
3.22.02 @ 6:22p

Furthermore, what I have witnessed with two doctors in the family, I have a high distain for the medical profession and pharmaceutical companies in general. While our "family" doctors are compassionate people, they also like to be catered to and have their bank accounts lined. Pharmaceutical companies do that very well. Take for example, Glaxo, which pays, bottom scale, $1,200 for a 10-minute speaking engagement, complete with all-expenses paid weekend trip at a resort for the doctor and family. This isn't just for the keynote speaker, either. A series of medical books purchased for an office just to win 15 minutes of a doctor's time to pitch a particular product. That's just what I personally have been told.

As consumers, we're led to believe the drug cost is locked up in R&D. While a modicum of that is true, we also pay for every expense account. As someone who once designed incentive programs for pharmaceutical sales reps, I can assure you there is serious corruption in that industry.

But we have very few choices when it comes to health care, don't we?


juli mccarthy
3.22.02 @ 6:23p

To me, the difference is between thinking "Ya know, I am gonna kill that kid if she interrupts me again" and thinking "Oh. My. God. I am afraid I might really kill that kid if she interrupts me again."

Oh, yeah....been there.

matt morin
3.22.02 @ 6:57p

Like I've said before in this discussion, I think the big danger is for those who know something's wrong, but are made to feel stupid for thinking so.

If you break a wrist, no one says, "Oh, do you really need a cast and some painkillers, do you?" But when something else is physically wrong - like depression, people tend to wonder if you really need the medicine.

No one hesitates to take Advil - which affects the way your brain deals with pain, but the same people don't think it's necessary to take Paxil, which affects the way your brain deals with stress and anxiety.

lee anne ramsey
3.22.02 @ 7:29p

Does Advil affect the way your brain deals with pain?

I thought that Advil was a blood thinner that allowed the "healer" blood cells to get to the source of the injury faster. (There I go with the quotation marks again. I really do use them too much.)

lee anne ramsey
3.22.02 @ 7:34p

When it comes right down to it, Depression is a lot like Cancer and AIDS - most of us know someone directly affected by these diseases. And most of us wouldn't dream of trying to relate to someone who has cancer or is HIV positive unless we ourselves were in the same boat. But some people DO feel like they know what Depression is like, because they have perhaps experienced it once or twice on a less severe level.

From what I understand, the times when I thought I was really depressed - couldn't will myself out of bed, couldn't stop crying at everything and nothing, and the inability to figure out what "normal" is and how to try to be that way - that is NOTHING compared to what severely depressed people go through. Sometimes chemically depressed people have constant, never ending physical pain in addition to all the emotional stuff.

On top of that, someone who is mentally ill usually has some knowledge and understanding of their own illness. Which makes them think since they are not "insane," they should be capable of controlling their own emotions. Which, in most cases, they are not.

matt morin
3.22.02 @ 7:56p

I know someone with Social Anixety Disorder, and I've been told that's exactly the way they feel, Lee Anne. They know they shouldn't be afraid of public speaking, or being on a crowded bus. And they know they should be able to control their emotions and fears. But they just can't.

sloan bayles
3.22.02 @ 8:36p

WOW. What a discussion. I'm glad the pissing contest is (hopefully) over. While I think I understand the point Allegra was trying to make, the tone did come across as shortsighted. Speaking as someone who was Rx'd a mild anti-depressant about 8 months ago, I can say it has definetly changed my life. Not that the world is a rosier place now (or that it wasn't before), but I "deal" with things much better now. What it took for me to get to the point of realizing I maybe couldn't control my depression or anxiety was counseling. And like the people Tracey talked about that she's interviewing, I was one of the many that didn't think I needed help. I was lucky enough to finally realize I did. For years I thought "pulling myself up by my bootstraps" was not only what was necessary, but what was expected. After all, I wasn't clinging to the top of a bell tower with a semi-automatic, or going "postal", just slowly and consistantly driving a wedge between me and the people I cared most about. Accepting the fact I may be on medication for the rest of my life throws my control freak nature into a tizzy, but if in doing so I am a better wife, mother, friend, daughter, etc. it makes it worth every pill.

adam kraemer
3.25.02 @ 11:38a

But at what point do you draw the line? I know I'm not clinically depressed, but I also know that a mood elevator would make me feel happier than I am. Is that the only criteria? If it makes you feel better, it must be the right thing?


tracey kelley
3.25.02 @ 12:47p

For situational depression, studies have indicated that general counseling with some type of healing professional, exercising and - believe it or not - chocolate in moderation - are the best mood elevators.

Matt, Lee Anne, you're absolutely right about those who have certain conditions or fears being very aware of their fear, knowing that it is not right, but not being able to "control" it. It's the same question I posed - when you are aware that you are not your normal self, how do you decide to cross that chasm...to make a decision to help yourself get back to what you do consider normal?

I believe that simple awareness and acknowledgement, like with a drug or alcohol-related disease, is the first step toward healing.

tracey kelley
3.25.02 @ 12:50p

Since most discussions wind toward movies, let me prompt that by saying that everyone should see A Beautiful Mind if you haven't already. Yes, the ending is a little pat, but what Nash went through is painful and horrifying. And if anyone can honestly say that you would know the difference between the sane and not so sane mind, more power to you.

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