Wednesday, February 8, 2012

P.S. Please Don't Stigmatize Medicine

I recently wrote a response to the central message of Ian Williams' NYT op-ed--that Mormons are hopelessly out of touch with the real, messy world.

But in my response, I didn't respond to one line that bothered me for reasons that go beyond Mormonism.

While ragging on his perspective of restrictive Mormon morality, Williams said "the L.D.S. worldview would positively smother most Americans. It might be smothering most Mormons; Utah's antidepressant use makes it one of the most-medicated states in the country."

Now, this is pretty shaky evidence for condemning a culture. While it's possible that aspects of Mormonism are causing or compounding depression, there are plenty of alternate explanations for why Utah (which is not actually all Mormon, but let's ignore that for a moment) might have a high medication rate. One possibility is that Utah actually does have high depression rates--but because of another factor such as weather or high levels of some recessive Scandinavian depression-related gene. But since medication rates are not the same as depression rates, it's also possible that Utahns are not actually more depressed than any one else, only better medicated. It's possible, for example, that because of Mormon influence, Utahns are more likely to go to doctors for medication than to self-medicate through substance abuse. Or else that Mormons are more likely to find voices that decrease the stigma of mental health treatment, either in official church publications or just through brothers and sisters who are informed about or experienced in dealing with medical depression.

Which brings me to my big problem with Williams' critique: using Utah anti-depression medication rates as evidence of Mormon sinisterness doesn't just stigmatize Mormons. It also further stigmatizes medication for people struggling with depression.

And since there are a lot of people in this country who don't get their very real depression treated because they don't want to show "weakness" or disappoint others' expectations, more stigmatization is about the last thing we need.

I've known and loved many people, Mormons and others, who have been quite happy with their lives and struggled with depression at the same time. Personally, I consider it a great blessing whenever someone dealing with any mental illness can find a medication that works reasonably well for them.

So, Mr. Williams, if you're reading this--next time, could you look up Utah's chocolate consumption rate and use it as evidence that we need some vice instead? ;)


  1. Thank you for adding this! I might also propose that another reason for the increased use of anti-depressants is the higher number of births. Many women struggle with postpartum depression after childbirth and Utah does have an awful lot of moms with multiple children!

  2. I came here through a friend's link on FB, and I've been poking around. I think I'm in love with your blog. Must share with the spouse when he gets home from church tonight :)

  3. Well said, James. Once again, spot on. I'm amazed at how many of my friends have shared your last post on Facebook. It caught me off guard - I was like, wait - how does she know James? Him too? What's the connection? Then I just realized it was because of your fantastic blog post. :)

  4. I have struggled with depression since I was a teenager (which also happened to be the time I was least active; a coincidence I am sure, but at least proof that the Church wasn't what caused it). I didn't seek treatment or do anything about it until my mission, when I spoke with an RM who had started seeing a doctor on his mission.

    So that night I started the process - talked to the district leader, who had me talk to the mission president's wife, who set up the appointments with the LDS Social Services counselor, who ended up referring me to the psychiatrist. This psychiatrist was also LDS - not really relevant to treatment, but at least he understood what being a missionary is like.

    And it helped. A lot.

  5. I think you're on to something. I have numerous Mormon friends who have seen counselors, attended addiction recovery meetings, etc. because they had gone to see their bishop about their problems and he'd directly referred them to these resources. It's something that bishops regularly do. The Church has a built-in structure to help its members get the help they need--not just physical needs but mental health needs as well.

  6. I agree with everything I've read of your so far. And, I am please that you posted this particular rebuttal to the man who used Utah's anti-depressant rate to try to drag it down.

    First off, I would agree with the substance abuse thing; most people I know from home smoke or drink or do other stupid things that make them "feel better". At times, I wish I could join them, but know that's not the right choice for my life, and certainly not for our religion.

    Secondly, THANK YOU for telling him in this post that he shouldn't stigmatize like that. It took me several semesters of very poor grades at the "Y" to finally seek help. Even then, I couldn't go back and erase those experiences; apart from the terrible downward spiral feeling I got, culminating in a total apathy toward just about everything, I wouldn't even want to, because I learned a lot about things otherwise.

    So, thank you, as both a Mormon and a sufferer of depression. Both of those groups need more understanding, and they certainly don't need to be ashamed - of anything.

  7. That you for this insight! I have had conversations about this before with people and you brought up some great points I hadn't though of. I am this blogs newest fan :)

  8. I had the same thought when I read that in his article, but once again, you say it so much better than I ever could! I'm so glad to have found your blog.

  9. I've spent the last hour (thanks to a Facebook link to one of your blog posts) purusing several of your thoughtful, humorous and well written essays. Bravo, James Goldberg! Thank-you for addressing, in a reasonable fashion, the "medicated Mormons" issue. You are officially added to my "blogs that I follow" list.

