Are Women Being Overmedicated?
Psychiatrist Julie Holland wrote in the New York Times this weekend about adjudicating the female mood, which ever since the publication of the feminist classic The Yellow Wallpaper, a book chronicling the imprisonment of a “hysterical” woman, has been the subject of peculiar debate. When a woman is moody, does it mean she’s crazy? Or is she simply experiencing hormonal or emotional differences that serve her evolutionary purpose?
Thankfully, as of 2015, we’ve come to a consensus closer to the latter point of view, at least scientifically. This is chronicled in Holland’s cheekily titled book, Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy.
But colloquially and in everyday life, the “psycho” bitch who won’t stop calling after a breakup, the crazy girlfriend who’s super jealous, the chick who’s a nightmare when she’s PMS-ing — these tropes are all too common. Even the woman who responds in what seems to be excessive fashion to the grief of a lost relative is seen as exaggerated and dramatic. And what Dr. Holland has discovered is that in her field, rather than treat such moods like physical manifestations of psychological issues — which they often are — women are instead overmedicated, and in much higher numbers than men.
In the early days of my treatment for depression and anxiety, I was talked to death by female psychologists who thought all my problems could be solved by probing the depths of my neuroses. It didn’t work, and I got worse, even psychotic. Later, the problem went in the opposite direction: Male psychiatrists doped me up but didn’t ask me anything about my inner life or what was happening with me at the time. My psychology remained obscure, as did relief.
I now see a psychiatrist (male) who insists upon assessing the psychology first, which can feel quite revolutionary when it happens.
In the summer of 2004, for instance, my cat — one of those needy, Velcro cats that was like a physical appendage, and thus incredibly beloved — got terminally ill. I cared for him at home with IV injections and other dramatic interventions for months; he was clearly in agony, and I was in agony trying to decide what to do.
Meanwhile, my grandmother had just moved to a ghastly nursing home where she was wasting away after the last of her six sisters died. She told me she was no longer eating because she wanted to die. Her roommate railed at her; the staff there wanted to give her shock treatments; I felt torn and guilty and ripped apart inside.
At home my relationship with my boyfriend was crumbling, and within six months, I’d euthanized my cat and laid next to my grandmother’s skeletal body, whispering, “You can go. I love you.”
It was all a bit much.
During this time, I felt such acute psychic pain — but not the pain of depression or psychosis that has marked my bipolar episodes. Those, ironically, I understand. I recognize what’s happening when the world takes on its twisted contours and reality warps; in those moments I can feel the chemicals sloshing into the wrong places, and I know the illness has come to claim me for a day or week, or whatever it wants of me.
But this was different. This was normal. Anyone going through this stress would be distraught and sad and guilty. Perhaps I took it a little farther than most when I started cutting myself with a blade — an icky habit picked up during sloshy-chemical moments — but basically, I was feeling sad for pretty sensible reasons.
I didn’t know that at the time, though. I just thought I was going crazy again.
“I’m going crazy again,” I said to my psychiatrist, and told him what was going on. “No, you’re not,” he said. “You’re responding emotionally to a set of extremely harrowing circumstances. You’re a woman having emotions. I’m sorry for you. We’ll continue to talk about it. If you start getting sloshy in there, we’ll talk about medication. But you’re suffering something very real, and we’ll get through it together. We don’t need to medicate regular old sadness.”
And you know what? He was right. We talked about it and I made it through.
Another time, we worked things out a little differently. I was ending a 10-year romantic relationship with someone I loved deeply. I hadn’t lived alone for 14 years. The “divorce” was excruciatingly painful. I knew, however, that I wasn’t going crazy this time; breakups and divorces are painful and sad, and I was going through a terrible time. My psychiatrist and I processed it together and I didn’t feel crazy, exactly, but there was a problem: I couldn’t stop crying. I cried when I woke up. I cried on the trolley to work. I cried at my desk and in the bathroom. I cried on the way home, and then I got into bed and cried while I played videogames on my phone. I’ve never cried so much in my entire life. It was like an involuntary spasm; I was a faucet I couldn’t turn off.
And that is how we ended up putting me on what I call the Anti-Cry pills. Dr. Holland critiques SSRIs in her piece, for good reason. She wants people to feel their feelings when it’s appropriate. Of the drug that turned the faucet off, she writes:
Crying isn’t just about sadness. When we are scared, or frustrated, when we see injustice, when we are deeply touched by the poignancy of humanity, we cry. And some women cry more easily than others. It doesn’t mean we’re weak or out of control. At higher doses, S.S.R.I.s make it difficult to cry. They can also promote apathy and indifference. Change comes from the discomfort and awareness that something is wrong; we know what’s right only when we feel it. If medicated means complacent, it helps no one.
But as I worked through my issues with my shrink, I needed to be able to be on public transportation without dripping snot on the seats. I needed to be able to converse with colleagues, and with cashiers at CVS. Able to function, I even started dating again. I don’t think I became complacent, but if I did, it was a temporary tradeoff. I went off of the Anti-Cry when I felt stronger.
There is no question that Americans are overmedicated and overprescribed when it comes to psych drugs, and it is beyond refreshing to see a clinician say so. It’s also inarguable that women (as well as elderly populations) especially get overprescribed because of certain notions about their dramatic inclinations. I’m hoping that despite its glib title, Holland’s book is as nuanced as I suspect her practice is. I’ll definitely be reading it.
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