author – activist – faculty – mom
In my early 20s, I knew a guy who took antidepressants, and they didn’t really help him. He did, however, end up with a ringing in his ears (tinitis) that persisted for years. He and I were in a support group, and many of the people in the group had heavy early childhood trauma. My own childhood trauma tends to manifest in speedy and workaholic behavior, so I rarely experience the depression end of the PTSD. Also, I got a lot of healing resources, starting in my early 20s, so I didn’t have to suffer well into my adult life.
A lot of people in the support group suffered from depression. They had also survived huge amounts of neglect and abuse, which ranged from physical to emotional to sexual. All of us seemed to have good reasons to feel anxious and depressed.
Meanwhile, the medical and psychiatric industries kept explaining to people I knew that they needed anti-depressants, because there was a chemical imbalance in their brains. But I knew these folks. I knew they couldn’t sleep because they had flashbacks of sexual trauma. I heard them talk about how they could barely face the world because they felt unlovable, and their parents had been verbally and physically abusive. They felt unable to go out and build good lives, because their parents had not provided them, and told them they didn’t deserve them. So I couldn’t figure out where this brain chemistry stuff fit in. Did the abuse cause the chemical imbalance? Did the child’s brain chemistry have to adapt because of the neglect?
In a recent article in HuffPost, researcher Johann Hari has validated everything I have long suspected. Brain chemistry causing depression is a myth. While some do find relief from depression and other mental health challenges with pharmaceuticals, these drugs fail to treat underlying causes and don’t work for many people.
Meanwhile, the targeting of people with mental health challenges is vicious. From social stigma and being called “crazy” on one end to being locked up and losing control of one’s life on the other end. For fear of these outcomes, people learn to suffer in silence and often blame themselves. Also, our country is founded on the Protestant work ethic (except for the wealthy). Work makes you worthy. Productivity makes you valuable. Self-care is self indulgence. Vulnerability is weakness. Anyone who has emotions that cannot be controlled by logic and willpower is deserving of scorn and any mistreatment they encounter. Only the owning classes are exempted from all of this. Like royalty, their wealth makes them inherently worthy of all the best things in life, without having to lift a finger. But the rest of us, we better get the hell back to work.
Around the same time that I went to that support group in my 20s, I was running a program in the alcohol and drug field. A few years into that job, I became a harm reductionist. Harm Reduction is a set of strategies to reduce drug-related harm to individuals and communities. They opposed the draconian tactics of the war on drugs, and instead offered reality-based solutions. They also delved into the politics of how and why different drugs were legal and illegal, and whose economic and political interests were served by those designations.
I attended a lecture on the history of the club drug “ecstasy” (better known today as “molly”). The lecturer explained this history of the drug. In 1985, MDMA was added to the list of illegal drugs in the US. It had become popular in clubs and raves. Prior to being made illegal, however, a small number of psychotherapists were using it as an anti-depressant.
The drug makes people feel stimulated and opens their senses. People may feel sexual or simply more emotionally connected. Therapists were calling the drug “empathy” and they used it in much smaller doses.
The therapists would use the drug with people who felt isolated and depressed. They would schedule them to come to a therapeutic site where there were single rooms, they would administer the drug, and it would open up the patient’s sense of connection with the therapist. Then the patient would go to sleep in the facility, wake up, and return to their life with a greater sense of human connection. That is to say, it added the memory of being deeply emotionally connected, and the patient could build on that experience moving forward. The drug was only used once. It didn’t necessarily cure the person’s depression on the spot, but it opened up their sense of possibility to connection and helped break the isolation that reinforced the depression.
Prior to being officially classified as illegal, the drug was in a bit of a legal gray area, so the therapists did not widely publish their findings. Then MDMA became illegal, at the same time that the pharmaceutical industry was developing and marketing a series of drugs to treat depression. All of them would need to be prescribed by medical doctors and psychiatrists with medical licenses. Many patients would need to take them for life. The lecturer (this was many years ago, and I cannot find the references to the lecture) pointed out that the profit potential of a drug that was administered once was profoundly limited, while a drug that would need to be taken daily for years, decades, or life, was a big pharma gold mine.
