An Opinion on Medication

Posted on May 1, 2018 by Corbin Humble

Before I share my thoughts on the use of psychiatric medications for mood disorders, let me first clarify my lack of credentials.

Some people think the terms psychiatrist, psychologist and counselor are basically interchangeable, but there are some distinct differences. A psychiatrist is a medical doctor who is an expert in mental health and prescribes psychiatric medications. A psychologist is an expert in mental health with a Doctorate degree. A counselor is an expert in mental health with at least a Master’s Degree. All can provide talk therapy, but only a psychiatrist can prescribe medication and has extensive training in brain physiology, chemistry and the like.

I am a counselor.

So, when I share my opinion on psychiatric medications, it is from the perspective of someone who believes in the power of insight oriented solutions, a belief that changing circumstances and thinking is a means to make changes in a person’s mood and life. My opinions come from observations, rather than education and detailed understanding.

Many of my clients also make use of psychiatric medications, either prescribed specifically by a psychiatrist, or often by a primary care doctor. I have learned a lot from their experiences and insight, as well as by seeing the effects in their lives.

Some people are eager to find the relief they need in medication. Others are very resistant to using medication. I would say my initial attitude on medication was similar to those people who want to solve their problems on their own, by their own will power. Other people are afraid of becoming addicted, dependent or having side effects. It is an unfortunate fact that I have met some people who have ongoing suicidal thinking, depression or other lasting side effects from bad medication reactions.

But the research I have seen suggests that counseling and medication are more effective together than either one separately. I tend to simplify the matter by thinking of medication as something that can make the emotions less raw, and counseling helps people make real changes to their thinking and behavior. If you just take medication, you may feel better, but may not make any real changes. However, for some people, counseling alone is unlikely to be productive if the emotions are just too overpowering. For some people, medications may be like a scaffolding that is put in place while a structure is being built, but then can be removed when the building is complete.

However, for others, there is a legitimate ongoing chemical imbalance that needs ongoing treatment. I witnessed the reality of chemical imbalances when I saw my wife go through post-partum depression. Here was a woman just blessed with a beautiful new baby and she knew she was supposed to be happy, but every night she found herself weeping when it got dark. The doctors predicted it might happen because she had been producing chemicals for two and now suddenly she was getting all those chemicals just for one. And as the doctors also predicted, the depression went away after a few weeks. I saw the very real mood effects of a chemical imbalance. It was not due to external circumstances, my wife’s thinking or anything she had done wrong. She was aware of what was happening, but the feelings were still just as real and just as painful.

If someone had asthma, would you expect them to run a race without an inhaler? Thyroid conditions, blood pressure issues and many other medical conditions require ongoing medical treatment to manage symptoms, so should there be any shame in needing medication when there is a legitimate chemical imbalance? Do we expect people to just will power themselves through slipped discs or vertigo?

So, sometimes medications are in order for long term chemical imbalances and sometimes they are just temporary aids while people make the necessary underlying changes via counseling. Sometimes people are unsure which is the case. I usually just trust each person’s judgment. I have seen cases where people weaned off of medications as they made progress, but I always suggest this be done under advisement of a medical doctor. I have also seen some people start without medications and when they have thoroughly addressed their thinking, behavior, beliefs and circumstances and they still feel depressed or suicidal despite no discernible reason, then they usually feel satisfied that they have done their due diligence and a medical approach is in order.

At the end of the day, I just generally encourage people to stop worrying about the stigma and pressure about what others think they should do, and instead trust their own judgment about what they need.

13 Reasons Why – I Killed Hannah Baker

Posted on May 10, 2017 by Corbin Humble

This is my spoiler filled blog about the Netflix show 13 Reasons Why. If you want my review without spoilers to decide if you should watch, then click here.

Ok, at this point I am assuming you have seen the show. This blog post is part of my process to unload the burden it left on me. Perhaps you have a similar feeling.

First off, let me say something about this post. I have decided that I may edit it for grammar or spelling, but I will not go back through and edit it for content. This is a flow of thought exercise in being vulnerable and real. So forgive me if it is a bit of a mess.

We’re all a bit of a mess. That is part of the point of the show. And how do we go on with that knowledge? As the show points out, one of the things that keeps us separated is that we are always curating our identity. Anytime I write a blog already scares me because I am putting myself out there to be critiqued by everyone, but at least I usually have some security that I can reread, revise and edit to make me look more intelligent or avoid saying stupid things.

Not today.

Oh, by the way. I killed Hannah Baker.

