Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Sunday, September 30, 2012
Please Pass the Valium
In today's New York Times, I learned that Roche, the makers of Valium, will soon be closing the doors of their New Jersey plant. In Valium's Contribution to our New Normal, Robin Marantz Henig writes:
Taking a pill to feel normal, even a pill sanctioned by the medical profession, led to a strange situation: it made people wonder what “normal” really was. What does it mean when people feel more like themselves with the drug than without it? Does the notion of “feeling like themselves” lose its meaning if they need a drug to get them there?
Ah, we like to question What is Normal here at Shrink Rap. Okay, time to pop my Xanax.
Posted by Dinah on Sunday, September 30, 2012
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um, how do you think EVERYONE who takes an anti-depressant thinks at one point or another?!?
While the idea has merit - it's still silly.
Why do type one diabetics have to take insulin? Who defined the "normal" level of blood sugar?
The answer - everyone living a functional life.
Blood sugar probably isn't a fair comparison.
Let’s take Viagra. Who says it’s normal for a male to get an erection every time he wants? How long is it supposed to last?
Who defines normal?
The answer to this is – “everyone else.” It’s about expectations. We’re a society that deserves what everyone else has. Pick a topic – Education, Income, Marriage, Opportunity, Entertainment, or even Feeling Good.
We see what others have – and that is “normal.” If we see someone else that’s happy all the time – we’ll want to be like them. The real question isn’t about who defines normal, or do we all deserve happiness – the real question is whether or not a pill is the answer.
Nine out of ten times, "This Can't Be Normal..." would be my number one reason for being non-compliant with my meds.
Normal feels weird and wrong. My normal is great big months-long blips in mood; not having them feels so... absurdly abnormal.
You'd kill for the depression to be gone, and for the first few weeks it's all "WOOHOO! I'm free!" but after that it's so awkward. I don't know how people ever remain compliant with their meds. I can never seem to last very long at "normal" before "normal" drives me a different type of crazy.
Benzodiazepine addiction, including the issues of tolerance, dependence, and withdrawal from _prescribed dosages_ of medication, is the cause of enormous suffering. Millions of lives have been thrown into chaos by these addictive drugs, sacrificed on the altar of profit for the psychiatric and pharmaceutical industries.
I went through the withdrawal process from psychiatric polydrugging with benzodiazepines and antipsychotics - the symptoms of withdrawal were often nearly intolerable. I'm sure it breaks some people and they stay on the drugs forever. I'm sure some people die from the process, or commit suicide. I know, it nearly broke me, but I managed to see it through and recover to a greater or lesser degree. However, in the process, nearly 4 years of my life were burned away.
The worst part about it wasn't really that, though. The worst part about it was that my suffering received nearly zero acknowledgement from the psychiatric or medical community. At the first sign of trouble my therapist bailed on me, and once any other therapist I went to see got wind of what I was doing, they wanted no part of it either. "It's your underlying disorder. Your symptoms are due to your underlying disorder." When I reduced too quickly on the antipsychotic dose I was taking, I developed a 102 degree fever. Is that in the DSM-IV? Do people develop akathisia without exposure to medication?
I'm well-convinced that all psychiatric medications, of course including Valium, have the problems of dependence and withdrawal to a greater or lesser degree depending upon individual factors. Anyone who thinks differently is kidding themselves. Perhaps because of psychiatry's somewhat unique position in medicine (that is to say a discipline where there are no objective tests and diagnoses are all a matter of opinion) it becomes the ultimate fair-weather friend; always there for you when you are compliant, but ready to turn on you in an instant if you suggest that things are going south and that it's not your fault. I think the more subjective nature of the profession admits an even larger blindness to the issues of iatrogenesis, and that the huge quantities of pharma dollars being made compounds the effect. "The medications are the instruments of our power, they're all we have, they're what makes us a part of 'real medicine' and not just a therapist." I think if psychiatry had to acknowledge that the medications are not only capable of good, but also extreme harm, that even the act of practicing the profession might become untenable. How does one write a script for Valium or Xanax with a clear conscience, when stories and videos of the extreme suffering people go through from such drugs is only a click away? I think psychiatry has walled itself off from much of this, simply as an act of self-preservation. GlaxoSmithKline couldn't wall itself off from it, though, as the recent successful class-action suit for Paxil withdrawal injury shows.
I'm sure some consider there experience with psychiatry to be a positive one, and in some sense I envy them - I still have plenty of mental health "issues," which, at least for me, are usually quite clearly distinguishable from the indescribable neurological chaos of acute medication withdrawal. I'm not one of those zealots who says "mental illness is a societal construct" or "mental illness doesn't exist." I don't think there are any such simple answers. All I can say is that at, least for myself, the psychiatric option is closed forever for me.
Since you've asked nicely for me to pretend I'm siting in your living room when leaving comments, I'll close with stating that that I'd like nothing better than for the the whole psychiatric/pharmaceutical industry to go get stuffed, and any amount of expletives you'd like to add to this sentence wouldn't overstate my sentiment.
"Normal" is the mathematical concept of the bell curve. Everything under the central part of the curve is normal, and that under the tails is abnormal.
OK, so it's probably not that simple, but I love simple answers!
PDF Doc - Well said.
I don't really get why patients like valium. I took it once before a dental procedure and it didn't make a dent in my anxiety. I don't know if I just wasn't at a high enough dose or what, but I didn't feel like it made any difference whatsoever.
Normal is synonymous with stability in my book... and it feels AWESOME, even if it requires many meds.
It means feeling normal ups and downs and not having them crush you like they have in the past.
I don't think anyone can really say what normal is.
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