Even though I make fun of it sometimes, I am a sucker for self-help. I am secretly hoping that I’ll read an article that will offer that one piece of advice that truly changes my life. It’s why I read all (eh, half) of the the Medium articles that flood my inbox. It’s why I read James Altucher and Jeff Goins and Benjamin Hardy. I’ve read Wayne Dyer and The Seven Habits of Highly Effective People.
As self-help proliferates, though, I notice how the gurus are ultimately trying to sell you a book or get you to watch a video. They’re selling you their product, which isn’t change, it’s the hope of change.
The New Yorker article Improving Ourselves to Death says that self-help “reflect the beliefs and priorities of the era that spawns it.” Now, out era of “technological innovation… has yielded to the hard doctrine of personal optimization.” Alexandra Schwartz offers example after example of expert after expert telling us how to live. It’s overwhelming and the only solution seems to be to step away from it all.
But here’s the thing: my meditation app and my calorie counting app have really improved my life. The title of Dan Harris’s book about meditation, which I have not read, is 10% Happier. That’s how meditation has made me feel. It’s not much. It’s not drastic but it’s just the right amount to make my day better.
I read Is Everything You Think You Know About Depression Wrong? in The Guardian by an author named Johann Hari. His new book Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions comes out later this month. Hari postulates that there is far more to treating depression that just antidepressants.
The first psychiatrist I ever went to was on Park Avenue. Framed drug posters covered the walls of her waiting room and office. She was indeterminately European but sort gave off a German, Austrian, Swiss kind of vibe – basically Bond villain European. Her natural speaking voice quavered. She was very well put together and very professional and I didn’t trust her at all.
After a brief consultation, she put me in a closet sized room with a television/VCR combo and played a tape of her asking a series of questions asking the viewer if he or she had been out of control. It was clear from the questions that she was trying to suss out symptoms of bipolar disorder. I answered no to all the questions as I totally could have done had I actually been bipolar. How about a face to face examination, doc?
She prescribed me Zoloft and wanted me to take Ambien. I said no thanks but every time I went back she asked if I wanted Ambien. She was very pro drug.
I once asked her if I could get off Zoloft. She said no. There was one caveat, though. She said that I could stop using it if I started going to bed at 7:00PM and waking up at 3:00AM as that is the natural sleep pattern for human beings. Monks do it, she said, though I can’t recall if they were Buddhist or Christian or if she was completely making that up.
I stopped going to her. I simply stopped showing up and there were no consequences. Her office didn’t follow up. Perhaps that’s the practice of most doctor’s offices but should it be the policy of someone dispensing prescriptions for psychotropic medication?
The second psychiatrist I went to was an older gentleman. He spoke slowly and when he wrote out prescriptions, he put his glasses up on his head and put his face inches from the pad. During our first meeting, he described a bunch of different medications and mentioned that technically we don’t really know what SSRIs do. He mentioned Paxil, Zoloft, Lexapro, Wellbutrin. Then he paused, “So, which one do you want to try?”
I just want to pause here to let that sink in. The doctor asked me – a not doctor – which drug I wanted to take.
“Uh, I’ve heard good things about Lexapro,” I said.
“Alright,” he said, “let’s go with that.” Then he put his glasses on his head, put his face inches from his prescription pad, and began to write. After a year or so of refills, I decided to stop going to him too.
So, I have reason to distrust drugs. Also, I’m back on drugs and they’re working.
There’s evidence that points to SSRIs being psychosomatic. Cool. I’m totally fine with that.
I’ve always taken issue with people who, when discussing SSRIs or any other antidepressant, say something to the effect of, “you just take a pill and then you’re happy.” When they say that I know that they’ve never been on one. I don’t feel any physical effects of the medication. All I know is, after a while, I notice that I’m not imagining a future in which I’m homeless under a bridge or asking myself, “Should I go to the ER right now to see if I have cancer?”
Hari’s main argument is that there are many other causes for anxiety and depression besides brain chemistry, such as loneliness and a lack of purpose and low life satisfaction. In order to treat anxiety and depression, you have to treat those things as well.
Wow. Ya think?
In my most recent extended period of anxiety, I had all of those circumstances in my life. I had worries about work, money, relationships. They all took a toll but setting about changing those things didn’t remove the cloud of dread. After visiting my primary care doctor yet another time so he could check the phantom sensation I had just to make sure that it wasn’t something more serious, he said, “So, how’s your anxiety these days?” And then he wrote me a prescription.
I’ve heard anxiety and depression described as being stuck in a well. The medication is like a ladder that helps you climb out of the well.
Now, when you’re stuck in the well, what doesn’t help is someone telling you, “You know, studies show that there are ways to avoid falling in wells.” Great, tell me about them when I’m out of this one.
I’m not perfectly happy. I still worry. I still get angry. But it’s 10% better.
I’ve wanted to smack the person telling me how much they love meditation. I’ve been offended when someone has suggested medication. I’ve scoffed at self help and bemoaned the state of affairs where everyone needs a pill just to live their life. I’ve been that guy, so, I get it. But I read articles like the ones I mentioned above poking holes in the things that are working for me and I get a little nervous like I’m Dumbo about to drop his feather. But what I know is, the cloud of dread is gone and I’ve got some daily habits that are making me feel better. So, whatever’s going on in my brain, I’ll take it.