Yesterday was the fifth anniversary of the day I started taking meds for my they-don’t-like-to-apply-labels-but-it’s-bipolar2. I’m glad I was too busy yesterday to post, so I can say a few words now, in the light of an interesting piece by Louis Bayard on Salon today:
In a study published last January by the Journal of the American Medical Association, scientists conducting a meta-analysis of existing research found that antidepressants were unquestionably "useful in cases of severe depression" but frankly not much help for the rest of us. "The magnitude of benefit of antidepressant medication compared with placebo," the study's authors concluded, "may be minimal or nonexistent, on average, in patients with mild or moderate symptoms."
In other words, antidepressants work, but only because we believe they're working. If we're not seriously depressed and we're taking a tricyclic or a serotonin reuptake inhibitor or a norepinephrine booster, we'd fare about as well with a sugar pill. Which means that antidepressants are, to borrow the phraseology of Newsweek writer Martha Begley, "basically expensive Tic Tacs."
And so, like millions of Americans, I'm left with the problem of it: that little white pill that travels down my gullet every morning. What is it really doing down there -- up there? What if it's not doing anything? Is there any good empirical unassailable reason that I should be swallowing it day after day after day? If I stop believing in it, will it stop working?
This hits home for me. I like to pretend I’m Mr. Rational, making fun of people who reject concrete evidence, but the truth is, I’ve often wondered if the reason my meds “work” for me is that I was ready for change. It took me until I was 51 to finally accept that nothing else was working … I started feeling better almost immediately after starting the meds, sooner than I would have expected for them to begin to affect me … maybe I just needed an excuse to quit being an asshole, and the meds gave me that excuse. I wasn’t trying to be nice, the meds were making me nice. (Yes, I’m aware of the twisted nature of that “logic,” that I preferred being controlled by drugs to admitting that I wanted to be nice.)
But … if you go back to the top of this post, you’ll see the term “bipolar2.” Yes, I had a tendency to get depressed, and yes, it occasionally got pretty serious, and no, I don’t feel that way anymore, for whatever reason. But it’s the “2” that really matters. The most evident difference between my life five years ago and my life today, a difference that I noticed right off, is that I no longer suffer from anxiety. As I said at the time, until I was 51, I didn’t know I suffered from anxiety, because I’d never known anything else … I thought the state of anxiety was just how life worked. You don’t recognize black unless you know white; I didn’t know the absence of anxiety, so I didn’t recognize anxiety. When I suddenly lost that feeling, when I realized I didn’t have to be afraid of every step I took, every tiny change in my schedule, every unanticipated event, every interaction with others … well, that was remarkable. And I don’t think I could have just wished that away … I don’t think a placebo would have gotten it … I didn’t need an excuse to quit being anxious, because I didn’t really know I was anxious.
So yes, it is possible I’ve taken an antidepressant for the last five years without the drug doing anything concrete for me. But I’m willing to bet my anti-anxiety meds are working on my chemistry. And I’m not sorry.