Ok, so that was a bit corny. I gave in to the urge to try to come up with a clever, click bait title. I’ll try to keep that to a minimum. No clever organization of this post into 13 Reasons Why we should be better to each other.

But seriously, I’m a counselor and I totally identified with #13 Mr. Porter. When he was talking to Hannah in episode 13 I just so desperately wanted him to shut up. I knew if he would just listen and be present she might be able to connect and heal.

And yet, what I am doing here is trying to model honesty and vulnerability, and to do that, I have to admit that when I listened to Mr. Porter talk, even though I knew he was missing the mark, I had the gut wrenching concern that I could make that same mistake so easily. Perhaps I have. I have been counseling for over a decade and have seen many suicidal teens, but to my knowledge none have committed suicide. To my knowledge. And that could just be luck. Ugh.

I had a professor in my Master’s Program that told me about the Imposter Syndrome. The idea that even professionals, doctors, professors, most adults secretly feel that they don’t deserve to be where they are. That if anyone really knew how out of our element we are, we would get fired, run out of town or worse. And the idea is that this inadequacy and secret shame is extremely common, if not universal.

When I watch Mr. Porter in episode 13, I figure everyone else sees him and thinks how terribly unfit and poorly trained he is, but I see him and think that could be me. I mean, the questions seemed reasonable. He had good intent. He wanted to help, but was focused on the problem and not the person. I’m sure I have done that before. It’s a pretty common fear.

There are so many, many things I could talk about at length regarding this great show, but in order not to bore you, I just wanted to try to stay focused on the communication barriers in the show. How many times did you just want to scream that they should just say something. Just say how you are feeling! Just say what you are dealing with! Ask for help!

But this wasn’t some annoying sitcom device to perpetuate tension. This was an in depth analysis of the things that keep us quiet. Netflix included a 30 minute follow up that I highly recommend. In it, they remind us that the teens aren’t just being difficult; they seriously lack the skills to express themselves. I don’t mean to offend any teens here with this statement, but it is simply a fact to accept. There is no shame in accepting that you are where you are in the process of learning those skills.

Listen to adults talk about High School. They usually explain how they “survived” it. But when we think back on it, we think about it with the benefit of all the skills we gained and so easily forget that you are just now learning them. We also often forget that things really are so much different now.

Ok, jumping around, but upholding my promise not to edit, how do we help teach those expression skills? Well, that is what I am doing now. I’m modelling by being vulnerable and present now. I’m muddling through. I intentionally avoided reading any other reviews or commentaries on this show. I did not go do research on all the signs of depression, grounding techniques or the expert opinions on suicide. All those things could make me look more like I know what I am doing. But they also come across as clinical and detached. Don’t they?

That’s not to say they aren’t important. That’s not to say that other people do not have better things to say than me. But I’m here. I’m being me. I’m muddling through. That’s all we can do.

That is all we can do.

And it is enough.

Perhaps you don’t even know why I’m acting like this is a thing. But I’m honestly choking up now. And that’s embarrassing. Being real is so foreign that we don’t even realize how rarely we do it.

What if I decide that what I think I have to say is worth saying? Isn’t that arrogant?

What if I encourage people to be honest and real and they can’t handle it? What if my words lead to someone else’s pain? Then aren’t I responsible?

I’m trying to build a business and if I make a fool of myself in this blog, will I still be able to provide for my family? Why take that risk?

I took note really early on in the show, that while we so quickly may think the teens should have communicated more, look at the adults. Lawsuits, businesses, jobs at stake and rules quickly exerted just the same amount of barriers to communication for the adults as it did the teens who worry about reputation, consequences and future.

I liked what one of the producers in the show said during the follow up. It was something along the lines of, “It takes an immense amount of self-determination and strength to stand up and act in that 15 seconds where it really counts.” (That’s not a direct quote. I don’t feel like stopping to research it. Let’s muddle forth!)

And that’s one of the key things to take away from this show. It is so easy to judge where other people fail, but all it takes is a moment of fear to keep us from acting before it is too late. And aren’t we all guilty of that? Haven’t we all killed Hannah Baker?

Ok, sorry, corny again. But it is an excellent phrase to capture the fact that we are all guilty, all capable and all responsible for a life full of moments where we failed to connect, communicate and help people.

And the alternative is to do something. To muddle on. To get messy, make mistakes and do better. You have probably heard it said that you don’t have to have it all figured out, but did you assume the person saying that DID have it figured out? I bet you did. But the reality is, anyone who says that is equally trying to help you have the courage to keep going just as much as they are reminding themselves.

There I go getting choked up again. Oh well.

