Thursday, September 29, 2011

Medication As Magic Bullet: The Shadow Side

Nobody likes to be uncomfortable, physically or psychologically. Who can blame them! When we are uncomfortable, especially when we are in physical or psychic pain, we hurt. We want the pain to go away. Discomfort or pain is important, because it provides clues to what ails us--be it superficial or deep, minor or serious. And when what ails us is serious, some kind of treatment or intervention is most often required, to help us feel better, alleviate our symptoms and reduce our discomfort or pain.

There are many approaches to how we might identify the root cause of an ailment, and what kind of treatment might help us heal. Some approaches use a mind-body perspective. Others use a more scientific or biochemical model. But all in all, as a culture, we have little tolerance for pain and often lack the ability to discern helpful, growth-promoting pain from truly pathological pain which requires a psychological or medical intervention.

Because we don't like to feel our pain, we seek "quick fixes" and immediate "solutions" to rid us of our unwanted pain. And we want our "quick fixes" to "deliver us from evil," with no cost or negative consequence. In our fairy tale story, we have created the "magic bullet" as the pharmacological hero, armed with the power to provide a simple solution to what may actually be a complex problem. Sadly, like most fairy tales, this one may not come true in reality. Our pharmacological hero may not be as simple as we wish for or as all-powerful either.

In his book, Anatomy of An Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Robert Whitaker traces the "'magic bullet' model of medicine" back to sulfa drugs and antibiotics, which were very simple in theory. In each case, doctors defined a cause of a disorder, and developed a linear treatment to counteract it. "Antibiotics killed known bacterial invaders." Likewise, when Eli Lilly developed insulin therapy, it was "a variation on the same theme." Once researchers determined that diabetes was caused by an insulin deficiency, providing insulin to diabetics was a logical solution.

Unfortunately, this concept of drugs when applied to psychiatric ailments did not work as simply or linearly. Whitaker points out that the first generation of psychiatric drugs were called, "antipsychotics, anti-anxiety agents and antidepressants--words that indicate they were antidotes to specific disorders." The big difference here, is that psychiatric ailments are not linear nor uniform. And there is no one ailment to a non-linear disorder. While there may be a cluster of symptoms that lead to a diagnosis, they are emotional, mental and behavior symptoms whose roots may be in trauma, family history, neglect, unmet needs or struggles in the here and now.

Whitaker notes "the psychopharmacology revolution was born from one part science and two parts wishful thinking." While some psychiatric medications DO help people, what is far too often not discussed is that with any medication there are the desired effects and other effects, often called "side effects." You cannot take a medication and guarantee you only get the desired effects. In some cases, people are far more impacted by the other, lesser talked about effects. Too, the long-term impact of a biochemical solution for what may not have its roots in a biological problem may leave a person weaker and more vulnerable than when they started treatment.

For example, many anti-anxiety medications are addictive, and when a person decides to stop taking them, they are not aware of the withdrawal effects of stopping, including the increased anxiety that may result. Some of the ADD drugs given to children and adults have been correlated with cardiac arrhythmia and atrial fibrillation. In their book, Your Drug May Be Your Problem, authors Peter Breggin and David Cohen note that antidepressants "can cause emotionally and physically distressing and dangerous withdrawal reactions," and may permanently alter brain and body chemistry in less than desirable ways.

These side effects, withdrawal effects, and long-term biochemistry altering effects are often unspoken or less spoken than we might think they should be for a person to make an informed choice about using the biochemical tools that are so readily pushed as "solutions." While I am a firm believer in education about all possible tools that might be helpful in a given health situation, I feel it is very important to paint a complete picture, so we really understand as many consequences of our choices as possible, prior to making them.

I have had many clients go from one medication to the next, hoping to find their magic bullet, only to be disappointed that they have invested time, much and faith in substances that cause unwanted side effects without the intended benefit they wished for.
I have also had clients who gain relief from a medication for a period of time, unaware that they are becoming chemically addicted to the substance, and that they will go through withdrawal if they choose to stop taking it.

I strongly advocate for more complete education about the pluses and minuses of biochemical interventions. I believe it is essential we recognize that there may be no magic bullets, and some of the conditions we are trying to treat are not simple but complex. If we have a more complete understanding of the shadow side of medication, we can benefit from the positive effects consciously, and choose to disengage consciously as well, in appropriate.

©2011 Linda Marks

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