CPPNJ - The Center for Psychoanalysis and Psychotherapy of New Jersey

Sunday, October 23, 2011

Contentment: What you can find in a pill

According to a new survey, the use of antidepressants rose 400% in the United States in little more than a decade. (If only I could say the same for my stock portfolio.) The National Center for Health Statistics reports that antidepressants are now the most commonly-prescribed medications among 18-to-44 year olds. Nearly a quarter of women age 40 to 59 take them.

Sadly, less than a third of people taking antidepressants, and less than half of those taking two or more, had seen a mental health professional in the previous year.

It gets more depressing -- every pun intended. According to the study, most people on antidepressants suffer from relatively minor depression (sometimes called dysthymia), and some may not be clinically depressed. And yet as many as two thirds of Americans with severe depression receive no treatment at all.

A number of experts believe that we have reduced depression, anxiety and other states of the mind into simple neurochemical disorders, failing to address the broader psychological aspects.

Psychotropic (psychiatric) medications have helped many people; I have strongly recommended them for some of my patients over the years. I do not wish to minimize their importance in any way. But their overuse, particularly without accompanying psychotherapy, is part of a larger problem. As a society, we are mired in a get-well-quick mentality that treats complex emotions like a Betty Crocker cake mix -- a right-out-of-the-box approach that's quick and easy, but minimizes the pleasure and importance of finding out what's really cooking, so to speak, to cause a person's suffering.

Something is wrong when we have gone from self-examination to Prozac Nation -- a situation which has only worsened since the famous book of that title was published in 1994.

When people pop pills without also engaging in psychotherapy, they are not addressing the deep-seated problems that are caused their depression, anxiety, self-doubt and compulsions. The act of avoiding what makes them anxious about themselves likely is at the heart of their problem to begin with. Without making the effort to address how they got stuck, they are likely to only perpetuate their shame and feelings of inadequacy regardless of the effectiveness of the medication. "I am not strong enough to tackle my problems," is the message they give themselves. "I have to find an easy way out."

The benefits of psychotherapy are numerous, particularly a psychodynamic approach which looks to understand the underlying causes of maladaptive patterns and find ways to permanently alter them. The person's sense of self and ability to navigate their lives improve immeasurably. There is great joy in being able to understand and master issues which have kept us stuck. As change unfolds in the psychotherapy sessions and in the person's every day life, most people find their relationships -- with themselves and others -- and their sense of accomplishment and confidence improve in dramatic ways.

The process involves work -- more than just popping a pill. But if you really want to get to the crux of your problems, looking inside to find a sense of purpose may be more profound than anything you keep in your medicine cabinet.

-- Eric Sherman, LCSW

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