Many years ago, when I first moved to Portland, Oregon from Colorado, I began suffering from a bout of depression, undoubtedly related to the absence of sunshine (Solar Affective Disorder). It wasn’t a true clinical depression, as I could still function relatively well. The worst symptom for me was how irritable I was. I felt that my irritability was getting in the way of my work relationships, and I mentioned it to my primary care physician who was more than happy to prescribe 10 mg of Prozac for the condition.
I began taking the drug, and immediately felt more energized with improvements in my mood. After about four months, I decided that I would stop taking it. My doctor, didn’t see why I would want to stop taking it if it was working. “I don’t want to be dependent on a drug,” I had said. “I would prefer to figure out how to be happy without it.” I tapered off it, and have never looked back. I think the drug was a good thing for me in that moment; it helped me to break some mental behavioral habits that I had fallen into, but it didn’t seem like something I wanted to be locked into for life.
A couple of years later, a teacher suggested evaluating our middle-school daughter for ADD. We did that, and left the doctor’s office with a prescription for Adderall. I felt ambivalent about it at the time, as it seemed wrong to me that so many children were being put on drugs for the sake of classroom management, and frankly, nobody really knows what the long-term impact of drugs like these will have on children’s developing bodies and brains. We gave it a go anyway. Our daughter began taking the meds, and we could see an improvement in her ability to concentrate. After about ten days on the drug, however, she began to complain of headaches, and generally not feeling great. By the end of a month, she was still complaining, so we honored her wishes and took her off it. We have never looked back.
Recently, in my own life, after going through treatment for an early-stage breast cancer, and then having a serious post-surgical infection that required the use of six different antibiotics to cure it, I experienced a bout of anxiety and depression. I had to take a leave of absence from work, as I was fairly dysfunctional. When I tried to get my short-term disability (STD) insurance to cover during my absence from work, I was denied. I wondered if I should appeal the decision and began doing research. I learned that STD will deny coverage for mental health absences if the patient is not on drugs and not seeing a psychiatrist at least twice a week. I had said/done all the wrong things.
Of course, my primary care physician offered to put me on drugs when I casually mentioned that I was experiencing anxiety and depression, but I had declined. My reason for declining was that I had no idea what was causing my altered mental state. I suspected that it was the last antibiotic that I was on, Zyvox, a weak MAOI, but it also could have been the result of dealing with the traumas I had endured for the months prior, or the fact that my situation at work was less than stellar, or that due to my cancer treatment my estrogen level was at zero, or all of the above. I wanted to solve the problem through proper nutrition and exercise, which is what ultimately I did. I did yoga, walked and went bike riding daily with my daughter. I rested. After about six weeks, the anxiety and depression dissipated, and I was back to being myself. It upset me that the insurance, which I had paid for, and never tried to use until then, would not cover me unless I were on drugs, as if somehow being on drugs proves that one is suffering from a bona fide mental illness.
This morning, I stumbled upon an article about menopause, and treating it with ADHD drugs. During menopause, as estrogen declines many women experience what is known as “brain fog,” an inability to concentrate for which many doctors are prescribing attention deficit disorder drugs. Then I Googled “Menopause and ADHD.” Â Lo and behold, a slew of articles popped up touting the benefits of all sorts of amphetamines for menopausal women. It turns out that doctors are handing out amphetamines to women like candy. I have several friends and relatives who are taking them, ostensibly to treat their late-diagnosed cases of ADD. No doubt, menopausal women experience hormone related attention issues, but I would argue that taking amphetamines is not a wonderful long-term solution. The list of side effects for amphetamines is daunting, and some of the long-term mental and physical consequences are dire.
What disturbs me most about the suggestion that menopausal symptoms, and menopausal women, should be treated with powerful psychoactive drugs is that it reflects the medical industry’s continued view of women as psychologically fragile. I am reminded of a story my mother tells of having high blood pressure back in the sixties that began as the result of taking birth control pills. Her doctor prescribed Meprobamate, a tranquilizer, a practice that was driven by the belief that women are prone to neurosis by virtue of their hormonal imbalances. The drug was intended to subdue her as much as it was to lower her blood pressure.
Gender bias in diagnoses and treatments is a well documented phenomenon that doesn’t just have an impact on women; it has an impact on everybody. According to the World Health Organization, men suffer from mental health disorders at the same level as women, but “doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms.” Furthermore, being female “is a significant predictor of being prescribed mood altering psychotropic drugs” (https://tinyurl.com/yythl5d), a fact that bothers me greatly.
I am not anti-medicine. There are many compelling reasons for people to take medications for mental health issues, for hormonal imbalances, and for any number of other health issues. I feel strongly, based on my own family’s experiences, that doctors are too willing to hand out pills as easy fixes to difficult problems. Looking at people’s whole lives–their families, diets, cultures, physical and mental activities–and helping people make changes without lifetime use of drugs should be a preferred goal. We need to question the biases and motives of our medical practitioners. They do not know everything, and they come with all of the cultural baggage the rest of us do.