So, if you want to be the hero of the story, you have to realize that you have to do something in that 15 second window. You won’t have a warning. It will be scary and uncomfortable.

Just. Do. Something.

And, you won’t. Sorry. You won’t. You’re going to fail. Oh well. Or maybe you did something, but it was wrong. Oh. Freaking. Well.

And keep trying. Dangit! Tears again.

Yeah, you may have noticed I don’t cuss. I have my own reasons. Let’s not judge each other.

And you take a deep breath and keep going. It is ok.

Just like when Tony and Clay climbed the hill. Tony explained, “You wouldn’t have died. You might have broken a lot of bones, but you wouldn’t have died.” (Again, imperfect quote). Now, I dunno. He might have died if he had fallen wrong.

Anyway, that’s what you have to do. Take risks. Muddle through.

*****

I got interrupted writing at this point and did not get back to finishing for a week. And all week I wondered if I should post this. The fact that I admitted getting choked up when trying to be motivational is so embarrassing.

I remember a Sunday School teacher who was telling us how much he cared about us and getting teary eyed. We were all uncomfortable and thought something was wrong with him. I think that memory simultaneously scares me about showing emotion and modeled for me that it can be done. So, now 25 years later, I’m doing the same thing.

Here’s what you have to remember when you take emotional risks, or any risks in life.

If you do anything that matters, then someone will be upset. The only way to never upset anyone is to never do anything worthwhile.

So even if you are afraid, take a chance to express yourself with trusted friends and family.

Some may criticize 13 Reasons Why, because it may prompt some to suicide. You will hear about this when it happens. But, you will probably not hear about the countless lives saved and people who treated each other better because of it.

The alternative is to be afraid to talk about suicide. To be afraid of speaking up. To be afraid of connecting with people. If you play it safe and fly under the radar, you may never feel the pain of mistakes, but you’ll be guaranteeing that you will miss out on unknown opportunities for helping, connecting, growing and saving lives.

Fear and inaction killed Hannah Baker as much as any other reason.

So, I’m going to take a chance and post this.

13 Reasons Why – Should You Watch?

Posted on May 1, 2017May 1, 2017 by Corbin Humble

This is a spoiler free blog about my opinion on whether people should watch “13 Reasons Why.” My spoiler filled thoughts will follow soon in a separate post.

As whispers of controversy about the new Netflix show “13 Reasons Why” began to arise, I started to get questions from parents, young adults and teens as to whether I had seen it or what I thought about it. The people I visit with wanted to talk about the details or were wondering if they should even see it.

I had seen the description while perusing Netflix so I was aware of the plot. A teenage girl commits suicide and leaves tapes explaining why. I made a couple assumptions at first sight.

This is the kind of show that people are going to form strong opinions on without even seeing.
It will probably be very difficult to watch.

I still stand by those assumptions. The well founded fear that it would be hard to watch kept me from it for a while, but as people brought it up more and more I decided that I needed to see it for myself so I could be educated on a topic relevant to the people I care for. So, last Friday night I started watching and on Sunday I had finished. I binge watched because I had to know how it would end.

There were a lot of questions and concerns that I had before watching that I want to clear up for anyone else considering it. I don’t consider these spoilers.

Q: Is it worth watching?

A: Definitely! I’ll just get this out of the way now so you know where I am coming from for the rest of the review. I’ll discuss triggers and safety concerns later, but for the most part I think everyone that can watch this should watch it. If you are a parent, teen, young adult, teacher, counselor or have anything to do with teens, then it is an extremely valuable insight into many serious but rarely discussed issues related to teens.

Q: What kind of content will it have?

A: The show is rated MA and for good reason. It addresses some heavy stuff including suicide, bullying, death, sex, grief, violence, rape, drugs and alcohol. But the important thing to consider here is that those are very real issues that need to be addressed and addressed honestly. The show is graphic but not gratuitous. There are several scenes that are difficult to watch, and the producers admit they were made intentionally uncomfortable. As I said, it was difficult to watch, but it always had purpose.

To be more specific, there is no frontal nudity, but several sexual situations and bare butts. There is extensive vulgarity throughout the show. There is nothing I would consider gory or excessively violent, but the suicide is depicted clearly without fading to black or anything to spare the viewer. Drugs and alcohol use are prevalent. Again, I firmly believe that everything included is included for the purpose of authenticity and connecting the viewer with the pain and stresses of the characters’ lives.

