Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Mental Health: Too Many Pills, Too Little Truth

This is my column in [the September 17th] Greenville News. It’s a follow-up to a recent column I wrote on the mental health “crisis” in America, as seen in our emergency rooms.

My last column addressed the unfortunate truth of the overwhelmed mental health system in South Carolina, and indeed in much of the U.S. While I lament the fiscal condition of our mental health system, and while I feel for those who truly need the help we are often powerless to supply, I would be a poor observer if I didn’t report the truth. And the second truth we must face is that much of what we call mental illness is neither truly “mental,” nor even “illness.”

Let me first state the obvious: The brain is an organ. It is incalculably complex and truly a wonder of design and engineering. But, it remains an organ despite its wonderful capacities. Therefore, it requires energy, its support structures feel pain, it may be injured and swell, it can bleed and parts of it can die when its owner has a stroke.

Sometimes the dysfunction of this fantastic organ, or of the chemicals which course through it, is manifest[ed] as mental illness. In certain cases, medications can restore the brain to normal function. Therefore, I am not suggesting that true mental illness is wicked, or reflects character flaws. I have met too many sweet, confused schizophrenics to believe either of those things. I am suggesting that too often we allow character flaws, unpleasant personalities, remorse over bad choices — and even, yes, wickedness — to masquerade as mental illness.

Our mental health system is crushed for many reasons. But partly because we take frustrations and uncertainty, call them anxiety, then medicate them. We take sorrow and grief, call them depression and medicate them. We take genuine, appropriate guilt and sedate it. We create entities like “intermittent explosive disorder,” (which has to do with anger) and medicate it rather than occasionally incarcerating it.

We sedate rage and anesthetize sorrow. While anxiety and depression and anger issues all genuinely exist, my sense is that we overmedicate because we find it far easier to hand out pills than to listen to a story. We find it easier to prescribe than to sort through a human life and use discernment to suggest changes. We are desperately afraid of “judgment,” so we prefer to allow others to wallow in medicated misery. And we find it all cheaper, in the end, to give drugs than to give time.

We also medicate because we refuse to confront the real problems of human life. The woman abandoned by her adulterous husband may be chemically depressed, but she is also quite reasonably, and rationally, grieving. The man who wrecked his business and business partners by embezzlement and lies may feel genuine anxiety, but he also has (hopefully) guilt that needs to be addressed, not chemically camouflaged.

We need a combination of factors to cure the mental health crisis. Some solid cognitive therapy, widely available, would go a long way. This involves teaching individuals to face and master problematic thought patterns, rather than accept the popular lie that we are at the mercy of our thoughts and that our only hope is pharmacologic.

We also need a redistribution of some very important truths. Humans are valuable and good, but often very bad. Intact families are best for both parents and children. Promiscuous sex, alcohol and drug abuse are devastating to mental (and physical) health. If you were abused as a child, it wasn’t your fault. My allotted space constrains a complete list.

And if secular medicine, with its surplus of pills, cannot cure the broken and comfort the sad and confused, then science may simply have to accept the (horrific) possibility that faith offers some guidance that medicine is currently too timid to give.

If only the church would have the courage to step into the gap! The church should look at this crisis as an opportunity to empty some mental health clinics and fill some pews. We should offer listening ears and open arms. We should offer kindness, truth, and repentance to a group of people who now struggle and stumble from clinic to clinic, from pill to pill, from razor to rope, looking for answers that science all too rarely offers.

Let me repeat myself: Mental illness is real and many suffer from it. But not every problem can, or should be medicated or psychoanalyzed. And with love, and the truth that love produces, we might just end up needing fewer psychiatric beds and pills.

It sure would make Saturday night in the ER more pleasant.

*This blog post was originally published at edwinleap.com*


You may also like these posts

Read comments »


Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »