Tuesday, January 08, 2008

Why everyone is not entitled to an opinion about everything.


Actually, the title of this post is about a larger issue, something I've blogged about before - the notion that one is not entitled to believe something abjectly stupid. I mean, I can't prevent you from having an opinion, and I certainly wouldn't try to stop you from proclaiming your ignorance to the world, but I don't think that having a brain gives people an automatice right to hold opinions about things about which they know nothing. Or, to put it another, perhaps clearer, way - I don't think you are entitled to be listened to or respected simply because you have an opinion. All opinions are not created equal.

What this post is really about, though, is the case in point: Elaine Vigneault's opinion of depression and anti-depressants.

Sometimes the watch words are phrases like "I believe." When someone says "I believe" or "my belief is," it can preface almost anything - it can be an informed opinion based on research, or it can be a suggestion that dinosaurs didn't exist, or it can be an explanation of personal faith, or what have you. I note this only because I found the phrase noticeable in this sentence:
"my belief is that depression is a normal state of being, a state some have called the human condition. Not all people are depressed, but such a significant portion of highly intelligent people experience symptoms of a 'disease' called clinical depression that I believe that depressive habits of thought are common enough and safe enough not to warrant a disease classification."

This is not a new idea, certainly, this notion that "if you're not outraged, you're not paying attention" (see? it's even a bumper sticker!) or that intelligent and creative people are particularly upset about the state of the world and so take to their beds in a kind of melancholia.

But it's also not an accurate definition of "depression." Depression is not dissatisfaction with the world. It is not outrage. It is not sadness. If you imagine depressed people as revolutionaries (which she does - see below), then you're not getting it. Depressed people, people who are depressed enough to go on anti-depressants, often don't make it out of the house. These are people in pain.

Here's the quote:
"My theory is that many people’s depression is anger turned inward. Anger is a powerful emotion that can be both destructive and constructive. Anger that is unjustly aimed inward becomes debilitating depression, but justified anger aimed outward towards things like injustice can be a powerful motivator. I think if more people embraced this view and used their anger as a motivator, we’ve have a revolution and possibly a better world.

There’s a saying, “if you’re not mad as hell, you’re not paying attention.” And another one “ignorance is bliss.” I think both are true. I think happy people are people who wear rose-colored glasses and don’t see reality clearly. That’s not to say happiness is ignorance; I’m saying that constant bliss can only be achieved through drugs, ignorance, or some other form of blurred reality. Occasional bliss is available for anyone willing to accept it: puppy pictures, flower bouquets, a compliment to or from a stranger, a familiar tune, a tickle, a love note, a memory… But constant bliss… that’s not real.

So, anyway, I just think we should be really, really careful about medicating the depressives, because they could be future revolutionaries and powerful dissidents who we need to lead the changes to our social world
." (see comment #106)

So, first, Vigneault has a theory about depression (kind of like Elaine Showalter has a theory about chronic fatique syndrome, eh? And not a bad analogy, at all, in terms of the effects these kind of ignorant assertions have on other people's lives). And second, she's basically giving the finger to all the people who are so depressed that it's an effort to get out of bed, the people who think seriously about swerving into oncoming traffic to just make it stop. You know, because the rest of us need their pain so that they can lead us. And third, she's saying that if your anger is turned inward, it's your own damn fault: you could control this if you wanted to and were motivated to do so.

One of my favorite bloggers is Heather Armstrong, who has written frequently about her struggles with depression and her near death from it - and the salvation that has come to her from her meds. Recently, she posted a link to her husband's reflections on living with someone with chronic depression. It's funny that I happened to read this just after reading Vigneault's Tom-Cruise-like response on Feministe. Jon points out that people who make these kinds of comments are really, really not helping: "Stop being an arrogant know-it-all. You aren’t right. You are wrong. If someone tells you they need help, your opinion means less than that of professionals. Stop being ignorant. Stop being obstinate."

Vigneault comes to her postions from her own experiences: she is "seriously against anti-depressants myself because of my own experiences with them and how they fucked me up." OK, that's fine - I have zero problem with that, and most people, I would guess, have zero problem with that. The problem comes in when the leap is made from "they didn't work for me" to "they are horrible and don't work for anyone." She says "my opinions about depression come hard earned." Only her opinions come hard earned, I guess - no one else, in the history of time, has ever had a different, valid, opinion based on experience (forget about research).

