Volume 54 Number 10
Produced: Thu Feb 15 5:54:07 EST 2007
Subjects Discussed In This Issue:
Drug abuse (and depression) in the frum community
[Mark Symons]
Drug abuse in the frum community (2)
[Art Werschulz, Izzy]
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From: Mark Symons <msymons@...>
Date: Wed, 14 Feb 2007 23:34:57 +1100
Subject: Drug abuse (and depression) in the frum community
> Russell J Hendel <rjhendel@...> wrote:
> I wish to make it clear that the primary thrust of my remarks was
> directed to depression.
>
> ...there are 3 separate cases to consider.
>
> 1) Preventative: Take 5-6 year olds, teach them to
> complain personally to God in their prayers, teach them to get involve
> in chesed projects, and when they grow up there will be a minimal (if
> any) incidence of depression.
What is your evidence for this? On the other hand, there is good
evidence that loss of a parent early in life, a family history of
depression, increase the risk of depression later in life. Marriage
reduces the incidence of depression in men, not necessarily in women.
> 2) About to go to doctor: Mike might also agree with me that a person
> who was depressed or who was about to try drugs (or who tried it once or
> twice) is advised to try and solve his problems himself -- thru prayer
> and drugs --- prior to going to the doctor.Here I am talking about a
> person "giving himself one last chance" before
> going to the doctor.
Why should going to the doctor be seen as a last resort?
> 3) Already under treatment: How would I deal with a person already under
> treatment for drug abuse or depression...
> I would encourage such a person to start praying and doing chesed
> projects As he improves I would like his doctor to coooperate and take
> him off the medication.
Why is coming off medication regarded as such a positive thing? Too many
times patients with depression discontinue their medication prematurely
and relapse. We don't really know how long a person needs to stay on
antidepressants to prevent relapse. After 1 episode 6-12 months is
considered reasonable, but the risk of relapse continues to decrease if
antidepressants are continued longer. Someone with recurrent severe
episodes may need to stay on medication indefinitely. Depression is a
life-threatening illness through its high risk of suicide. There is good
evidence that various antidepressant medications, ECT (EST),
psychotherapy, exercise, bright light treatment can cure/control
depression. I am not aware of evidence that praying, doing chesed or
chicken soup can also do this.
> ...as the Rambam clearly states "The primary purpose of the Torah is
> spiritual and the cure of
> spiritual problems "
That statement by the Rambam, notwithstanding its clarity, sounds like a
philosophical one, not a halachic one.
> If a person needs a therapist to cure him/herself then he/she has
> contradicted the essence of the Torah ("cure for spiritual problems.")
> On the contrary we must look to the Torah for cures.
That sounds like a big leap from the Rambam's statement.
> if I have improper spiritual habits it is these improper spiritual
> habits that CAUSE the chemical imbalances that
> we call depression. In other words although physical cause was a
> MEDIATING VARIABLE for the depression the ROOT CAUSE was the spiritual
> problems themselves.
Again, where is your evidence for this? Someone who is depressed is
often irrationally guilty, with a sense of failure, both about perceived
failures in their life and about the depression itself. When depressed
frum people hear these sorts of attitudes expressed it just plays into
their guilt as they blame themselves for being spiritually inadequate
enough to cause depression.
Mark Symons
Psychiatrist
Melbourne, Australia
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From: Art Werschulz <agw@...>
Date: Wed, 14 Feb 2007 10:23:08 -0500
Subject: Drug abuse in the frum community
Hi.
Frank Silbermann <fs@...> writes:
> If after taking shots of vodka at a few ferbrengens a college student
> with a tendency towards alcoholism begins to notice a sense of craving,
> how can he _not_ realize that this is a danger sign -- and that alcohol
> is therefore not for him? How does he _imagine_ that people become
> alcoholics?
There are some things that people know in their heads, but not in their
hearts. The strength of addiction is a prime example. "Alcohol is an
enemy that is cunning, baffling, and powerful," as the saying goes.
Moreover (to quote another saying), "denial isn't just a river in
Egypt". Addicts are *very* good at justifying their behavior.
Art Werschulz (8-{)} "Metaphors be with you." -- bumper sticker
GCS/M (GAT): d? -p+ c++ l++ u+ P++ e--- m* s n+ h f g+ w+ t+ r-
Internet: agw STRUDEL cs.columbia.edu
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From: Izzy <izzy@...>
Date: Thu, 15 Feb 2007 04:18:18 -0600
Subject: Drug abuse in the frum community
Thank you.
Frank Silbermann writes:
> I can sympathize with people who suffer anxiety, depression or some
> other psychic pain which they are not able to relieve via their own
> spiritual efforts (and so might choose to rely on a Prozac-like drug.)
Well... I tried Prozac but it tended to give me suicidal thoughts so I
stopped using it (carefully reducing the drug). Alcoholics and drug
addicts react to anti-depressants in strange ways. Most doctors in
general practice will not have experience working with
alcoholics/addicts. I would suggest seeing a skilled psychiatrist, not
for mental therapy but to manage an alcoholic's meds.
