“Our country is over-medicated.”

I get that a lot, usually right after I tell someone that I write a mental health blog. Not as a hobby. As my job.

Part of me agrees, the part that doesn’t want to get into a long and frustrating conversation, where I explain that it’s really not that simple… That the issue is fairly nuanced and complex.

Are some people overmedicated in this country? Yes. Absolutely. I devote a few chapters of my book, Beyond Blue, to describing the dangerous phase in my recovery led by a doctor whom I call “Pharma King.” I was taking something like 16 pills a day, enough to drop my head into my cereal bowl every morning for about three months. And I wasn’t at all uncomfortable with how the nurses at the outpatient psych program I attended jumped to an increase in medication every time a patient voiced a complaint or raised an issue.

I wanted to scream out, “For crying out loud, let the woman try to sort through this a tad before we up her prescription.”

This is my 22nd Mother’s Day. Or my first, depending on how you look at it.

You can read my experiences with being a birthmom here and here. Part 3 is rather happier: This is the first Mother’s Day following my ridiculously blissful reunion with my wonderful son and his equally wonderful parents.

It’s hard to say much, mostly because the memories of those few days in December are so intensely personal and the emotions still so raw. I’m not quite ready to let the world in on them. What I will say is that, as magical as it all was, and as healing as it all was, it wasn’t a cure-all. Right now, I’m on my third antidepressant combo in two months, trying to get out of the most recent episode, just so you know that even really joyous events don’t instantly cure longstanding mental illnesses and trauma.

I wanted to mention that because May is also Mental Health Awareness Month. I saw a headline the other day stating that most Americans think the stigma of mental illness is fading. I’d say it’s a safe bet those are the people who don’t suffer from it or know anyone who does. My mental health has, directly or indirectly, cost me every job I’ve ever had, and affects even my part-time, work-mostly-from-home gig now. Trust me — there’s still plenty of stigma to go around.

A while back, a reader asked me if I’d cover the topic of intimacy complications with regard to antidepressants.

Ah. Yeah. Every time I write about this controversial topic, I usually get hammered by the left, right, and center. This is obviously delicate ground, so let me tread lightly.

In a recent Johns Hopkins Health Alert called “The Challenge of Antidepressant Medication and Intimacy,” I read this:

While sexual dysfunction is a frequent symptom of depression itself (and successful treatment of depression may eliminate it), antidepressant medication can sometimes worsen or even cause sexual problems. In fact, sexual dysfunction is a potential side effect of all classes of antidepressants.

Mark Hyman, MD, is a “practicing physician and pioneer in functional medicine,” according to his bio on the Huffington Post where he recently penned the nonsensical, “Why Antidepressants Don’t Work for Treating Depression.” I say “nonsensical” because this article is based upon a study that came out 3 years ago, so writing this article to educate the public seems not to be its primary purpose.

Exhibiting sound reasoning and logic also doesn’t seem apparent in this article, since generally a scientist or doctor would not dismiss an entire class of medications — antidepressants — based upon a single study. Or when there are many different types of antidepressants and sub-classes — SSRIs, tricyclics, MAOIs, SRNIs, etc. The study questioned by Dr. Hyman only looked at the more modern and commonly prescribed antidepressants, but it had nothing to say about the older, cheaper antidepressants still prescribed widely in other parts of the world.

The U.S. Federal Aviation Administration (FAA) on Friday cleared pilots who have depression to regain their flying privileges, with one tiny caveat — they have to be taking one of only four “approved” antidepressants. I can only express my extreme disappointment at this decision because while it has the potential to help pilots take to the air again if they were suffering from depression, it fails to recognize other effective treatments for depression.

Apparently, the FAA doesn’t recognize the effectiveness of psychotherapy in the treatment of depression. This despite something on the order of four decades’ (or more) worth of research demonstrating its effectiveness for everything from mild to severe depression. In fact, if anything, there’s more research that calls into question the effectiveness of these four antidepressants than there is showing they help.

I sometimes wish I didn’t have fodder for this blog, that I could graduate to writing a Happiness Project like Gretchen Rubin, and give you tips that could increase your happiness level. Alas, after weekends like last, I know that I will have the content to write a blog on depression for many more days.

In Beyond Blue the book, I describe my analogy of recovery from depression and bipolar, from anxiety and addiction, as a four-story apartment: the first level is staying alive, the second staying out of the psych ward, the third status quo, and the fourth gusting toward better health. Although I wish I could say the majority is spent in the penthouse on the deck, the truth is that I stay mostly on the third, going up for a quick visit to the fourth some afternoons, and taking the escalator down to the second at times.

Today I have the pleasure of interviewing Bruce Cohen, M.D., Ph.D, who is Director of the Harvard University McLean Psychiatric Hospital and Professor of Psychiatry at Harvard Medical School. He is also the coauthor, with Chelsea Lowe, of the recently released book Living with Someone Who’s Living With Bipolar Disorder: A Practical Guide for Family, Friends, and Coworkers. Cohen lives in the Boston area.

Question: I have always maintained that the best thing a person can do to support a bipolar loved one is get educated. But if you could offer folks a crash course, what are the five most important things you think a loved one should know about bipolar disorder?

Dr. Cohen: Getting educated is good advice. Here are five important things everyone dealing with bipolar disorder should know:

Jonah Lehrer’s essay “Depression’s Upside” in the Feb. 28, 2010 New York Times Magazine raises many important questions about depression, and what, if anything, we can “learn” from suffering a bout of serious depression. Alas, the article obscures almost as much as it illuminates, and I fear that its net effect may be to perpetuate what I call “The Myth of Depression’s Upside.”

But first, let’s be clear: a “myth” is not the same thing as a lie. A myth is a transgenerational story we tell ourselves, which often has a grain of truth to it, and which usually serves some unifying function in our culture. It is a myth that George Washington threw a silver dollar across the Potomac River — there were no silver dollars at the time — but the story usefully reminds us, across many generations, that our first President was a powerful man capable of great accomplishments. No lie in that!

So, too, we have the myth of depression as a “clarifying force,” or as an “adaptive response to affliction” — notions being advanced by a number of psychologists, psychiatrists, and sociologists. Thus, Lehrer quotes psychiatrist Andy Thomson as saying, “…even if you are depressed for a few months, the depression might be worth it if it helps you better understand social relationships… Maybe you realize you need to be less rigid or more loving. Those are insights that can come out of depression, and they can be very valuable.”

Since Newsweek published its article on antidepressants last week, we’ve seen a wide range of opinions posted about it online.

Psych Central blogger and …

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