Pills and Therapy

Things people sometimes say about mental health issues relate to trauma:

You’re just not trying enough.
Your faith isn’t strong enough.
It’s for attention.
You don’t really want to be well.
“It’s just in your head….” This is partially true, because that’s where the brain is, and trauma injuries like PTSD start in the brain (and show up on scans).
And my favourite (by which I mean it makes me want to spit and stomp my feet)- “Well, so-and-so has been through the same kind of stuff and turned out just fine, so that just goes to show that anybody can just overcome if they are strong enough/if they want to/if they try hard enough…”

But it turns out, it’s equally inadequate to push pills and tell people they have a chemical imbalance and Big Pharma will fix that for you.

This article is about therapy vs drugs, specifically psychotherapy. I’m a fan of EMDR therapy, myself. But it is not the first time I’ve read that the hard science behind the theory of a chemical imbalance causing depression is just not very strong at all.
This is what I want to point out first, though:

“When Julia Morath and other German psychologists studied refugees with PTSD, the number of breaks in the refugees’ DNA was equivalent to that of people who’d been exposed to an atomic bomb blast. That’s how badly trauma affects every cell in the body.”

Therapy resolved that, producing healing to the DNA, and drugs did not. And breaks in DNA strands are not the result of weak faith or just not trying hard enough.

And while the article acknowledges that there are sometimes other causes for mental health issues, the experience of childhood trauma is almost like dropping the victim in a chute launching them directly to a lifetime of mental health issues:
“Psychological injuries have a surprising impact on physical health as well. Just consider what it’s like growing up with a parent who might lash out at you at any time. Children in this situation are frequently in fight-flight-or-freeze mode. Cortisol and adrenaline are pumping into their little blood vessels multiple times a week, sometimes for hours at a time. Given how often their amygdala is activated, they get easily launched into an alarm state, and take much longer to calm down. The sympathetic nervous system is firing over and over and over. Fear, anger, shame, guilt, and sadness flood through their body repeatedly. As a result, the areas of the brain responsible for planning and emotional control don’t develop fully. The insulation on brain cells, the myelin, doesn’t form correctly. Even the DNA is altered: the more frequent and intense the trauma that people experience, the more methyl groups are attached to their DNA, which can turn off certain genes. Repeated trauma shapes the person’s biology at a deep level.”

Well. I don’t have to imagine that at all. It’s deeply familiar. I don’t read that and feel a sense of surprise or ‘ah, I have learned something.’ My strongest feeling in response is recognition. This is where I’ve lived my entire life. It’s immensely better since EMDR therapy, but I also feel like somebody who has an autoimmune disease- treatments alleviated the worst and made it possible to function again, but I expect to spend the rest of my life managing symptoms and avoiding things that make it worse.

“Someone fortunate enough to have grown up in an emotionally healthy home had an 18 percent chance of developing depression by middle age. But having just one adverse childhood experience (ACE) boosted the risk by 50 percent. Two ACEs boosted the risk by 84 percent. And people who had five or more ACEs had a 340 percent greater risk of developing depression than someone who’d grown up in an emotionally healthy environment.”

But what about some of the other mental health issues? Even schizophrenia and bipolar disease are more often linked to childhood trauma than previously understood. And rather than it being addressed well by medication, it’s more that sometimes medication helps with treating symptoms, but it still works better in combination with therapy.

For those with depression and related anxiety issues, placebos work just about as well as the prescription pills, and exercise actually helps *more*. But exercise doesn’t have a big pharmaceutical company pushing it, insurance doesn’t cover it.

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