Pull Yourself Together Woman!
Recently media has been awash promoting Mental Health Awareness week and quite rightly so. This has led me to consider and reflect on the actual, real changes in the perception and treatment of mental health, specifically in women.
I grew up in the 1970’s where the use of Valium (Diazepam) was commonplace amongst housewives and mums. The Rolling Stones wrote a song about it, titled, “Mothers Little Helper.” The use of mood altering drugs amongst women was also the focus of the cult classic, book and film, “Valley of the Dolls.”
Ironically the use of drugs to cope with the demands of day to day life was not hidden but widely acknowledged, probably more so than the use of SSRI’s are today. The use of benzodiazepines was normalised due to the widespread use and accepted belief in the benefits. I am not sure if the side effects and potential for addiction was either minimised or not fully understood.
In terms of Diazepam being affectionately named “mothers little helper” my experience as a child was completely the opposite of helpful. I was subjected to, at best, detached parenting, at worst violent mood swings. I can recall my mother having a seizure in a café and also discovering her on the dining room floor, which I now understand is a symptom of withdrawal from Diazepam. At the time this was brushed aside as something that happens when you are “bad with your nerves.”
Interestingly this medication seems to have been targeted at women, specifically housewives and mothers. I am being purely speculative in wondering if this was a response to dissatisfied women presenting at GP’s needing to be anaesthetised them from their mediocre lives and quieten their unfulfilled ambitions. I would be interested to learn if the push on benzodiazepines was a result of an observed increase in problematic drinking amongst women at home.
Something frequently spoken about in hushed tones was, “nervous breakdown.” As a child my interpretation of this was someone melting or dissolving into a heap, therefore being “bad with your nerves” instilled cold fear into me and something I believed only ever happened to women.
Many women were dependant on Diazepam for many years, having many painful attempts at reduction and detoxing with little or no success. As with any substance a tolerance builds therefore dosage needs to be increased to achieve the desired effect. While there was a realisation and acknowledgement of being addicted to Diazepam, I don’t believe there was a full comprehension of what withdrawal and a life without the drug looked like. This resulted in myths and fear about what may happen should they reduce or detox. I have witnessed similar fears of withdrawal, not unfounded, amongst heroin users.
As an adult I learned that I had been prescribed a course of Diazepam at five years old. The thought of a child being prescribed such a risky controlled drug is abhorrent to me. The reason for this course of treatment? My father had died in a car accident, I was experiencing nightmares and was grieving. It appals me that this treatment option was deemed preferable rather than a child processing and expressing the loss of a parent. I understand that doctors had Godlike status back then and their decisions were accepted without question, I also realise I am assessing this with 21st century values and beliefs. I also recognise that as a parent if there was a pill to prevent your child from suffering it would feel like the kindest option. Some years ago I came across some research findings which concluded that adults who had been prescribed benzodiazepines as a child were more likely to develop alcohol addictions. I have often wondered if taking Diazepam as a child had some unconscious influence on my previous propensity to rely on alcohol to manage difficult feelings.
There was a shift in public perception, Diazepam went from saint to sinner if not during the late 70’s certainly in the early 80’s. Thankfully mass prescribing of a benzodiazepine is as bygone as hot ladybird summers, droughts and power cuts.
I am acutely aware that I sound as though I have an absolute aversion to benzodiazepines. This is certainly not the case. They have their place when prescribed appropriately and for a short period. My objection lies with witnessing the suffering and fear that people endure in attempting to disentangle themselves from these drugs. I have also witnessed babies displaying jitters and an inability to be soothed months into infancy as a consequence of being born to mother’s dependant on benzodiazepines. My criticism is not of the individuals who were prescribed these drugs nor the practitioners who naively and recklessly prescribed them but I do take issue with a drug being used to ensure the compliance of women.
I read, “The Female Malady” by Elaine Showalter which relates to women, mental health and the varying treatments from 1830-1980. I found it to be a riveting and sometimes horrifying read due to my ignorance of the treatment of women. Elaine Showalter queries whether women were medicated or institutionalised to quieten their unhappiness linked to desires for equality rather than to treat any mental health condition. Chemical restraints had proved far more effective in psychiatry than the literal, physical restraints of Victorian times. A prevalent theory throughout the book was the belief amongst men that women’s mental health was directly linked to their reproductive organs. There appeared to be many maladies attached to puberty, pregnancy, lactation and menopause. The word ‘hysteria’ originated from the Greek word for uterus. Reading about the many possibilities for insanity in a woman it is a small miracle to me how there were any women free to roam the streets and not incarcerated in institutions. I find it intriguing that when men displayed the same symptoms of hysteria following active duty in World War I this was reframed as ‘shell shock.’
Up until a couple of years ago I misguidedly believed that the primitive practice of ECT had long since ceased to be. Nowadays it is a less reactive treatment and is administered under strict clinical conditions at a specialist centre also patients undergo a general anaesthetic. This doesn’t alter the fact that passing electric currents through someone’s brain, inducing a seizure and altering brain chemistry continues to be viewed as an acceptable treatment for symptoms of chronic and enduring conditions including experiences of trauma.
The end of the 80’s and beginning of the 90’s saw a new kid on the block, Prozac, hailed as the wonder drug. This new breed of mood stabilisers known as selective serotonin reuptake inhibitors (SSRI’s) flooded the western world. There were the inevitable horror stories, however on the whole things seemed to be pretty positive. The difference with SSRI’s was that men seemed to be also taking them. I don’t believe a pill cures all, however I feel they can be helpful in ‘steadying the ship’ in order to purposefully engage in talking therapy.
As part of mental health awareness week I recently posted on social media encouraging people to ‘wave’ if they had experienced stress, anxiety or depression, the response was overwhelmingly positive. The post was shared many times, it reached many, lots of loves and likes and some people ‘waved’ to admit one or all of the above. I felt quite happy about this until I considered what kind of reaction I might have received if I’d asked people to ‘wave’ if they had ever been suicidal, treated as an inpatient or were currently prescribed anti depressant medication. This led me to conclude that we have become more comfortable talking about and admitting to stress, anxiety and low mood but there is still a heck of a way to go when it comes to suicide, psychosis, visual / auditory hallucinations, bi-polar disorder and other chronic & enduring conditions.
Fluoxetine (Prozac) is now being prescribed to women to combat symptoms associated with the menopause, it appears to have less side effects than HRT and is proving helpful with certain symptoms.
This leads me to question if this is progress or a slip back to the 70’s…?