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Wednesday, May 12, 2010

Mental Health & Modern Society

I've been called "crazy" more than once in my life, but truth be told I'm actually fairly healthy when it comes to the mental front. I'm lucky in that regard, as that's not true for everyone these days. In fact, if you look at one indicator, namely the use of anti-depressant drugs, there has been something of a mental illness explosion in the United States.

Explosion? Well according the the Archives of General Psychiatry, the use of anti-depressant drugs has increased about 75% between 1996 and 2005 (citation here). There are other reference out there, but I add this one specific fact to simply add credence to the conventional wisdom that anyone sensitive to this issue knows to be true.

Why is this? Well I think there are several potential reasons for the "explosion", and while I'm not an expert on the research in this area, I do have some ideas:

Better Diagnosis - It could be that there is no more mental illness out there now than there has ever been, it's just that we are better these days at the diagnosis. Maybe in the past we just called it being "eccentric", or we didn't fully understand that the town drunk may have been someone with a mental illness who was just engaging in a form of self-medication.

More Options - Along with better diagnosis, there are also far more treatment options available these days. As I write this there is a commercial for Abilify on the television. When there are more options, people may be more willing to actually seek out treatment or continue treatment when some options fail. Treatment has become less invasive as well; the visuals of the movie One Flew Over the Cuckoo's Nest have been replaced by a confidential doctor's office visit and a trip to CVS.

Pill Culture - With the successes out there in a variety of medical fields, I think our society is becoming accustomed to the notion that just about any problem can be cured with the right pill. Think about it for a moment: we now have pills that you can take to prevent pregnancy (birth control), we have pills that can lead to pregnancy (Viagra, etc.); we have pills that can cure infections and pills that can prevent infections. We want it all, and we want it to just take a visit to the 24 hour drug store and a glass of water.

Now recognizing mental illness as a medical condition that can be treated is a positive thing. The problem occurs though when our zest to recognize and treat runs into our lack of a societal attention span. We want to treat mental illness, but we want it done fast. We also want it done with a minimal effort. It's almost as if we somehow think that there should be a pill that turns the "sad" into the "happy". Maybe there should be, but then how could ever grow as individuals?

I've learned the most important lessons in my life in part by overcoming adversity. If I had a pill that would take the edge off of that adversity, would I truly be better off? Yes, sometimes adversity can get the better of you, but in my book that's okay as I've learned even more from my failures that I've learned from my victories.

I'm not advocating that medication has no place in the treatment of mental illness. Hell, I'm not nearly smart enough to being to even form that kind of argument, let alone actually believe it myself. Instead, I'm suggesting that medication is probably best thought of as being part of a treatment plan, not the treatment plan. That seems to run counter thought to what we want in this country.

Is it that we have a pharma-conspiracy bent on selling pills for profit at the expense of all else? I doubt it. Conspiracies require far too much effort to pull off.

Is it that we just suffer from a collective laziness when it comes to our mental health? Probably yes. There are parallels to our physical health here: we are getting heavier and there is a proliferation of "miracle diet drugs" out there that promise svelte-ness without the work. Sound familiar? Just take that pill and it will be all right.

In the end I've always believed that in life it's the journey that matter's the "not ceasing from exploration" that makes this whole mess worth the effort. Yes, sometimes we may need a little help along the way, but there is a big difference between getting help and expecting a pill to solve a problem. There is no happy pill, and I'm actually glad that's the case.

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