Psychiatric Medications Provide Relief for "Normal" Americans

In fall 2003, I had the privilege of attending a course taught by Dr. Reginald Ray, a Buddhist scholar of some renown and notoriety, and the author of several books on Buddhism. Dr. Ray teaches at Boulder Colorado's Naropa University, a small, Buddhist-based liberal arts college that recently gained accreditation and an aura of prestige and exclusivity. Dr. Ray was no wild-haired revolutionary sixties throwback, in fact he was modestly conservative in his dress manner and grooming, as is customary in his circles. After two or three classes with him however, it became clear to me that his radicalism often exceeded my own, and that his social critiques were often harsh and blunt when directed at the American mainstream.

An idea that usually surfaces only in counter-cultural settings, that "You have to be insane to function in this society," was one of many that Dr. Ray addressed and agreed with. His term for the mainstream corporate culture of America, on all levels, was interesting. Just as some refer to the counterculture erroneously as "the drug culture," Dr. Ray labeled the culture of corporate America as "The Caffeine Culture." I'm not here to bash the drug caffeine itself; in fact it's one of my favorites, and not all members of the caffeine culture use caffeine. But power and greed-driven minds set the pace that all must keep, and for many, the legal and relatively benign drug is all that stands between them and actual amphetamine addiction. A recently noticed "Crystal Meth Epidemic" has give the media a plethora of lurid and grotesque imagery: white- trash families living in dilapidated shacks and trailers with two-foot deep debris on the floor, sitting around the kitchen tables and passing the meth pipe, and an upper middle class suburban high school girl letting Oprah's cameras follow them through a couple of days continuous methamphetamine smoking before the heart-wrenching "intervention" on national TV, complete with a limousine waiting to take the newly saved and repentant teenage meth-freak to treatment. The show ends with the limo pulling away. But mom and big sister don't look all that healthy themselves, it's just that somehow (the author suspects) they have kept their jobs, and a few vestiges of sanity by controlling there amphetamine intake; for them, falling into a dysfunctional binge is not a viable option, although indeed it may happen eventually.

We get closer to the real story with methamphetamine when we examine anecdotal evidence from oil-rig towns in Wyoming, and factory towns in the Midwest. Occasionally, we hear of some town in Kansas where everyone works at the one and only major employer, a chicken slaughterhouse, being the site of a huge methamphetamine bust. Properly manufactured methamphetamine can make that all-too necessary overtime more bearable. People have to make ends meet, and spending 15.00 to 25.00 for a quarter gram of good meth is an investment. Methamphetamine, like beer and cheap liquor, is a working-class drug.

But what about those for whom caffeine, taken in relatively moderate amounts will suffice to get them through their working days, and who would not dream of touching an illegal drug except perhaps an occasional hit of weed? The upper working class and lower to upper middle classes, living in quiet, harmless suburban respectability, classes who are by no stretch of the imagination immune from the temptations of hard drugs, but who have among them, a surprisingly large number of people who object to drugs on moral, legal, or health grounds. What do these people do when they don't want to feel what they are feeling? Remember, this is the "caffeine culture," the dominant culture alternative to the "drug culture."

There is "medication" available. It is advertised via the most heavily used and universal drug of all, the television. For those gainfully employed, financially enslaved and pressured, but not burdened beyond their ability to cope, with extra money to spend after the bills are paid, to suffer from panic attacks, or continual anxiety, or to be dysthymic (which is a milder version of depression, I hesitate to use the word depressed here because clinical depression is often severe enough as to be completely debilitating) -in essence to be dissatisfied, when all things about you seem to be as they should be, implies that something is wrong. Something is wrong with you. But you don't have to feel that way, just ask your doctor.

The television already told you what is wrong with you and what pill you need, so chances are, you are giving your doctor valuable information that he did not have before, and given his busy schedule, may not have been able to come up with on his own, connecting his brief chat with you and a brightly colored page in a professional journal. Now the pharmaceutical companies have their traveling representatives who do their very best to keep your doctor up to date on the state of the art pharmacological treatments for "mood disorders", but in the end, no one knows better than you, the patient. In this situation, for once, the drug user has considerable power at their disposal, the power of the market. While it is true that the doctor still must write a prescription for these wonderful drugs, the user always has the option of taking their business elsewhere. Thanks to TV, they know how they feel, that they don't want to feel that way anymore, and they know what pill will make them feel better. That pill -is the pill with a television ad that strikes a resonant chord in the psyche of the consumer, through cartoon depiction, or clever photo-video montage approximations of symptoms (I personally like the ads marketing atomoxetine [Strattera] as a treatment for adult ADHD, fairly realistic and humorous too). However I tried Stattera and found it to be fairly useless, doing little if anything for me that a good cup of coffee couldn't. It did make my liver, already weak from Hep-C, hurt. It also turned my piss to what a nurse described as a "dark amber color."

Fearing even further damage to my liver, I discontinued use of this drug and the symptoms cleared up. But the shrink at the treatment program tries to get everyone on Strattera, feeling that it is his duty to free people from more stimulant ADHD remedies. He did this to an older gentleman, a veteran user of Dexedrine in small, controlled doses for purposes ADHD control. This individual experienced a number of distressing results, and finally, he was able to obtain his Dexedrine legally from another doctor, after establishing contact with supervisory parole agents, who confirmed that his parole officer did not have the power to prescribe, or proscribe medications. There are as many different opinions about psychiatric medications and the uses of controlled substances for the long term treatment of psychiatric symptoms as there are practitioners, as far as I can tell from my own limited experiences in this area. Again, prejudices and opinions seem to be based on philosophical, religious, and ideological positions rather than on anything resembling medical science. But the practice of chemical shamanism thrives in America. The shrink writes out my hard-won benzodiazepine ration with a pen that says: "Paxil: The Anxiolytic Antidepressant". The computer refuses to recognize the word anxiolytic and informs me of this with an angry red zigzag underline of the psychiatric neologism. But I tell the dumb machine to add it to the dictionary. It's a brave new world. It seems that the industry has responded to charges that Paxil is both ineffective and addictive with even bolder claims. It sure kept my friend Leonard, in prison, grinning. It's gotta be helping some people.

Maybe Dr. Ray didn't have the whole story down, with regard to the prerequisites of adequate functioning within the caffeine culture. Maybe you have to be insane to function, but if you're not insane, perhaps you need to be "on drugs". In any case, it seems that many people are one way or the other.