We’ve been thinking about people who come to our clinic, say that they are not sure that they have a mood disorder, and they want to try get off of their medications and use dietary supplements to cope with their ups and downs.
We have a lot of interest in the idea of using various non-medication options for managing moods. That’s one of the reasons for this website.
On the other hand, over the years, there have been some worrisome failures (as well as successes) in working with people who are considering alternatives to medications.
What does this have to do with the philosopher, Jean Jacques Rousseau?
Rousseau wrote about the idea of a “noble savage”. His belief was that man living in a purely natural environment was the highest form of human life.
You can wander through almost any art gallery and see pictures that were inspired by this romantic ideal of nature. If you do, you will probably also notice that the pictures don’t have very much in common with the experience of really living in nature. Often, the images are clearly fanciful. Women in delightful pastels frolicking in an idyllic landscape.
Rousseau came up with his view about the desirability of avoiding of “civilization” (the idea of living as a “noble savage”) without any knowledge of the reality of “primitive” cultures. He lived his whole life in upper class society in Geneva, one of the most highly civilized cities in the world. And he never left that environment, despite his many books about the joy of uncivilized life….
The problem with some of the people we see who are intent on using purely “natural” means to deal with their moods is the same lack of realism.
Embedded in the approach some people take is the wish to get away from the realities of depression, and moods that can become unstable and out of control.
Just as Rousseau and his view of nature was really about a rejection of the civilized life that he lived in, without really considering the primitive life he embraced.
We usually can tell if a person is thinking realistically about reducing medications by observing the way they approach the problem. If the person who is tapering down off of medications becomes increasingly less attentive to mood as their medications go down we get very worried. If you think about it, is the opposite of what would be desirable since, as medications go down, the possibility of mood instability increases.
And then if that person wants to come in to see their psychiatrist less often, and they want to stop keeping track of their moods we know that we are facing an unrealistic notion of how to reduce medications. We know, in other words, that this person is intent on embracing a new romantic ideal of “life without bipolar.”
The results can be catastrophic. Two of the handful of folks we know who committed suicide took this approach.
By contrast, people who are really interested in seeing what the smallest effective dose of medications is, will pay particular attention to moods as they taper, will want to consult with their psychiatrist, and are generally well aware that nature’s way can be harsh, as well as beautiful.