Amy: We have become a nation of fixers. We want to fix stuff as soon as its broken, including our moods. We don’t have much tolerance for ambiguity, or lack of resolution. Or emotional pain. What’s the problem with that, you might ask? Because often our attempt to “fix” our moods, or our pain, ends up making the problem worse, or more long-lasting. This reminds me of a Rabbi I heard on the radio several years ago: He was talking about personal growth, and he said,   “There’s a Long, Short way and a Short, Long way.” 

That’s part of what I worry about with the easy use of anti-anxiety and anti-depressant drugs. It’s not so much the drug itself, although I do worry about the  impact on the brains of young kids.  But mostly, I’m concerned that  it’s the” Short, Long way”. The medication thing tends to reinforce the idea that feeling bad is dangerous.   I’ve had  many patients come to see me who are afraid of their emotional pain, who worry about being depressed or anxious.  They’ve lost sight of their inner resilience and health.  Their “symptoms” feel like something alien, a powerful enemy to be stomped out, rather than a painful reminder of a life that may have gotten off course.  Medications can be a way of “out-sourcing” or covering over, a chance for healing.

And perhaps most important: Symptoms like depression and anxiety  often contain important clues that we need to pay attention to. These distress signals, like a fever, may be pointing to an underlying illness in our personal relationships  that we may have ignored. Or suppressed.

I’m reminded of a case of a young woman urgently referred to me by her mother:

The Case:  I was at my office in  mid-October, as autumn was descending upon us,  when  I got a phone call from from an alarmed mom. She described her daughter, a freshman at college in New York, as “depressed” and in “need of medication”. The mother, who lived in Los Angeles, had gotten my name from a friend, whose family had recently seen me for therapy.

I told the mother I didn’t prescribe medication, but I would be happy to see the daughter for an evaluation. Since the mother indicated that her daughter was in crisis, I agreed to meet with her at the end of my office hours that day.

When my bell rang at 9 p.m., I was surprised to see a vibrant, robust-looking 18 year old young woman standing at the door.  She was accompanied by her aunt, her mother’s sister, who happened to be in town helping a family member who had just given birth. As they settled themselves into my office couch, the young woman, Leah, began to talk about her very rocky start as a college freshman.

images-3Leah talked about how she had been depressed and crying since September. She was now on her second college, having transferred from the first school shortly after the semester started. Both schools were high-quality, “artsy” schools–which theoretically should have been a good fit,  but instead she felt “miserable”.

Her aunt clearly empathized with Leah’s unhappiness. She worried when Leah interviewed at the first school in the summer, with no students present. She knew that Leah wouldn’t get a real “feel” for the school that way. Leah and her aunt seemed to enjoy a relaxed, open sort of relationship.

I gathered a little family background: Leah talked about how she “adored” her mother, and had a less close but loving relationship with her father. Leah’s older sister sounded like more of a straight-arrow, sailing through college without complaint or obvious distress. She and Leah were not especially close, though not in any real conflict.

Leah’s parents divorced about ten years prior, though they were on friendly terms. Dad’s current girlfriend was a “nightmare” according to both Leah and her aunt. Leah’s mom had ended an earlier romantic relationship with a nasty-sounding guy–-a relationship that proved stressful for everyone. This past year, her mom had gotten “serious” with a great guy who won the family’s approval. Leah talked about feeling good about this new relationship.

The most striking thing about Leah, in contrast to what I expected, was her composure. This young woman was very open and in touch with her unhappiness, her feelings of depression, and she spoke thoughtfully about all that’s she’s been through. She talked about the recent selling of the family’s summer home in Vermont which had always been an anchor for her. It seemed to me that she arrived in New York somewhat off-balance, and it went downhill from here.

images-6Leah knew that her Dad, a high-powered film guy in Los Angeles, worried about “how it would look” if Leah left college, but Leah herself wasn’t much concerned about this. She was actually quite a competent young woman, having single-handedly arranged the college transfer, and now was involved in exploring possible internship and job prospects in L.A. She had researched the issue of financial reimbursement for her father regarding college expenses. She was remarkably unconfused and clear-headed  about what she needed. She might has well have been wearing a big “PAUSE” sign on her forehead.

Leah’s aunt concurred that her niece was a terrific, intelligent young person who probably should not be forcing the issue of college at this point. And our session had assured me that Leah’s college distress wasn’t a sign of worry about her parents. Some times young folks carry unconscious anxiety about what will happen to their parents when they leave home. Or they may pick up on the parents’ anxiety about the separation, which can be contagious.  None of this appeared to be the case with Leah.

We ended the session, and I wished Leah “good luck”, as I told her how I admired  her thoughtful approach to her life. And I’m sure I conveyed the impression that I wasn’t worried about  her feelings.

I got a call from the Mom the next day thanking me for the session. She said both Leah and the aunt felt good about our meeting, and that Mom agreed that Leah should take some time out to figure out her next moves. Mom’s voice sounded much lighter.

It’s interesting to think that Mom’s initial, not uncommon, reaction, was that her daughter needed medication. If fact, Leah’s unhappiness WAS her medication. Her unhappiness helped her to know what she wanted, and what she needed. Not covering over her unhappiness with medication allowed this young woman’s growing process to continue unimpeded. She needed the feedback of her discomfort to guide her and shape her direction. Medication doesn’t get better than that.

 

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