You know what’s not a gold mine? Giving patients the amount of therapy that they would need to actually heal from childhood trauma. The rise of pharmaceutical drugs coincided with the rise of “managed care” and HMO-style plans for health care. I had Kaiser, the nation’s first HMO as a child. Back then, HMOs were only for working class and low income people like my family. The care was awful. We would wait on hold for sometimes upwards of an hour to talk to a nurse who would have to give us permission to come in to be seen for an urgent problem. Or we could wait in an emergency room. Basically, it was clear that they wanted to give us the least amount of care possible. At that time, middle class people had health insurance that allowed them to go to their private doctor’s office when they thought they needed it, and it covered all or most of the cost. In the 80s, managed care became a merger of the two insurance and treatment models. So now middle class people would get much less choice and care and attention, and primary care physicians would have fifteen minute visits for a single issue where they would be the managers to keep costs down.
This had huge implications for mental health services. Gone were the days of self-referral to ongoing therapy. If you weren’t suicidal or addicted or out of control, you couldn’t get any resources, but you could always get psychiatric drugs to help your anxiety, depression, panic attacks, whatever ailed you. One visit to prescribe. Brief, infrequent monitoring. Whether or not it worked for the patient, it worked to keep costs down and profits up.
Sometimes the drugs were prescribed in combination with counseling. But many people reported that the drugs flattened their feelings overall, so they didn’t have the emotional bandwidth to process the issues that may have led to the depression in the first place. The explosive episode of rage at an abuser or the inconsolable hour of weeping at an early loss can be incredibly cathartic. The shrieking of recalled panic at an early experience of terror can be profound. About a decade ago, I worked on some terror issues from my childhood. I shook and cried in a series of sessions. By the end of the year, my sweat didn’t smell the same. I though maybe something was wrong with my body. I asked my counselor about it and she asked, “does your sweat smell sweeter, more benign?” It did. She said I had just released some of the early terror that had affected my body chemistry. TMI? I’m just saying, the process of healing from early traumatic stress often requires going to the edges of big emotion. And psychiatric drugs numb those same emotions. This is not to blame or shame anyone who has found help with those medicines. However, I believe that the society has developed a medical and psychiatric policy that emphasizes drugging people so they can keep going with jobs, school, parenting, domestic work.
What if the society gave survivors a chance to stop being productive and to take a deep dive into healing emotional trauma with culturally competent, labor-intensive resources? Our country could afford it, if all the money weren’t going to enrich corporations and billionaires. This would be my vision of a healthy society. When something is wrong, let’s go for healing, not patching people and just sending them back into the rat race.
But real healing would also require taking a look at the fact that we are a society that regularly traumatizes children, and that trauma is often connected to male domination. Trauma for children is not an aberration, it’s the norm. Sexual abuse is rampant, as well as physical and emotional abuse. If we became a society that prioritized zero tolerance for conditions that led to abuse and neglect, the policy implications would be profound.
First of all, abortion would be a pro-child, human right, because being unwanted by one’s parent(s) is so clearly traumatic for a child. However, family leave policies and safety nets would also need to be put in place so that families wouldn’t devolve into abuse and neglect under the stress of economically harsh conditions. Government funded, well-regulated childcare would need to be available so no parent would be forced to leave their children with sketchy caregivers while they went to work. But above all, we would stop telling ourselves the lie that the family is a happy place in America. Nope. The family, and the nuclear, male-led family in particular, is a toxic location of domination and sexual trauma. The statistics bear this out: domestic violence, sexual abuse of children, and women’s highest risk of falling victim to murder being by a male partner. We need to take a hard look at the family as a violent institution. This is not to say that families are bad or men are bad. This is to say that the conditions for raising a family in this country are a cesspool of toxicity. And the joy that families manage to manifest is the loving hard work of the parents and caregivers in spite of the economic and political realities. As well as the resilience and joyful energy of children, who are the natural leaders of fun and play in the world.
In recent years, the DEA has returned to considering MDMA for use as a therapeutic drug again. Hopefully, they will consider the research of those 1980s therapists who used it to transform, rather than to develop chemical dependency. Meanwhile, I’m overjoyed to see research debunking this unsubstantiated lie of brain chemistry causing depression. This myth has been critical in covering for the damage of male domination. As feminists, let’s connect the dots and press for policy changes that can make crucial changes for those who currently suffer from mental health challenges and preventing the suffering of future generations.