Tuesday, January 28, 1997
HEALTH:
Potential exists in facing illness without numbing effects of
Prozac
"The sky isn’t always blue, the sun doesn’t always shine,
it’s alright to fall apart, sometimes."
-some singer
The topic of this column is one of a very sensitive nature, one
difficult to talk about. It’s about depression.
Although depression may not seem to openly permeate the Ivory
Towers of UCLA, it exists. No matter how many are rushing about
smiling day after day through classes, no matter how many have an
"I know what I’m doing" way of carrying themselves, no matter how
stoic, silent, conceited or indifferent many others may seem, I
have found even subtle forms of depression to be a fact of life for
a silent minority at UCLA.
Before I go any further, I need to give some kind of a
"concrete" definition of depression. When I did my research on the
topic, though, I realized that there are no satisfactory
definitions of this condition, since I found no particular one that
did not lead me, as one who has suffered/suffers from depression
(and anxiety), to feel like I’m psycho under modern-day, technical,
medically "professional" terms. Nonetheless, for the purpose of
critical analysis, I will share a definition that more or less hits
home.
According to Aaron T. Beck, M.D., in his book "Depression:
Causes and Treatment," depression has the following
characteristics: 1. There is a specific alteration in mood:
sadness, loneliness, apathy; 2. There is a negative self-concept
associated with self-reproaches and self-blame; 3. There’s a desire
to escape or hide (from life) or die; 4. There’s a vegetative
change, such as anorexia, insomnia, or loss of libido; 5. There’s a
change in a person’s activity level, such as agitation or loss of
appetite and/or weight (or a loss of interest in otherwise habitual
activities). But just because, from time to time, you may
experience the above symptoms to one degree or another, it is not
to say that you directly suffer from depression. I therefore need
to share what is "supposed" to be a "normal" mood, according to Dr.
Beck:
A "normal" mood is a term that is, for the most part, applied to
a "spectrum of feelings extending from the elation of happiness at
one extreme, to happiness and sadness on the other." In other
words, it is normal to be sad, angry, frustrated, happy and a whole
array of other emotional/mental states during our lives Â
they’re all a part of everyday life, without which we could not
evolve. But depression is an exaggerated form of the "normal,"
i.e., one is either exaggeratedly sad and self-deprecating or
exaggeratedly happy and ridden with anxiety and self-enhancing
delusions.
Now let’s get into some treatments of this "condition," such as
anti-depressant drugs like Prozac. According to Michael T. Murray,
M.D. in "Natural Alternatives to Prozac," Prozac is the most widely
prescribed, most popular, and most profitable drug on the market at
the moment. What is interesting to note, though, is that according
to Dr. Murray, one reason for its popularity is not because it’s
more effective than other anti-depressants or treatments, but
because the media has played a key role in casting its almighty
influence and hyping Prozac up to be the "major breakthrough" in
the treatment of depression. This drug is also popular because it
fits into what Dr. Murray refers to as the dominant theoretical
model of depression; the "biogenic amine" hypothesis, which focuses
more on biochemical factors in the brain causing depression rather
than psychological factors.
According to the biogenic amine hypothesis, depression is due to
a biochemical deficiency that is characterized by imbalances of
amino acids, which form neurotransmitters known as monoamines.
These monoamines include serotonin, melatonin, dopamine and
norepinephrine. Prozac "works" by specifically inhibiting the
re-uptake of serotonin at the nerve endings of the brain.
Consequently, serotonin is likely to bind to receptor sites on
brain cells and transmit the serotonin signal. Serotonin is a very
important neurotransmitter because it is the brain’s natural
anti-depressant and tranquilizer. A decrease in serotonin is
thought to be a major cause of depression, anxiety and insomnia.
Prozac is therefore seemingly and conveniently a "better fit" for
drug therapy, as it fits smugly in counteracting this
imbalance.
But no matter how dandily Prozac seems to fit in the above
model, Dr. Murray argues that despite the fact of Prozac’s
popularity, the darker reality of this drug is not necessarily
(readily) publicly accounted for by the media or any of its other
proponents. For example, Prozac is popularized as being tolerated
more than any other anti-depressant drug because studies have shown
that "only" 17 percent of patients discontinue using it as opposed
to the 31 percent of patients who discontinue using other
anti-depressant drugs. Yet there is rarely any direct public
reference that sheds light on the fact that Prozac is NOT
characterized as a well-tolerated drug, nor that for many it
carries far more "pricey" costs like side effects such as nausea,
headaches, anxiety and nervousness, insomnia, drowsiness, diarrhea,
loss of appetite, sweating and tremors, rashes and loss of libido.
In addition, it is also most likely to cause violent, aggressive
and even suicidal behavior in some people.
OK. Let’s get off of the technical stuff. I am not a biology
student and I therefore do not presume to know everything about the
technicalities of depression and Prozac. But I did need to briefly
share some of the information that I found on these subjects
because it is important to learn about what is hurting one (who is
undergoing depression) to try to understand oneself better.
