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  • Writer's pictureDr. Amy Mednick

In Defense of the Medicated

Updated: Mar 30, 2022

Lucy’s brain was trying to kill her.

From the age of 13 until she first saw a psychiatrist at 24, Lucy was unaware that there was something abnormal about the constant message of self-destruction that she lived with as background noise. She did not know that there were people who did not live with a cheese grater attached to the raw ends of their nerves. If Lucy had been limping around with a large ulcer in the center of her foot, her friends and family would have told her to see a doctor or even brought her themselves. But with a large ulcer in the center of her soul that no one could see, she was told to buck up, to try harder to be happy, to eat right, and to stop complaining. It took 11 years for Lucy to learn that she deserved health. Then she began treatment and the noise turned off, and Lucy was able to begin living as the actual person who existed beneath it.

We live in a society in which people are seldom looked down on for having arterial walls that are crusty with plaques and need medication to help blood to flow. Rarely are those whose insulin resistance has increased over time shamed for needing to regulate it artificially. Hearts, kidneys, livers, and lungs malfunction all the time and no one thinks twice about a person who requires medication to repair them. Yet for the most complicated and least understood organ of all, the brain, the same practice is too often frowned upon. Why should this of all organs be expected to function perfectly?

The brain’s problem, in grossly oversimplified terms (because it is sheer narcissism to think we could ever truly understand that thing with which we think and understand) is this: Our species is defined and set apart by its possession of a magnificent neocortex, a brain system which allows us to plan and problem-solve and make symbolic representations, to inhibit behavior and delay gratification. This impossibly intricate machine is slapped on top of a primitive, animalistic, impulse-driven limbic system like an ill-fitting cap, tethered and connected with trillions of unknowably complex circuits, and expected to chug along error-free without a single round of debugging. But there are errors, and the cap in varying degrees rarely fits just right.

The heart has hardly had to adapt one bit throughout evolution. It is the same organ that was pumping blood to our ancestors’ legs as they fled from saber-toothed tigers in the jungle. If anything, its job is far easier now, with elevators and cars to do all its corporeal scut work. The lungs are processing the same oxygen and carbon molecules present since the beginning of time. The kidney is permitted to fail and shut down entirely while the organism lives on, its job taken over by a dialysis machine. Yet the brain, designed to rapidly trigger a fight-or-flight reaction to the tiger, is now instead dealing with electoral injustice, existential angst, air travel, threat of nuclear annihilation, and ex-lovers’ Facebook statuses. It is confronted with an aggressive boss and launches the same response it would to the saber-toothed tiger, and there you are burning through all your sick days because your body will literally not allow you to leave the safety of your own bed.

Miraculously, that very same human brain has developed treatments for itself. It has developed treatments for all different organ systems, in fact, gradually expanding our time allotment on this earth by decades.

Just as some kidneys never require outsourcing, not all brains require treatment. For example: if your job is stressful, and you overextend yourself, and as a result you feel tense, then medication might not do much for your situation and some better planning and perhaps a bit of meditating and exercise may be in order. Or, if you’re someone who gets in a dark mood once in a while until something comes around to cheer you up, this might be something you just need to power through. However, if your job is not so stressful, yet your mind is constantly throwing itself into endless looping spirals in which you get caught, paralyzed, and unable to function for hours on end, then you might need help to carry on with your productive normal day. Or if the darkness swallows you whole where things that once brought you pleasure feel now like a saw to your soul, and the saw shreds its way right through that most basic of instincts, to live at all costs, then your brain is ailing and you must seek help.

What is it about this great invisible pain that is harder for many to accept as the medical issue that it is? Is it the mistaken belief that all suffering is universal, that because we know what it is like to be sad we pretend understanding of what depression might feel like? We don’t do this with other pains. Though we’ve all had headaches, we are still equipped to say to our friend who is writhing on the floor in agony gripping her forehead as blood pours out of her ears: “Hey… I think you need to get that looked at.”

If every person could in their lifetime say that simple sentence to one invisibly suffering person, then someday the message might reach all the Lucys, sitting alone in the dark not knowing that there is hope: the message that the darkness inside is not something you should have to live with; that this chemical misappropriation is not something that should or can be defeated with perseverance or strong moral character, any more than such could be said for a case of pneumonia; that there is no need for you to silently struggle; that you may seek help, and not be judged.

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