Big Mike: Am I Blue?

March 10th, 2010

Things have been going awfully swimmingly the last few months. The Loved One and I are thrilled with each other. Work’s going well for us. Our home is in fairly good shape. The car’s still running. Our doctors aren’t warning us to wrap up our financial affairs just yet. And — hoo-rah! — spring seems to be here (although Constance, the big potato over at The Book Case, keeps saying You watch, it’s gonna snow again, the scrooge.)

It’s times like these — rare though they are — that make me wonder why I still keep taking Zoloft. I’ve been on it since 2002. Before that I did imipramine and desipramine, a couple of early anti-depressants that today seem laughably primitive. I also swallowed a lot of Xanax back in the 1980s and 90s.

Magic Pills

In fact, I wouldn’t leave the house without at least a half dozen Xanax in my pocket. Not that I was going to take all six of them. But merely having them clacking around in the plastic pill case gave me just enough spine to go out into the world and face down agoraphobia, panic attacks, and — horrors — people. So I’d take one or two on a good day, four on a bad day.

Not only that, I had my head shrunk by psychiatrists, psychologists, and licensed clinical social workers. I tried prayer, meditation, chanting, booze, and good old positive thinking. No matter what I tried, my terrors of going outdoors, high places, confined spaces, and the rest of the cornucopia of neuroses I entertained made me a shuddering wreck.

I’m thinking about all this because I just finished reading a piece in The New Yorker about depression. The author, Louis Menand, seems to think all the rage for diagnosing depression in people is a load of crap. He implies that this mania is nudged along by drug manufacturers who want to peddle more and more anti-depressants.

He’s not the only one who thinks that way. He writes of a hot new book out called Manufacturing Depression: The Secret History of a Modern Disease. Its author, Gary Greenberg, also sees a lot of business opportunism in telling people they’re pathologically blue.

Gary Greenberg

Gary Greenberg

None of this is new. My old pal Danny long ago told me his daddy-o felt psychiatrists, psychologists, therapists and the like loved to tell you your head was fucked up “so they could get you hooked.” It’s unclear whether Danny’s poppa-rino meant hooked on medications or hooked on weekly visits — probably both. The latest stats seem to bear his fears out. The National Institute of Mental Health reports that 26.2 percent of Americans can be diagnosed with a mental disorder (primarily depression) in any given year.

Sheesh! That means if you’re car-pooling this morning with three other people, you’d better hope today’s driver isn’t the NIMH’s one-in-four, especially when the car nears that concrete support column up ahead.

One Way Out

“Please, Please, Please Don’t Be One Of The Four!”

Then again, as Menand and Greenberg argue, the driver merely might be experiencing some normal everyday sadness — the loss of a loved one, say, or a pressing financial concern. She or he feels down about it all, happens to catch an ad for Cymbalta on TV, makes an appointment and says Hey doc, lemme have some of those skull jockey pills.

Menand even cites the case of Paxil. Its manufacturer discovered in the 90s that the drug seemed to make people less shy. So it went about the business of positioning shyness as a mental disorder so that shrinks could prescribe barrels-ful of Paxil.

No doubt all of this is true. Trivializing clinical depression just to make a buck is so craven you’d think a Wall Street banker came up with the idea. The only problem is when I read this stuff I start thinking that maybe — just maybe — I’d fallen victim to all the hype back when I was that shuddering wreck.

I don’t shudder so much anymore. I have no idea why. Was it the Zoloft? Or was it a combination of meditation, therapy, and booze? Or — worse — was I just imagining it all?

Someone very close to me once scoffed at my collection of loose screws. I won’t identify him because I don’t want to embarrass him (although I should.) Let’s call him Thomas. One day Thomas had as much as he could take of my little madnesses. “You know what your problem is?” he said. “It’s all in your head.”

Uh, yeah.

Even though I’m pretty certain Thomas was full of shit, there’s still that tiny little part of me that fears he was right. Then when I read the indictments put forth by guys like Menand and Greenberg, I start obsessing: I wasn’t really depressed; There was nothing wrong with me; It must have been all in my head.

Every once in a while, though, some crystal clear memory of the existential terror I felt being trapped in an el car some forty feet above the pavement hits me. I think of my racing, pounding heart. I recall hyperventilating. I can almost feel the sweat pouring out of me again. I get twitchy thinking about how I’d struggle to resist the urge in every cell of my being to tear the doors open and jump out. And that was only one of my little madnesses.

Then I realize that Thomas was right. It was all in my head. He just didn’t know how right he was.

Here's Where The Problem Lies

All In My Head

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