Mental Health: Too Many Pills, Too Little Truth

This is my column in??[the September 17th]??Greenville News.??Ita??s a follow-up to a recent column I wrote on the mental health “crisis” in America, as seen in our emergency rooms.

My last column addressed the unfortunate truth of the overwhelmed mental health system in South Carolina, and indeed in much of the U.S. While I lament the fiscal condition of our mental health system, and while I feel for those who truly need the help we are often powerless to supply, I would be a poor observer if I didna??t report the truth. And the second truth we must face is that much of what we call mental illness is neither truly “mental,” nor even “illness.”

Let me first state the obvious: The brain is an organ. It is incalculably complex and truly a wonder of design and engineering. But, it remains an organ despite its wonderful capacities. Therefore, it requires energy, its support structures feel pain, it may be injured and swell, it can bleed and parts of it can die when its owner has a stroke.

Sometimes the dysfunction of this fantastic organ, or of the chemicals which course through it, is manifest[ed] as mental illness. In certain cases, medications can restore the brain to normal function. Therefore, I am not suggesting that true mental illness is wicked, or reflects character flaws. I have met too many sweet, confused schizophrenics to believe either of those things. I am suggesting that too often we allow character flaws, unpleasant personalities, remorse over bad choices — and even, yes, wickedness — to masquerade as mental illness.

Our mental health system is crushed for many reasons. But partly because we take frustrations and uncertainty, call them anxiety, then medicate them. We take sorrow and grief, call them depression and medicate them. We take genuine, appropriate guilt and sedate it. We create entities like “intermittent explosive disorder,” (which has to do with anger) and medicate it rather than occasionally incarcerating it.

We sedate rage and anesthetize sorrow. While anxiety and depression and anger issues all genuinely exist, my sense is that we overmedicate because we find it far easier to hand out pills than to listen to a story. We find it easier to prescribe than to sort through a human life and use discernment to suggest changes. We are desperately afraid of “judgment,” so we prefer to allow others to wallow in medicated misery. And we find it all cheaper, in the end, to give drugs than to give time.

We also medicate because we refuse to confront the real problems of human life. The woman abandoned by her adulterous husband may be chemically depressed, but she is also quite reasonably, and rationally, grieving. The man who wrecked his business and business partners by embezzlement and lies may feel genuine anxiety, but he also has (hopefully) guilt that needs to be addressed, not chemically camouflaged.

We need a combination of factors to cure the mental health crisis. Some solid cognitive therapy, widely available, would go a long way. This involves teaching individuals to face and master problematic thought patterns, rather than accept the popular lie that we are at the mercy of our thoughts and that our only hope is pharmacologic.

We also need a redistribution of some very important truths. Humans are valuable and good, but often very bad. Intact families are best for both parents and children. Promiscuous sex, alcohol and drug abuse are devastating to mental (and physical) health. If you were abused as a child, it wasna??t your fault. My allotted space constrains a complete list.

And if secular medicine, with its surplus of pills, cannot cure the broken and comfort the sad and confused, then science may simply have to accept the (horrific) possibility that faith offers some guidance that medicine is currently too timid to give.

If only the church would have the courage to step into the gap! The church should look at this crisis as an opportunity to empty some mental health clinics and fill some pews. We should offer listening ears and open arms. We should offer kindness, truth, and repentance to a group of people who now struggle and stumble from clinic to clinic, from pill to pill, from razor to rope, looking for answers that science all too rarely offers.

Let me repeat myself: Mental illness is real and many suffer from it. But not every problem can, or should be medicated or psychoanalyzed. And with love, and the truth that love produces, we might just end up needing fewer psychiatric beds and pills.

It sure would make Saturday night in the ER more pleasant.