Does that make me crazy?

A friend of mine was recently advised by her GP to go see a psychologist for some problems she'd been having with her family for several years by now, that were causing her a lot of stress. I happened to speak to her boyfriend before I got to talk to her, and he mentioned she was having a bit of a rough time with that advice. So I gave it some time, and gave her a call - it was high time we meet up again anyways. So we chatted for a while, and then got to the advice from her doctor. "I'm still so young," she said "I shouldn't be messed up yet!"

Meanwhile, another close friend is having trouble with his thesis, and running into fear of failure problems, which had already been diagnosed when he was in highschool. About 9 months into what should have been a 4 month project, he asks me whether I can't help him work it out. I'm a psychologist, after all, but since I'm also a friend, he'd feel less crazy asking me for help.

Somehow, there's a big stigma attached to seeing a psychologist. So let me make one thing clear: seeing a psychologist does NOT make you crazy. In a lot of cases, in fact, it might make you a lot more mentally healthy than not going.

The fact of the matter is, sometimes things break under stress, whether that's your mind, your body or your car. Put enough pressure on it, and it'll start having problems. And sometimes things break down in easy-to-fix ways, that you might be able to fix yourself, or have fixed by a friend that happens to be good with cars. Other times, you need a professional - or you might want a professional to have a look before things break down to prevent problems. That doesn't make you crazy. That just means that life is rough sometimes, and that an outsider with knowledge of and experience with how these things work can be more helpful than the friend who might listen well and have good advice, but who, even if they know their way around these things, are too personally involved to be quite objective. Staying away from help when you need it is only making your life needlessly harder.

Pop that pill

I did my internship at a very ambitious university. This is the kind of school where if you're not getting top grades, you might as well have failed in the eyes of many teachers and co-students. The material was tough, too. This university is renowned internationally for being one of the top schools in its field. My job there was too counsel students, and it was not uncommon for students to just flat-out ask whether they couldn't just take some pill. After all, they were doing a high-profile study, which they needed to excel at. They didn't have time to be unwell. Pop a pill, get back to work.

My mother is in psychology as well, and works with a primary and highschool students, with a focus on problems they're experiencing at school. Of course, the most popular diagnosis in those cases is ADHD, and schools are of course very aware of that diagnosis. So if a kid is being extremely disruptive in class, they're likely to start calling ADHD. And, how convenient, you can pop a pill for that! Mom has had multiple cases where, before a diagnosis was even made, school was calling for the kid to be put on Ritalin. She's had cases where the child was put on Ritalin in spite of her objections. Sometimes, it worked out okay. She's also had crisis calls where a child that was put on Ritalin in spite of her advice to the contrary had to be taken to the hospital by ambulance because they went acutely psychotic as a consequence of completely wrong medication for the child's problems.

I remember being in the US, and being astounded at the fact that there are commercials on TV for prescription medication. There is a reason these medicines are prescription only - it is not safe for non-medically-trained persons to decide about these. So why put doctors in the situation where they have to turn down the request for a certain drug time and time again, for perfectly valid reasons that patients might or might not understand? Why give these people false hope? Why advertise something people can't buy?

Here's the thing about medication for mental health problems: for some people, it's a life-saver. I know people who are able to function by grace of their Prozac (or substitute other brand name) or Ritalin (likewise) or haldol. However, that is true for a limited number of cases, and only if you actually have the chenical imbalance the drug in question corrects. If you don't have that imbalance, that's where problems come in. It is perfectly possible to be a busy child and disruptive in class without having ADHD and the underlying neurochemical problems. Give that child Ritalin, and you might end up with a child that completely loses touch with reality. Give haldol to a person who's not actually psychotic, and you'll introduce a syndrom that very closely mimic Parkinson.

Of course, not every case of mismedication is that dramatic. In 99% of cases, Prozac does actually make people feel a bit happier. However, it does have side effects - including such fun things as sexual dysfunction, gastrointestinal problems, headaches, nightmares, insomnia and seizures. Also, SSRIs, the drug class Prozac belongs to, are a relatively new drug, having been found in the 1980s. There's no way of knowing what the long term effects of taking in over decades might be. Also, the jury is still out on whether Prozac might not actually cause extreme violence or suicide in a small percentage of those who take it. Prozac manufacturer Eli Lily says not. Eli Lily also hid research results that might point to the contrary. Also, the nasty thing about SSRIs is that the symptoms you get from weaning your body off them look a lot like depression, making it hard to stop taking them.

Now as I said, there are people with a chemical imbalance underlying their depression that have little choice in the matter. However, a lot of the time, depression can be caused my circumstances and thought processes. That can be solved by changing circumstances and getting into talk therapy. Talk therapy can be pretty quick and easy. Cognitive behavioral therapy often brings significant improvements in 5-10 45 minute sessions. Weigh that against years, or even just months, of side effects and taking pills - and the knowledge that you learn things that will last even after you quit therapy, whereas when you quit the drugs, the effect is over.

You still sure that the pill is the easy solution?