1) I don’t see a practical difference between legal or illegal substances (including alcohol), prescription or OTC (over-the-counter) substances.
2) I actually believe in the concept of treating mental illness much as you would treat physical illness—I don’t just give lip-service to the concept.
So this means that I readily acknowledge that sometimes physical or emotional pain may be so overwhelming, you might need some kind of chemical pain reliever to deal with it.
Note: Just like headaches or muscle cramps do not necessarily signify "illness" (even if one has a tendency toward such pains), so too emotional pain also does not necessarily signify "illness" (even if one has a tendency toward such pains).
This is another truth that often gets lost in the claim that one is treating mental illness like physical illness.
In other words, I try to be consistent.
However, if someone tries to sell me the beloved psychiatric canard that because mental illness is just like physical illness, then that means that someone must ingest behavior-altering substances for the rest of their lives—substances that even top scientists aren’t sure how they work or what exactly they do, and even doubt their long-term effectiveness—then I will have the same problem I'd have if you'd tell me that you need to take percocet or cocaine or whiskey or even ibuprofen every day to control physical pain.
I will be concerned that there is a deeper issue not being addressed.
Because physiologically and spiritually speaking, there are correlations between physical and emotional pain.
Treating Emotional Pain like Physical Pain
“Mm.” (While thinking, I’m not for it, but having met her mother, I definitely understand. So what can I say…?)
Ditto with the friend who after being continually ganged up on by her husband and his mother while hosting his mother and, after standing up for herself in a calm, polite, yet firm manner, could not fall asleep, even though she desperately needed to in order to restore herself for the stressful upcoming day she knew she faced again with the Dynamic Duo she’d married into: She took a doctor-prescribed sedative.
And I responded the same way I would’ve if she’d said she’d smoked half a joint, treated herself to a couple of martinis, or taken a Tylenol: “Yeah, I understand you. I don’t see anything wrong with it as a one-time solution.”
She doesn’t do it all the time. The situation comes up for her maybe once a year.
I remember a Rav Avigdor Miller lecture in which he helped treat a depressed man by giving him a few shots of schnapps, some cake, and sitting with him to encourage him with words of chizuk and reassurance. And he recommended this technique for similar situations.
Some people will be appalled that the rav would ply the guy with alcohol, and even more so that the rav recommends this.
But I say, “What’s wrong with it?” Rav Miller was very clear that this is an rare remedy (i.e. not once a week nor even once a month; this was a one-time scenario) and he didn’t just fill the guy with whiskey and send him on his way. Rav Miller sat with him. He shared his pain. He offered him support and chizuk.
Believe me, sometimes with depression, just the right “kick” can jolt a person out of it.
If treating a depressed person in a caring and nurturing manner while getting him out of the depression itself by getting him a bit tipsy will get the guy back on his feet, then that is miles better than handing him a prescription for Prozac (whether for weeks, months, or even years) and sending him on his way.
(It goes without saying that if the guy was showing up regularly for some of this “Anti-Depression Treatment,” the rav himself would’ve taken a whole other tack to dealing with it.)
No Medication EVER: The Opposite Extreme
Some say that you should never medicate emotional pain.
Do they say the same about headaches and physical pain?
Again, consistency is important.
If we say that mental/emotional pain and physical pain are the same, then we must actually treat them the same.
So the same goes for if people occasionally take pain medication, whether OTC or prescription. (I’d say the same for illegal pain relief too, but it's rare for people taking illegal pain relief in a measured and sporadic manner; it’s usually to add to the prescription dose they’re receiving. But some people do take illegal stuff because it's the only thing available that works.)
I don’t think people should break the law, by the way. Interestingly, the worst of illegal drugs are often made into prescription drugs in the laboratory. And there is a whole black market of illegal consumption of prescription drugs. So it’s just odd to me that people make such a big deal about drugs only based on their legal status.
What about Herbs, Vitamins, & Other Natural Treatments?
The difference is that with most (though not all) natural treatments, you are actually restoring to the body something it needs.
For example, your body needs calcium.
So if you feel stressed or have physical problems (like muscle cramps), you could have an actual deficiency of calcium that supplements can treat. Ditto with vitamins B, D, Omega-3 (fish oil), and GLA (found in primrose and borage seed oil). Treatments like acupressure and acupuncture actually restore the body to its proper balance by releasing energy blockages and energizing weak energies.
No one is suffering from deficiencies of opium, marijuana, vodka, Prozac, or Tylenol. These things play around with your brain in ways that aren’t fully understood by even the top experts in their fields.
Note: Psychiatrists claim that depressed people suffer serotonin imbalance or lack, and that Prozac fills that balance. Studies seem to show that this is not true, and even if so, Prozac and SSRIs don't seem to be the solution.
