Josh was 21 years old and he was suffering, crying uncontrollably for days on end, feeling utterly lost. “Give me some meds, Doc, please; I can’t take this anymore.” But Josh’s depression, in my mind, was not biologically based. I told him to forget about meds, that the hard work of psychotherapy and spiritual connection would help him much better in the long run. “Give me some meds, Doc, please”, he pleaded. I then told Josh that Abraham Lincoln went through intense depressions, even to the point of being suicidal, and came out a stronger person because of his internal work. And Lincoln didn’t take even one pill of Prozac! “Please, Doc, I need meds; meds!” I looked Josh straight in the eye and explained that many people these days just want quick relief in everything, medications included. “It’s the curse of your generation, and Josh, you’re beyond all that.” But Josh did not accept this. He said he wanted to join with the cursed of his generation. He said that Abe Lincoln was a great man, but times have changed. “Why are you depriving me? Why?” I paused. Josh was desperate. I tried telling him that life is filled with pain and challenges and that‘s how we grow. And now is his chance to look at his real self….. And with that, Josh fell silent. And looked away. In the medical profession we are instructed to listen closely to our patients. And then we need to use our judgment for what we think is best….. …….the next morning, I wrote Josh a script for Prozac. I didn’t mention a word about Lincoln or spirituality or life being difficult. Josh thanked me profusely and then, wouldn’t you know it, in a couple weeks he started getting better. Slowly, steadily he climbed out of the pit of his darkness. Was it the Prozac? Would Josh’s improvement have happened anyway, simply with the march of time? Or was it because he searched inside himself? Trying to figure this all out is why being a psychiatrist is so damn hard and wonderful.
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