I'd like to say a word about psychopharmacology. This word's been percolating for a couple of busy weeks and today presents my first opportunity to express it here.
Obviously I haven't been blogging predictably for a while. Part of this is generic busy-ness. Part of it's apathy and self-defeat. But part of it's crippling, numbing depression. (Okay, I admit, that and the apathy and self-defeat might be related. Just a bit.)
Look, it's been a helluva Fall. The past several weeks in particular have been difficult.
And for whatever reason, in the midst of all the difficulty, I made the patently farcical decision to titrate off of my SSRI.
Uh, yeah. Awesome idea. That went about as well as you might expect, particularly given my absence in these parts as of late. (Which usually implies a not-so-hot spell.)
So, I titrated off of my meds. Some vagueblogging-worthy stuff occurred. I ended up in my therapist's office this Tuesday, sobbing.
I started stepping back up to my normal SSRI dose Tuesday night. I already feel better. Everything isn't roses and rainbows and kitten farts, but I feel better.
In a certain slice of our culture, it's correct to conclude that we're an "overmedicated" society. There's this assumption that we're "overmedicated," that we as a greater entity are happy to pop a pill rather than… whatever other option we might have. Even when we're the ones directly benefiting from psychopharma meds, as in the link there, some of us (including me sometimes) are dedicated to the belief that our culture is overmedicated, pill-happy.
But what does that really mean? This month I've been percolating the idea that maybe it's just an extension of our Puritanism to insist, even if we are individual evidence against the theory, that we are An Overmedicated Society and that medication is Usually Not The Answer.
Well, what do we mean, "overmedicated"? What do we mean when we say that?
Do we mean to support the stigma against psychiatric treatment? Because the trope that Americans are ready to pop a pill rather than deal with a "real" problem supports exactly that.
Do we mean that medication should be reserved for "real" problems rather than depression, which we should white-knuckle through? Or rather than personality disorders, which aren't directly impacted by medication according to current evidence? Because medication can mean the difference between having and not having the extra psychic energy to mount a fierce battle against, say, borderline personality disorder, or bulimia.
But, you know, I don't care what we mean. The implication of "overmedicated" is, eventually, "over-treated." The implication is hierarchies, is real struggles and ersatz ones. Is a continued stigma in reaching out for support for mental illness. Is, at the end of the day, continued bullshit.
We're not "overmedicated." We're under-treated.
Please take a second to imagine a U.S. in which psycho-social counseling and other treatments were readily accessible and universally unstigmatized. Really, really take a moment and imagine what that might look like.
Now tell me with a straight face that you sincerely think we'd still be "overmedicated."
I know I don't think so. I don't know - I might be in denial. I might be exactly identical, psychopharmacological speaking, in this alternate reality as I am here and now. But maybe not.
Look at me, write to me, with a straight face and in good faith, and tell me that more accessibility from day one might mean less need for psychopharma medication at day seventy-three hundred (or day two thousand, or day whenever). (I'm at day eleven thousand two hundred eighty-something.)