The Challenge of Going Off Psychiatric Drugs

> due to the ill-understood nature of the brain,

I think this is exactly the problem. We have a bunch of drugs that seem to work, and we think we know how and why they work, but we're not able to directly measure the problem in those terms. If someone has a bacterial infection, we can culture it and prescribe the correct antibiotic. If someone has a mental health condition, we almost always have to consider the way that it's presenting and make an educated guess as to which drug is going to be effective. It's not at all uncommon for that first guess to be incorrect, which leads to either iteration or a "cascade" depending on the practitioner.

The problem is when the sadness becomes the crippling kind that prevents you from acting to change the situation that's making you sad to begin with. It can be helpful, I think, to take anti-depressants long enough for you to be able to enact positive change in your life.

My wife was taking anti-depressants as she finished up college, then she went traveling, met me while we were both backpacking, we got married, have two kids. She weaned off the anti-depressants while we were engaged. She gets transitory anxiety attacks every once in a while, but she's told me she's never had a relapse of depression. I think she was just bored and lonely and stressed in college -- a temporary situation.

This is all just my personal opinion, i'm not a psychiatrist.

But heck, look at the diagnostic criteria for Bi-Polar,

> The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

That line about "marked impairment in occupational functioning" is a common theme in the DSM. (Hypomania has a lower threshhold, but still involves risk to self) If someone is able to live their life, hold down a job, isn't a risk to themselves / others, then they should be directed to a psychologist or therapist.

Bloody hell, the DSM says this, again and again and again.

In the must be met criteria for ADHD:

> There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

Major depressive disorder, again, with this requirement:

> Cause significant distress or severely impact social, occupational or other important life areas

The diagnostic criteria is pretty on point.

But even so, misdiagnosis is possible. If someone comes in and says that they hate their job and their spouse is abusive, the correct solution is a lawyer / career training (probably in that order?), not a pill!

If someone comes in and says "my life has no meaning", maybe it isn't anhedonia, maybe the activities in their life legitimately aren't of interest to them!

We all feel social pressure to fit in with the culture we grow up with. The great thing about America is, if we don't fit in with that culture, plenty of other culture's abound! But first people have to realize that they can leave the culture they are familiar with if it isn't bringing them happiness.

We all know that one engineer who decided to be become a brick layer, and who is now super happy! Heck one of my friends and old co-workers went from being a preacher to coder!

We all need to realize that laying bricks is just as fulfilling and meaningful as writing code[1] and not being judgmental about people's choice to leave one career behind and go into another.

My masseuse used to be in the corporate world.

One of the best Chocolatiers[2] alive used to work at Microsoft.

Parents, if you kids aren't happy living the upper class lifestyle that you dreamed of when you were working your way up the ladder, then support them doing something else! Tell them that they don't have to live up to your dreams, or fit into the societal image of perfection created by the culture one is surrounded by.

[1] Possibly more so, the bricks are going to outlive 99.9% of code that is ever written, and will likely be appreciated by far more people.

[2] I've traveled to quite a few countries and found her equal, but none that surpass. http://bruggechocolates.com/

Meanwhile I expect to be on my anti-anxiety medication for my life, as my brain chemistry is not going to fix itself.