People who “don’t believe in Prozac”

Every now and then I hear somebody say, “I don’t believe in Prozac” (or other anti-depressant or anti-anxiety medication.) It has become increasingly harder for me not to reply. That statement can somehow instantly suck my Zen serenity right out of me and deflate my bubble of hope for the other person.

My first question is, “What do you mean you don’t believe in it? You don’t believe that it exists, like Santa Claus?” Yes, it’s just a little bit of play, an attempt at a lighthearted opening to a non-confrontational or non-defensive discussion. Then I’ll hear some version and combination of the following statements:

“I really don’t like putting chemicals into my body.”

They’ll say something about being very leery of taking drugs – even medicinal, even mild medicine such as aspirin – to alter their brain function, but they’ll tell me this over a cup of coffee, a can of soda, a bottle of beer, or a glass of wine . . . all the while munching on processed foods packed with artificial sweeteners and chemical preservatives. (Yes, I know it is human, but nonetheless it is inconsistent logic.)

Many, many people seem to have this belief that their personality is pure and separate from the meat of their bodies, that their cosmic soul is not hampered by their human genetics and filtered through their day-by-day biochemical balance. It is commonly understood that everything about our bodies – the shape of our faces, the color of our eyes and hair and skin, our general physical builds, our level of innate athleticism, and even our various levels of intelligence – are strongly influenced by both genetics and diet (biochemical balance), so why is it such a hurdle to extend this understanding to the product of our primary organ, the brain?

We know that our thoughts (and their resultant feelings) reside in the brain; we knew that long before science could explain exactly how a “hard knock on the noggin” could severely change a person’s mental functioning; we knew that long before science could explain why women’s moods tend to change with their hormonal cycle; we knew that long before science could explain why normally sensible men became someone else when under the influence of testosterone (in love or war). Hell, we know it when we excuse a friend’s behavior when we say, “Don’t worry about; he’s just had too much to drink.” So why is it that we can believe, that we can empirically and scientifically know, that our thinking is done by our body’s brain – a biological organ subject to biological influences and problems – but somehow completely separate this, disassociate this, from our ephemeral and “pure” personality? (Yes, I know it is human, but nonetheless it is inconsistent logic.)

“I prefer to do without it, to live the way God made me.”

They’ll take their insulin or blood pressure medication, they’ll wear their eyeglasses or contacts, they’ll go to the dentist or orthodontist, they’ll even get cosmetic surgery – but oh, no, they won’t mess with the way God created them, the way they move through life . . . (And again, inconsistent logic.)

“I don’t need it; I’m not that bad off.”

Oh, is that so?   Maybe they should ask the people around them and then not dismiss or discredit their answers.

“I tried it and didn’t like it, didn’t like the way it made me feel.”

Okay, that’s perfectly valid. The big question, though, is whether they tried the right medicine and right dosage for them, and if they took it long enough for their bodies to adjust to it.

This statement is almost the same as the next:

“I’ve had bad experiences with it.”

Slow down; there are a couple of points here:

1. Yes, absolutely, as we hear in the warning sections of so many pharmaceutical commercials on TV, yes, it is entirely possible that the prescribed drug exacerbated the problem and created fairly-appraised “bad experiences.”
2. So, again, did they have the right medicine and the right dosage?
3. Did they try more than one or two medications? If your adult child went out and dated just one, two, three, or four different people then came home and said he or she was not ever going to date again because he or she “had bad experiences with it,” what would you say? Or the same with two or three jobs? Keep looking!
4. What were the current circumstances of their lives?   If they had several stressors active at the time, can they be sure it was the medicine and not the circumstantial stress that was giving them headaches, clouding their minds, making them sleepy, and so on? As in all other areas of life, most people simply do NOT carefully separate all possible variables to identify the true cause.
5. THE TRICKIEST REASON to understand and accept just might be that the medication did indeed work, that it made them healthier and strong enough to begin to face whatever problems and dysfunctions and demons were stressing them. Disrupting the status quo and finding themselves in unknown territory can be quite unnerving. (I know a man whose wife stayed by his side for 20 years while he was a (self-proclaimed) drunk, but soon after he finally sobered up, she divorced him.)

“Everyone I know who has used it is still unhappy and kind of wacky.”

Yes, they are.   (Well, actually, maybe not: it is doubtful that anyone is aware of every person around them who uses anti-anxiety or anti-depressant meds at a maintenance level.) But, how unhappy and more wacky might they be if they didn’t have their meds? No one can say for sure, but – if they’ve been accurately diagnosed and properly prescribed – they’re probably better off. Ask the properly medicated what they think of their medication use. The meds are not a magic pill; they don’t make you instantly happy and mentally healthy. For that, you have to change the way you live your life and maybe even change the circumstances of your life. Not only does that take time but also it is an endless struggle, for all of us. The meds are intended just to enable you to get out of bed and make it through a day with at least half a chance of being functional enough to make progress on your own.

“It’s a crutch. I’ll be stronger if I learn to do without it.”

Uh-huh, yes, it is.   If their ankle were sprained, would they use a physical crutch? Same with their coats in cold weather, shoes on their feet, etc., no?

Readers, I have been taking anti-depressants for about 20 years now, and there is a clear demarcation between the first “half”, the “before” part of my life and the second, “after” part of my life. The medicinal drugs don’t make me a superman, that’s for sure, but I shudder to think of living without them. You know those futuristic apocalyptic movies where either in the city or in the desert even basic living is brutally hard? Without my meds, that would sort of be the world I would be living in today, here, now (but with less bizarre clothing.) They’d call me (No-)Med Max . . . So, yes, hell yes, I “believe” in anti-depressant and anti-anxiety meds.

I have one question for steadily depressed or anxious people who tell me they don’t believe in meds.   So far, I haven’t asked it of anyone, but each time the topic is broached, I can feel that question crawling up my throat. One of these days it will escape my lips, so I hope I can lead up to it gently, and find softer words than I have up till now. Here it is:

Instead of you taking medication, more convenient than you taking medication, are you forcing your family and all the people around you to suffer your behavior and make adjustments in their lives to deal with all the overt and subtle repercussions of your maybe simple biochemical imbalance? Especially with your family, is it fair, healthy, and loving of you to dump long term echoes of dysfunction permanently into their hearts and lives simply because you are afraid of finding medicine that will help you?

Ya, I know: ouch.

Maybe before I get so pointed I’ll say just – when steadily depressed or anxious people tell me they don’t believe in meds – that I have had to adopt a policy for investing my energy where I believe it will do good and not investing it where I’m banging my head against a wall while there’s a doorway open to me. Aww, hell, maybe I’ll tell them I “don’t believe” in helping to solve the depression or anxiety problems of people who “don’t believe” in proper medication . . .