She also self-righteously defends her position that anti-depressants are universally dangerous by painting herself as a martyr: "Suffering is the human condition. I choose not to medicate." Which again suggests that her understanding of what depression can become for some people is seriously lacking. Again, it's not that there's a problem with her personal choice not to medicate. It's that she is dismissive of everyone else.

Look - I am skeptical when it comes to the medical monster that is our health care and pharmacological system. I have had anti-depressants practically forced on me and refused them all the same. But I would never take my own experience and decide that it is universal and that everyone else is completely deluded, which is what Vigneault is doing here (to a commenter who says that anti-depressants helped them, she replies "I’d argue about whether they really did the trick or if you just believed they did..."

And, to come back to Elaine Showalter - it's really, really uncool to use the term "hysteria" when talking about treatments for depression or about any health issue, particularly one that predominantly affects women.

This is where I was originally going to end this post, but something's been nagging at me. When I read Vigneault's blog and she expresses her frustration with the negative responses she's been receiving to her comments, I have to wonder if she honestly thinks that this is simply an issue of people not wanting to hear what she's saying and therefore shutting her down. I think she really doesn't get that what people are reacting to is not a criticism of "big pharma" or a healthy suspicion of the diagnosis of an illness and the effects of its treatment, but rather the fact that she comes across as determining for everyone else, for all time, that depression is not a mental illness and that anti-depressants cause brain damage and don't work (oh, and also, that therapy doesn't work, either). It's one thing to launch a criticism - it's another to insist that your criticism is valid because everyone else is just like you.

And if there's one thing we know for sure about brain chemistry, it's that everyone is different.

Elaine Vigneault responds, sort of. Here's my comment in response to her:
"Well - it's true that I did not make the reference to Cruise to paint a flattering picture of your argument. I think he was wrong about much of what he said about depression and anti-depressants. However, like it or not, state it or not, you are in agreement with Tom Cruise. He says the exact same things you do about depression and anti-depressants and psychology. So why do you see it as name-calling when I point this out? About the only difference between your two positions is that you focus on social change as a response to depression (when you're not denying that it exists, because the way you describe depression bears little resemblance to serious depression) and he focuses on vitamins and Scientology.

As for proving that depression is a mental illness, as you know (because you mention it), the DSM does that quite nicely, whether or not you choose to agree with it. And yeah, psychology isn't a perfect science, nor is it unbiased. But the fact remains that, according to the professional, expert, and research community that has the qualifications to determine these things, depression is a mental illness, and you can argue this until you're blue in the face, but it won't change this fact. Even you, yourself, say above that "we don’t have a clear understanding of depression and other mental illnesses" - which is true, both in that we don't have a clear understanding of what causes them and how they work and how to treat them, AND in that depression is a mental illness.

But now it sounds, from what you say above, that part of your issue is that you want to be able to say you're depressed without having to also be perceived as disabled or as having a mental illness. Which opens up a whole 'nother area of discussion.

In my post, I did, of course, make other criticisms of your argument - which you have not addressed - beyond the five words that you quoted and offered as an example of how I wasn't criticising your points..."


Dianne said...

"all opinions are not created equal" - I may need to steal that. It made me think of the wonderful quote from Daniel Patrick Moynihan - "you're entitled to your own opinions, you are not entitled to your own facts"

I recently went back to therapy after almost 20 years and for the first time in my long and illustrious life I also felt I needed meds - it was a hard decision to come to, I've always been a just keep moving type of gal but that was exactly IT - I literally couldn't move - it was a physical pain unlike anything I ever felt before.
I still haven't been able to really blog about it - not out of shame - I am who I am and I'll show you me every time - but out of it all still being so new.

I loved this post - made me get started on telling another piece of my story.

oblion said...

Thank you for posting this!!!!

This issue is personal for me, but also just having my psych background from undergraduate years, her analysis leaves lots of room for critique.

I could say so much more on this, but I'll try to limit myself. I become quite irritated when people proclaim medication is horrible when the may not have experienced what it's like to be truly depressed and all other things do not work.

Plain(s)feminist said...

Hi Dianne and Oblion,
I'm glad you liked the post!