  10. Well reasoned, James. I'm sceptical though about the need in many instances for any medication, whether self-administered analgesics (alcohol), escape through illegal drugs, or doctors' prescriptions. I've been there. I've taken the drugs my doctor gave me (at my ex-wife's insistence), and it was a disaster. Terrible consequences.

    On the other hand, I've dealt with depression several times since that abusive relationship ended, most often triggered by the loss of all contact with my son, among other setbacks in my life. And I'll say this: What a blessing those experiences have been! Like Joseph's captivity in Egypt, they become the greatest things to happen in my life, provided I don't run from them through drugs or other unconscious behaviour but instead seek the divine purpose in every circumstance. Seek inwardly and upwardly for an end to suffering.

    That's one thing the Church doesn't teach us or explain very well - how to end suffering through enlightenment. We have all the basic ingredients and beliefs necessary, but do we effectively assemble them into something that allows us to transcend pain? To transform struggle into peace? To quiet a noisy, troubled mind and make it an instrument of knowledge, wisdom and Truth?

    The mistaken belief that the Church is everything we ever need might disable some members from the most rewarding spiritual journeys they can ever make - those taken entirely on their own. Without medication.

    (And yes, I well understand that many conditions require specific medications to be effectively treated. I'm talking about "normal" unipolar depression that is the epidemic of our age. I will be accused of being uncompassionate, but the opposite is really the case.)

    Enjoying your blogs!

    (PS my ancestors came from a small town in the former DDR named Rodewisch.)

  11. Another thing that the NYT author doesn't really touch on - antidepressant medication is used for more than just depression.

    Prozac is also a popular ADHD medication.

    The "Mormons are messed up because Utah uses more antidepressants" hypothesis that's been crowed about on exmormon blogs so much is really all kinds of unscientific confirmation bias.

  12. A true journalist shows due diligence in their homework before spewing hearsay as "facts". If Mr. Williams had done his homework, he would learn that the "Mormon Depression Myth" was fueled by an unofficial "study" released in 2007 by "Mental Health America" (formerly known as the National Mental Health Association, however as a private organization NOT endorsed or funded by national government, the misleading name was finally changed). The study was released as an un-official "examination" of US states + Peurto Rico for diagnoses of depression. It was not an official clinical peer-reviewed paper, but was often cited as if it was. Utah was listed as 51st on their scale of depression diagnoses. (Alaska ranked #1 for suicide at the time and many other states were far ahead of Utah on suicide rates and other serious mental health issues, however those stats were not factored into the rankings)

    The media leaped on the Utah depression tidbit like a fat kid on pancakes and spewed the "statistic" out ad nausea while drawing their own (biased and unfounded) conclusion that this ranking somehow correlated with Mormonism. (say what?!)

    1. This "study" was paid by a $2.7 million dollar grant from Wyeth Pharmaceuticals, one of the largest drug manufacturing companies in the world. It was biased from the start with as many holes as swiss cheese.

    2. The "study" was not about Mormons. It did not ever have any indication in their data of how many Mormons, if any, were actually involved. Since early 2000s Mormons are no longer the majority of the overall population of Utah.

    3. Utah does not have Parity Law.
    This is a CRITICAL factor when talking about mental health in Utah. Parity requires Health Insurance to classify mental illness as a medical condition and must cover mental health equally to any other medical condition. Including equality in payment for doctor visits and prescription medication. Parity is Fair, Balanced, Humane health coverage for all MEDICAL CONDITIONS to prevent deterioration and loss of life. Nearly every state in the USA finally has Parity, except Utah. This has nothing to do with the predominant religion, and everything to do wtih a corrupted Legislature heavily bribed by a powerful health insurance monopoly.

    Currently, Insurance companies get to decide willy-nilly how they will cover or even IF they will cover mental health care for Utah. Utahans have not been given a fighting chance to have consistent mental health care. This directly correlates to higher incidence of serious mental illness problems.

    4. No Central Database
    Those who are diagnosed on one insurance plan must see a different doctor and receive a new diagnoses when switched to another health plan which happens often in Utah. The 2007 study counted all instances as separate diagnoses because there was no centralized Utah Health database to merge people to data.

    5. In 2008 a different study was released. The conclusions got little-to-no attention. It was a peer-reviewed study published in a respected medical journal - NIH article #PMC2673327.

    The conclusions clearly state how the LDS FAITH AND LIFESTYLE actually IMPROVES MENTAL HEALTH:

    a. Weekly church attendance significantly lowers odds of new-onset major depression. Attending more than once per week (such as auxilliary meetings or activities) lowers the incidence even more.

    b. LDS individuals know how to talk about their feelings..."culturally conditioned to disclose psychological problems, given that they attend monthly testimony meetings where individuals publicly and extemporaneously bear testimony to their religious beliefs, and how these beliefs have helped them cope with life's adversities and make important decisions."
    Hopefully, I have offered some helpful facts when pondering the "Depressed Mormon Myth". - MoSop



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