REPRINTED WITH PERMISSION from South Florida Health, v. 2 (1), pp. 19, 24

I used to be like any other therapist on the subject of psychotropic medication. My rude awakening came one sunny Sunday as my son, then 14, was preparing to visit a friend. “Don’t forget your Ritalin,” I told him, “so you don’t drive your friend’s mother crazy.” “Nah,” he replied, “I’m in the mood to have fun today.” There was that familiar grin on his face. “That’s precisely why you need the meds,” I pointed out. Patiently, and still grinning, he answered, “I can take it if it means that much to you, but I‘ll override it anyway.”

“I can take it if it means that much to you, but I’ll override it anyway.”

What??? I drove the whole five miles to his friend’s house with my jaw on my knees. What exactly did he mean? As I thought about this over the following months and years, I began to understand why antidepressants, antianxiety drugs, and other psychotropic drugs often stop working-or won’t work at all. The answer is a personal thing. In fact, it’s at the intersection of brain chemistry and the soul. Because emotions originate in a more primitive area of the brain than our rational process, they have been thought not to be too responsive to reason.

Therefore, the standard treatment for emotions has up to now been psychotropic medication. However, the neurons firing for emotions, meaning-making, and social relationships all run through the same brain circuits; they interact. This means that emotions are tied to the meaning we place on experience which is, paradoxically, a very high-order brain activity.

Even if emotions are nothing more than brain chemistry, that chemistry is always going to be subject to the meaning we attribute to them. That is how a child who wants to have fun on a Sunday afternoon can “override” his medication. That is how a depressed person can-easily-remain depressed, even with large enough doses of medication to make him lethargic. If the child is prepared for fun, fun it will be. If the adult sees the world as bleak, bleak it will be, medication notwithstanding. So, am I advocating not using medication at all? Not at all. My son has, indeed, been on either Ritalin or Concerta since third grade.

He is 18 now. In fact, he frequently will remind me to refill his prescription “so I can concentrate better in school.” He wants to do well and notices the difference it makes. The important part is that he is not fighting the medicine. On the contrary, he and it are working together for the same purpose. The same thing would be true of anti-depressants or anti-anxiety medication. When people understand what triggers their symptoms and learn to THINK DIFFERENTLY ABOUT and HANDLE DIFFERENTLY the life situations that bring it on, the medicine and their thinking process cam work as a team.

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