This Essay is Brought To You By Klonopin (No, Really, It Is)
Soft pink layers of fat; gentle strokes of color and contained vivacity; a dark black center that begs for light: though Georgia O’Keeffe is famous for her yonic depictions of flowers, her piece “Grey Line with Black, Blue, and Yellow” is even more genitally explicit than some of her other pieces, displaying an incredible psychological vulnerability.
Every color in the piece is layered on top of the black, scab-shaped center, brightness covering up a darkness that is longing to overwhelm everything else. The black-to-color ratio is disproportionately large, yet the bright yellows, greens, and pinks cannot overcome the dark tone of this piece. Moreover, the shape of the piece looks like pottery, yet the ripples in the painting, particularly toward the bottom, destabilize the structure and blend the various bright colors. There’s a sense of anxiety the longer you stare, an overwhelming urge to cover the black and just make it go away.
As I experience this painting, fragments of Anne Sexton’s poem “Courage” float through my head, lines like “you’ll bargain with the calendar” and “picking the scabs off your heart” that complement the tremendous strength and endurance in O’Keeffe’s work. Then I remember that Anne Sexton killed herself, and the moment is ruined. I move on to another painting.
O’Keeffe’s painting is a visual depiction of depression. The viewer cannot help but be drawn into the black, the scary, the unknown of the middle, despite all the color and life that surrounds it. At least, that’s how I experience depression. No matter how colorful, how bright, how alive life can be, I cannot help but feel the heaviness and resounding darkness that’s centered. Like many great artists, O’Keeffe has used her brilliance as a painter to beautifully illustrate a human condition: depression.
In a country where the rate of antidepressant use has increased over 400% in twenty years, it’s impossible to ignore the fact that mental illnesses seem to be increasingly more common. But of those medicated people, less than one-third have seen a mental health professional in the past year (Daily Mail, 2011). In the Journal of Medical Ethics, B. A. Manninen uses a 2006 Newsweek article about “the different types of drugs…that can be used to help a child deal with emotional issues” to prove that we as a society seem to be throwing drugs at our problems (Manninen 101). The quandary isn’t the seemingly higher rates of depression (though that is another issue worth looking into); it’s why we use the medications we take to treat mental illnesses.
Because we want an easy solution to a complicated problem, we submit ourselves to pills. In a climate of fake news, constant debate, and a hyper-necessity for technology, we juggle and multi-task so many issues and activities that it’s easy to lose sight of our needs, whatever they may be. The twenty-first century is a fast-moving world, encouraging our mental metabolism to process quickly and produce results instantaneously. So when we encounter a problem, it’s important that we fix it fast, however possible. Because we value efficiency and immediacy, we prioritize medication and immediate chemical balance, perhaps over taking the time to be in therapy or seeing other mental health professionals. We accept change willingly, almost expectantly. But in the Journal of Medical Ethics, Manninen is clear that medication cannot be a “substitution of self knowledge or self development” but should be used alongside “interpersonal psychological therapy” as a means of chemical support (101).
But drugs work quickly, producing fast results. If you believe you have depression, you want the numbing sadness to subside quickly, just as O’Keeffe attempted to stifle the the dark center in “Grey Line with Black, Blue, and Yellow” with other colors. In the regular series podcast “The Hilarious World of Depression,” host John Moe interviews comedians about their experiences with mental illnesses, medication, and their work in comedy. In season one episode seven, Moe interviews Jen Kirkman, who says that taking Prozac helped her “tolerate the holiday season and all the Christmas jingles that come with it”. Though her psychiatrist explained that it would take six to eight weeks for the medication to kick in, the effect felt immensely relieving, even if caused by the placebo effect.
The immediate effect of drugs can be great, but it can also be addicting: “[m]ore than sixty percent of Americans taking an antidepressant drug have taken it for two years or longer, and nearly fourteen percent have taken the medication for ten years or more” (Daily Mail, 2011). If we get used to relying on a bottle, it can be hard to not need it. It’s a safety net, a guarantee that depression, anxiety, or anything you’re being treated for won’t get worse if we have pills — and if we feel worse? Just increase the dosage.
