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Tue, Jan. 13th, 2009 03:29 am
Utsu: drugging the ordinary sadness of Japanese and children

76CommentReplyFlag

krskrft
krskrft
Tue, Jan. 13th, 2009 03:30 pm (UTC)

This is all fine and well, and I've got a healthy skepticism about mental illness myself. But I do actually know people who've suffered from bipolar disorders (namely my father, my sister, and a very good friend). It would seem to me that a bipolar disorder (manic highs and rock-bottom lows) is something that is fairly observable, and easy to segregate from "normal" or "healthy" feelings and/or behaviors (i.e. those feelings and behaviors which allow a person to maintain at least a baseline functionality in his/her life). This, as opposed to, say, ADHD, where diagnosis is incredibly vague, and for which it is very difficult to segregate behaviors from "normal" or "healthy" responses to certain stimuli (i.e. the fact that kids tend to have more unspent energy, aren't equally socialized for, say, the classroom environment, have been raised under different cultural circumstances than those of the generation doing the diagnosis, etc).

I have firsthand accounts, from one of my best friends, of what his life was like when he was manic, and before he was briefly institutionalized. I believe him when he says that he literally had no idea what he was doing at the time, that he was being controlled by an out of whack brain chemistry. And this is what I come back to whenever anybody, in response to the slimy behavior of the pharmaceutical companies, tries to deny that there is absolutely no such thing as a mental illness. That experiencing a mental illness merely means "to experience the full sensory palette." It would seem to me that only a person who's never gone through such an experience could formulate such an assertion.

I had a roommate in college who wanted to study neuropharmacology (and was in graduate school doing just that, last I heard). He wanted to create the "perfect drug," which he argued would probably be like exstasy, only with no side-effects. His (oh so clever) argument was that nobody should have to feel pain or discomfort or depression or any kind of anguish. Such a drug would be better than anything. It would be all we would ever need. And the question I immediately put to him, knowing that he'd just started going out with this girl: would this drug be better than her? Would you not need her? And of course, he sort of giggled and didn't answer me. At the time, I didn't have the vocabulary or academic background to explain it, but I was coming around to what I now understand to be the structuralist/post-structuralist idea, that we can't know a thing without the existence of its opposite, or of those things which allow us to distinguish it by comparison or contrast. We can't know what it means to be happy without knowing what it means to feel sad, or angry, or any number of other emotions that some pharmaceuticals purport to "cure" or otherwise cleanse our lives of. And it seems like that's what you're trying to get at when you talk about "the full sensory palette."

But at the same time, severe depression and severe mania are real, observable things. They may be conditioned, triggered, whatever, to a certain extent, by the things that happen in our lives, or the ways we live, or the things we do. In many cases, it is just a simple matter of "getting our shit together." But when you're wandering around a big city thinking you're a superhero, and the day before you were fine, and after the fact you can't recall what made you feel that way, or when you do pin down the trigger, it seems like it would not have triggered such a severe reaction in most others, that's kind of a red flag.

Misdiagnosis is rampant in psychiatry, but we shouldn't take that to mean that there aren't some "disorders" worth paying attention to. As always, I think the controlling factor should be that the patient desires care due to not being able to engage in normal, everyday functions. Everything should be on the table: life changes, habits, diet, and yes, even medication.


ReplyThread Parent
imomus
imomus
imomus
Tue, Jan. 13th, 2009 03:49 pm (UTC)

Yes, the structuralist or even karmic view does inform my take, you're right.

I've tried to avoid talking about this, because it's such a painful experience. But I lost a friend in 2002 after the following sequence of events:

