wellbeing-brand-logo

Inspired living

Do you medicalise your emotions? Discover how to stop fixing and start feeling


Do you medicalise your emotions? Learn to stop fixing and start feeling

Credit: Toa Heftiba

The human condition is unique but not so different from that of other species which also feel a range of emotions, from elation to desolation.

Our evolutionary design meant that we needed to act upon feelings as part of our own self-preservation. After all, it was handy to experience fear when being chased down by a sabre-toothed tiger or to crave tribal belonging so as to not have to fend for yourself in the wilderness.

But in the past 50 years survival has come down to diagnosing and labelling rather than acknowledging and accepting the very real sensations that inform us about our human experience. The medicalisation of emotions has meant we’ve forgotten that to be human is to feel rather than to formulate.

Popping the happiness pill

The 19th-century American short-story writer William Sydney Porter, famed for his wit and surprise endings, wrote simply and succinctly about what it is to be human: “Life is made of sobs, sniffles and smiles, with sniffles predominating.”

The kicker in this aphorism is the perception that sadness outweighs happiness. And many of the great writers, theologians and philosophers throughout the ages subscribe to this notion of life and the nature of being.

In the age of positive thinking and pop psychology, we have become so fixated on happiness that we think of it as an entitlement as opposed to viewing it as just one aspect of the varied human experience.

Modern thinking, by contrast, insists we simply cannot accept this thesis. Unlike our ancestors, who were fighting just to stay alive, self-preservation for many of us in the Western world is not really a consideration although we do need a sense of safety and physical wellbeing.

As a result, we have become more introspective and this is a good thing as we ponder the meaning and purpose of our existence. But, in the age of positive thinking and pop psychology, we have become so fixated on happiness that we think of it as an entitlement as opposed to viewing it as just one aspect of the varied human experience.

This sense of emotional entitlement has made us less resilient and even less realistic. We are not as fortified to deal with the onslaught of emotions, especially those that would plunge us into despair. That’s why we turn to quick fixes. GPs who have little training in mental health prescribe what are colloquially known as happy pills, based on minimal criteria and even less investigation of the patient’s situation.

This frivolous term has slid easily into our modern lexicon and seemingly makes this form of treatment as commonplace as coffee. In my own practice, I have seen many young teens who were prescribed antidepressants based on a set of converging symptoms but with virtually no discussion of how they are actually feeling. If not checked and challenged, taking prescription drugs may become a way of life.

Branding emotion

Because we have been sold the notion that happiness should be our default emotion, we find ourselves yearning for a happier, more successful life, only to fall subsequently into a state of chronic dissatisfaction.

In this Instagram- and advertising-driven world, where happiness has been marketed to us by chasing extrinsic outcomes such as fame, fortune and adoration, we’re left emotionally unarmed.

We have forgotten the teachings of past scholars who subscribed to a more stoic approach where even on sunny days the considered person should be armed with an umbrella. Even our Buddhist guides speak of suffering as a part of life that can be overcome by ceasing our attachment to personal desire.

Making ourselves more emotionally resilient requires support, contemplation and having meaningful relationships that are reciprocal rather than transactional. Like our ancestors who knew at a base level that life should not be taken for granted, we too need to understand that it’s not an easy, painless ride. And there are no quick fixes.

In actual fact, none of us can outsmart getting hurt but nonetheless we expect love and gratification while dodging the bad stuff. We want a safety net and, more frequently, this comes in the form of a neat diagnosis with a chaser of a prescription.

We too have become quick to label. If someone is deemed self-consumed or conceited it’s easy to jump to the conclusion that they must be a narcissist. And how many people have you termed a psychopath, or jokingly accused someone of having OCD if they’re super-neat or a clean freak?

Based on Dr Google, we assess traits or behaviours and then label people with conditions from the psychiatric handbook, consigning them to a composite to suit our need for comprehension. We no longer take the time to investigate the nature or motivation of people; we just carelessly brand and move on.

It has come full circle where the clinicians have medicalised emotions and we in turn hide from emotions in medical jargon and terminology.

Taking the path of most resistance

Oftentimes, sadness or grief is diagnosed or rebranded as depression and as such this term becomes a clinical bypass to circumvent the examination and experience of true feelings. A diagnosis provides the supposed safe landing where we don’t have to confront how we feel.

