Mercury and Vitriol

Context: Last month, I posted on Facebook a link to this article (which is quite interesting despite the dismissive title and tagline) about how it may be that antidepressants work not by simply by providing extra access to brain chemicals, but by healing the brain by that is losing brain cells due to chemical imbalance. It mentions in passing that physical exercise can have a similar effect.

A friend (acquaintence anymore, really) reposted it with the comment (paraphrased because she since deleted it), "Not sure I buy it, but interesting. It mentions exercise as a treatment, which more people should do rather than popping a pill because they had one bad day."

Cue argument, as you might expect. She insisted that she knew people who should just go for runs rather than take pills because they weren't that bad but who chose to take pills anyway, with a side of insinuating that she knew what she was talking about because of family members with severe mental illnesses.

I hit many of her fallacies on my side the argument--not all treatments work the same for everyone, regardless of severity of the illness; treating a sudden onset depression in someone with no prior history can be quicker and more effective than starting with exercise alone, as exercise IME works best as a long-term maintenance activity; that unless she was the doctor of these people she knew, she was not intimately familiar enough with their actual needs and history to pass such judgements on the best way to treat their illnesses (with my own side of insinuation that having mentally ill family members didn't make her any sort of expert or not failing in empathy).

But my insomnia-addled brain just now had a couple of flashes of insight about two perhaps more subtle points of her fail. One is that she might think the people of her acquaintence aren't 'that bad' because their medication is, you know, working. The other one, the one I have painful personal acquaintence with, is the utter cluelessness of handwaving the impact 'one bad day' can have. I had a nervous breakdown I may never completely recover from because of one bad day. I'd had trouble for some time and was on slow decline (bipolar disorder: the disease that turns most sufferers into a statistic!), but that one bad day was what broke everything apart.

I know this isn't at all uncommon. People with mental illnesses often get good at pretending-- out of denial, out of not even realizing their mental processes have gotten gravel in their gears, to avoid stigma, and to just get on with life. One bad day with the right kinds of triggers can bring that all sliding down.