But adding more medication to your body’s system is like O’Keeffe adding more colors to her painting: no matter how much color is present, the black center is still there. Medication then becomes a necessary evil, an important tool in the process of psychological healing. This puts our mental and emotional stability, or lack thereof, in the hands of science and in the care of pharmacies who profit off our pain. Like any other corporation, pharmaceutical companies value profit. The cause and effect is simple: if we need more drugs, they make more money; so if they come up with more reasons for us to need drugs, they make more money. Prozac, often the first antidepressant that people are prescribed, was introduced to the market in 1987, ushering in “[m]edia coverage of SSRIs [that] not only made antidepressant usage more acceptable to mainstream society but also sold the idea of depression as an illness affecting a large number of the population” (Wilkinson, “Serotonin Reuptake Inhibitors”). In less than five years Prozac became the most frequently prescribed drug in psychiatry and “garnered more than $20 billion in sales” in its first decade (Wilkinson). But after fifteen or so years of success, as the patents on various SSRIs started to expire, generic pills, essentially antidepressant knockoffs, began to sell. In order to keep up the profits they had been making off of SSRIs, the pharmaceutical companies “developed new possible uses for SSRIs”, such as treating OCD, bulimia, and general anxiety disorder (Wilkinson). Additionally, the pharmacies played around with the half-lives of pills, which would force people to take their medication(s) more frequently as half the dose would be eliminated from the bloodstream more quickly (Purse). For example, “[s]ome agents such as bupropion, which has a half-life of [sixteen hours, was] initially given several times a day” (Craig, “Antidepressants”). In order to keep the medication active in their systems, people take pills more often, leading to more frequent trips to the pharmacy, meaning more money for the pharmaceutical companies.
Antidepressants’ widespread use has led to more prescriptions for more people. In Buzzfeed’s article “35 Reasons People Take Medication For Their Mental Health,” site users and readers detail and validate their experiences with their own mental health issues and illnesses, professing their chemical insides for the world to see. Due to the pharmaceuticals’ prioritization of making money, more people rely on medication because they believe they need it. The very existence of this Buzzfeed article, albeit its contents, proves the long-lasting effects of pharmacies and demonstrates our belief that we need to be medicated for A, B, C, etc.
While medication is an important part of healing mental illness, too many people forgo in-person therapy as a necessary and complementary treatment. Maybe that’s because taking a pill is easy. Maybe it’s because therapy is time-consuming and typically expensive. But talk therapy is a journey: it’s repetitive, it’s hard, it’s supportive, and only you can do it for yourself. Think of Frodo Baggins in The Lord of the Rings movie trilogy: he is entrusted with the one Ring to rule all of author J. R. R. Tolkien’s Middle Earth and ordered to destroy the toxic burden. He must travel to Mount Doom, a distant, dark volcano where the Ring can be eradicated, and he has the help of wizards, elves, and more to help him along the way. Much like therapy, Frodo doesn’t know when his journey will be over, and though he’s supported by The Fellowship (particularly his best friend and fellow Hobbit Samwise Gamgee), he can only take this burden upon himself to complete the journey. Why go through months, maybe years, of talk therapy if one little blue pill can take away the pain, brighten the emotionally-taxing day-to-day struggles of living a somewhat neurotypical life? That’s what ten percent of the American population aged 18-44 do every day, along with four percent of the population aged 12-17 (Daily Mail, 2011). It’s best that we use drugs and therapy, that we combat mental illness chemically and psychologically. But despite therapy that’s used in conjunction with medication, we still deal with life’s miseries with an influx of serotonin that is changing, affecting, and drugging our brains.
For adults, the critical development of the brain does not need to be taken into consideration if medication is a choice made available, as our brains have fully formed by about twenty-five years old. But for adolescents, teenagers, and even young adults, the medication that will chemically influence how their brains learn to function and grow can have negative effects on their brains’ development.