Saying we are depressed is easier than acknowledging we are sad and subsequently investigating its causes. We have been taught to avoid the discomfort of that state. Because we have been given shelter under umbrella terms such as depression or anxiety, we are given permission not to explore what we might be truly feeling.  We squirm and wriggle out of not confronting our unexplored emotions because it hurts so much. But sometimes we just have to sit in it and wait it out. While the sun might not come out for a long time, it will come out.

As patients, as clients and as human beings it’s time we take back our emotions and experience them for what they are as opposed to what they are prescribed to be.

Dr Joanne Cacciatore, who suffered the loss of her own child, has written extensively on grief. Her seminal book on loss, Bearing the Unbearable: Love, Loss and the Heartbreaking Path of Grief, provides no shortcuts to recovery and she certainly doesn’t advocate diagnosing or pathologising loss as many of her colleagues do.

Her aim is not to cure grief but rather to accept and live with the pain, finding ways to come to terms with the unbearable discomfort. What other emotion could one feel but inconsolable pain for the loss of a child? There’s nothing medical about it.

In the 1950s, the American Psychiatric Association devised a manual, commonly called the DSM, which provided a comprehensive list of all known mental illnesses including depression, ascribing both symptoms and treatments. However, they didn’t know what do with bereavement so they created what was called The Grief Exception so that grief quite rightly would be regarded as a “normal” reaction to loss.

But, by the fifth edition, this exclusion was scrapped. Grief, the most human of emotions, was in effect medicalised by psychiatrists who redeployed it as a form of depression. It could be argued these clinicians sought to clinicalise the human condition, reducing emotion to a medical ailment that can be cured with a pill.

Now, in the US, a parent can be diagnosed and prescribed antidepressants within minutes of their child perishing. This supposed medical progress comes at the cruel expense of compassionate understanding and healing.

In the animal world, bereavement is a community event. If anyone has seen a David Attenborough documentary on the family and community structure of primates, big cats or dolphins, loss is handled with great empathy and mutual suffering by the group. A mother elephant, upon losing her calf, will stand over her child for hours, gently goading it back to life. The wider family consisting of aunts, cousins, brothers and in-laws supports the grieving mother until it is time for the herd to move on. The mother reluctantly moves with the herd, never failing to look back at her fallen child.

Death is a social, sombre event and grief is experienced in a deeply visceral and heartrending way. There is a community to support the distraught mother.

We no longer operate in herds and we lack the social support our tribal ancestors enjoyed. For many of us, loss doesn’t need exclusively to pertain to death — it can be the loss of a relationship, a job or home — and is a very isolated, solitary experience. How many people can you really call on in times of dire need?

Human intervention is the cure

We see more and more that everyday feelings are being given a clinical moniker. No longer can you feel lonely or despondent — no, you must be depressed. Anxiety too has become a dirty word when we all feel overwhelmed or under pressure at times.

Anxiety and depression are real and some of us experience it at acute or chronic levels, but the solution to managing these so-called conditions can often be myopic, uncreative and far from holistic.

The seven-minute consultation has meant a person’s problems have been reduced to a medical issue rather than a psychological or emotional state. Doctors ask the question, “What’s the problem?” rather than “What’s the cause of the problem?” and then, more often than not, a prescription is written.

Nowadays, a high proportion of people are presenting to therapy already taking antidepressants. This compares unfavourably with even 10 years ago when the numbers were much lower. Talking therapies or even just social engagement and support are running a very distant second to the clinical approach, which can be both cynical and formulaic. The human condition is not taken into account.

We have always been social beings from the time we conjured up fire and the ironic thing is now more than ever we need real connection, not connectivity, for survival. Sharing a conversation over a cuppa is in fact far more medicinal than popping a pill. A bear hug can be the best antidepressant of all.

The World Health Organization in March 2018 stated that mental health was not an isolated issue merely based on the individual’s state of mind. Instead, it is a social issue with predetermining factors including genetics and sense of wellbeing but also social and environmental factors.

Unlike our tribal ancestors, we no longer live in tightly woven communities, all looking out for each other; rather we live mainly alone in homes cut off by four walls where we have minimal contact with our neighbours. Some people have little or no meaningful contact with any other human being, experiencing chronic loneliness, for instance, yet are treated with antidepressants. This is a sign of the times.

