Letter 12: Medication
Much groovy and wonky.
Hello everyone!
I hope that you are surpassing your limits and staying active. One thing I love about summer is guaranteed trips to my hometown where I can enjoy the scenery of the mountains and see my family. A place that I will always have a soft spot in my heart, such a beautiful city. Where you are free to express your creativity and talents, explore new hopes. Although I would love to move back and get my master’s there, I’m too far from that time to decide. Moving to my current area has brought in a lot of good and bad; on the positive side—I met so many people that have showed me something within myself or inspiration for the better. I am not sure if I would’ve gotten the same experience if I lived in a different place. As time goes on, I understand that some people won’t come back and I won’t force anything. For a while I was dwelling and grieving those friendships. I will say that they will be missed and I cherish the friendships I had with people from my past. Whatever is meant for me will always come back.
Letter 12: Medication is about Mrs. Pipher talking to Laura on how to handle people that need to be medicated and the procedure of handling medication. She starts the letter off with telling Laura that the blues are hitting her hard this time around, she feels like sorrow over work struggles or a friend’s sad news. Other times it seems like she suffers from biochemicals that overtakes her mind and paint her life with mud.
She acknowledges that Spring is the season for suicides. No one understands why, it may be something biochemical, or it may be that if people are still unhappy with all this loveliness around, their depression feels inescapable.
She brings up her and Laura’s disagreement about if Laura’s client should be on medication (antidepressants) or not. She understands that their differences were theoretical, and some felt more generational. Mary went to graduate school before there was good psychiatric medication and she was trained to see solutions in terms of the therapeutic relationships than prescriptions. While Laura is more of a biological determinist than Mary. What they discussed Marlene’s case philosophically—Is she just sad because her boyfriend dumped her? When is medication appropriate? Laura makes a funny remark and says, “Biology isn’t destiny, but it isn’t chopped liver either” How does that statement reflect on you?
In the psychology field there are many competing notions about why humans act the way they do. There are earlier theories that have died out but thousands other and some still very old, are brought up to this day. Mary says, “Our theories range from biochemical, genetic, and environmental to spirituality and existential.” People believe that certain troubles come from certain kinds of brains, inborn temperaments, victims of childhood abuse, members of an oppressed minority, or because of their birth order. Mary suggest misery is related to maladaptive behavior patterns, poor communication skills, irrational thinking, and a lack of meaning in life.
There is certainty that some depression is biological based, entrenched, and has nothing to do with the environment. Mary has seen clients who remind her of a man named Richard Corey. A man that was healthy, loved, and successful but commits suicide in Edwin Arlington Robinson’s well-know poem. She knew someone that was so drenched in their despair that even good luck caused her dismay. The clients fortune cookie said, “Money will fall from the sky.” She shouted, “My god, I will be killed when it hits me on the head.”
For the most part, what we call depression is simply sadness brought on by events. Mary starts to think about Erin who had a dull life, uncaring husband, a lousy job, and there wasn’t a lot of fun and being rewarded. She thinks of Amin who ran a gift shop at the hotel Mary was staying at in Toronto. He was a psychiatrist in his native country but was unable to use his license a practice in Canada. He spoke highly when he presented a paper at an international conference in the Azores. Now he spends his days selling breath mints and bottles water. So many unfortunate events can lead us in a never-ending fall on sadness… unless we do something about it.
Mary quotes an old country singer Sam Morrow, “We need to be able to tell the difference between ‘that’s life’ and ‘that’s nuts.’” She emphasizes that the most important part of our jobs is to help clients distinguish between depression and sorrow. We need to learn tell which one is which. For example, Richard Corey might have been helped by antidepressants. Erin could benefit from a new job, some woman friends, and a hobby. Amin needs a cultural broker to help him get through the physician’s credential system. But she goes back to Marlene’s case where they can struggle to reach consensus. Her case is most likely not either/or but rather both/and. A mixture of both.
Just how light can be considered as both particle and a wave, we can understand that mental health problems often are both biochemical and environmental. In other words, both factors interact with each other. As Mary says, “Research demonstrates that reactions to circumstanced engender permanent changes in the brain. Depressed people have different brains than non-depressed ones, but they also often have different lives. They jog less and attend fewer parties and picnics.”
In Mary’s experience, bipolar disorder and schizophrenia are more easily to manage if they are not homeless, fighting breast cancer, drinking heavily, or in an abusive relationship. Different lifestyles and existential choices can affect mental health just as physical health. In a sense, every disorder has many causes. Mary asks what factors we should emphasize more.
Clients with ask why questions. “Why me? What’s causing this?” Mary encourages to choose the gentlest and kind theory possible, a theory that requires the fewest radical changes before they feel better. She doesn’t want us to blame their parents, their recovered memories, or their chromosomes. She says, “We want to frame their situation with a theory that leads them toward good decisions.” I have a goal to research theories that require growth, understanding, and be able to process our truths.
Back to Marlene, she wants to influence her on what she does, how she sees herself, and how others see her. When you are labeled as depressed, Mary believes that it’s a mixed blessing. It can help Marlene obtain support, but it may make her feel that her happiness is beyond her control. Being labeled as depressed may cause others to write her off as unreliable and hopeless which is not true!!!
Mary finds some common ground on the debate of how they should treat Marlene’s case. Theoretically, Marlene is dealing with a combination of sadness, which is coming from her breakup with her boyfriend and depression. She wants to give her a month to fight the depression without medications. While that is in process, she wants Laura to gather information about her family history, her relationships, her sleep, and alcohol/drug use. Laura can assign her Be-Good-to-Marlene homework which is making sure she is around people that care about her. Encouraging her to go to the movies, have a bubble bath, and listen to soft music. Anything that gives her time to do self-care, especially exercising. Mary wants her to teach Marlene to take mini vacations, little breaks that gives her time to enjoy the now. Being able to talk through her emotions and troubles. She wants her to see how much time she recovers, if Marlene is not doing better in a month, they should consider medications.
As a reflection of this letter, she doesn’t glorify nor condemns medication; instead, she frames it as useful, sometimes necessary, but not a substitution for the slow work of healing. She views that medication should support a person’s growth rather than mute their inner life. Pipher emphasizes that therapists must stay thoughtful and humble, recognizing both the benefits and limitations when it comes to using perscribing medication. She worries about our society toward quick fixes and reminds readers that suffering often carries unmet needs, unresolved grief, or environments that must change. At the same time, she acknowledges that for some clients, the ones that are immobilized by depression, overwhelmed by anxiety, or unable to function need medication. Which can create the stability needed to engage in therapy. It seems like there must be a strive for balance and understanding coming into the psychology world.
Thank you for reading.
