Saturday, February 23, 2008

It's the Water

Years ago Olympia Beer had the slogan, "It's the Water" -- suggesting its delectable beer came from its excellent water.

Although Miller closed this brewery in 2003, I recently remembered the slogan while taking a course called "Leadership in Green Health Care", through Teleosis Institute in Berkeley, CA. It educates physicians about the link between our environment, medicine, and human health. The whole idea of "Sustainable Medicine" is to provide better health care while also protecting our limited environmental and medical resources. It's an up-and-coming trend, I hope.

Part of the course involved learning about all the medicines in our water supplies . . . including Prozac, Zoloft, and Lipitor. Did you know your personal metabolic by-products can survive waste-treatment plants and end up in rivers, lakes, and oceans?

An even larger culprit is the practice of flushing unused medicines down the toilet. Did your doctor or pharmacist ever tell you to do this?

There must be some un-depressed fish with low cholesterol swimming in our streams, rivers, and oceans these days. Maybe they're having their endocrine and neurological systems rearranged in other ways too. And then we eat them. hmmm . . . . could there be a problem here?

There's a brief podcast on Marketplace about this issue, also mentioning medicine take-back programs being set up in various cities so that this kind of pollution won't happen. The medicines can be incinerated so they don't impact marine life. Of course, drug companies feel this is much ado about nothing -- could it be because they might have to pay for ways to avoid polluting water supplies with their products? hmmmm . . .

Personally, I like clean water. And, I vote for staying as healthy as we can so we need less medicine in the first place.

Wednesday, February 06, 2008

Medicalization of Sadness

Can it ever be healthy to be sad? Does sadness serve any useful purpose, or does it always indicate pathology?

It's a question that troubles our society (including Psychiatry).

Coached by pharmaceutical companies, some might believe immediate intervention is needed for any 'down' emotions whatsoever. Lose your boyfriend? Get fired from a job? Here: take a Prozac, it'll be all better.

As a psychiatrist I know there's a difference between life-numbing depression and basic everyday suffering. Not to discount the painfulness of the latter, this difference matters even if it's not always clear.

A patient come in the other day telling me about his first visit with another psychiatrist. "Within the first 15 minutes," he said, "that doctor started writing prescriptions and explaining how they would help me 'feel better.' But I wanted to know what I was feeling better from."

He tried the medicines (antidepressants and antianxiety agents) for awhile, but wanted a second opinion and possibly different approach.

I thought about how pressured we often are to feel "good" these days, as if there is no room for regular human discomfort -- even suffering. But, short of life-sapping depression that engulfs us in apathy, can't sadness and discontent alert us to things needing change? Can they even result in growth? This has often been true in my own life . . . and probably in both Barack Obama's and Hillary Clinton's campaigns. :-)

This week Newsweek (Feb 11, 2008) published a story entitled: "Happiness: enough already" ; it is a kind of backlash against being flooded with demands for constant joy. We've been flooded by ads for well-being, as if normal ebb and flow of emotional responses cannot be a part of this.

I admit that Sigmund Freud's idea of successful psychoanalysis sounded pretty dour: "substituting hysterical misery for basic human unhappiness." We focused on pathology for so many years, leaving out what facilitates health and healing. Then there was valuable research on happiness, resulting in an entire field: "Positive Psychology". Nothing wrong with that -- but what about regular okayness, simply being?

Jerome Wakefield, a professor at New York University, tells all about it in his book: The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder.

Making room for this seems realistic to me, but maybe Pfizer and others will disagree.