Medication Under Consideration
Posted by fxckfeelings on September 10, 2009
No matter what your illness, medication should never be your first option for treatment. Everything you put in your mouth, from aspirin to spinach, has risks attached, so you should always proceed with caution before you add chemicals to the mix. Then, once on medication, most people are eager to get off it as soon as possible, but that has its own set of risks, as well. If you make your health the first priority, then the choice of whether or not to medicate won’t become risk-free, but it will become clear.
–Dr. Lastname
Before I got treated for depression, my marriage was rocky, but not doomed. I would be irritable and lethargic, which was tough for my husband to deal with, but mostly he was concerned and caring, and he was glad when I decided to get help. Now I’m taking medication, which has helped a lot in stabilizing my moods and keeping the black clouds away. The downside is that my meds have also, surprise, made my sex drive disappear, and this is doing way more harm to my marriage than my depression ever did. My husband isn’t a creep—he’s put up with a lot, and has always been supportive—but I can tell that there’s a distance growing between us. It’s different now that I’m the same old me but not interested in him physically, as opposed to a crying mess who wasn’t interested in him but also couldn’t get dressed in the morning. Is there anyway to not be depressed and not be libido-less? My goal is for both me and my marriage to be healthy.
Equating a happy marriage with a lusty sex life (as does every magazine in the supermarket checkout line) is dangerous, because it directly links the state of your union to something you don’t actually control.
If you could control it, you wouldn’t be writing to me in the first place. More than that, the fact that there are so many sex therapists should tell you how limited your control is (as is theirs).
That’s what the word therapy means in ancient Urdu: doing something that may or may not help for a problem you don’t control but think you should. And if therapy fails, then you’ve got a bad marriage because you’re libido-deficient.
Your goal isn’t to have a lusty sex life (as desirable as that might be); but to make the most of the lust you got, and prevent a biological accident from devaluing your partnership.
Of course, it’s possible that a change in meds could restore your sex drive. On the other hand, it might not, and the new medication might be less effective at controlling your depression (because each and every antidepressant has a relatively high, 35% strike-out percentage), so don’t back yourself into a corner.
With those stats, try another medication if and only if you can afford the risk of switching to a dud. And be prepared to live with a diminished sex drive if that’s what’s required to keep your depression under control.
Compromise, as the therapists say, is a big part of marriage; giving up your medication in order to save your marriage isn’t reasonable, but giving your husband the occasional charity fuck seems pretty fair.
Being the sensitive guy he is, your husband may find it harder to enjoy sex if you don’t seem aroused. But stick to your goal, which is not to make him happy, or even to make you happy, but to separate sexual satisfaction from marital quality and, in effect, make him less sensitive to you and more focused on the big picture.
If the two of you care enough to at least try to make one another sexually happy, that’s what counts. If it doesn’t work, that’s too bad, but it’s not your department. Credit yourself and him for trying and for doing the right thing by your own health and hold yourself responsible for nothing more. And the therapists can shove it.
STATEMENT:
Prepare a statement that protects the two of you from being responsible for the vagaries of sexual chemistry. “Honey, I know my low sex drive disappoints you, but it doesn’t change the fact that you’re a great partner for sex and everything else. We can’t help my lack of libido but you will get more satisfaction if you remember that I love you and that sex with you is pleasurable and meaningful to me, even if I don’t get sexually excited. I’m excited, in a deeper way, by the kind of person you are and the way you stand by me. “Stand By Me” is more important than “I Can’t Get No Satisfaction.” Remember that, and have some sexual fun on me.
Recently, I discovered that most of the dumb shit I’ve done in my life—all the trouble I got into at school, the speeding tickets, the fucking up at work—is probably because I have ADD. As in, I was sitting in the doctor’s office waiting for my girlfriend, reading a pamphlet on ADD, and I answered every question yes (or HELL YES). Now that I know what’s wrong with me, I want to know how I can get medication to treat it. After all, now that I know I’m sick, I should get a pill to make it better, right? Do I need to go to any doctor or a shrink specifically? My goal is to get better.
Here’s an important fact to get out of the way right now: ADD is not an illness. Depression is an illness. ADD is a set of traits that makes it harder for you to do some things, and easier to do others.
As you saw in your pamphlet, the symptoms of ADD include impulsivity, distractibility, and a need for a burst of internal adrenalin before you can focus and learn. So if you’re doing something active where it helps to be spontaneous and unpredictable, like fighting or playing sports or trading or politicking, it helps.
On the other hand, if you need to sit and study and focus on work without fucking up, it gets in the way. Today, everyone must spend much more time sitting and logging-in and studying than ever before in human history, so we have an ADD “epidemic.”
If you expect to control ADD, you’ll give yourself a headache and wind up more frustrated and self-critical than ever, which will add to your distraction. Your mind works the way it works, and there’s only so much you can do to change it. Your goal isn’t to find medication that will change yourself; it’s to manage your ADD traits to minimize their getting in your way.
ADD often makes school a miserable experience, but school isn’t forever. Eventually, school is over and you’re free to look for work and play activities that ADD helps. ADD helps salesmen stay active and engaged. It gives teachers energy and spontaneity. It gives artists creativity. Your job is to find your niche, not force yourself to fit a niche for which ADD is a disability.
How far you go in treating ADD depends on how much trouble you think it’s causing you. If it’s causing you nothing more than embarrassment and a need to work a little harder, then there’s no reason to try to treat it and take meds.
If it’s threatening your job or preventing you from acquiring important credentials, then it’s worth more of your time, money, and willingness to endure risk. Before seeking treatment, do your own risk benefit assessment.
Explore non-medical options first because they have fewer side-effects and risks and, often, lower costs. Take courses or tutorials on how to stay organized, prioritize, build good study and work habits, and counteract distraction. If and only if these non-medical options fall short and you believe improvement is really necessary should you pursue medical treatment. It’s your decision to make, not your doctor’s.
Think of treatment as a trial experiment to be conducted by you on you. You don’t know, before you try, whether it will do enough good to be worth the risk and cost. No, it isn’t very risky, but there’s a much bigger chance it either won’t work, will cause you unpleasant side effects, or both. So your goal isn’t to get medical treatment; it’s to determine whether a trial is worthwhile and then conduct it. That’s your prescription.
STATEMENT:
Prepare a statement to clarify your responsibilities for managing ADD. “I have traits that undermine my self-control and ability to learn and I desperately need to manage them better, if I can. I will continue to look for behavioral techniques and ideas, but I need more and have thus decided that trying medication is worth the risk.”