And again, what really, really disturbs me about most psychiatrists is their refusal to run a simple test of vitamin deficiencies on their patients. Why on earth would you prescribe expensive medication with potentially dangerous side effects and unpleasant common side effects when all your patient might need is extra calcium or vitamin B12 (as methylcobalamin) or folate (not folic acid) or vitamin D?
Should anemics be prescribed speed rather than iron to up their energy levels?
One psychiatrist cured his patient of OCD with probiotic supplements (and I’m assuming also some dietary changes). Usually, psychiatrists prescribe antidepressants with no goal of curing, but merely to contain the behavior.
And even with herbal remedies, you still have to be careful. (I think many of us tend to forget that the worst illegal drugs are all herbal in origin.) For example, when I was going through an impossibly and overwhelmingly stressful situation with no solution in sight, a naturopath gave me motherwort.
I loved it.
Yet I noticed that if I didn’t take it every day, the feeling of all my nerves being shot immediately returned. Eventually, I realized that the motherwort was not actually balancing my body chemistry, but merely altering it.
(Some herbs do balance you from within as a tonic, like nettle and dandelion and others.)
And so I continued on my quest for a better remedy.
While I am grateful that motherwort enabled me to be a much calmer mother than I would’ve been otherwise and without nasty side effects, it’s no more a long-term solution than Prozac or Valium (which are not long-term solutions).
Later, I read that motherwort can indeed be addictive.
If It Quacks like a Duck...
Yes, I'm sympathetic to the person's pain and trauma that led to self-medicating.
But I ask these questions:
- Does having had too many beers justify your drunken outbursts?
- Does being high justify your mania or the inappropriate things you say or do?
- Does your doctor-prescribed medication excuse or justify the inappropriate and hurtful words cheerfully popping out of your mouth because your doctor-recommended medication has blunted your sensitivies or induced mania?
I personally know people who have terrible attitudes toward their own children and can be rude and insulting while having been on antidepressants for years to treat “chronic depression.”
I knew someone on medication for bipolar disorder who led her children to mock and disrespect her tzaddik husband due to some “temper” she imagined he had. And she did so while on medication.
Drugs of ANY kind do not in any way substitute for work on one's middot and one's emuna.
Probably a lot of you (even if you're taking drugs, whether legal or not) agree with the above statement. But for some reason, many frum people taking these meds do not seem to observe the fundamental obligation of cheshbon hanefesh and working on middot and emuna.
If they feel bad in some way, they seem to assume that it's their illness and not their lack of emuna or faulty middot.
Chemical substances mask or numb unwanted emotions.
(Or sometimes make them much worse, and suicide or homicide ensues.)
So if your decision is to treat yourself long-term with any behavior-altering substance (legal or illegal, prescription or OTC) and thus in a sense say, “I don’t care who I hurt. The main thing is that I need to feel good and guilt-free. My feelings are the only feelings that matter”...then why should anyone respect that attitude?
Honestly, how is that different that an alcoholic or drug addict who behaves the same?
Remedies for Emotional Pain
Covering it up with chemicals does not deal with any problem at its root.
In many ways, drugs make it worse.
So my unprofessional recommendations (which you’re free to take or leave) are as follows:
- Try to avoid any behavior-altering substances, whether doctor-recommended or not.
- Treat the problem at its source.
- If you do occasionally need to take a behavior-altering substance for pain relief, that is okay in my unprofessional opinion, no matter what purists tell you. If you want to say that Hashem put physical pain relief here for a reason, then you can say the same about emotional pain relief.
- Be consistent with your attitude. Examine how you really feel about physical pain as opposed to emotional pain and whether the attitudes propagated in most media (including frum media) are actually consistent and don't contradict each other.
Teshuvah is always possible, no matter how badly you've behaved. And I can tell you about people who've behaved badly on antidepressants for years and are destroying their children.
Yet Hashem loves them too and is waiting for them to take those first baby steps in the right direction.
Note: Recently, I heard a Rav Arush shiur regarding “soft drugs,” and he made the point that smoking pot is like offering incense to avodah zarah. Because this drug, as opposed to other drugs, utilizes smoke and aroma, the rav’s point is clear. Before, I was unconcerned about the rare use of pot for the reasons noted in this post, but I'm definitely rethinking it based on Rav Arush’s logic. Also, it’s illegal in most of your countries, so it should be avoided anyway.
Links referred to in the article:
Acetaminophen Study of Emotional Blunting
Curing OCD with Probiotics
How Prozac Really Works
Treating Mental Illness like Physical Illness: How We Don't and Why We Really Should