Finding the right medicine



I ran out of adrenaline last semester. I went to a walk-in clinic to figure out what was going on. It began as a quaint visit — I couldn’t remember the last time I’d been to see a general practitioner, and I figured a check-up was due.

We had our conversation, she spoke medicalese, and I agreed to get blood tests. Then she asked if depression ran in my family. It does. She suggested I try an antidepressant. I don’t see why?

“You don’t have any need to worry,” she said, trying to reassure me — as if I was unsure of something. “This is a mild antidepressant, and they’re very common.” I feel like I’ve heard this sales pitch before.

I’m not depressed. And I do understand its complexity. So I was surprised to have medication pushed on me when I came for what I thought was a different issue. Yes, I was worked up about finals, but I really went to the clinic for one of two things: a way to mainline epinephrine into my dome, or to find out if there’s a reason why I’m waking up more tired than the night before. Either way, I didn’t need antidepressants. What I needed was to push through the last of my exams.

Our conversation got uncomfortable, we argued about my need for antidepressants for a solid 10 minutes. Ultimately, I couldn’t leave the doctor’s office without a prescription for antidepressants. They were for “just in case.”

Antidepressants are the second highest category of drugs claimed by UFV students through the health and dental plan. Not all students claim their medications, but this gives a good indication as to what’s being taken. And so I wondered, if I was handed them like candy, what are those other hundreds of students’ experiences?

In a New York Times article titled, “The Antidepressant Generation,” Doris Iarovici writes: “A growing number of young adults are taking psychiatric medicines for longer and longer periods, at the very age when they are also consolidating their identities, making plans for the future and navigating adult relationships.”

According to a study by the Organization for Economic Cooperation and Development, Canadians consume 86 doses of antidepressants per 1,000 people per day. We are the third-highest consumer among 23 developed countries surveyed. The report suggested that antidepressants are increasingly prescribed for “milder forms of depression, generalised anxiety disorders or social phobia.” In every country surveyed, antidepressant usage is on the rise.

In another recent study, the Canadian Association of College and University Student Services found that a fifth of post-secondary students battle mental illness, which includes depression and anxiety.

Depression is a serious form of mental illness, and thanks to many advocates and campaigns, this culture is beginning to see past the stigma.

I saw an “interesting facts” meme a while back; one of them said that in Japan, until the late 1990s, depression was incredibly stigmatized and antidepressant use was nearly nonexistent. In 1999, pharmaceutical companies launched an ad campaign: “kokoro no kaze,” which literally means “a cold of the soul.” They then began selling the problem of mild depression, and the solution for it. As the idea caught on, more and more people began to realize they were depressed.

Accord to the BBC, after this campaign, the market for antidepressants skyrocketed and in 2006 it was worth six times what it had been prior. Doctor visits for depression-related issues also rose dramatically.

In pre-1999 Japan, the word for depression was associated with disorders like schizophrenia and severe mania. Since the campaign, mild depression has become a buzzword, according to Kathryn Schulz, writing for the New York Times.

Mental health had long been inadequatly addressed in Japan. Suicide rates are disgustingly high (third highest in the world according to the Washington Post) and the culture has been known to be dismissive of mental illness. The problem with the ad campaign is that it didn’t differentiate between levels of depression.

Arthur Kleinman is a psychiatry professor at Harvard and the co-author of Culture and Depression. He told the New York Times that “there is no question in my mind that severe clinical depression is a real disease…But mild depression is a totally different kettle of fish. It allows us to re-label as depression an enormous number of things.”

Without a doubt, real clinical depression is as crippling as losing a part of your body. It is losing part of the body — it’s losing your kokoro. But while some injuries need a John Hopkins surgical team, others need a pep talk and a pat on the back.

The campaign did some good, it opened depression as a legitimate conversation. But Schulz also noted that other forms of treatment haven’t caught up with medication. Now that medication is so prevalently used to treat anything from periodic sadness to full-blown depression, psychiatrists in Japan are trying to introduce other forms of treatment, like counselling and talk-therapy. What’s concerning is that a lot of people might not be getting the help they need, if mood swings are treated like brain infections.

I didn’t go for a follow-up. I figured if it was an external stressor that jumbled up my neurochemistry, it would best be another external change to tidy it up. So instead, I went for a hike; I wrote without a goal; I devoted an allotted time for rest — a Sabbath, or Uposatha, if you will.

Many ancient spiritual practices ritualize focused rest. It’s a bit different from doing nothing, however, it involves focusing on being at peace, or amongst a community of friends. When you pay attention, you see there are rhythms to everything. We call them seasons, currents, rotations, cycles. Rest is always a part of these cycles. If everything else on this planet is attuned to it, I reason I’d better do the same. And it seemed to work. Even that short practice of rest reversed my woes from the entire semester.

I threw out the prescription. Not because of a moral superiority, purely because of pragmatics. I just don’t need them. Like I didn’t need cigarettes either — and although I’ve quite smoking dozens of times, for a long time I regretted my first drag; there were better ways to relax. I don’t know much about psychiatry, but I find that whatever is bothering me always pales in comparison to grandfather cedars and prehistoric glaciers.

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