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Is It Me or My Meds?Review - Is It Me or My Meds?
Living with Antidepressants
by David A. Karp
Harvard University Press, 2006
Review by Jo Doran, M.F.A.
Oct 3rd 2006 (Volume 10, Issue 40)

If one believes that words can heal, or that language--and specifically, narratives--can empower a person, then David Allen Karp's goal will be realized in his book, Is It Me or My Meds? This, Karp's latest book on depression, could be seen as the third in a trilogy. In his first book, Speaking of Silence, published in 1996, Karp endeavors to understand how those with depression make sense of their illness. His second book on depression, The Burden of Sympathy, published in 2001, reflects on what causes caregivers to continue to care in spite of overwhelming odds. Underlying the foundation of all three books is Karp's reliance on narrative language and his subsequent ethnographic work carried out through individual interviews. In Is It Me or My Meds? it is easy to see his continuing attempt at meaning making through his examination of the treatment of depressive disorders with the use of psychotropic drugs. This is a complex and complicating issue, both to those who deal with depression personally and to caregivers of those disabled by depression as they work through the ongoing process.

Personal identity, meaning making, and the authenticity of the self are not new ideas, especially to writers. The promise of thoughts brought to life, the ability to name one's feelings, and the continuing attempts to put words to one's imaginations are at the heart of writing. As writers, we are constantly attempting to maintain our own individuality while trying to find a comfortable place, or space, in society. Many of us with disabilities write because of, or through, our emotional pain. Karp is troubled by what he sees as the increased use of psychiatric drugs as a result of "a culturally induced readiness to view emotional pain as a disease requiring medical intervention" (15). This issue prompts several questions: Is emotional pain a disease to be treated, or is it 'normal?' Are we, as humans, meant to experience suffering? What is 'normal life pain?' Should spirituality or religion be enough to work through depression, without the use of medication? And perhaps most important, who decides the answers to these questions?

The voices in this book, those of the fifty individuals (forty adults and ten teenagers) who were interviewed, are those who deal with such questions daily. These are people who continue to ask themselves such questions. These are also voices that we would not hear, were it not for the 'spokesperson' role that Karp takes on. His readers may know of their own experiences, yet rarely, if ever, get to hear others who have similar experiences. His readers may be caretakers who are striving to understand depression from a more global aspect.  Either way, the fact remains that depression is often an invisible disability. Karp's statement that "[d]epression's pain is significantly multiplied when it is disbelieved by others" (52) can be understood by everyone who has ever tried to explain this kind of suffering. Therefore, the idea of "Giving Voice," the title of chapter one, is an apt reference for the desire to help others understand the experience of depression and the complexities of taking medications.

Our society rarely depicts those with depressive conditions as functional, valuable, or valued. "Despite the popularity of biological explanations for mental-illness, as a society we expect people to manage their emotions, and we have very little tolerance for those who cannot" (Karp 104). In addition to inner expectations of the depressed individual are the hopes of caregivers, family and friends, who desire, and sometimes demand, the depressed individual to adjust to social 'normalcy.' In other words, the social view of mental illness impacts the depressed individual's choice to take (and stay on) or abstain from psychotropic drugs. The path to medication acceptance, according to Karp, includes four stages an individual will go through: desperation, experimentation, engagement, and marriage. 'Success' stories involve such criteria as working with an understanding and caring physician, finding a drug that works (hopefully with few side effects), adjustment to or acceptance of loss of creativity, and, perhaps most importantly, the understanding that there is no easy and perfect answer: this is an ongoing process. Consequently, we can 'define' depression as a chronic disability: one that is not always physically evident but, nonetheless, never really ceases to exist.

  To discuss whether a depressed individual should take medicine is a moot point at times. There are many for whom there is no choice, and for these, the questions and struggles usually take a back seat. Karp shares the voice of one individual, a twenty year-old female sociology student who states "Instead of thinking I was becoming inauthentic by taking medication, I realized that I was totally inauthentic when I wasn't taking medication..." (125). Put this way, we could doubt how anyone could question the value of anti-depressant medications. However, it is exactly at this point where Karp's book makes so much sense: disability is individual. What is unbearable by one is manageable by another. What is uncomfortable for one may become an occupation for another. In addition, it is just this struggle to balance and make choices--to take or not to take medications--that is a palpable current throughout this book.

Karp, as a well-read sociologist, professor, and writer who suffers from depression, struggles with these same issues of taking medications in his own life, and he makes no claims to categorize or cure depression. Reading this book is somewhat like sitting outside a door--listening: to participants discussing their experiences, convictions, and struggles. Other 'people' enter (through footnote references): Arthur Kleinman who wrote the very interesting book Illness Narratives; Milan Kundera, author of the beautiful novel The Unbearable Lightness of Being; L. Slater who wrote Prozac Diary; A. Solomon, author of intriguing book, The Noonday Demon: An Atlas of Depression; T.M. Luhrmann, who authored Of Two Minds: The Growing Disorder in American Psychiatry; and many more. Some familiar faces show up for further reading: Sylvia Plath, William Styron, Kay Redfield Jamison, Virginia Woolf, Elaine Showalter, J. D. Salinger, and others. Amidst all of this is Karp's clearly understood voice, talking, sharing, sometimes referring to more scholarly or professional journals, for those who want such readings.

As a holistic and narrative view of some of the troubling ramifications of integrating psychotropic drugs into the lives of depressed individuals, Karp's book symbolizes the spokes of a wheel: a variety of paths, which lead to informative sources that are narrative, poetic, academic, or medical. For those who are looking for 'more,' the references should be referred to. Problematic, with regard to this book, is the omission of an alphabetical bibliography. In order to garner the wealth of references that Karp offers, the reader would have to highlight or write out any interesting authors for further reading. Since his two previous books on this subject contain bibliographic listings, this must be an oversight by the publisher.

One strength of Karp's book is also a weakness. His willingness to approach the question of the construction of mental illness interferes with his "sample [that] is skewed toward those who are more severely ill than would be the case for all Americans treated with psychiatric medications" (17). In a sense, he is dealing with two incongruent issues: that of arguing the value of the self within society's mandate of 'normalcy' and learning about those who need to take psychotropic drugs yet struggle with control, identity, and their own comfort level. 'Cultural conceptions of normalcy' (211) might better be relegated to those who have more choices than Karp says his participants own.

Authors who write about their own disabilities, especially mental or emotional, are often severely criticized by an objective public. How much personal information is enough? Too much? Has the issue been beaten about enough already? In this area, Karp should receive no complaints. Although his short (eight page) prologue depicts his own story of disability by depression and his desire and failure to be free of medication, his voice holds no self-pity. On the contrary, Karp's voice is one we can rely on to show us more than we know, to offer other, informative and intriguing views, and through it all, to hold onto a clear and calm sociological view that neither falsely comforts nor causes despair.

 

© 2006 Jo Doran

 

Jo Doran, M.F.A., is a second-year Ph.D. student in Rhetoric and Composition at Purdue University, where she teaches composition, professional writing, and works as a tutor in the Purdue Writing Lab. Her main research is in the area of language and grief. She has also published poetry in various journals.


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