Personally speaking, I find Prozac, and any other drug for that
matter, somewhat terrifying, as I believe that drugs only serve to
superimpose themselves on an underlying internal chaos that really
needs to be dealt with. I have been told though, not only by
therapists here but by other students, that Prozac does not make
you dependent on it, that it actually does "calm" you down, that it
helps you "sort things out" and "get through the day." These
various arguments have almost been very convincing.
But on the opposite side of the spectrum, I’ve been around
others who have taken or are taking SOME kind of medication, and I
have seen reactions to it and the side effects (anxiety, tremors,
insomnia) that arise. What is most bothersome is that they think
they "need" it. They think they are not capable of otherwise being
strong enough to let themselves face their confusion and pain
because it is too "overwhelming." They "can’t do it," and their
all-knowing "doctors" have therefore advised them against stopping
their intake of medication.
I remember many years back how an 11-year-old sibling of mine
reacted to his medication (he has Down syndrome). He became very
aggressive, angry and depressed, and every time he was taken to the
doctor, the dosage of his medication was increased, as did the side
effects. I furiously objected, and it was extremely frustrating to
me to not know what to do to help, as even then I felt the
medication was harming him more than anything else. But once again,
some doctors and others who "know" what’s best for you when you are
"sick" become powerful in their influence in terms of helping you
believe you cannot heal YOURself inside. I’ve seen this even at
UCLA. Several times I have found that once certain internal chaotic
conditions (i.e. depression, anxiety) hit someone, they pop in a
pill to "numb" the pain. And then they tell me that it’s temporary,
only to help them "think," to "calm down," and to help them get
through work or school.
I had been "numb" to things inside for too damn long, and
depression made me see that. Yet despite the hell it has put me
through, and still does to this day, I have not taken any
medication for it.
Depression hit me in November of 1994. I lost 15 pounds in three
weeks, had nightmares every night, and had no family around to turn
to. With the coming of the holidays that year, I became terrified
at the solitude I’d be facing again. I became desperate,
anxiety-ridden and I felt a gradual loss of energy and rise in
paranoia that I could not explain. As I consequently found myself
no longer capable of handling myself alone, I called up a clueless,
life-long, shocked friend who literally came daily to cheer me up
as best he could. He fought with me for four weeks  we fought
against my breakdown. His loving encouragement and support helped
me make it through that winter break. And for the past two years
since then, I have learned to at least crookedly stand on my own
two feet, INside, to stop running away from the hell inside, and to
instead face it.
I am still fighting.
In no way, shape, or form am I patting myself on the back by
publicly revealing myself as an example of ANYthing. In actuality,
this is in no way easy for me to do. It’s difficult for a person to
try to express a point of view, to try to share something
troublesome (to put it mildly), without being portrayed as
narcissistic, high and mighty, eccentric or "stronger" than anyone
else. I really hate that. For example, I’ve been told by a few
people, even some who are taking medication (Prozac), that not
everyone is as "strong" as I am, and that therefore I cannot expect
what I did, what I am still doing, to be realistic for others. BUT
I’M JUST HUMAN TOO! Therefore, to me, it’s not a matter of
unrealistic expectations. It’s a matter of somehow gradually
overcoming deeply entrenched, self-defeating beliefs that one
"can’t do" something to help oneself. I fervently argue against a
self-defeating mentality because each and every single individual
has the potential and capacity to overcome any chaos inside,
without external fixer-uppers like medication. When you think about
it, how can anything on the OUTside ever really help in healing
INside? When do you decide, "OK, I don’t need this medicine
anymore"? When do you decide that you’re "OK" enough to stop using
Prozac and the like, when it supposedly helps you feel "calm" and
maybe even "rational" and "OK" while you’re still on it?
Just taking a look at the side effects of such medication has
prevented me from using it. Without it I already go through
anxiety, nervousness, "loss of libido" (he-he), etc.
I can’t say, though, that I assume others are using a cop-out
way of dealing with depression just because they use medication. I
am just a firm believer in each and every single one of us, our
abilities, our potential inside. I therefore think medication
clouds these things, makes you "numb" to "you."
So, for those suffering through depression (or anxiety), i.e. a
freshman or a transfer student trying to adjust to the
overwhelmingness of leaving home to attend UCLA, a second-, third-,
fourth-, fifth- or sixth-year student STILL trying to adjust to
UCLA, someone who doesn’t have family around or is not sure about
where they are going, how they fit in, or if they WANT to fit in,
someone who’s shy and/or is afraid of self-expression for fear of
being misunderstood, someone who is confused, lonely or who
sometimes is all-of-a-sudden anxiety-ridden in a middle of a
lecture …
To that silent minority, I say this. A friend of mine recently
told me that someone told him that confusion is a sign that you are
actually "thinking" and that "something wonderful is going on
inside."
Therefore (and I don’t mean to trivialize depression by saying
this), regardless of whether or not you take medication to "help"
you, I warmly extend out my hand, my heart, and I send you an
almighty hug in empathy.
Hang in there. You are not alone.