Reflections du Jour: It’s Happening Again

I’m not doing this without a heavy sigh. Well, several. This came down the pike:

 http://www.commondreams.org/headline/2014/04/09-1

Briefly, some kid with two knives ran around stabbing and cutting fellow students at his high school in suburban Pittsburgh. No motive has been discerned as of this time. 

The questions that go through my mind at a time like this include:

  1. What in the unadulterated hell is going on here on a societal level as well as in the suspect’s microcosm?
  2. Which, if any, psychotrophics was the suspect taking?
  3. Whisky-tango-foxtrot?
  4. Has the suspect ever had a workup by a qualified mental health provider and a healthcare provider who takes a holistic approach and doesn’t just scribble a prescription to make the suspect sit quietly in class? Probably not, but one can dream. 

For those of you who don’t know, I graduated with an MS in psych in the late ’80’s. My first and only job in the field was at a community-based mental health and addictions treatment center. Prozac, touted as a cure-all for mood disorders, came on the market at the same time. 

Indulge me with a little shop talk: it’s a selective seratonin re-uptake inhibitor, or SSRI. Drugs in that family lengthen the time that it takes for the brain to reabsorb the seratonin, the feel-good neurochemical produced when a person is in a good place with themselves. Too little leads to depression. Too much leads to suicidal ideation and delusions. 

Now, I know several people who have greatly benefitted from modern psychiatric medication. They are adults whose brains were fully developed when they began taking appropriately prescribed meds. I also have memories of calls from clients who went on Prozac and developed suicidal ideation within a few days of beginning treatment. Peeling someone off a roof is no one’s idea of a good time. 

Another class of drugs that may help-or not-are the ones widely prescribed for ADD and ADHD. The theory is that people living with either condition are deficient in internal stimulation, causing them to be unable to focus on what’s in their surroundings and leading to impulsive behavior. Many of them are in the amphetamine family. As in speed. And you don’t outgrow ADD/HD, either. 

AD/HD has also been linked to chemicals in the food supply and to processed food. Back in the ’50’s, a pediatrician named Dr. Feingold had noticed a spike in consults for behavior problems. One night as he read the paper, he saw a story with a graph depicting the rise in food processing after the end of World War II. He asked the parents to make more of their food at home to avoid sugar and chemicals, and this obtained good results. So was born the Feingold Diet.  

Again, I know several people who have had their lives made liveable with appropriate medications such as these. However, for example, the kids responsible for the carnage at Columbine were on meds that had been linked to increases in violent behavior.

How, then, do we respond to the near-weekly episodes of violence at schools? “Complex” doesn’t begin to cover the question. In the days to come, there will be another round of finger pointing at the parents, the school, violent video games, and so on.

What I’d like to see is our culture taking a collective step back and asking why we need violent entertainment, why we need to arm ourselves to the teeth for trips to the grocery store, and why we need to implement solutions where someone gets hurt as the first line of defense instead of the last. I’d like to see food without dyes and additives linked with craziness priced affordably. Let’s add in holistic and alternative treatments as the remedies of choice and meds as the last line of defense instead of the first.  And let us not forget lots and lots of time in nature to help children understand that everyone and everything is a part of the web of life, and that no one is ever really alone. 

That is the long answer. 

The short: I don’t know.

That is the long and long term answer.  

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4 thoughts on “Reflections du Jour: It’s Happening Again

  1. Very good post. What you said about serotonin and “Too little leads to depression. Too much leads to suicidal ideation and delusions” really clicked — I don’t think I’ve heard anyone, anywhere put it like that before. Nothing I had read before gave any explanation as to why sometimes people starting SSRIs get more suicidal, not less.

    I remember the first time I brought up the subject of some treatment for depression, back in 1997. I was seeing my primary doctor, and I expected she would refer me to a psychiatrist or someone. But she just scribbled out a prescription for paroexetine (Paxil) and said “Half the people in my waiting room need this.” So off I went and … well, did OK with it. But there was no follow-up. It was only in reading anecdotes from other users that I found out what really happens with an SSRI. The medical establishment didn’t really address side effects or withdrawal effects for the longest time.

    Maybe if my doctor in 1997 said “cut out the junk and eat real food,” she would’ve done me far more good.

    1. I’m gobsmacked that the doctor was so cavalier and casual about writing the prescription like that without a followup.

      Very few mainstream physicians get any training about nutrition and tend to prescribe the flavor of the month in new drugs without doing much research or waiting to see what happens after they’ve been on the market for a while. They also get a lot of pressure from insurance companies to put patients on antidepressants to speed up treatment so they don’t have to pay for as many therapy sessions.

      Someone I know was prescribed Paxil off-label for headaches. It caused suicidal ideation in that instance as well.

      Thanks so much for sharing your story. May those shadows never darken your door again.

      1. Skip forward a bunch of years, and last year my current doctor put me on Lexapro (escitalopram, basically Celexa with a new patent) for the off-label use of preventing late-nite carb binges. It doesn’t work; I can carb-binge with the best of ’em even now. But since the last six months have been so hard, I’ve been loath to go off it because maybe it’s keeping me as (minimally) functional as I could be. Still, it’s not doing what it’s supposed to, and I’m not sure it’s doing much with depression either. The prescription was pretty cavalier again, too.

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