Thursday, December 11, 2008

Are ALL Psychiatric Issues Related to a Lack of Emunah/Midos Work?


Frumhouse has a great followup on my post yesterday, where I illustrated why, for those kids that need it (and aren't prescribed it just to make it easier for the parents/teachers), ADHD Medication can be a real lifesaver. She points out another angle to explain the opposition to treating ADHD with medication, even when it helps. She says that one problem that often exists in the frum community is that we stigmatize any mental health issue, to a point where we make it worse for the people who suffer from these things by blaming them, despite the non-volitional nature of the conditions that are involved. It's well worth reading!

Frumhouse: Prescription for Psychiatric Issues: Increased Emunah?

-Dixie Yid

(Picture courtesy of NYTimes - It's not really related to the topic of mental health, except that I was writing about how we raise kids, and this is a picture of kids - But such cute kids!)

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7 comments:

frumhouse said...

Thanks for your intriguing post on ADHD and the link to my response!

Issac said...

It would seem one influential chossid had the humility and wisdom to seek help when he felt he needed it:
http://www.jhberke.com/Freud_Lub_Rebbe.htm

I currently work in a mental health hospital. We diagnose and prescribe meds too quickly and too rarely consider psycho-social-enviornmental (and spiritual) issues when working with patients.

We are a symptom reducing machine - and we don't even do that very well.

So why do I stay? a) pays the bills b) some of my colleagues appreciate the nuance of emotional/psychological healing, which makes the rest of the mishugas easier to put up with.

DixieYid (جنوب يهودي) said...

Isaac,

Thank you for sharing that very very interesting article about the encounter between the Rebbe Rayatz and Sigmund Freud. I very much enjoyed reading about it. It's certainly something to learn from.

As to the shortcuts the doctors take with regard to helping people in the proper way, I'm sorry to hear that. At least those of us who know to look deeper, should make doubly sure that we make sure we are getting proper medical advice and multiple opinions before making major medical decisions like whether to go on long term medication.

-Dixie Yid

Issac said...

"As to the shortcuts the doctors take"

My colleagues are only doing what the system is asking them to do. Nothing more.

For an excellent overview of what is wrong with my field, please see this book (written by a psychiatrist):
http://www.amazon.com/Healing-Soul-Age-Brain-Medication/dp/0140254897/ref=sr_1_1?ie=UTF8&s=books&qid=1229026554&sr=8-1

yehudis said...

I used to work with a Rav who has written a number of books on mental health/self-help. When we hit a chapter on depression, I mentioned that I thought his complete avoidance of a discussion of medication was going to seem strange to readers. I asked him about his feelings on the subject.
(He is a Rav who trains mental health professionals in Israel in Torah-based cognitive-type therapy in addition to working with clients privately.)
He answered, "Medication is sometimes necessary, but in the vast majority of cases people could alter their brain chemistry through other, more effective (but more time-consuming) efforts. Unfortunately, in the depressed state, it is very difficult to work up the energy to make these efforts.
Maximum, most people ought to use their medication as a means of garnering enough impetus to actually do these other actions, so that the medication can be phased out as soon as possible."

He was speaking about depression, but this was his attitude about other disorders as well.
Most people on psychiatric meds (not only in the frum community, but everywhere) are taking anti-depressants. They represent a huge portion of total prescriptions.
It is overly simplistic for Frumhouse to label the post "Prescription...Increased Emunah?"
I think that drawing a definitive line between "clinical depression" and the narcissism described by Rebbetzin Jungreis is mainly self-serving.
Most people taking anti-depressants are dysphoric in a culture that does not teach them the tools they need to deal with dysphoria. [I like to draw a distinction between severe depression and the kind of anxiety/dissatisfaction/unhappiness that sends most people to the Prozac.] Emunah and bitachon play a very large role and are powerful tools. There are others--collectively, we call them hischazkus, self-strengthening. It is an art (like emunah is an omanus--a craft), and these skills are often neglected, especially in chinuch habonim.
To our great detriment, unfortunately.

DixieYid (جنوب يهودي) said...

Isaac,

I hear.

Rebb. Golshevsky,

I'm sure what he said about depression and perhaps other mental health issues may be true in the majority of cases. However, and I think you acknowledged this, when other or more natural methods will not work in a give person's situation, one shouldn't withhold from himself or his children the medication that would help. And yes, as soon as he can find another way to avoid the same effects of his ADHD/depression/whatever, he should not stay on the medication any longer than necessary.

Although that's not unique to psychotropic drugs. Dixie Dad used to be on cholesterol medicaiton but worked hard excercising every day. Now he's off of all medications, B"H. It's certainly better if you can get along without them but it's important not to let those hesitations about medication (whether it be for ADHD or cholesterol or whatever) prevent their use when they are most effective relative to other options in a person's individual situation.

-Dixie Yid

yehudis said...

Yes, of course. I hope that I didn't sound like someone who says that medication is never in order!
Since depression is the most prescribed-for modality, I am just too much of a Breslover to be quiet about the fact that the very effective techniques the Rebbe taught us for dealing with marah shechorah and atzvus do work. They work if you work them.
And they don't if you don't.