M asks: I've been under significant financial stress. My family has also been hit by a couple of major health crises. I'm in the midst of some serious ambiguous grief, mourning my mother, whose dementia has taken a sudden turn for the worse over the past couple of months. And I've been trying to pick up the pieces when my dad hasn't been able to manage on his own (although I live abroad, so that comes with its own challenges).
In short, I haven't been at my best—I'm emotional, withdrawn, and quite tired. A couple of friends and family members have urged me to try antidepressants, but I’m wary of their side effects and the challenges of getting off of them, and it also seems strange to me to "treat" what seems like a fairly normal response to a challenging season of life with pharmaceuticals.
But it's true that my outlook is heavy, and I'm having a hard time pursuing my goals or looking optimistically toward the future. They think I'm standing in my own way, when an antidepresant would make a world of difference. Do you? How do you work with clients when they're trudging through dark and dense seasons of life?
I’m grateful for your question. It’s one that comes up a lot in clinical work and with friends and family of my own. It’s such an important inquiry.
First, I’m sorry to hear how stressful and just all-around hard things have been for you lately. You’ve been hit with a lot all at once. Any one of these stressors on their own would probably have been too much.
At root, I really hear you asking: how much pain is too much pain, and what is the “right” way to tackle it all?
You’re not in a foggy depression that has no known source, as you say. You know what the larger issues are. You know what you’re up against. The problems are traceable. So, isn’t taking an antidepressant a bit like taking morphine when you have a broken bone? What you really need is for someone to fix the break!
But that’s just it, really. You may very well need both. It’s a lot easier, ultimately, to fix a broken bone with some pain meds on board. Of course, the pain medication isn’t a replacement for the surgery, cast, and physical therapy, but it’s likely to be a major assist. We might see it as a miracle of modernity that some pain doesn’t need to just be endured.
Before becoming a psychotherapist, I was very skeptical about the pharmaceutical industry and the trend to always “medicate away the pain.”
Emotional and psychological suffering can very often be addressed through deep inquiry, work with dreams, deepened relationships with others, the treatment of past traumas and pain, exercise, changes to nutrition, and efforts to listen to what one’s body and soul might be begging for. I try to employ all of these tools when working with clients—and in my own life.
But I’ve also learned a great deal through my clinical work that it doesn’t always need to be an either/or issue with medication.
It probably took me too long to refer some earlier clients to a medication provider. I’ve learned over the years that, in some cases, antidepressants and other psychiatric medications can be the thing that changes a client’s life. I’ve learned how, for some clients, the right medication(s) can be a partner in the therapeutic work and not an alternative approach.
(To be clear, I am still quite skeptical of the pharmaceutical industry. There’s a great deal about the industry — its practices, and its products — for all of us to question. But we needn’t throw the baby out with the bathwater, as the strange saying goes.)
I know you have a tremendous amount to tackle in your life right now. An antidepressant is not going to make your mother’s dementia go away. It’s not going to ease your financial burdens. It’s also not going to transform the larger systems within our modern societies that make elder care, financial survival, and everything else an almost singular burden with life-or-death consequences. But, in the toolbox of what we currently have available for managing psychological suffering, medication might be a helpful tool for you to add to the mix. It might just provide you with more energy and clarity, in the way that turning on a light in a dark room can help with orientation.
Of course, not all antidepressants are the same. Some have a lot of side effects and some have very few. Some are quite hard to get off of and others far less so. To complicate things, none work the same for everyone. I am not a prescriber myself and don’t want to venture into specifics with you here, but I do encourage you to find a prescriber whom you trust. If it’s complicated trying to find someone, trust a friend or family member to take the lead on this and don’t hesitate to ask people in your circle what medications they may have loved or hated in the past.
I hope that life eases up for you soon, whatever you choose to do. No matter what, please remember that pain in itself is not virtuous. We grow and transform through a lot of pain. Often, pain tells us what needs to be adjusted for the future and where or why we hurt. But some pain is just pain. If you have access to the tools, it’s okay to make it go away.
xo, Satya
Do you have a question for a future edition of “Something Better Than This”? Just respond to this email or send a note to satya[@]quarterlife.org