* Friend married and got pregnant.
* Her partner didn't want her to have the baby.
* Chemical abortion which failed.
* My friend fell into depression / rage, made suicidal gestures.
* Friend hospitalized in Brooklyn.
* I visited my friend daily in mental hospital. She refused to talk to anyone, but communicated on slips of paper. "I am not selective mute". "I feel like my life is a game I have lost." "They diagnozed bipolar. Zoloft."
* My friend was given a second abortion, surgical this time.
* My friend's doctor was reluctant to meet me, and, when he did, oddly breezy in his office. Then, in the elevator, he totally refused to talk to me, as if he feared lawsuits should my friend later commit suicide.
* I invited my friend's mother from Japan to US to take her back to Japan.
* I left, unable to stay longer in US for visa reasons.
* In Paris, I learned that my friend's mother had returned to Japan without her.
* My friend was released from hospital after one month -- not for medical reasons, but because one month is the period her medical insurance covered.
* Somehow, my friend was left alone in her apartment on her first night out of hospital. Nobody was given keys.
* My friend made a few phonecalls, took pills and drank alcohol, opened her veins in the bath and died.
* Two years after my friend's death the FDA issued a warning for Zoloft and other antidepressants, stating that the drug can in some cases cause suicide and violence.
* I remain convinced that my friend would still be alive today if she had not been hospitalized, diagnosed, and medicated, or -- if those things had happened -- she would still be alive if she had been treated in a medical system which puts the welfare of patients before their ability to pay.


ReplyThread Parent
imomus
imomus
imomus
Tue, Jan. 13th, 2009 04:12 pm (UTC)

There's also my own experience of medical treatment -- five years of personality-changing (and not in a good way) steroids and immune-suppressants followed by total failure to save the targeted organ, my right eye, itself harmed by a Johnson and Johnson contact lens. I was harmed by a product, and not helped by the drugs supposed to cure this harm. I did get a sense of how drugs can change your personality, though; I became aggressive and short-tempered on steroids.


ReplyThread Parent
count_vronsky
count_vronsky
Tue, Jan. 13th, 2009 07:34 pm (UTC)

I have been on short courses of steroids twice in my life, once for a busted eardrum from a scuba diving incident, and once to battle a case of pleurisy, and both times I was gobsmacked by the personality changes it engendered. The first day was always a sense of beautiful euphoria followed by days of almost overwhelming despair and angry outbursts. I would find myself wanting to weep over the tiniest things. Oh and the insomnia, which wasn't just normal tossing and turning but it was as if the sleep function in my brain had been permanently erased. My sis was on them for years -- she suffers from Crohn's disease -- and now that she is off of them (thankfully she has been in full remission for quite a while) she seems like a different person.


ReplyThread Parent
krskrft
krskrft
Tue, Jan. 13th, 2009 04:23 pm (UTC)

The structuralist view informs my take as well. Don't get me wrong: I don't think people should seek medication as a first response to severe mental trauma, mostly because the process by which we think and feel is not analogous to the process by which we digest food or breathe or circulate urine. Taking a pill will never solve every single aspect of a mental problem. And for every single person I've never known, or ever heard of, who had mental issues, their lifestyles played a significant role in either triggering or perpetuating/prolonging those issues.

But one still comes down to the fact that this can't possibly explain the infinite ways in which people react to similar stimuli. Some peoples' brains pump more happy juice than others, and those people, sometimes, can use medication to regulate that condition. Again, with manic-depression, we're talking about something that is pretty easily identifiable. We can observe the behaviors of a bipolar person and come to a fairly objective conclusion that we're seeing an irregularity. Now, irregularity is fine, as long as the patient is okay and can function to his/her own satisfaction. That's all good. But if the patient is coming in for help, and says "Shit, I have these crazy mood swings, and I can't control them, and I can't get any work done, and sometimes I feel like killing myself and five minutes later I'm on top of the world" then we would have to be morally bankrupt to say "hey, just get your shit together, you're supposed to feel the full sensory palette, after all!"

Know what I mean?


ReplyThread Parent
krskrft
krskrft
Tue, Jan. 13th, 2009 04:30 pm (UTC)

Also, what about anxiety disorders, for which people have found Xanax to be quite effective? I think the anti-psychiatry argument loses a lot of its footing when we look at mental problems that cause physically-identifiable trauma. A person with an anxiety disorder can pass out, stop breathing, or even suffer a heart attack. Is that not real? It definitely bridges the mind-body gap, which would make drugs a viable option, right?


