Friday, July 01, 2005

tom cruise is right, godamnit.

Well, I certainly didn't expect to end the evening with a sympathetic word for Tom Cruise, who is a fairly pathetic actor and not a particularly likeable person. Granted Peter Bradshaw's movie reviews are always really good entertainment, but his take on War On The Worlds in the Guardian this morning was particularly good value for the Cruise baiting.

"The opening sequence, in which the Earth's crust slowly cracks open in a New York street and sends buildings, churches and cars hither and thither, is undoubtedly impressive, but all Tom Cruise can do is look stunned and smudgy-faced and then run away, to show that it's scary - but also keep looking defiantly back, to show us he's not a wuss. It would be easier for him to run slowly backwards in a sort of Chuck Berry duckwalk of courage. The metal three-legged thingies, when they emerge, emit a deafening synthesised honk in the key of C and zap folk with a death-ray, vaporising everything but the victim's trousers."

Ha ha. But it turns out that Cruise, when not getting engaged to nubile young actresses for publicity purposes (anyone else notice that although he proposed to Katie Holmes 'on the spur of the moment' on the Eiffel Tower, he still managed to arrange a press conference at the same location within an hour of the event?), has been stirring up controversy with what has been labelled a 'ridiculous rant' at the actress Brooke Shields. Shields dealt with her post-natal depression by taking anti-depressents, and has been forthcoming in recommending the remedy.

"Before I was a Scientologist, I never agreed with psychiatry," Cruise told the host of the American 'Today' programme. "And when I started studying the history of psychiatry, I understood more and more why I didn't believe in psychology ... And I know that psychiatry is a pseudo science."

Disputing the effectiveness of antidepressants generally, Cruise said, "all it does is mask the problem." He added, "There is no such thing as a chemical imbalance."

Well, using his ridiculous belief in scientology as a starting point for his argument was never gonna win him any friends, and I dunno whether it's possible to argue that no chemical imbalance ever occurs, but I'm very much minded to agree with him that in a great many cases the use of antidepressents is just a way of putting off underlying problems. I've heard many a story of people who have gone to the doctors, explained that they are unhappy and been given drugs without the doctor thinking to find out that, for example, they had recently suffered a bereavement or have another perfectly logical reason which underlies their unhappiness. So a rare conciliatory wave for Tom Cruise.

"Hi Tom!" (waves)

Incidentally, when Tom Cruise attends film premiers he has his 'people' build him a small ramp on the red carpet so that when he's photographed next to his leading ladies he doesn't look like such a short-arse. I've been thinking of building a similar ramp on my route to the station each morning.

[Update: some futher thoughts in the comments section: just to clarify - I'm not saying that all pyschology is 'pseudo-science', I'm just saying that I'm far from convinced that such a thing as a 'chemical imbalance' is a valid explanation for depression.]


Pete Ashton said...

Um. Surely that's more to do with doctors prescribing drugs to people who don't need them. That's a somewhat different issue to whether or not depression, real depression that cripples someone, is caused by a chemical imbalance.

Anti-d's should be used carefully and intelligently. They are not a cure-all but they do take the edge off and allow the sufferer to regain a semblance of a functional life and to start addressing those underlying problems. They're a crutch.

Tom Cruise is a fucking loon and dangerously wrong about this.

jonathan said...

Making a diagnosis in cases of depression is extremely difficult; while there are plenty of doctors who will talk happily about a chemical imbalance, such talk is based, as Dorothy Rowe puts it, 'on faith, not research'. Of course scientists have never come anyway near identifying what they might call a 'balanced brain'!

Antidepressants do indeed offer an extemely valuable crutch to people who are unable to cope without them, there's no doubting that. But people who take them are subscribing to the view, held by most psychiatrists, that depression is a physical illness that can be 'managed'. Depression will re-occur and have to be re-managed.

Psychotherapists, on the other hand, believe that it is a response to our upbringing and our circumstances, along with our sense of self worth, and offer the idea that it can be overcome.

I know which idea I prefer.