Q: Will this have a realistic ending? *Minor general spoiler*

A: For all I knew, this would be some sci-fi show or have a supernatural twist ending. I was worried throughout that it was going to have one of those “it was all a delusion” type endings, or that she would not really be dead. I was immediately enthralled in the show and found it haunting, but in a very real way, and as I grew to appreciate how good the show was, I dreaded that it might have an awful ending that ruined the whole experience. Let me say, it of course could not really be a happy ending, but it was a satisfying, realistic ending.

Q: Will it glorify or romanticize suicide?

A: No. One of the many morals of this story is that understanding a behavior is not the same as excusing a behavior. This show is an exploration of all the forces that could lead someone to commit suicide and it challenges viewers who may be quick to say they would never do it to consider what if every anchor that kept them grounded got taken away. One of the reasons that the suicide is graphically depicted is so that it is seen for exactly what it is.

Q: Will this show encourage or lead people to commit suicide?

A: Probably.

What? Didn’t expect that answer? Well, one of the many things the show encourages is honesty. And doing something. Let me clarify my answer. There are enough hurting people in this world, that odds are, someone will take this show and find in it some reason to tip the scales towards suicide. And that is tragic beyond my ability to write. Some would say that this possibility alone should get the show banned. But I firmly believe that the show will save so, so many more lives. To even weigh human life like that seems so awful that most just avoid the conversation altogether. You can’t be wrong if you don’t have an opinion. But that is one of the biggest points of the show, you can. Not doing anything is possibly the worst and most common mistake. The show models its own point. It is not afraid to try to help.

Q: Will I be able to watch this?

A: I don’t know. If you have experienced suicidal thoughts, the suicide of a loved one, sexual assault or other traumas then you should consider not watching it. There is no shame in recognizing what you are not ready for. Don’t let curiosity, the fear of missing out or perceived weakness to put you in a position to be re-traumatized or worse. It takes strength to accept that you have limitations and take care of yourself. Perhaps some counseling, time or learning about grounding techniques will prepare you to watch it someday. For some people it could be very therapeutic, but it might be wise to have a trusted friend watch it with you or on standby. Perhaps you should pace yourself.

If you are not worried about being triggered or traumatized, but just wondering if you will be able to handle some of the material, let me say that it is paced well in the show. The main character struggles with his own inability to listen to the painful stories. About halfway through, there is an episode that serves to renew strength and hope to persist in the process.

This discomfort that you may want to avoid is a key element of the show. On the other side of that discomfort is the ability to connect with people, help them and heal yourself.

Q: Should parents watch this with their teens?

A: My daughter is only 4, but if she were a teen I would watch it with her. If you have the kind of relationship with your teen where they would agree to watch it, be prepared for some awkwardness. Perhaps you should even watch it alone first to be prepared. Still, it could be an invaluable conversation starter.

However, I think a lot of teens would not want to watch this with their parents. The disconnect between teens and adults is a common theme. So if they do not want to watch it, do not pressure them. That attempt to control and force them to share with you is one of the things that builds up walls. It is of course understandable to want to do everything you can and be willing to upset them in an attempt to save your precious child, but one of the hardest things to accept is that you can not control your teen. Trust and respect are one of your best bets at fostering a relationship where they can actually talk some day.

Q: Should teens watch this?

A: I watched this as a man who was socially awkward in high school two decades ago, as a parent, as a counselor and as a human being. I found it useful for all those roles to give me a greater understanding of others and myself.

And understanding is one of the things this movie offers to teens. Another key theme in the show is the confusion and inability to express emotions that so many teens struggle with. This is one of the reasons I said before that I believe this show will save lives. Being able to see the whole story, being able to feel like you aren’t alone in your struggle and hearing the characters muddle their way through their feelings are invaluable tools to help teach teens how to make sense of their own experiences. For some, especially those who have secret traumas, this show may be the only source of guidance they feel safe enough to allow in their lives.

Conclusion:

As I said before, anyone who can watch this should watch it. The show depicts very realistic, in-depth human characters. They are all flawed, and their fears and concerns are universal. The show explores how easy it is for our baggage to cause pain to others and keep us from connecting with each other. The relationship dynamics are spot on. The show is clearly an act of love, done tactfully, respectfully and perfectly.

And remember, In case you missed it before, understanding allows us to connect with people and it is not to be confused for excusing or justifying their behavior.

So, anyone who wants to be a better person should challenge themselves to watch 13 Reasons Why and allow the difficult experiences and the authenticity of the characters to help move them toward a greater understanding of a whole constellation of issues relevant to teens.

One last tip: The soundtrack is excellent. Be prepared to hit the button to continue with the credits so you can sit with the music and decompress a while before it fires up the next episode.