Furry little pill

Medpundit can't bring himself to dislike a new pop-psychiatry book with a really long name:

"...But pills, and even talk therapy, can't obliterate the horror of facing your mortality, the pain of a lover's rejection, or the loneliness of old age, let alone erase the emotional scars inflicted by man's general inhumanity to man.

Dr. Servan-Schreiber knows this all too well. He has spent a lot of his time doing psychiatric liaison work. That is, he helps other doctors deal with the repercussions of their illnesses. It's these sorts of patients who modern psychopharmacology fails the most. And it's these sorts of patients Dr. Servan-Schreiber has in mind when he talks about the instinct to heal.

Take the example of the lonely old person. Many's the time Dr. Servan-Schreiber was consulted by other doctors to recommend therapy for them. He knew from experience that no amount of psychotherapy, no potent anti-depressant, was going to cure their loneliness. So, he often made sensible recommendations instead. Recommendations like 'get a pet.' The response of his colleagues was not kind...

This strikes me as a little dangerous. Granted, I'm being reckless by quoting, possibly out-of-context, a book I haven't read. But then again, I'm on a psychiatry consult-liason service right now, so that's got to count for something.

We get a few bogus consults from docs who see "bipolar disorder" on the Past Medical History and instinctively throw their hands in the air. But most of my depression consults have had merit -- ie, major depression that was interfering with the patient's recovery from surgery or illness.

What troubles me is the popular notion, out there, that Western doctors tend to overdiagnose and overmedicate. Hyperactive kids get a pill, old people get a pill, but really all we need is love (via pets or traditional families or something). Critics of overmedication will point to this book by one of those "sensible doctors" who's blowing whistles and ruffling feathers in that heartless, moneymaking healthcare industry.

I used to be skeptical of ADHD and depression until I saw what some families deal with. I still don't know if these drugs are given out too easily. But the bigger problem now, in my mind, is not overmedication -- rather, it's getting people to realize that depression is its own, real disease. An old person with cancer who speaks less than ten words a minute, and doesn't lift her head off the bed all day, is probably suffering from something more than just cancer.

That extra "something" is a disease, with diagnostic criteria and proven remedies. These medications got popular, by the way, because they tend to work. But in the interest of full disclosure, I have to admit: my cat has gotten me through some rough times.