Don’t Medicate Away Student Angst – Chronicle Higher Ed

Sun, 15 Jun 2003

The Chronicle of Higher Education has published a superb essay by Joli Jensen, a professor of communications from the University of Tulsa. Jensen recognizes the harmful effects of medicating students to suppress their experience of normal, turbulent, and necessary emotions. Hers is a voice in the wilderness that needs to be widely disseminated!

“My students have been told that their feelings of sadness or worry or fear are due to a chemical imbalance in their brain, and that the imbalance can be corrected by drugs like Prozac or Celexa or Paxil. A Newsweek cover story last fall featured a sad-eyed adolescent girl holding a teddy bear, and described an “epidemic” of undiagnosed mood disorders among teenagers. The article quoted a professor of child psychiatry warning parents that moodiness, oppositionality, and irritability aren’t normal teenage traits and should be treated as symptoms of an underlying disorder.

But those traits don’t seem all that abnormal to me, particularly in academe. Frustration, hostility, anger, and resentment, as well as feelings of hopelessness and insecurity, have long been features of our common life. Oppositionality is our stock in trade.”

Jensen asks what is normal and questions why too many people listen "to stories which benefit those telling the stories." The tellers are: the drug industry and their army of psychiatrists and other mental health professionals who function as pill pushers. They follow the Willy Sutton Theory (when asked by a reporter why he robbed banks) Willy replied famously: “because that’s where the money is.” Mental health professionals, taking their cue from psychiatrists, gravitate toward pushing psychotropic drugs “because that’s where the money is.”

The difficulty is that this multi-billion-dollar-a-year business masquerades as a healing profession. But, wasn’t it George Bernard Shaw who said, “The road to hell is paved with good intentions”? Whether the intent is good or not, the profession operates without a scientific basis—merely on the basis of oft repeated, but unproven theories about chemical imbalances in the brain. Psychiatry and the mental health industry lends support to questionable state policies—such as removing children from parents who refuse to medicate them with mind-altering psychotropic drugs.

The practice of prescribing of psychotropic drugs for children is nothing short of non-consensual human experimentation. That’s because the safety of psychotropic drugs for children is the focus of much debate. Though long-denied by the drug industry, a body of evidence demonstrates drug-induced harm from the SSRI antidepressants. In some cases the drugs have induced suicidal behavior. See: Children in Clinical Research: A Conflict of Moral Values. Am J of Bioethics: http://mitpress.mit.edu/journals/AJOB/3/1/sharav.pdf

Recently uncovered evidence about suicidal behavior by children prescribed Paxil (Seroxat) has led the British, French, Irish, and Canadian government to ban the drug for children. Paxil is the most prescribed SSRI antidepressant (others include Prozac, Zoloft); in the US 30.4 million people are prescribed Paxil—many are under 18. See: http://www.wral.com/health/1715207/detail.html Following a request by Sen. Charles Schumer, the FDA is examining the evidence from nine pediatric Paxil trials.

Several astute critics have pointed out that unlike other medical professionals, psychiatry wields extra-legal authority for exerting social control with none of the due process protections imposed on the police.

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http://chronicle.com/weekly/v49/i40/40b00501.htm

The Chronicle of Higher Education
6/13/2003
Let’s Not Medicate Away Student Angst

By JOLI JENSEN

My student told me that she was having trouble in my class because her doctor hadn’t yet found the “right” mood medication for her. I had known something was up because she hadn’t been the delightfully contentious student I had met the year before. This semester she seemed distracted and subdued, and she had been missing class. A few weeks after talking with me, she returned to attending class regularly, but mostly to listen while others spoke. The “right” medication for her, apparently, was one that made her no longer want to argue in class.

A surprising number of my best students are on antidepressant or anti-anxiety medication. Both the student health center and their own physicians prescribe the drugs in response to complaints that seem to me to be normal, even necessary, aspects of young-adult life. None of these students previously felt themselves to be at risk; none were behaving in self-destructive ways. Many were initially surprised by their diagnosis of “clinical depression” or “social anxiety disorder.” Yes, they were feeling self-doubt, uncertainty, insecurity, melancholy, as my best students always have, and as do I, still. But they accept the diagnosis because they find that the medications help them succeed in college, and they are grateful for their newfound calm.

I’m not so sure. Are the characteristics of late adolescence — and of life — being mistaken for evidence of pathology? Do our best and brightest students now believe that they need drugs to handle class? And, in taking prescription mood medication, do they avoid, even stifle, the emotionality and zeal that feed intellectual growth and make the life of the mind worth living?

Good students use college as a time to explore and experiment, to try on different perspectives, and to become different selves. Strong emotions, shifting commitments, and difficult relationships help all of us sort out who we are and what we believe. Emotional upheaval helps us figure out what matters and what doesn’t. But for students focused on productivity, those developmental struggles stand in the way of what they define as academic success. It’s hard to write good papers, study assigned material, join clubs, be a leader, do community service, and build a compelling resume if you are experiencing doubt about what it all means. Existential angst makes it more difficult to do the kinds of things that supposedly get you ahead in the world.

