Thursday, March 01, 2018

Strong mind, strong body -- take your pick

Just added to my reading list: "Blue Dreams: The science and the story of the drugs that changed our minds" by Lauren Slater. I will tackle it once I finish "Lincoln in the Bardo" by George Saunders.

"Blue Dreams" is a non-fiction account of psychiatric drugs and their effects by someone who is both a patient and a psychologist.

"Lincoln in the Bardo" is a novel that explores something that seems a lot like severe depression and PTSD in Abraham Lincoln, who is mourning the death of his 11-year-old son, Willie, in 1862.

Would Lincoln have benefited from a regimen of Prozac or other SSRIs? Perhaps. Maybe he would have recovered from his dark moods more quickly with a couple hits of Molly or LSD.

We'll never know. But psychedlics figure into Slater's book. Party drug MDMA (Molly) has been tested on those with PTSD. It has shown some remarkable and lasting results. As Slater recently described it on NPR's "Fresh Air:" those who take Molly and relive their trauma are able to shift that experience into another section of the brain, possibly the prefrontal cortex, helping remove it from the "fight or flight" amygdala. They can then get a handle on a horrible memory without degenerating into bouts of anxiety or self-harm, even suicide.

Slater wonders if this experimentation may lead to another golden age of drug therapy. The previous golden age brought on by lithium and Prozac may be nearing its end. Slater testifies that medications have helped her stay sane, raise a family and write books. They also have shortened her life.

That's the trade-off. So goes the old witticism: "Sound mind. Sound body. Take your pick." After five stays in psychiatric facilities between the ages of 13 to 24, Slater's doctors discovered Prozac. In a rush of Seratonin-laced good will, she finsihed finished her education, married, had two children and embarked on a writing career.

Then came trouble, in the form of the return of depression  and the start of her use of Zyprexa, which caused her to gain weight and lose her libido.

We patients are guinea pigs. Researcher still don't know the inner workings of these drugs. And their long-term effects. If you are in the midst of a severe depression, you want immediate help. Doesn't happen. Prozac or Zoloft may alleviate the symptoms eventually. Studies have shown that two-thirds  of those with depression would recover just as well with a placebo. That's depressing enough. Add side-effects into the mix and you have to wonder what in the hell we are doing.

I have been taking antidepressants for almost 30 years. I feel better, go off them, and crash. One of my psychiatrists once lectured me: "You have to stay on these the rest of your life. You have depression."

That made an impression. Unfortunately, I don't always listen. I went off my Zoloft six years ago and the walls came crashing down. I was out of work for a month. My psychiatrist at the time, who fled Wyoming for Hawaii one winter and never came back, tried a return to Zoloft and then several other meds. We finally went back to Prozac with a nighttime dose of Remeron. Several months later, I felt better but also was back exercising on a regular basis and eating right, which helped. Also, I was in talk therapy with a therapist and regularly saw my psychiatrist. Still, that summer I was still experiencing bouts of depression interspersed with anxiety. It probably took a good six months for my moods to stabilize.

Six months later, on Jan. 2, 2013, I had a heart attack. I recovered quicker from a "widow maker" than I did from depression. Got more help, too. Add an inept mental health care system to the fact that the docs know so little about the drugs and the human mind. That makes for a killer cocktail of ignorance. At least I have both Medicare and private insurance which enables me to navigate the system without going broke.

But I am not only here to complain. I am here to critique books. "Lincoln in the Bardo" is a wild ride and I'm only on page 98. This is how an award-winning short story writer writes a novel. Truly unique. I am a short story writer working on a novel. I find encouragement in Saunders work.

I have ordered Slater's book. I, too, would like to know what happens with long-term use of these drugs. My life depends on it.


Lynn said...

I hear so much about side effects. Sort of a damned if you do-damned if you don't thing, isn't it?

I argued recently with my doctor about statins, told her, "I don't trust doctors anymore, not since the opioid crisis. How can I believe what you tell me? Or are you just spouting what the pharmaceutical company has told you to say?"

It wasn't really fair, but I wonder sometimes if a doc with a prescription pad is a dangerous thing, in the long run. But we all have to do the best we can, with our own situations.

And depression can kill, no doubt about it. I lost a stepdaughter to it. So please take care and know that your family and friends need you around for a long time yet. Do what you have to do, is all I'm saying.

Michael Shay said...

Thanks for the encouragement, Lynn. So sorry to hear about your stepdaughter. Depression can kill, that's a fact. I may take a page from your book and question my docs more about the meds they prescribe.