Medication Is Not the End-All Be-All for Distress

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You finally sit down after a long day, with frayed nerves. You turn on the TV to find:

Cartoon Mom enters the scene. She looks a little gloomy. The announcer says she has “hard-to-treat depression.” Oh, she MUST. NEED. MEDICATION.

Viewer: What about those side effects? They seem intense.

Big Pharma: What’s a little drooling, a few extra pounds, dizziness, paralyzed jaw, constipation, or risk of death to deal with? Plus, it can work as fast as two weeks. You can trust us.

Viewer: Are there other options?

Big Pharma: Lifestyle medicine — getting proper sleep, nutrition, and exercise along with evidence-based cognitive behavioral treatment have plenty of research to back them up, but you should talk to doctors we spend $1.4 billion on to verify our claims. They’re totally impartial and have no conflicts of interest.

Viewer: Do these commercials run across the world? Is all this medicine healthy for us?

Big Pharma: Only the United States and New Zealand are lucky enough to get this kind of information regularly presented to them. Seventy percent of Americans are on prescriptive drugs, and the United States has worse health outcomes than other industrialized countries, but don’t worry. Just keep on kissing our ring, and we’ll have your back. Did we mention we have pills for bad backs, too?

Pharmaceutical companies pump out three billion advertising dollars annually to get us to realize how “sick” and “abnormal” we are. A 2015 Centers for Disease Control and Prevention report revealed that of the 2.8 billion drugs ordered, anti-depressants were in the most frequently prescribed category.

They’re capitalizing on our culture of overwhelm and obsession with fast relief.

We diagnose natural reactions to life — grief, loneliness, sorrow, and fear — as absolute signs of mental illness. There seems to be a disorder de jour for all of us.

In his book Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, Dr. Allen Frances warns that “overtreatment” and biological-only approaches are causing us to fall prey to interventions that might not entirely be in our best health interests. It seems like our hyper-focus on the “worried well” dilutes our attention from those in desperate need of treatment — those of us with moderate, severe, and chronic mental health conditions.

Given the complexities of brain chemistry, it would be irresponsible and dangerous to advocate against treating biological conditions without medicine. It saves lives. But when we ignore the psychological and social aspects of the depression and anxiety spectrum, we’re being equally irresponsible.

To get us away from getting too either/or, we can take the following steps:

Use a biopsychosocial lens to understand your depression and anxiety. We cannot rely on simple solutions for complex problems. In a 2015 report, The American Psychological Association reported that only one-third of patients receiving anti-depressants were engaging in evidence-based interventions, such as cognitive behavioral therapy. Modern psychotherapy that integrates brain science and social context provides a powerful lever for restoring and maintaining our mental health.

Remember that prevention is less costly than repair. This is true in any health situation, but particularly for mental health. Chronic stressors eat away at us; they throw us off kilter. Engage in self-care and growth strategies. Sleep. Hydration. Solid nutrition. Human touch. Technology breaks. Connection. Belonging. Identity. Finding your purpose. These are all protective factors we need, especially in our drive-thru context that threatens and disrupts us from doing so.

Get professional help. Resist the urge to self-diagnose or believe everything the commercials are telling you about your symptoms. Find a licensed practitioner who knows what they’re doing. Help them get to know you fully. Your strengths. Your passions. Your backstory. Your health and family history. Unique stressors and life stage. Your social roles and responsibilities. What’s working well. What’s not working well. Find someone to partner with you to understand the kind of specialized treatment plan that will be most effective in helping you thrive.

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Save your normal. Not everything is a full-blown disorder. And even when there’s something major going on, there’s still plenty of room for healing and resilience to come in. New research reveals that we all fall on the mental health diagnostic spectrum, and that we vacillate in and out of various episodes across our lifetime. Season of life, losses, trauma, isolation, and stressors can overwhelm our thresholds for coping — it’s part of being human. Instead of ruminating over what’s wrong with you or glossing over your dark emotions, make space to work through them. Mine for strengths and embrace your quirks along the way. Self-depreciating humor works wonders, but when it turns to self-sabotage, dial your therapist.

Put pressure on leaders and policymakers to recognize there’s no health (physical, economic, institutional, societal, interpersonal) without mental health. Ask them to rethink DTC practices. The World Health Organization (WHO) projects depression as the leading cause of disability by 2030. Tell your leaders that you want them to prioritize mental health for all. Encourage them to adopt a lifespan approach to mental health, to put funding dollars towards early intervention, integrated services, and comprehensive treatment for all ages, and especially for vulnerable populations — those marginalized due to race, class, socioeconomic status, gender, sexual orientation, ability, or otherwise. Tell them that you want to live in a society where discrimination and stigma are things of the past. That you want to see prevention and response in schools from day one. That they need to address the critical shortage of trained mental health practitioners. That they must put a stop to this culture of fear and despair and find ways to work together to get important business done. Ask them to put this into a public service message, instead of selling us pills that won’t change many of the reasons we need them in the first place.

*This is not a substitute for medical advice or intervention. If you or someone you love is experiencing mental health challenges, please consult with a licensed practitioner for proper assessment and treatment.