My students have been told that their feelings of sadness or worry or fear are due to a chemical imbalance in their brain, and that the imbalance can be corrected by drugs like Prozac or Celexa or Paxil. A Newsweek cover story last fall featured a sad-eyed adolescent girl holding a teddy bear, and described an “epidemic” of undiagnosed mood disorders among teenagers. The article quoted a professor of child psychiatry warning parents that moodiness, oppositionality, and irritability aren’t normal teenage traits and should be treated as symptoms of an underlying disorder.

But those traits don’t seem all that abnormal to me, particularly in academe. Frustration, hostility, anger, and resentment, as well as feelings of hopelessness and insecurity, have long been features of our common life. Oppositionality is our stock in trade. Another supposed symptom of mood disorder is absorption in particular activities (research? writing?) to the exclusion of an active social life. All the introverts, eccentrics, and productive intellectuals I know have those “symptoms,” as do many lively, interesting teenagers and young adults. Does that mean we are all diseased and need medication? Or that, whether or not we are dysfunctional, we would benefit from taking mood-altering medication?

Much is still not known about the biochemistry of emotion. The neuroscientist Elliot Valenstein notes in Blaming the Brain that there are surprisingly few long-term studies on mood-altering drugs, but quite a few troubling side effects, and even scary suggestions about permanent changes the medications may cause. Nonetheless, drug-company advertisements offer glowing images of confident, restored selves, implying that drugs bring the brain back to a naturally happy state.

Does this matter? What my students (and increasing numbers of my colleagues) tell me is that they don’t really care how their drug works, just that it allows them to function more normally. But who is defining normal? And for what purposes?

Academic life is indeed stressful. There are many good reasons to be moody and irritable. Others may imagine a relaxed and contemplative work environment; we know a demanding, all-too-corporate existence, replete with competition, status anxiety, politics, and chicanery. There is a risk, I believe, in seeking ways to thrive cheerfully, no matter how toxic our situation. If the pills work, we can believe that we, not circumstances, create “the problem.” If the pills work, we may give up the chance to learn from our persistent or recurring melancholy and discontent. If the pills work, we won’t have to think about our collective beliefs that we should publish or perish, or lecture at alienated students, or train graduate students for nonexistent jobs, or be at peak performance all the time.

For our students, in particular, who are in a period of life when they have both the energy and the mandate to question and transform, pills can be a tragic deflection. Not only do the students lose the chance to struggle with what is true and right for them as individuals, but they also quench the discontent that fuels the desire to make a difference in the world. Discontent is volatile, but it is also a necessary catalyst. Our students are being told that their unhappiness is about their brain chemistry, not their situation, and that they should address their unhappiness with medication, not action.

In my media-studies classes, we read social critics who warn about the ways mass culture deflects social change by semi-satisfying the discontents that modernity creates. Many cultural critics contend that we keep going back to popular culture or shopping or work, seeking but never finding what we really need. As Theodor Adorno and Max Horkheimer put it, we are being given the menu, but never the meal. What is especially worrisome is that we don’t even realize the switch has been made; we keep expecting the menu to feed us.

Adorno and Horkheimer’s claim that we are being duped into meeting capitalism’s needs rather than our own usually hits home with at least a few of my most contentious students. They understand that what pleases them right now may not be what is best for them in the long run. Such students can often get their classmates to see how easy it is to fall for stories that serve the interests of those who are doing the telling. This semester, however, the class consensus seems to be “so what if we’re being duped, as long as we’re happy.” Few students argue for the value of “seeing through” myths in order to challenge them and come up with something better. Why make yourself unhappy for no reason?

I’ve always felt a little uncomfortable with my pedagogical role as the skeleton at the feast. Much of my professorial energy is spent getting my students to at least consider the possibility that the very things that give them solace and pleasure — like television and shopping — may not be giving them what they need to lead a meaningful life. Part of my obligation as a professor is to demonstrate the nature and worth of being an intellectual. And I assume that the value of the life of the mind is that it takes nothing for granted without interrogating it for consequences.

So I think that it is our responsibility to help our students become more alert, more contentious, and yes, more troubled. I’m not arguing that medication is never appropriate. Just that it may be given too easily, and taken too unthinkingly. I want students to be motivated to recognize what is absent or being hidden in contemporary culture, and to become familiar with alternatives from the past, and from points of view other than their own. In the end, I want them to seek ways to imagine themselves more as citizens than as consumers.

Unfortunately, many of my students (and colleagues) subscribe to what I’m starting to call “psychic Taylorism.” They are willing — even eager — to trade messy, inefficient doubt and worry for neat, effective productivity and cheer. Just as Frederick W. Taylor, the father of “scientific management,” found ways to eliminate the idiosyncratic movements of individual workers so that they could perform their repetitive jobs more efficiently, my students and colleagues are willing to eliminate their idiosyncratic emotional responses in order to become more resilient and productive workers. But messy, inefficient, troubling angst is the very stuff of creative, productive, challenging intellectual life. It wakes us up. It shouldn’t be medicated away.

Joli Jensen is a professor of communication at the University of Tulsa. ________________________________________________________________

Copyright 2003 by The Chronicle of Higher Education

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