Monday, March 14, 2005

"Mystery of Neurochemistry"

In today's issue of Salon.com writer Ayelet Waldman has published an article called "Living out loud -- online" (you have to subscribe or watch an ad to read it). In it she discusses her blog which she uses to chronicle her personal life including her bipolar disorder. Recently she published her intentions to kill herself on her blog, sparking quite a crisis. Her article describes the incident this way:

I informed my readers, among them my husband, that what I have, the milder form of the disease, has a 24 percent suicide rate. Then I wrote, "It does not help to know that one's mood is a mystery of neurochemistry when one is tallying the contents of the medicine cabinet and evaluating the neurotoxic effects of a Tylenol, topomax, SRRI and ambien cocktail.

It makes me sad to think that anyone regards themselves as hostage to their brain chemistry and some cold table of statistics. In my opinion it engenders an unhealthy helplessness that is counterproductive at best.

That doesn't mean that medication doesn't work or help. I think that everyone who finds themselves struggling with mental illness should seriously consider giving medication a try. It does help lots of folks. Some people's lives are saved by it. However, I liken psychiatric medication to aspirin - it can help stop the pain and symptoms long enough to treat the wound that initially caused the pain. And as we know, in the case of depression there is ample evidence that placebos work as well as the latest pharmaceutical concoction.

Of course, people started down this 'helpless to brain chemistry" path to combat the phenomenon of family members screaming at depressed loved ones, "You're just being lazy! Get up!" People are so extreme sometimes. While you can't blame it all on brain chemistry, you can't entirely blame the intentions of the ill person either, or their family. People and their lives are complicated. Aren't you complicated? I'm willing to bet that it takes years to truly understand who you are, what you're about, what causes your pain, how you got to where you are, and where you want to be one day. It is foolish to think that anyone's problems could be resolved with a simple pill.

Even though Waldman was under a psychiatrist's care and on his prescription when the incident happened, still she thinks the answer lies in medication alone. When her 7-year-old expresses fear that she might one day really kill herself, Waldman writes:

I sat him down and explained what had happened, that I had been taking the wrong pills and that my doctor had fixed my medicine. ... I hugged him, then I told him that I knew why he was afraid. I told him what a good doctor I had and how careful we were now to make sure nothing like this ever happened again.

At least she sounds somewhat less helpless when she concludes:

I promised him that I would never, ever hurt myself. A rash promise, perhaps, but I do my best not to break my promises to my children. And I don't intend to start with this one.

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