Colleen Arnold

To me, telling clients that I take anti-depressants is like a cardiac specialist telling his patient he takes a certain heart medication. Clients are often nervous about taking medication, and I’m telling them, hey, I have some personal experience with this. I can relate, and I understand the worries.

When I first started taking Prozac, back at age 30, I was advised not to tell my boss, and I didn’t. Part of the reason I feel freer now is because I work for myself and I stopped judging myself for taking Prozac a long time ago. I’m 45 – I know my brain. I know my brain off Prozac, and I know my brain on Prozac, and believe me, my brain works a whole lot better on Prozac.

I was depressed as a child, a teen and a young adult. When it finally reached a breaking point and I couldn’t eat or sleep, I reluctantly saw a psychiatrist. She looked at me at the end of the interview and said, “If I felt like you do, there’s nothing I wouldn’t try to feel better.” Because I SO wanted to feel better, I tried Prozac. And damn if my brain didn’t turn “normal.” I could not believe how fabulous “normal” felt. I still am amazed at how wonderful “normal” feels. I have ups and downs, but my goodness, they’re within a “normal” range. I’m not struggling to keep my head above water. I can relax and enjoy myself. It’s not taking all my energy to go to work and maintain friendships.

People call psychotropic medication a “crutch.” “I don’t want a crutch,” they’ll say. I respond, “If you broke your ankle, and couldn’t put any weight on your foot for a week, would you refuse crutches?” “No, of course not,” they laugh. “Would you feel like you were somehow more deficient than the average person because you needed a crutch to walk?” “No, but that’s different…” they say.

I’m saying it’s not all that different. Crutches are to help you when you need a crutch to keep walking. I take allergy medication too, daily, because my nose is ridiculously allergic to anything that can float in air. Do I feel it’s a character flaw that I’m so allergic? Of course not. My brain needs more serotonin than it produces without medication. That’s not my fault, it’s not a character flaw, and it’s only an obstacle when I don’t treat it. My willpower is not going to change my serotonin levels.

I do admit, there are a few people I wish I hadn’t told that I was on anti-depressants. There are a few people in my life who continue to hold the view than depression is a mind-over-matter issue and I’m just not trying hard enough or am not strong enough to persevere without the “crutch” of medication. I’ll have to live with that, because now they know and although I’ve tried to educate them, they’re going to think whatever they’re going to think and apparently I’m not going to change them. That’s on them.

Some have even counseled me that I shouldn’t be revealing this to my clients. Maybe some prospective clients will read this and decide they shouldn’t seek my services because I may be flawed. It shouldn’t be news to anyone that we’re all flawed, including therapists. The fact that I am on anti-depressants is a much smaller flaw, in my profession, than my inability to return all phone calls in 24 hours (I’m working on that one, believe me. By the way, I’m faster with e-mail).

I refuse to walk around afraid that someone is going to find out I have Prozac on my medication shelf. It’s not all I do to treat my depression (which, by the way, I haven’t had a relapse of in 8 years – I had a short issue with PPD after my first child was born and treated it). I also exercise, nurture my relationships, seek spirituality, watch my sugar intake and try to live the best life I can. But taking Prozac has been a big part of my journey and if I, a mental health practitioner, can’t be comfortable admitting that, than how can I expect my clients to seek treatment without shame?

The shooting in Tucson, AZ of Congresswoman Gabrielle Giffords and 19 others, six fatally, has provoked much discussion on the current climate of aggressive and negative rhetoric in the media and by politicians.

I’ve heard very little about what I think is the real lesson from the shootings – we have a mental health system that is broken. Reports of Jared Loughner’s bizarre behavior are coming out from former teachers and classmates. His behavior was so frightening, he was told to leave Pima Community College and not to return until he had a mental health evaluation. In this post, I’ll be referring to mental health issues such as chronic schizophrenia and schizoaffective disorders, which affect an individual’s ability to function in society. I’m not talking about the many people who struggle with other disorders, such as depression and anxiety, but are still in touch with reality. I also want to be clear that people with mental illnesses are no more likely to be violent than anyone else. That’s important.

Jared was an adult, 22 years old at the time of the shootings. As an adult, he has the right to refuse treatment for mental illness. What do we do when a symptom of the illness is that the afflicted doesn’t think they have an illness? To the patient, it makes complete sense to refuse treatment and it’s easy to see those who insist that the patient take mysterious pills or get shots as persecutors. To the friends and family of the patient, it’s another hurdle in a long line of hurdles facing them and their loved ones.

We don’t know what kind of help his parents tried to get him, and confidentiality laws prevent any local professionals from revealing whether or not he was treated, but I’m guessing he wasn’t very cooperative and didn’t agree with the college’s suggestion that he seek treatment.

People who have long-term chronic mental illness are not always easy to deal with. They burn bridges, get evicted, don’t follow the rules of housing alternatives. They go off their medication. They usually can’t work and live off long-term disability. Many of them develop substance abuse issues as well, complicating the treatment picture.

I used to have a job where I evaluated people for involuntary hospitalization. I was threatened with all manner of lawsuits and called many names by the people I was trying to help. They saw me as taking away their basic rights and they were right – I was taking away their right to refuse treatment. If I determined they needed to go to the psychiatric hospital, and they fought that decision, they would be handcuffed and restrained. One particularly searing image that stays with me was a terrified, very psychotic woman in her 80’s, screaming as she was wheeled out on a stretcher “I’m being kidnapped! Kidnapped! Someone save me!” The terrified look on her face haunted me. She really believed she was being kidnapped.

Parents looked at me in horror when I explained that yes, they’d need to stop paying their psychotic daughter’s rent and let her become homeless before we could force her to go the hospital, because her behavior, while bizarre, wasn’t dangerous enough yet.

Mental health budgets continue to be cut all over the country. It’s expensive to take care of these members of our society. The care we do give them is substandard. Ever been to a SRO? Unless it was brand new, I don’t think I’ve ever been to one that didn’t reek of urine and wasn’t dirty and worn. The staff who work with the chronically mentally ill have a very difficult job and are not paid well.

We have no safety net for these people. We offer them very basic care, try to keep them housed and safe and stable. We can’t do much more for them. Trying to offer some kind of quality of life is out of the question, because there is no money for it. We as a society don’t want to deal with the mentally ill.

I’m certainly not saying that what Loughner did wasn’t heinous. What I am saying is that it’s not as easy as, “Hey, this guy creeps me out. Let’s put him in the hospital.” Maybe he did go to the hospital and while being evaluated, told the staff, “I’m fine. Really – I live with my parents, I eat and shower daily, and I don’t need medicine.” That would probably be enough to get him discharged into his parent’s care.

What’s the answer? I wish I had one. Taking away a person’s rights is serious and needs to be considered carefully. But by focusing our efforts on protecting those rights, are we abandoning a large segment of our population?

(edited 1/14/11 to correct the shooter’s name)

I Take Anti-Depressants Daily, and I’m Not Embarrassed to Tell You That

Thoughts on the Arizona Tragedy