“Take Your Meds!” Not a Joking Matter

Over the past few weeks and months I've been subjected to a tremendous number of pressures in my personal and professional life, causing me extraordinary stress. Work has been crazy to say the very least. My theater company participated in (and won) a statewide competition. My personal life has been dealt some serious blows by friends I thought loved me. And then the stress of traveling for the holidays... yeah. 

Now, everyone experiences stress of this nature, and I know that. I know more than most, I believe, as sometimes it is difficult for me to deal with situations and navigate life in ways ordinary people can easily do, with little effort. In the deepest, darkest valleys of my life experience, for example, just getting out of bed could be a struggle. Taking a shower took almost all the energy I could muster, to the point that I would need to rest – physically rest – prior to getting dressed or putting on my makeup.

And all this because I have a mental disorder. I am mentally ill.

Treating My Illness

My mental disorder is Major Depressive Disorder with Generalized Anxiety Disorder (MDD with GAD). It’s not terminal, or even life threatening in any way. But it is incurable. It’s treatable, but I will never be completely cured.

The good news is that modern pharmaceuticals have been able to treat my disorder for decades now. With the birth of Prozac in the late 1980’s, those suffering various forms and intensities of Anxiety and Depression have been saved by a class of drugs known as Selective Serotonin Reuptake Inhibitors (SRRIs). In that class of drugs, you will not only find Prozac (fluoxetene), but also Paxil (paroxetene), Lexapro (escitalopram oxalate) and Zoloft (sertraline), among others.

[Sidenote: Another class of Depression treatments that includes medications such as Effexor (venlafaxine) and Wellbutrin (bupriprion) also aid in the reuptake inhibition of nor-epinephrine and dopamine, other neurotransmitters that aid in the regulation of mood and emotional states.]

Now, I’m not a physician. I have no medical training beyond a CPR course at the local Red Cross. But since my Depression diagnosis in late 2001, and subsequent Anxiety diagnosis three years ago, I have done more than a little reading and research in order to better understand my illness. I like to think I know a little more than the average person not so inflicted.

Here is some of what I learned.

Serotonin is a neurotransmitter that aids in regulating a human being’s mood. What happens in Depression – and really, no one knows how, why, or when – is that either the brain cannot manufacture enough of the chemical, or although manufactured in sufficient quantities, for some reason as yet unknown, the bloodstream absorbs whatever quantity of this neurotransmitter is available, and sweeps it away before it can do its job. Thus, the individual cannot easily control his or her emotional states. The mechanism simply isn’t there. SSRI medications prevent the bloodstream from robbing the brain of the necessary chemical, enabling the individual to enjoy more normal levels of these essential neurotransmitters.

Lest I amble down a neuro-chemical bunny trail, my point is simple. Depression and Anxiety, although considered mental disorders, do have a physical manifestation. Something in the brain and body has gone wrong, and the mechanisms necessary for a full and balanced life cannot function unaided.

A Much Maligned Affliction

Although the physiological results are well-known and documented, they are still much misunderstood by the general population.

Again, I am not a doctor, but I recognize that the prevailing understanding of physical illnesses – sickness, disease – is that they are generally caused by some pathogen, a virus or bacterial infection. There is generally no blame, judgment or chastisement of the afflicted attached to such afflictions. They’re not (generally speaking) behavioral in nature.

However, society seems to have a somewhat skewed perception of mental illness – and particularly, Depression: You must have done something or made some mistake in your lifestyle or behavior. You’ve caused this, brought it on yourself, neglected yourself in some way. That’s why you’re depressed. It’s all in your head. Stop thinking sad thoughts. Be positive! Just snap out of it.

But that’s the trap: we cannot “just snap out of it.” The physiological mechanism simply isn’t there.

To draw an analogy, consider Diabetes, a chronic, debilitating and incurable illness. Sometimes behavioral (poor diet, a sedentary lifestyle, etc.), often genetic in nature. With certain types and severities of Diabetes, the individual may be prescribed insulin, to combat the fact that the body does not function as it should. This chemical keeps the person alive and functioning.

Such an individual cannot function without insulin. You’d never dream of saying to this person, “It’s all in your pancreas. Just snap out of it.” A diabetic can no more “snap” their pancreas into producing the right amount of insulin to counteract the effects of excess glucose in the bloodstream, than someone with Depression can force their brain to produce the right amount of neurotransmitters, or “snap” their bloodstream into not washing it away before it can work.

Think Before You Speak

I take a daily dose of a medication that essentially keeps me functioning as, what I hope to be, a valued and contributing member of society. Juvenile jokes and snarky remarks about “taking your meds” aren’t funny to me. They are hurtful. They are harmful. They perpetuate the misconception that a person suffering mental illness and taking “meds” in order to function normally is somehow at fault. The intent of such comments may not be to hurt or harm, but that’s exactly what they do.

So please. Next time you’re tempted, no matter the situation, please think twice about making a joke about mental illness or the medications that treat it. It is difficult enough for the mentally ill to navigate the world without pharmaceutical assistance. We don't need the added anxiety such ignorant, insensitive comments can bring.

We don’t want to be sick. We want to be well.

Depression hurts.

Words can be painful, too.

(Dismount soapbox.)