Selective serotonin reuptake inhibitors (SSRIs) are this country’s second most widely prescribed medication, following statins used to lower cholesterol (Wilkinson). Any and all drugs will affect the brain, and SSRIs are no different. Antidepressants are meant to block serotonin, our bodies’ natural mood stabilizer, and norepinephrine, a stress hormone, at the presynaptic neuron in the brain, where neurons connect and transfer information among each other. Antidepressants increase “the availability of these neurotransmitters at the synapse…[so] autoreceptors on the presynaptic neuron turn down the firing rate of those cells and less neurotransmitters are released” (Craig, “Antidepressants”). Basically, serotonin, a neurotransmitter, makes us happy; SSRIs block serotonin from being reabsorbed in the brain, making more of that natural, chemical happiness available to us. In the long run, our “autoreceptors are desensitized and the firing rate [of neurotransmitters like serotonin] returns to its tonic rate” (Craig), gradually increasing the baseline of serotonin available in the brain. And, supposing that the SSRI dosage is taken daily, medication does help efficiently, because it’s changing our brain chemistry and circulating through the body.
Due to adolescents and young adults’ higher susceptibility to medication’s dangerous side effects (Wilkinson) there’s a long list of parents who are ready to write a strongly-worded letter to any school counselor or nurse who recommends therapy, psychiatry, or psychology treatment to an adolescent or teen. Their argument stands that drugging our kids negatively impacts future brain development, so we should just stop prescribing drugs to our kids, right?
Well, it’s not that simple, because while “one side [is] convinced that the risks of SSRIs for adolescents are too high for even limited use[,]…the other side [is] concerned about the ethics of not treating depressed youth with the best currently available treatments for depression” (Wilkinson). In a study on ADHD medications, Behavioral Disorders tracks the various dosages of various medications at various ages (divided into elementary school, middle school, and high school) and marks students’ improvements shown at school and at home. The teachers who worked with these students “[became] confident that they could identify students with ADHD-Predominantly Hyperactive-Impulsive Type”, and those “educational intervention[s]” are used to help manage ADHD (Runnheim 312, 307). The “combination of [medication] and behavior management was the most effective method in dealing with children with ADHD” (Runnheim 307), as teachers claimed in this medication study. By getting in tune with the children’s medications and tracking their individual processes, the teachers became acutely aware of who exhibited ADHD-like traits and noticed an increase in ADHD diagnoses.
If we are trained to find these peculiarities in our kids — they’re too shy, they’re too outgoing, they’re too odd or isolated — then who’s to say these problems aren’t just a chemical imbalance? We value their “normalcy,” and as the parents, teachers, and role models of kids, we have the responsibility to keep them safe and happy. Medicating any child that might have an oddity reveals that we so badly need our kids to be normal; we drug our children because we are uncomfortable with their “problems”, which, I believe, comes down to a matter of credibility in believing in the realities of mental illnesses.
The deeper question underlying this issue then is how valid is mental health in the public eye? The way we handle these issues, the methods in which we approach “curing” them, and even what we believe mental disorders are — that is the root of the problem, and the reason why we treat everyone with medication that will make it all “go away”.
The Lord of the Rings film trilogy is really a metaphor for depression. Bear with me. Frodo is given this powerful ring, the one Ring to rule them all, which no one else can bear for him. He’s in the wrong place at the wrong time, and must leave the Shire, his home, to destroy the Ring in the fires of Mount Doom, where the Ring was created. Frodo inherits the Ring from his uncle Bilbo, who’s driven insane by the Ring’s power. Frodo has no idea what to expect on this journey, though he understands he might not make it. Flash forward to the end of Return of the King, the third movie in the trilogy: Frodo and his best friend, Sam, have finally made it to the cliff of Mount Doom, the only place where the ring can be destroyed. All Frodo has to do is throw the ring into the fiery pits. That’s it. Then they’ll be done, and rid of this journey. But he can’t do it. He turns to Sam, an evil, selfish twinkle in his eye, and says, “The ring is mine.”
As a viewer, it’s frustrating. You’ve been sitting through a long journey (each of the three movies is about three hours long) and the protagonist can’t even do his one job. But when you think about it, how can you part with something that is so deeply apart of you, even though you know it’s harming you? Frodo has forgotten how he functioned before, and, as heavy as this burden is, he doesn’t want to part with the very token (substitute: Tolkien) that’s made him particularly unique, the defining factor that’s made him somewhat of a “chosen one”, even though he’s an ordinary hobbit.
Now replace the Ring with “depression,” or any mental illness of your liking. An average Hobbit inherits depression from his uncle. No one can help him bear this burden, though he’s given a system of support to help destroy depression. He’s on a journey to destroy the very thing that’s physically and mentally destroying him, but depression becomes so important to how he functions that Frodo can’t bear to part with it. He knows he might die prematurely along the journey, an unfortunate end for some who suffer from depression, like Gollum/Smeagol, who is driven to death by depression’s power.
