Ritalin Vacation

Husband started taking Ritalin in December. This isn’t the first medication related to depression that he’s been on. That honour goes to a medication used to treat incontinence in old ladies that happens to have some kind of anti-depressant side effect. At least that’s what the shrink told husband, which made both husband and me wonder about the wisdom of venturing onto the anti-depressant meds frontier in the, shall we say, less progressive world of British mental health care. (Never mind the bedside manner issues associated with telling a depressed, middle-aged, adult male that he’s going onto pills that help grannies with wee problems.)

Husband and I are both veterans of therapy from our years in L.A. In the great nature vs. nurture debate, his southern California mental health professional favoured nurture, which in turn led her to an anti-medication bias. Her logic was that you need to deal with the underlying issues, not just rely on medication. And so husband dutifully dealt with those issues, putting in hard time on the couch and in group therapy with me. This gave us both awareness and fluency and comprehension of root causes, all of which were helpful and necessary, but only go so far towards managing the damn thing if you’re the person in the thick of it. The problem seems to be that if you are in a very dark place, you can’t muster the will to use skills you may have acquired when you weren’t in the dark place. You may not even be able to get up off the couch.

The depression kept coming back, as is its habit, until finally it got so bad that husband broke with principles and got a prescription. This was not without angst. The abstinence from meds to date had been something of a badge of honour. Husband was dealing with his demons the hard way, rather like I imagine John Wayne would have done it. There were a few things that helped to rationalize the decision, two of which came from our time in LA as zen practitioners. One was the lesson that as soon as you recognize you are standing on a position, it’s probably worth considering get off of it. The second was the memory of a woman priest who practiced with us and was dying of cancer. The pain had become unbearable, but she was wary of going onto pain killers knowing they might make her out of it. The sensai would hear nothing of it, insisting she take the morphine — he called it “dharma-cology” to make her feel better about it. And finally, I realized in a very real, living up close with the demons kind of way that whatever caused what was happening, be it nature or nurture, it was a physiological thing and it made sense that something that has a physiological effect might help.

The incontinence medicine didn’t work out so well. You might not wet your pants anymore but you’ll feel pretty speedy. That’s when Ritalin came on the scene, which is better known for treating hyperactive nine-year old boys than depression. Husband’s inability to focus wasn’t in the pre-adolescent, pogo-sticking around in circles sense. It was more a ‘what’s the point of anything when humans are all shit yet I still need to get this PowerPoint done by noon’ kind of thing. Since it is one of husband’s most life affecting symptoms of the depression, it’s what got treated. And it seems to work.

Which is why it was a surprise when husband informed me he’s decided to take a Ritalin vacation. Specifically he’s decided to forego the meds for the three days per week we’re in the Cotswolds. He says he feels better when we’re out here. There’s something about the fresh air, the peace and quiet, the wide open spaces. I buy this, but I also suspect this experiment is borne out of a lingering feeling that the meds are somehow wrong, and now that he’s found an escape valve from the stress of London he doesn’t or shouldn’t really need them. As Jessica Apple wrote in the FT on the occasion of the 20th anniversary of Prozac: “We may indeed be a Prozac Nation, but one thing remains clear: we’ve yet to come to terms with our diagnosis.”

Earlier in my married life this news would have caused me great distress. I would have been on WebMD scouring the implications and freaking out that husband was making changes to his meds without consulting a physician. But not now. I’m married enough to know any protest would be a waste of energy. He is going to do this experiment whether I like it or not. On the one hand, it’s his body, and he has the right to determine what he puts into it. On the other hand, it is asking rather a lot of me. This means only his colleagues, many of whom he loathes, will be the beneficiaries of the drugs. Surely as the wife I should get something out of this too. He might be the lab rat, but I’m the hamster’s wheel, having to spin like crazy or not depending on the day’s experiment.

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