You’ve no doubt noticed the onslaught of pharmaceutical company sponsored advertising flooding television commercials and magazine inserts. You can hardly glance at the media without hearing about side effects such as 36-hour erections (okay, we don't have to worry about that one!), loose, oily stools, nausea, cramping, bouts of mania, and unexplained bleeding. These same ads proclaim the medication’s benefits even more loudly – freedom from migraine headaches, depression, obesity, and erectile dysfunction. The message seems to be that there’s a pill to fix anything that ails you. Sometimes it seems like every kid you meet is on ADHD medication, and half your friends are on some form of anti-depressant – and it’s true that these medications are prescribed with far too much ease and far too little deep consideration. Yet on the other side, there’s a backlash from those who claim that the body is a self-regulating mechanism; that diet, supplements, and yoga can cure anything up to and including cancer; and that all drugs (prescription medications) are poisons that disrupt the system.
As a psychologist treating primarily patients who are dealing with a chronic or acute illness or medical condition, particularly PCOS and other endocrine disorders, my interest in pharmaceuticals relates to both the psychotropics (medications used to treat mental conditions) as well as the medications prescribed by my patient’s physicians to address the physical symptoms of their conditions. Very few of us actually want to be on medication, but there’s a special stigma still associated with the medications we use to treat our brains. People report feeling weak, broken, damaged, crazy, and worse when it’s suggested that psychotropic medication might be helpful in addressing their depression, anxiety, bipolar disorder, or other condition. Consequently, they often refuse to try the very medication that provides them with the support they need so that they can really achieve something meaningful in their psychotherapy.
The truth is that the mind and body are inseparable, and many mental disorders have a biological base – there is literally a chemical imbalance in the brain, and it can be helped with medication. Just like insulin helps the diabetic, or synthetic thyroid replaces thyroid hormone for someone with hypothyroidism, medications that enhance neurotransmitter functioning can fill in the gaps in brain functioning. Non-pharmaceutical approaches such as nutrition, supplements, and mindfulness meditation practices can be useful, but are often not inadequate, or work too slowly. They require dedication and persistence to work, and many patients suffering from a period of depression or facing significant stressors may not have enough time to implement these methods. Sometimes the"medication" you need to consider is something non-pharmaceutical — Chinese herbs, Sam-E, or St. John's Wort, for example.
My perspective is that medication can serve as a support for the brain while you’re learning better coping skills, allowing the brain to rebalance, and getting relief from your worst symptoms. Yet we continue to demonize Big Pharma as money-grubbing, disrespectful of natural processes, and potentially harmful when it is true that even natural substances can be harmful or fatal – to the patient who is allergic to peanuts, a taste of peanut butter may be far more harmful than a large dose of a medication, and in fact, it’s medication that may save that person’s life. For me personally, medication is always a last resort (unless I've got a serious infection, or acute pain, in which case, I say"bring on the meds — and pronto!"). If my clients are stable enough, I also support their trying other things first. But I feel like Big Pharma's part of my tool box — there when you need it, and I'm quite grateful for it when it lifts someone out of a long-term depression, alleviates suicidality, or decreases life-disrupting levels of anxiety.
Similarly, with pain, the old way of thinking is that you should suck it up, suffer, power through – anything but take painkillers. As it turns out, your body heals faster, your anxiety is lower, and there’s a lower incidence of depression when patients take painkillers as prescribed. For a limited time and a specific use, doesn’t it seem reasonable to use every tool at your disposal? I want my patients to feel better sooner rather than later, so we often have discussions about their ideas about taking medication, whether it’s for a medical or psychological condition. If you automatically reject the idea of medication, especially the psychotropic medications, I invite you to examine your attitudes to see if they’re outdated, impractical, self-destructive, or just flat-out wrong. As always, I advocate taking a proactive stance as a patient, whether that’s in your doctor’s office or the psychotherapist’s consultation room. Perhaps you’ll find that the enemy of wellness lies more within your own mind than in the face of Big Pharma.
Gretchen Kubacky, Psy.D. is a Health Psychologist in West Los Angeles, a member of the inCYST Network, and a frequent speaker and author on issues related to health psychology, women's health, PCOS, and other endocrine disorders. If you have questions for Dr. Gretchen, have a topic you'd like to suggest, or would like to learn more about her practice, please visit her website at www.drhousemd.com.