ReplyThread Parent
aienn
aienn
aienn
Tue, Jan. 13th, 2009 04:36 pm (UTC)

well, I don't have a medical degree to discuss these things in depth, altho my mum is a neurologist and I recall several discussions with her regarding depression. her point is that it's a symptom, not an illness. she told me it's completely normal to prescribe antidepressants (along with other drugs) to a person who is, say, terminally ill with cancer and in fact lives in constant physical pain, but a depression due to, say, “stress at work” should not be treated with drugs. she had similar discussions with her Western colleagues, their views differ on the matter. so is the way of things

mental illness is a very murky territory with lots of ambiguous and inconclusive diagnoses, countless drug and drug-less treatments which work or half-work or don't work at all et cetera et cetera, and it's an entirely different matter altogether

what I read in Momus' post is another example of Western-style brainwashing to create a new niche drug market — I'm quite glad that in my country this attempt, due to various reasons, some completely unrelated, failed — which is great


ReplyThread Parent
krskrft
krskrft
Tue, Jan. 13th, 2009 04:43 pm (UTC)

Yes, the proper, ideal response to depression brought on by stress at work would be to somehow resolve that stressful situation (i.e. quit, talk to the boss about it, take a vacation, etc). But what if it's not possible to resolve the situation sans drugs without broadening the depression? What if, for example, the person were to quit his/her job, but then the person finds him/herself in the position of having no money, and not being able to readily secure gainful employment. This situation would surely increase stress on the person in question, and stand a good chance of making the depression worse, not better. If drugs could moderate this person's mood, wouldn't that be the best available (and by "available," i mean viable and realistic) solution?


ReplyThread Parent
aienn
aienn
aienn
Tue, Jan. 13th, 2009 04:56 pm (UTC)

now we're talking of a differences between Eastern/Western mindset, not really drugs. I recall two relatively big social catastrophes in my short life — the end of USSR in 1991 and the financial crisis of 1998. I recall millions of people losing jobs et cetera et cetera, but I don't recall anyone starting on antidepressants — we had and we still have cheap Valeriana officinalis that is know since ancient Greece (and other mild herbal drugs). while I recall that in the very same 1991 in USA there already was a relatively big market for synthetic antidepressants. and now — oh, let's open Wikipedia on Fluoxetine: “Over 22.2 million prescriptions for generic formulations of fluoxetine were filled in the United States in 2007, making it the third most prescribed antidepressant” — that's not even an epidemic, it's a pandemia, completely unhealthy


ReplyThread Parent
krskrft
krskrft
Tue, Jan. 13th, 2009 05:03 pm (UTC)

And Russia's suicide rate is nearly triple America's and, surprisingly, beats out even Japan and South Korea, at least by the 2005 figures on Wikipedia.

Relying so heavily, as a culture, on pharmaceuticals may not be the ideal of good health, but nor is the cultural ideal of "get your shit together" an ideal of good health. I think we're looking at two extremes here: one that is so obsessive about mental health that it creates unnecessary categories just so it can diagnose people and get them on drugs, and another that is just unduly and cruelly dismissive of mental anguish.


ReplyThread Parent
aienn
aienn
aienn
Tue, Jan. 13th, 2009 10:07 pm (UTC)

well, let's peruse WHO data:
Russia
USA
Finland
[country list]

I say, this data doesn't really speak. Russia with its consistently failing health services shows triple the American rate, but here comes our small northern neighbor Finland with less suicide cases than us but twice the American rate — and Finland is a country with excellent healtcare system (I had several chances to visit their medical facilities while accompanying my mum) and overall quality of life that is much higher than in Ru.Fed (again, I've been there numerous times to be able to compare). Yes, Russia has other problems, like hundreds of thousands of people dying each year not of even alcoholism but of poisoning by substances containing traces of technical spirits (very ugly indeed), but our suicide data doesn't really relate to US of A or to Suomi Fi — and in Suomi Fi it's completely normal to cure depression with medication, and yet they have twice the American suicide cases. If we compare suicidal age groups in Finland and Denmark, we'll see amusingly different data (I'll leave that to you). Um?


ReplyThread Parent
krskrft
krskrft
Wed, Jan. 14th, 2009 12:34 am (UTC)

You're missing the point. I'm merely trying to point out that Russia's response to mental anguish, as you describe it, probably shouldn't be taken as any sort of ideal of treatment. In many ways, I'd rather that my country be obsessive about mental illness, and in that way at the very least be open to talking about the anguish that the language of "mental illness" (whether real or not) attempts to describe, than live in a place where people just tell you to buck up and get over it. At the end of the day, nobody is forcing pills down an American adult's throat. The reason why I get so bent out of shape with ADHD diagnoses in children is only because they don't have the same choice to stay off medication, especially if their parents are in on it.


ReplyThread Parent