To go back to the idea of a chemical imbalance, Rowe writes:

"the brains of some people who are depressed have been found to have levels of chemical transmitters different from those in the brains of some undepressed people, but no such difference has been found in the brains of previously undepressed people who then go on to be depressed" [Beyond Fear, p. 188].

That's without even thinking about the long-term effects of being prescribed extremely addictive drugs - like tardive dyskinesia (the irreversible brain disease caused by overexposure to tranqulisers).

I'm not saying pyschiatry is bunk; I'm sure it helps some people. Nor that drugs can't help: I think they can offer some short-term amelioration of symptoms. But I suggest that anyone considering their unhappiness books themselves in to see a therapist, rather than someone who will fob them off with mythical comparisons to physical or genetic illnesses!

Pete Ashton said...

While I know it's easy to take the wrong way, I happen to think that depression (and everything to do with the mind) is a physical issue. The brain is a physical thing and like all parts of the body it can go wrong. Whether this is a genetic thing from birth or caused by upbringing and circumstances, it still has a physical result which is that the mind doesn't work as effectively as it could.

I like the leg analogy. Some people are born with a limp, some people get a limp due to an accident, some people develop a limp because they wear bad shoes. They can alleviate their limp by being careful in how they walk and by undergoing physiotherapy, but sometimes a wheelchair will be very useful. Anti-d's are that wheelchair. You don't want to be dependent on it, but if there's no other way to get to the physiotherapist...

No-one really understands what's going on in the brain because it's incredibly complicated (which is why people think it's not a purely physical thing and spout off about "souls" and the like). This means we should be careful about what we do to it, both regarding drugs and non-medicinal therapies.

And above all, while there are people for whom anti-ds are a bad thing that should be avoided, and many for whom they do no good at all, there are countless numbers who's lives have been improved and even saved because of them. Also, you shouldn't confuse tranquilisers with more modern drugs like Paroxetine which are not addictive and, other than some mild side effects, not harmful. They don't just knock you out and turn you into a zombie - they take the edge off and allow you to really take a good look at what's going on in your mind without getting the major fear.

I haven't read any Rowe but I recommend Lewis Wolpert's Malignant Sadness for a more scientific take on depression, notable because he doesn't offer any quick-fix solutions.

(Needless to say I'm speaking from experience here!)

Pete Ashton said...

(Paroxetine is also known as Seroxat or Paxil and has been "in the news" because it's allegedly addictive. It's not. Coming off it suddenly will fuck you up and you need to do so slowly and gradually, but that's not the same as addiction. Within a few weeks you're off with no problems.)

jonathan said...

Hi Pete,

Thanks, I'll think about that and look at Wolpert. I'm still sceptical about the idea of genetic inheritance or a pre-disposition to depression, and indeed the notion of it being a 'physical illness', although I don't by any means want to infer that I consider it less important or worthy of treatment than a more straightforward physical condition! But I appreciate it's a much subscribed to viewpoint...


Pete Ashton said...

Skepticism is good, and like I said, the whole area is endlessly complicated. Even recent leaps in neuroscience have barely scratched the surface of how the thing really works. It's just the whole scaremongering of "you'll get addicted to anti-depressants" and "you just need to pull yourself together" stuff really pisses me off. Especially when it comes from fucking Scientologists! That kind of shit is just going to stop people who need help seeking it, and it's hard enough to get the guts to ask for help when you're a mental wreck who can't get out of bed.

No offense intended of course. ;)

Anonymous said...

...because it's allegedly addictive. It's not. Coming off it suddenly will fuck you up and you need to do so slowly and gradually, but that's not the same as addiction.

Well, what you say is at best misleading. I assume that what you think of as addiction is what is defined in DSM-IV and/or ICD-10. Those definitions most likely do not match what normal lay people associate with the expression "addiction".

Let's for instance use this definition of addiction: "a need for repeated doses of the drug to feel good or to avoid feeling bad". Now, are SSRIs "addictive" according to such a definition?

If you explicitly state that SSRIs are not addictive and yet do not explain that these drugs can give people horrible withdrawal symptoms, which most people will interpret as their being addicted to the drug they're taking, you're just being extremely irresponsible.