MISGUIDED ADVICE

Posted on November 22, 2011 by Jan Dirksen, One of Thousands of Life Coaches on Noomii.

Originally Published 1995

MISGUIDED ADVICE

Tell me to stop taking my medication and you might just as well place my head within a hangman’s noose. I, like approximately 10% of the North American population, live with a disease called chemical depression. This, in contrast to reactive depression which is a relatively short lived period of feeling “down”, is characterized by a persistent depressed mood. As the condition worsens the individual becomes less able to function in activities of daily living and may progress to a state of total inertia and helplessness. Feelings of guilt become all consuming and may lead to suicidal ideation, if not for the feeling of self-loathing, then in a desperate attempt to rid oneself of the perpetual sadness that is felt. It is described in Holly Wilson Skodal’s, Psychiatric Nursing 2nd Edition as follows:

1]“Medical-biological research has also found relationships between affective disorders and biochemical changes. Some, if not all, depressions are associated with an absolute or relative deficiency of catecholamines, particularly nor-epinephrine, at functionally important receptor sites in the brain.”1

Because of this and proven family histories, chemical depression is considered to be an inherited or genetic disease. For example, in my family, my father and his siblings have all experienced bouts of depression of which, as yet, only my father has found it necessary to seek medical treatment. His mother (my grandmother), who also received treatment, commit suicide. Thankfully, since then new antidepressant medication has been developed that is now capable of relieving depression; usually within a few weeks. Frequently however, one drug in particular, which is used in the treatment of depression, has been under repeated attack. The use of this drug, Prozac, due to much negative publicity, has become a social “No, no”, if you will. The extensive media coverage has left many a layperson with a tainted view of the drug’s effectiveness. In turn, these albeit well meaning individuals, emerge from their “dens of higher learning” to rid the world of this “nasty” drug. Their new found knowledge giving them not only freedom, but a sense of urgency to offer their usually unwanted advice. Which usually goes as follows:

“You’re on Prozac!” , “Oh, that’s bad.” … “Em, em, you’ve gotta stop taking that!”
“But it’s helping me. I feel better!”
“Nope, its bad.” … “Got lots of nasty side effects!”
“I’m not experiencing any!”
“You’d better get a new doctor!” … “Have you tried this new herbal tea laxative?”

Give me a break! I’m depressed not constipated! … You see, what the media fails to report adequately is that Prozac has saved the lives of many depressed individuals, myself included. Of course, some people do not respond well to Prozac, and some do experience extremely bad reactions, but can this not be said of all drugs? Penicillin is a good example. Many people have had extremely serious allergic reactions to penicillin. In fact, some have died as a result, but you never hear people trying to persuade others that penicillin is a bad drug! In fact, we “thank our lucky stars” for its discovery. Of course, all people do respond to drugs in different ways. Were this not true, we would have no need for the vast array of antibiotics and other medications now available. So, yes while it is always preferable to avoid the use of drugs, this is not always possible. Therefore, advising a patient who is under a physician’s care to stop taking their medication is not only dangerous but down right ludicrous. Yet, I and others are told on a consistent basis to do just that, often, by amateur herbalists who are riding the current wave of influence. They tell us this with no knowledge of our medical history. They don’t even ask, seemingly, because they don’t really want to know. And even when they do know, they can’t understand. I mean how can one explain to someone that at times one literally cannot get out of bed – that the world beyond their room become completely overwhelming and how your thought process becomes not only filled, but focused on suicidal ideation, and beyond that to planning. What lay person’s need to understand, yea know, is that the depressed individual has a suicide plan in place, in fact, they know exactly, EXACTLY what they would do, because this in an odd sort of way is their safety net. Yet, because suicide is not easily understood and even depressing to the unaffected, people stick their heads in the sand rather than having to deal with the real problem; and spew advice concerning the discontinuation of medication. In my case, even one “well-meaning” but idiotic naturopath told me to stop taking my Prozac and to come back and see him in one month when he returned from a lecturing tour. Smart move! Tell me to walk a tightrope without the balancing beam and then just to make sure when I fall I fall hard, take away the safety net too! What a fool! Have you ever, ever heard someone recommend to a diabetic that they stop taking their insulin? Of course not, that’s absurd! Well, the same is true of antidepressants. They, like insulin, alter hormonal imbalances within the hypothalamus of the brain. Insulin affects the blood sugar regulating mechanisms and antidepressants the emotion regulating mechanisms. My point: people’s lives “hang” in the balance. Leave their treatment or the lack thereof to the professionals. Do not pander your unsolicited advice on them. Instead, use your energy to educate yourself and others about the facts surrounding depression, its treatment and especially, offer your support. A listening ear and a kind word help to lift even the chemically depressed spirit. Mostly though, spread the word to others to keep their opinions about depression and its treatment to themselves, or at the very least not to discourage patients from continuing a prescribed course of treatment. To do so, “keeping your opinion to yourself”, may just save a life. Not doing so, may end one. So I say, “Please, DO NOT pass the noose of misguided advice!”, so that others like myself might live. Jan Dirksen, RPN

¹ Holly Wilson Skodol RN PhD FAAN, Carol Ren Kneisl RN MS, Psyciatric Nursing 2nd Edition (Menlo Park, CA: Addison-Wesley Publishing Company Inc., 1983 & 1979) 20.