Susie and Aretha Bright believe that mother-daughter teamwork is the answer - or maybe the last resort - for your sex advice needs.
Today, "SSRIs Killed My Sex Life"- and "Too Fat For Sex".
susie and aretha's new advice column via jezebel.com
Aretha and I have a few dozen new letters to choose from each week, for our advice column on Jezebel—and each week I take a gulp before I pick my "favorite" to tackle.
"This is going to reap us a world of shit," I suggested, "but if you're up for it, I'd like to answer this letter about losing your sex drive on Paxil."
The letter writer was very interesting, because she asked a medical question: "Why do SSRI's so often suppress libido?"
An exhaustive look through the public library or Google's search engine will reveal to you that there is no clear answer to this blunt question.
Instead, you see hundreds and hundreds of "that's-just-the-way-it-is" references, which seems to be the polite way of saying: Paxil's manufacturer, GlaxoSmithKline, doesn't know the answer— no one really knows. But that doesn't stop a billion-dollar marketing campaign from handing out these babies like M&M's.
I knew that if we wrote a strong editorial about the overuse of SSRI's, a cautionary message, we would be in for a strong reaction at Jezebel, which is representative of a mainstream cross-section of young American women.
Go read the story, so you can follow my post-reaction here…
Jez is a "talkative" blog with a robust group of commenters who are a big part of what makes it so fun to read. They're also a group who won't hesitate to say we're wrong, wrong, wrong. —About anything, but especially a hot-button issue like this.
I predicted the comment section would explode with reactions like this:
1) We would be told we can't criticize SSRIs because we aren't doctors.
2) We'll be told we were indifferent to those who are struggling with suicide and suicidal ideation.
3) The feminist issue of how women have been historically treated for mental health will be largely ignored. It will be treated as if each person is going through this entirely alone, a unique case each time.
4) Our recommendations to explore talk therapy, exercise, meditation, and nutrition will be dismissed as tree-hugging nonsense.
5) The woman's sex problems will be trivialized as incidental to her real problem.
(What I didn't predict was that one person would suggest we were "Scientologists." Wow, they really don't know me).
I remember the first couple of times, in the 1980s, I was asked to come speak at med schools to their grad students and faculty. Overwhelmingly, the students and professors spoke of how sexual issues in a clinic setting were not brought up in their training. They all wanted to discuss, "How do you talk to patients one-on-one about sex and health?" It comes up EVERY day in their practice.
It's clear to me that the 22-year-old female letter-writer we counseled today was given Paxil without any discussion of sexual side effects, without any thorough counseling on other alternatives... because that's how Paxil is USUALLY prescribed. That's the status quo.
Criticism of SSRI marketing and overprescription is not unusual. That's why Aretha and I spent days complementing our story with links to well-written articles, where you could listen to MD's, psychologists, researchers, and patients talk at length about their research. Even the FDA is in on it, now. The criticism has been so fierce in recent years that the pharmaceutical companies are admitting they've suppressed damning evidence.
I have no degree in the "work" I do. I got involved in education and writing because I was an activist and feminist at a time when middle class women were told that they could "take a little pill" and make their anguish go away. Jail for men and mental sanitariums for women; that was the norm. That's changed. Lots more women in jail now.
The idea that knowledgeable journalists, activists, and educators should shut up because they don't have a med school degree is quite disagreeable. There's plenty of doctors who've written much harsher words than Aretha or I did— and there's others who are quite apathetic or in thrall to the pharmaceutical panacea themselves. They're not an undifferentiated mass. We need more knowledgeable critics and public information, not less.
The accusation that I might be callous to suffering probably cuts me the deepest. So to speak.
Suicide not only runs in families, as Laura Miller wrote, it runs through it. I've been devastated by what anguish and despair can do to a person ever since I started losing close family members when I was a child. My quest for knowledge about psychology and psychiatric treatment began decades ago— and it's never stopped.
One of the last critiques I listed is the most embarrassing. In my youth, I thought that all that "clean living" and meditation stuff was wholesome to be sure, but hardly something one would want to RELY on.
I thought you had to be a stone jock, a macrobiotic vegetarian, a Hindu yogi— some kind of extremist— to get whatever benefits were available. I didn't identify with any of those labels. I'd walk outside, take a deep breath of smoggy air, walk back in and say, "I don't' notice a difference." I would have taken the same umbrage that my critics do now— "how dare you suggest these hippie-dippie solutions in the face of suicide and psychosis?"
I never thought of them as the first step in "do no harm."
Interestingly, AIDS changed all that for me— for everyone, really. At the height of the epidemic, when there were virtually no "doctors" or experts to turn to— everyone was broadsided— many became devoted to how to preserve their immune system as best they could under the circumstances.
Although something like yoga was obviously no match for the scourge of HIV, it was startling to see the results of giving one's body every chance at quality of life by treating it with care. I saw friends of mine who were drug addicts or constantly coming down with infections transform their lives. I witnessed loved ones who'd had their fair share of mental breakdowns turn their lives around with… long walks. Breathing exercises. Quiet time. Good food.
Some of them used pharmaceuticals, others herbs, others did combos. After all, what is a drug, anyway? It can be anything. I loved reading Andrew Weil's "From Chocolate to Morphine"--- that was a great book to give Aretha when she was a kid.
I have the most surprising relationship to "my mental health" now. If I can't exercise, in my own Susie fashion, and get my heart rate up, at least every other day, my mood sinks like a stone. My guts revolt if I don't eat right. As you get older, you just can't keep abusing yourself the way you used to. I also drink and take drugs... judiciously, I hope. Even prescription ones. (Where would I be without acyclovir?)
As for periods of calm and quietude, mindful meditation? I really need more of that... especially after I read the Jezebel comments. They get me so over-excited.
I'm going to go send our column to my doctor and my beloved old therapist right now!
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