Addicts and Anti-depressants

 

Mood changes, moods do change and I want them to change. We went on Friday night to the opera. We went to Glyndebourne. We went to see Prokofiev’s opera Betrothal in a Monastery. It’s not a great opera.  The final scene is fantastic, it’s such fun. Put me on Prozac? What an interesting opera. What a clever man Prokofiev was. That orchestration was quite interesting. I know all that.

The first act was a bit mundane. There’s a bitterness [0:00:50.2 unclear] where there’s a drum and a trumpeter and another instrument on stage. It’s just hackneyed; I think would be the word that comes naturally to mind. Put me on Prozac? What an interesting opera. He had a drum on stage and a trumpeter. I want to feel the bad bits. I want to feel the good bits. Put me on Prozac and I can’t feel either of them. That really concerns me that if we try to normalize people, standardize them to take away the bad bits, we will also at the same time take away the good bits. I want to feel sad when sad things happen.  I want to feel frightened, when frightening things happen. I want to feel great when beautiful things happen. I want all my feelings.

But once we start using psychotropic medications, we’re on the risk of having no feelings. I think that’s a terrible thing to do to human beings. Now I do believe that there are some clinical conditions that very much do need medication. I do believe that psychotic illness needs anti-psychotic medications.

I do believe that manic depression, when it does exist and when it’s not confused with alcoholism should be treated with lithium. So, I’m not anti-prescribing, I’m just saying that anti-depressant s, tranquilizers, sleeping tablets, they’re mood altering drugs where they do not have a place for us. I’m not sure their whole place anyway. But they certainly don’t have a place for people who have addiction problems.

We can cause another damage with that, because what we’re trying to treat here is a mood disorder and if we disturb the capacity for people to feel then how will they know whether their mood disorder is getting better or not. You could say, “Well, I’m putting the brain in a splint, like putting a broken leg in a splint just for a time.” And my argument is that during that time the patient will make no progress and that what we really need to do is to be able to encourage people to work with their feelings. Work through their feelings.

Now bear in mind, I’m the maverick. The other doctors are the orthodox ones.  What I’m saying is heresy in medical terms. There are lots of doctors who will disagree with me and you need to know that. You need to know that this is just my view.  One of the things that is really important for any of us is the acknowledgement, “I could be wrong.” Nonetheless, I will show you my views and show you the evidence of why I believe that it’s appropriate for me to have those views.

This is the work I do. We’ve had four thousand addicts through here over the last twenty years. I’ve got a lot of experience at this. I don’t do schizophrenia and I don’t have a view on it. We’re not a psychiatric hospital. That’s not what I do. We don’t do manic depression. If somebody’s genuinely manic depressive [0:03:52.9 unclear] somewhere else.

What we do is deal with mood disorders and for that I think we need to come to terms with our mood and work through them.  And when the mood has changed, that’s great, whether it’s up or down.  That’s great! We’re alive! We’re not trying to change our mood. We’re trying to come to terms with it. Work with it.