When clinical becomes cynical

Medical intervention, as opposed to social initiatives, has become the order of the day. By medicalising our feelings, our true selves are reduced to a set of symptoms.

Our society is undergoing a significant shift where we diagnose rather than discuss, where we dispense rather than taking the time to dismantle the problem to get to the root causes. And this is sadly evident in the rise of accidental deaths due to prescription drugs as well as the rise of misattributed disorders.

Journalist Johann Hari has gone about dispelling the myth that peace of mind comes in the form of a pill in his extensive analysis Lost Connections: Uncovering the Real Causes of Depression and Anxiety — and the Unexpected Solutions. He himself struggled with depression after being on antidepressants for over a decade with mixed and ultimately unsatisfactory results. This inspired him to investigate the validity and veracity of the antidepressant.

Citing a variety of preeminent neuroscientists and leading clinicians, he completely dismantles the long-held belief that a lack of serotonin in the brain chemistry causes depression, which GPs told him and millions of other patients for decades. The homeostasis of the brain cannot in fact be changed by the input of SSRIs or antidepressants, which allegedly increase levels of serotonin.

This notion has now been totally debunked but Hari strains to point out that antidepressants should not be taken “off the menu” as they provide some relief, even if that is in the form of a panacea. But they should be used in conjunction with other initiatives.

The cartel of drug companies would have you think differently as this is a billion-dollar business. We have become so addicted to the idea of the quick fix that for many of us the idea of eliminating antidepressants or antianxiety drugs — which comprise the benzodiazepine family — is enough to get the heart racing.

Hari interviewed Dr Christopher Davey from the University of Melbourne, who pointed out that “the idea you could reduce depression to one neurotransmitter is obviously absurd. It has as much to do with social connectedness and social supports.”

Now, this does not sound doctor-like at all! In fact, it sounds a bit warm and fuzzy. But this is the new thinking and it is supported by the World Health Organization as well as the United Nations.

But we don’t need these global institutions to tell us what we already know. All you have to do is look around and see that, as a society, there is so much social fragmentation and isolation.

Reclaim your emotions

In her essay titled Too Many Pills published in 2015 in The Monthly, Melbourne doctor Dr Karen Hitchcock discusses how the medical and pharmaceutical industries have hijacked the human approach to helping.

She claims that, while medicine does save lives and there have been great advances, “Western medicine keeps us sick for the financial gain of doctors and the drug companies.” She’s also critical of the supplements industry, stating that they are not as harmless as their manufacturers claim. Even alternative approaches can be diagnosis driven.

She writes, “I have sat through lectures by experts who beam PowerPoint slides with impressive diagrams of neurotransmitter pathways they say lead to the feeling of what would once have been called simply ‘despair’.”

She goes on to say, “The mysteries of human consciousness and our intricate connection to our world and those around us — the subject of centuries of philosophical thought — are reduced to a handful of chemicals acting on a cell in an individual.”

Here is a clinician who rebukes her own industry for medicalising the human experience. She is an advocate for spending a long time with a patient, asking lots of questions, and she says there is no such thing as “too much information”.

In her piece, Dr Hitchcock discusses a patient who turns up wanting antidepressants. The patient reports hating her job, her body and her husband yet when she goes to health retreats her suffering is alleviated. Ironically, she is resistant to the advice to consider how she can bring elements of her life at the retreat into her daily life — such as meditation, massage and yoga — as well talk to a therapist about the causes of her unhappiness.

As patients, as clients and as human beings it’s time we take back our emotions and experience them for what they are as opposed to what they are prescribed to be. We have to allow ourselves to be seen and to not resort or indulge in the quick fix.

It is up to you to make the changes in your life. We all have unmet needs in our lives and this doesn’t mean we are unwell or that our brains are malfunctioning. It can mean we need connection, comfort and consideration. Dr Hitchcock asserts that we have become a society that “seeks cures that are acts of consumption”. Well, how about we seek cures that are acts of compassion?

Let’s stop fixing and start feeling again.



 

Marie Rowland

Marie Rowland is a therapist in private practice on Sydney’s northern beaches helping people resolve the underlying issues that perpetuate conflict or disconnectedness so they can create meaningful and happy lives. Marie speaks at conferences, forums and community events on a variety of topics from wellbeing and positive psychology to practical philosophy.