Thursday, August 30, 2007

The Mind - Au Naturale

For decades, psychiatrists, surgeons, family physicians, and quacks have resorted to a myriad of methods to still the sadness and quell the voices echoing in our heads. Lobotomies, insulin treatment, electroconvulsive (shock) therapy were once standards of care for mental illness, along with all sorts of medicaments and solutions. Now, we're more humane – we manage most of our mental ailments by ingesting pills. And what a variety: olanzapine, lamotrigine, sertraline, paroxetine, quetiapine, aripiprazole, ziprasidone, duloxetine, venlafaxine. The syllables drip off my tongue, almost a lilting poem.

But folks who have the blues or other mental and emotional maladies are starting to tell their prescribing psychiatrists and family docs: no thanks. Why? The growing evidence that some medications are as effective as placebo, their prohibitive expense and increasing hassles imposed by insurers, and side effects that sometimes seem worse than the disease: weight gain, diabetes, lack of libido, and changes in cognitive and emotional capacities. And, of course, some people just don’t want anything screwing with their head.

Which I find fascinating. Why wouldn’t someone in the throes of severe emotional distress not gobble a small, white sphere to feel better? to become functional? To return to ‘normal’?

This dilemma underlies both my research and my fiction. During the day, I ponder how to improve patient ‘adherence’ to antidepressants and antipsychotics. My hypothesis: take your meds, and you'll experience improved clinical outcomes and save money. Crass, perhaps, but these are endpoints I can measure by crunching very large datasets comprised of millions of medical and pharmacy claims using fancy statistics and large hard-drives.

But the numbers only go so far: Why don’t people take their meds? Why do they resist medically-accepted treatments? Why aren’t people adherent to experts' proscriptions?

A pivotal section of BRIGHTER THAN BRIGHT finds Ben, my protagonist, wallowing in a mixed manic-depressive state and grappling with the decision of whether to take an antipsychotic. After days of fear and indecision, he succumbs and experiences a miracle - the reinstatement of his mind…

I waken and hear the whir of highway traffic and, more distant, the lonesome wail of a train. The night workers rustle, talk softly, prepare for the next group of caretakers. Someone moans from another room. These are the only sounds; my mind is quiet; there is no noise, no morbid, florid thoughts, no whooshing or thrumming or humming, no lingering nightmares or images or memories. Normal? Is this what normal feels like? I don’t remember.

There are many ways to attain and maintain mental health. Whatever it takes - pills, gamma rays, sun, running, talk therapy, magnets applied to your temples, Emotional Freedom Techniques, or hey, dirt - stay healthy and happy. Peace, Linda

For an excellent article on the pitfalls and pros of medications – and their 'natural' alternatives - turn to The Unmedicated Mind


  1. You are cueing up in my mind the genius of Kay Redfield Jamison's The Unquiet Mind and her brilliant observations in Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. Jamison’s perspective may help you flesh out Ben’s decision process…or lack thereof.

  2. Yes, Jamison is brilliant - and inspiring. Her latest - EXUBERANCE - follows in the same vein, though on a happier note. AN UNQUIET MIND comes into play when another character strives to understand the bipolar nature of Ben.

  3. I'm been circling the concept of voice for days now. And how some writers just leap off the page, you can HEAR them. Yet they don't intrude the least. I love your voice Linda, and I love that paragraph. But now I'm circling the concept of normal.