Frodo doesn’t choose to bear this ring; it is practically thrust upon him. In the same way, depression isn’t a choice for many: it’s inherited, it’s imposed, sometimes it just pops up. But no one can simply “stop being depressed,” just as Frodo cannot simply stop carrying the ring to Mordor.
When you’re stuck in the darkness, whether consumed by a ring or stuck in the black center of O’Keeffe’s painting, it is scary and hard to recover from, or be cured of, depression, or any mental illness, for that matter. Whether medication is part of that journey or not cannot be decided by anyone but the one suffering. It takes a village to raise a child, no matter the child or their implications, just as it took several armies to destroy the Ring and lots of paint to create O’Keeffe’s final product. The journey to completion — getting to live healthily with a mental illness, ending an epic journey, finishing a painting — is not entirely about the result, but rather the paths it took to arrive at the destination.
So with pharmacies that value money, adults that throw drugs at their problems, and a new generation growing up on iPads and Prozac, we cannot deny that psychiatric medication is not just a matter of mental health but an effect of and on livelihood. Understanding that these drugs are part of our lives forces us to reconsider what we desire to change about ourselves and, more importantly, our children. Because the more we change, the more we’ll want to change some more.
Sexton, Anne. “Courage.” The Complete Poems, introduction by Maxine Kumin, Mariner Books, 1999. <https://www.poetryfoundation.org/poems-and-poets/poets/detail/anne-sexton>.
O’Keeffe, Georgia. “Grey Line with Black, Blue, and Yellow.”
Rebolini, Arianna. “35 Reasons People Take Medication For Their Mental Health.” Buzzfeed, December 2015. <https://www.buzzfeed.com/ariannarebolini/reasons-people-take-medication-for-their-mental-health?utm_term=.pczEb4WxB#.inRKl023e>. Accessed April 2017.
Daily Mail Reporter. “Prozac nation: How one in 25 American adolescents now takes antidepressants.” DailyMail.com, October 2011. <http://www.dailymail.co.uk/news/article-2051134/One-25-adolescents-antidepressants—theyre-prescription-Americans-aged-17-44.html>. Accessed March 2017.
Manninen, B. A. “Medicating the Mind: A Kantian Analysis of Overprescribing Psychoactive Drugs.” Journal of Medical Ethics, vol. 32, no. 2. pp. 100–105. 2006. <www.jstor.org/stable/27719571>.
Runnheim, Veronica A., Frankenberger, W., & Hazelkorn, M. “Medicating Students with Emotional and Behavioral Disorders and ADHD: A State Survey.” Behavioral Disorders, vol. 21 no. 4. pp. 306–314. 1996. <www.jstor.org/stable/23888014>.
Moe, John. “Jen Kirkman, Bad Therapy, Good Therapy, and Nuclear Invasion.” The Hilarious World of Depression, season 1 episode 7. January 23, 2017.
The Lord of the Rings trilogy. Dir. Peter Jackson. Perf. Elijah Wood, Viggo Mortensen, Orlando Bloom, Ian McKellen, Sean Astin. George Allen and Unwin, 2001, 2002, 2003.
Wilkinson, Rebecca. “Serotonin Reuptake Inhibitors.” Cultural Sociology of Mental Illness: An A-to-Z Guide, edited by Andrew Scull, Sage Publications, 1st edition, 2014. Credo Reference, <https://ezproxy.library.nyu.edu/login?url=http://search.credoreference.com/content/entry/sagementcsaz/serotonin_reuptake_inhibitors/0?institutionId=577>. Accessed April 2017.
Nelson, J. Craig. “Antidepressants.” In Encyclopedia of Psychopharmacology, edited by Ian P. Stolerman. Springer Science+Business Media, 2010. Credo Reference, <https://ezproxy.library.nyu.edu/login?url=http://search.credoreference.com/content/entry/sprp/antidepressants/0?institutionId=577>. Accessed April 2017.
Purse, Marcia. “Medication Half-Life and Why It Matters For Your Meds.” Roden DM. Principles of Clinical Pharmacology. New York, NY. McGraw-Hill. 2015. Accessed May 2017.