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When Your Kid Asks About Anti-Depressants

My 12-year-old has a few things in common with his dad. Both of us have mental disorders (his is ADHD, mine is OCD with wintertime undercurrents of ADHD). Both of us take medication to help manage our ills. But until last weekend, he had never asked the big question:

“What do these pills do, anyway?”

Mood music:

To answer the question, I dusted off an analogy I had used some years ago to explain it to others. Essentially, I told him, the brain is an engine. When one part gets worn out, the whole the engine can fail. An engine needs the right amount of oil, transmission fluid, brake fluid, and so forth to function properly.

If the oil runs out, for example, the engine seizes up. If the brake fluid runs dry, the breaks fail. Too much of these fluids can harm the engine, as well.

Car owners and auto mechanics use many different techniques to keep engines healthy or fix them when they break. It could be something simple, like topping off the oil, to something more complex, like realigning or replacing faulty parts.

The brain works much the same way.

Heat map of brain activity, normal state versus depressed state

Think of a psychotherapist as the auto mechanic who is well versed in how to regulate the different engine fluids and pinpoint specific fixes for specific problems.

The different drugs are tools the mechanic uses to deal with specific problems in the engine. In the brain, when certain fluids are running low, the result is depression and a host of other mental disorders.

Antidepressants

In my case, Prozac addresses the very specific fluid deficiencies that spark OCD behavior. Since OCD is essentially the brain pumping and spinning out of control, I like to think of my specific problem as a lack of brake fluid.

When I explained it this way, I think he got it.

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Stop Whining and Learn From Your Pain

In my early 20s, I adored the Pretty Hate Machine and Broken albums from Nine Inch Nails. I still listen to them on occasion, but for the most part I grew tired of them because all Trent Reznor’s screaming about pain, loneliness, depression and rage got old. He never told us how to go from hopelessness to wisdom and personal growth.

Mood music:

[spotify:track:5ttpMaPCxRceWlR1kziBDZ]

That’s how Kerry Cohen, an author I’ve come to admire, feels about Elizabeth Wurtzel, author of Prozac Nation. In her latest Huffington Post blog entry, Cohen explains how important that Wurtzel book was to her at a fragile time in her life:

Wurtzel named a truth for us that psychology wouldn’t touch. We were a generation of depressives, of borderlines, of personality disorders. We were Generation Empty. I loved Wurtzel for how she made me feel less alone, seen.

But Cohen reached an impasse with Wurtzel:

My editor for Loose Girl summed it up when she said, “America loves a redemption story.” We wouldn’t settle anymore for emptiness that goes nowhere. People wanted to know how to get better. … There are times I wish I could call Wurtzel on the phone and tell her how much her work meant to me. … But until she has something new to say, something that is still truly about our generation, I wish she would stop.

I’ve never read Prozac Nation. I haven’t read Cohen’s books in their entirety, either, though I’ve dug into parts of Loose Girl and Seeing Ezra. I’ve mostly become a fan of her work through her blog posts and  what she shares on Facebook and Twitter. This latest post hits my core.

In my early 20s, I reveled in my depression. I filled notebooks full of poetry about my emptiness. I somehow thought it made me cool. I hit upon something that I felt “normal” people couldn’t experience. This somehow made me smarter, better. I was just stupid. I’ve searched everywhere for those notebooks. Not because I think I’ll find some brilliant spark from the past to feed my creativity today, but because I think I’d get some cheap laughs from it.

I remember going on a date in 1989 and spending the whole dinner telling the young lady about how bitter I was toward my parents and how dark I saw the world. That relationship didn’t survive the first date.

Eventually, I realized that the pain wasn’t going to send me anywhere in life unless I used it to gain a better understanding of who I was and what kind of good I was capable of. The ancient Greek scribe Aeschylus described the need to use suffering for personal growth this way:

In our sleep, pain which cannot forget

falls drop by drop upon the heart

until, in our own despair, against our will,

comes wisdom through the awful grace of God.

Robert F. Kennedy, who recited that poem to a shocked and angry crowd the day MLK was assassinated, understood all too well.  I’ve tried hard to take those words to heart. In this blog, I’ve tried to always explain how, in my personal experience, things get better. If all I did here was complain, this blog would go nowhere. I must always remember that.

Thanks for the reminder, Kerry.

ProzacNationBook

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All You Wanted Was a Pepsi. Instead You Got Drugs

A friend of mine likes to refer to antidepressants as “brain candy.” I hate when he does, because it oversimplifies the very complicated science of mental medication. It’s not about seeing flowers and sunshine where neither exist.

Mood music:

There is this notion that taking antidepressants is a sign of weakness. I come across a lot of people who see the medicine as something to take out of desperation and to get off of as soon as possible.

There are very legitimate reasons to want off of the drug prescribed to you. The most obvious is that sometimes the drug doesn’t work. I know plenty of people who have tried a litany of medications without success. I can’t blame them for wanting to be done with them. One friend has tried every antidepressant under the sun and still struggles with crippling depression.

Another good reason is that some of these drugs have side effects that the patient just can’t live with, like excessive weight gain or loss, headaches, acne or loss of one’s libido.

To learn about how antidepressants work, read “The Engine” and “Serotonin, Dopamine and Two Blue Pills.”

But if you and your doctor manage to find something that works and you get obsessed with getting off that drug simply because you don’t like the idea of needing it, that’s foolish.

It’s easy for me to say that because I’ve been fairly lucky. Prozac was the first drug I tired and it started working within a couple weeks. When it first kicked in, I felt like it was the first time I truly felt comfortable in my own skin. I’ve still had bouts of depression, especially during winter, and dosage adjustments have been required. This past January, I went on Wellbutrin as well, the idea being that it would help the Prozac work better. It worked. I either have a powerful army of guardian angels looking out for me or am just insanely lucky.

But I’m not a special case, either. I know plenty of people, including the friend I mentioned at the start of this post, who have gotten good results but wanted off as soon as possible.

If I thought I could manage my own issues without the drugs, I’d want off, too. But I don’t think I’m there yet. Not even close.

My attitude is simple: As long as the drugs work, I’m going to keep taking them. It’s better than feeling fear and anxiety again. It’s better than being a miserable bastard whose a beast to his family, friends and colleagues.

If I have to take the medicine for the rest of my life, so be it.

Those who want off the drugs simply because they fear the stigmas or feel weak if they can’t manage without it are barking up the wrong tree.

Stop worrying about your destination and focus on the journey instead.

Brain Lollipops