Synopsis: When someone is going through a time of emotional pain, one of the most common questions I am asked is: "Should I take medication?" Couples in upheaval, families in turmoil, those in emotional pain, often take matters into their own hands. As a result, nearly one in five Americans who take prescription drugs also take herbal remedies or other supplements. This mix-and-match strategy can place you, along with an estimated 15 million people, at risk since many herbs may adversely interact with some conventional medications. Consider this little known statistic: every minute two people are hospitalized for adverse drug reactions-1,500,000 a year-and there is a death due to legal drugs every five minutes. There are times when temporary help may get you through extreme feelings such as panic, depression, or sleepless nights that can occur when your life is in transition or when you are facing upheavals such as divorce, death, illness, family difficulties or a move. At such times, it may be wise to see a professional and get a prescription or use an alternative substance and pop an appropriate pill. But remember, most medications have side effects and while they may help you get through a tough time, they will not teach you the tools you need to change. Good counseling or therapy is usually the best answer to learning long-term change.

Emotional Distress and Medication

When someone is going through a time of emotional pain, one of the most common questions I am asked is: "Should I take medication?" Couples in upheaval, families in turmoil, those in emotional pain, often take matters into their own hands. As a result, nearly one in five Americans who take prescription drugs also take herbal remedies or other supplements. This mix-and-match strategy can place you, along with an estimated 15 million people, at risk since many herbs may adversely interact with some conventional medications. Consider this little known statistic: every minute two people are hospitalized for adverse drug reactions-1,500,000 a year-and there is a death due to legal drugs every five minutes. For those who think "natural" always means safe remember Socrates who committed suicide by drinking hemlock; or consider more recent scares: Several years ago we had the Melatonin craze, Melatonin, a hormone used to aid sleep became so popular that supermarkets couldn't keep enough on their shelves. Its acceptance was based on studies with mice and rats and some researchers hailed it as a cure for aging. But, when later reports cast doubt on the findings, sales of Melatonin went back to sleep. L-triptophane, naturally found in warmed milk, was compounded into another over-the-counter miracle cure to aid our sleepless population until several deaths were linked to it and insomniacs moved on to the next wonder solution. The range of psychological aids, from Prozac to St. John's Wort, is extremely complex, so always do your homework and consult several experts before starting a new drug, herbal remedy, or combination thereof. And, don't assume that your doctor always knows what is right for you. Many Americans, even their pets, take Prozac. Over 21 million people worldwide have now used Prozac with almost 10 million prescriptions in the U.S. alone. Although in the United States it is the most often prescribed mood-mender, it only holds the bronze medal in prescriptions written, lagging behind Zantac, an ulcer medication. Prozac, along with Paxil, Zoloft, and a host of other medications known as Selective Serotonin Reuptake Inhibitors or SSRIs, have gained popularity because they are supposed to impact on specific brain nerves with little or no effect on other neurotransmitter systems or brain functions. Mood medication is on the rise. Although warnings are already printed on most of our prescription drugs, I hope that individuals in distress will take more seriously the negative effects of our continued reliance on mood-menders. Pills need to be popped when necessary, but the ever-changing definition of "necessary" concerns me. When mind altering medication works it can seem as if you have been given a new lease on life. William, once a client of mine, is a case in point. A brilliant scientist who combated a history of attention deficit disorder (ADD) plus a family history of depression leading to suicide, managed to function well in most spheres of his life. Suddenly, at age fifty, his wife of 25 years asked for a divorce. Devastated, unable to sleep and totally disorganized, at a friend's insistence, William came to see me. Regaining his focus seemed primary and to this end sleeping medication seemed a good starting point. He was given a non-addictive sleeping pill and a prescription for Ritalin to help his ADD. Both the psychopharmocologist and I felt that pain around his divorce was situationally appropriate and to tranquilize or sedate him out of it for the short-term would only put off is pain and hurt him in the long-run. Once William regained a stable sleeping pattern and an ability to focus, he was able to use therapy to learn more about how he had contributed to the demise of his marriage and how he could use this new self-knowledge to better his life in the future. Interestingly, his wife Florence, also in distress and unable to sleep or eat, took a different tack. Florence's distress had manifested itself physically and she suffered headaches, backaches, stomachaches, and a menstrual period that lasted six weeks. Although no physical cause could be found, her gynecologist suggested surgery. With my support, since she was in no immediate danger, Florence opted to put off surgery to see what would happen once her stress subsided. Fearful of chemical compounds, she started on a regime of St. John's Wort, nutritional supplements, and psychotherapy, which after several months seemed to help. She began to feel better and, not surprisingly, her bleeding and other symptoms abated. Ultimately, she joined a psychotherapy group for self-knowledge and support. Florence's case demonstrates that a body under duress eventually rebels and that, if there is no emergency, it is best to allow equilibrium to return naturally as stressors are alleviated. William and Florence are excellent examples of the fact that, while we all share some common issues, each individual is as unique as a snowflake. Women are twice as prone to depression and anxiety disorders. Men are subject to more violent behavior, alcoholism, and drug abuse. Discrepancies are equaling out a bit-but not totally. Doctors still tend to evaluate men more thoroughly than they do women. A woman is three times as likely to be told a physical problem is "all in her head" than a man with the same complaints. When a doctor recommends a pill or a procedure, female patients should always ask whether its effects have been studied on women. Learning about gender-specific biology isn't an emotional issue, a feminist issue, or even a politically correct issue. It is a medical issue that should be afforded the attention it deserves. There are times when temporary help may get you through extreme feelings such as panic, depression, or sleepless nights that can occur when your life is in transition or when you are facing upheavals such as divorce, death, illness, family difficulties or a move. At such times, it may be wise to see a professional and get a prescription or use an alternative substance and pop an appropriate pill. But remember, most medications have side effects and while they may help you get through a tough time, they will not teach you the tools you need to change. Good counseling or therapy is usually the best answer to learning long-term change. This column's for you, Dr. D. Dorree Lynn, PH.D.

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