A Pill For Anything

I recently completed my mandatory rotation in the McKennan ER, where I usually volunteer, during which time I had the chance to sit down with patients in a different way than I usually do. One of the patients I got to talk to was a 22 year old guy, who had come in for a diffuse set of symptoms, including a headache and stomach pain. What I got to talking to him about, though, had little to do with his current ailments, and more to do with the kind of society we have become.

The guy, let's call him David, told me while waiting for the doctors to finish up their array of tests, that he'd been struggling with a general feeling of depression and unexplained sadness for the past 3 years. He had had a pretty normal childhood and adolescence, and even though his parents were divorced, he was mostly well adjusted in his various social contexts. When consulting his physician about the depression, there were no probing questions on what might have contributed to the mood disorder, what could have sparked the feelings, or any advice to try exercise or counseling. After the 10 minute consultation, David was prescribed 100 mg of Zoloft (an antidepressant) to take daily, which he had done every day since.

David told me he felt much better the very next hour after taking these new pills, and all of a sudden had a much brighter outlook on life. Gone were the feelings of sadness and anxiety, depression and irritation, and in their place a new, happier David was finally getting stuff done. He felt like a new person, and things that would usually have gotten him worried or sad would now bounce off him like a cat on a hot tin roof. He would smile for no reason, instead of cry for no reason, and could not help but to enjoy the medication he was now reliant on to function adequately.

This gave me a few things to think about, a few things to ponder if you will. The first part is the obvious one, whether or not doctors are doing too little to actually treat their patients with psychological afflictions. I think they absolutely are, and I think that the way pills are being pushed so naturally as the 'magic' solution to all our problems nowadays is borderline disgusting, and all the way saddening. The lack of appreciation for the complexity of our minds, beyond the basic and chemical, seems all too prevalent, and the easy way out of solving problems in this intricate cognitive organ we know as our brain. It is very true that the symptom of depression (or the symptom causing depression) is due to a chemical imbalance in the brain, but thanks to growing patient lists and increased time pressure docs usually don't have the time to dig much deeper than this. They opt for the easy way out, the quick fix, and parcel out pill after pill as if they were fantastic Tic-Tacs.

The solution to this problem (since I'm trying hard to be solution and not problem oriented here) is simple. Doctors don't necessarily need to spend more time with their patients, for that this health care system is too skewed and would just push those doctors out of business (because, sadly, people's health has become big business like nothing else). What physicians have forgotten is their primary responsibility to treat, and not simply mask, the patients' conditions. In 2006, an estimated 227 million antidepressant prescriptions were given out to Americans, more than any other class of meds around. This is a sign of our sad (but not antidepressant worthy) times, where pills have taken the place of psychotherapy and lifestyle changes, and where millions of Americans rely on a pharmaceutical crutch to get them through a normal day. If doctors aren't demanded to try healthier, more far-reaching and definite treatment options before throwing pills at it, and we just open our mouths and say "ah," nothing will change and we will keep hoping that what's ultimately hiding at the bottom of that pill jar is true happiness.

That brings me to the next question on my mind about David's and everyone else's story. Are our emotions really nothing more than chemicals sent over synapses in the brain? Are we defined by our serotonin? Is it really possible to change our entire view of the world by digesting a single, white pill? The last question has a verifiable answer, being yes, which would be very evident just considering how the industry of illegal drugs (think Ecstasy or Meth) is banking on this very fact. When considering the others, I am not that sure. I won't - in fact, I refuse - to believe that concepts such as love are purely due to any amount of chemicals in our brains, or that the very essence of our character and being, our soul, can be expressed in any empirical formula.

Pills with the power to alter our moods are in many ways eerie to me. They alter our moods - but do they then also in turn alter our identity, our personality, who we are? Is some little, or big, piece of us lost when we block it out with medications? I am not sure, but I definitely see that possibility. No, we shouldn't live in a sad, depressed world every day if we don't have to. But does the alteration of how we think, how we act, also in turn impact who we are as human beings? That is a heavy price to pay if that is the case, for a day of happiness.

Yeah, pills can tweak - and in some cases completely alter - our moods and mood swings for the better. I appreciate that, and think it's great that people with irremediable psychological afflictions not helped by therapy or other methods have a final, sure-fire resort. That's just it, though, it has to be the last tried alternative. Pills help us feel better for about a day, but without the pills the problems would resurface immediately. Medicine has not traditionally been about quick fixes or shortcuts, but our 'fast' food and 'fast' results driven society has regrettably been allowed to spill over into health care - fielding the advent of 'magic' pills. We're forgetting that an absence of sadness rarely constitutes happiness, which would rather come from digging deeper and resolving the actual, underlying issues. It takes time, yes, but we've got time. Especially when it comes to our own psyche.

Labels: Medical, Ponderings, Rants

posted by CK @ 05:45