I was thinking on my drive home today about something I think is related. Before I gave birth, I was really suspicious of medicalized childbirth (still am). I basically thought that pitocin (they drug they give to cause contractions) was evil, and most of what I'd read in my quest for a natural childbirth described it this way. I had a midwife at a hospital as my birth attendant, and I had a doula, so I felt confident that I would have as drug- and intervention-free a birth as possible.

But I also had a horrible case of PUPPP (a really miserable rash) that left me sleepless during my last few days of pregnancy, and I went into labor about as exhausted as I could be. My contractions began to weaken, and because Bean's head was at an angle, there wasn't uniform pressure on the cervix, which was beginning to swell (not a good thing), and it wasn't dilating properly. I needed stronger contractions to straighten him out. After trying everything else to stimulate contractions, my midwife ordered pitocin (the doctor on call wanted to do a cesearian).

So what I learned from my experience was that there are times when pitocin is necessary, even useful. That doesn't excuse the frequency with which it is given patients according to medicalized pregnancy, and boy, I still have a lot of cricisms of that whole thing. But I did realize that I simply couldn't assume that everyone's experience was just like mine and draw universal conclusions from it.

To be honest, I still have trouble with this - a lot of my feelings about things come from what I've lived. But I think it's really important that we keep listening to other experiences without judging them by what we know experientially.

Elaine Vigneault said...

Here's what I don't understand:
Why does anyone need or want my approval to do something they need or want to do?

Why must I listen to their experiences with how antidepressants saved their lives and they mustn't have to listen to my experience with how antidepressants almost took my life? Really. Explain that to me.

Plain(s)feminist said...

No one needs your approval, just as you don't need anyone else's approval to do anything.

Why must I listen to their experiences with how antidepressants saved their lives and they mustn't have to listen to my experience with how antidepressants almost took my life? Really. Explain that to me.

Glad to.

That's not what happened. You didn't just share your experiences. You declared for all people everywhere, based on your experience, that depression is not a mental illness; that anti-depressants don't work; and that all depression can be managed through self-control (not allowing oneself to have depressing thoughts), exercise, and exposure to sunlight.

Others have shared their own experiences because they are different from yours and thus suggest that your own conclusions are not true for everyone.

Of course, no one is making you listen to any of this.

Ravenmn said...

This discussion is interesting to me. I agree with Elaine on a couple of things: no one understands brain chemistry well and no one understands how anti-depressants work. This is something we can all agree upon no matter what our position.

In my life as a bookstore owner/volunteer, I once hosted a talk by Bruce Levine. I read his book, heard his arguments and encountered activists who believe all drug prescriptions are bad.

There were two issues that these people simply cannot explain nor are they willing to contemplate.

1. There are a lot of people who do not benefit from medications. There are also a lot of people who do. Some of these people are hopeless dimwits who pop pills for any damn thing and probably aren't doing themselves or the world any good by taking anti-depressants. BUT, there are some people whose lives have been saved by anti-depressants. True, our scientists don't know why this happens. True, our society might be able to provide cures for these people if we took care of each other responsibly. But since we, as a society, have not chosen this option, we can hardly cry foul when some people choose antidepressants as a way to survive in this world.

2. Anti-drug activists have absolutely NO answer for people who are endangered by the mentally ill. They have no accounting for people who are a danger to others, like Kactus' husband or my father or any other individual who chooses to cause misery, pain and even death to the people with whom they share their lives. I am absolutely clear that science has no explanation for the psychotic and no cure for their behavior. We do have a responsibility to protect those endangered by this small percentage of humans. If drugs can make a difference NOW, we have every reason to use them until we find another way to solve the problem.

I'm all for telling people to question big pharma and to second guess their doctors' tendency to over-prescribe medications.

Elaine's mistake is in believing that rejecting pharmaceuticals is a worthwhile goal. Until she can provide solace to those who cannot survive without medication or provide protection to those endangered by the dangerously mentally ill, her solution shows a reckless regard for the lives of her fellow human beings.

belledame222 said...

Here's what I don't understand:
Why does anyone need or want my approval to do something they need or want to do?

Um, no, that's not how it works. You say what you please; you don't get to control how people do or don't respond to what you say. Them's the breaks.

RMJ said...

Chiming in much later - this is a really powerful post that's helped me think about mental ableism in the feminist community. Thanks.