> What I cannot understand is why these people would even bother to try
> a harmful drug that is addictive or illegal.
We have a saying in Alcoholics Anonymous... "I don't have a drinking
problem. I have a thinking problem." There is a strange mental twist
that causes the alcoholic/addict to begin with a small, seemingly
harmless indiscretion that builds quickly into a disaster, somewhat like
how an avalanche occurs. But the strange mental twist is to say to one's
self, "This time it will be different," and to say so each and every
time until you think you must be possessed. It is frightening actually.
I find that drug addicts often start out by drinking and then move over
to illicit drugs when they find themselves in a social situation that
suggests doing more. Perhaps telling you how I became involved with
alcohol in the first place would be illustrative.
I was 14 years old. One of my friends had swiped a bottle out of his
parent's wine cabinet. There being five or six of us, we sat in his
backyard and drank it. One might call it "peer pressures" but I don't
recall feeling pressure. We did not drink to excess. However, while the
other kids seemed to mellow, I felt powerful, confident and I was
infused with a sense of well-being that I had never felt before. It was
tremendous! And it frightened me terribly. I vowed never to drink again
until I was 21 years old. I was to break that vow at 20.
I had not done well in University. I had been more concerned with my
social life than with my studies. I transferred to a local community
college. I was ashamed. I tried to renew my old friendships, the same
friends, now adults, with whom I had shared that bottle of wine lo those
many years before. My friends brought over some wine and feeling out of
place and having to admit to everyone of my failure I drank to
excess. The more I drank, the better I felt. All my problems seemed to
slip away.
Perhaps others have done the same foolish thing in a moment of weakness,
but my body was especially susceptible to addiction. If I had realized
it perhaps I could have stopped in time. But I didn^Ňt. Thereafter I
would run to alcohol whenever I felt out of place but rarely to excess.
I met a girl who I thought I would marry but when she rejected me I was
despondent. I spent several nights drinking to excess. When finally I
reconciled myself to her not returning, I decided to stop my excessive
drinking. The next evening I found myself drunk in front of the TV. I
said, "This is silly. I'll stop tomorrow." Yet, the next evening, there
I was again... drunk. I resolved never to drink again, but the next
evening it was the same. It passed through my mind that I might become
an alcoholic, but I was too young. It would take time, I thought.
By 22 years old I was convinced I would not see 23. Only G-d could save
me now.
In a last ditch effort I decided to accept voluntary commitment to
asylum ("Metro" - shudder!). My doctors agreed. "Just a couple of
weeks... for a rest," I remember them saying. I cried. I thought I was
going insane. I went to my boss to tell him where I was going. It was
embarrassing, but I felt he deserved an explanation. He had been good to
me, always supportive when I needed it, or kicking me in the backside
when I needed that too. At the end of my explanations he asked me not to
go into the asylum. He gave me an address. He said he would meet me
there that evening.
I walked into Alcoholics Anonymous. It was like coming home. Those
people thought the same way that I did. They had that same mental
quirk... insanity they called it. It is not insanity in the same sense
that we think of other mental illnesses, but when it came to alcohol, I
was insane. Though I did not believe I was an alcoholic, I wanted to
stop drinking. Luckily that was the only requirement for membership... a
desire to stop drinking.
I have been sober since November 14, 1977.
How do others start?
My daughter came to me after Kiddush one evening. One of her friends was
drinking all of the leftover wine. It seemed excessive. I spoke to his
father, telling him of my own troubles with alcohol starting in a
similar way. I offered to take the boy to an Alcoholic Anonymous meeting
for young people. He agreed so off we went. At the meeting a young boy
spoke with experience and wisdom I rarely grant to a man of thirty. The
boy was 11 years old and he was sober. I hope my protégé learned
something that evening. Perhaps I was overreacting, but if he did find
himself in a bad situation later, he would know where to go.
Why did my 13 year old daughter think to tell me about a friend's
drinking? It was because she knew I was an alcoholic when I was
younger. I had taken her to Ala-Teen meetings (part of the Al-anon
Family Groups for those who must live with alcoholics drunk or sober). I
told my kids what a lush I had been even though they had never seen me
that way. They trusted me to know what to do when they saw the same
tendencies in their friends.
> ... Do such children need to read stories which
> detail the day-by-day hour-by-hour process of becoming addicted --
> instead of just warning them about what happens _if_?
Well, I find that Orthodox (and Conservative to a lesser but effective
degree) try very hard to limit the opportunities for exposure to
excessive drinking. Modeling moderation and demanding strict control,
seem to help a considerable number of Jews as compared to Reform Judaism
which maintains fewer limitations. That is not to say that Reform
attitudes are any different in terms of alcohol consumption, but in a
world where the limits are set by an individual rather than by a
separate authority, it is easier to justify excess.
Nevertheless, while Orthodox alcoholism numbers are low in comparison to
almost any other group it is not zero and probably never will be. We
must help those unfortunates who are caught in this maelstrom. They are
out there and they need our help.
The larger problem is drug addiction where it is difficult to model
behavior for our children since our opportunities to teach moderate
narcotic use are limited to the occasional medical procedure. And it is
difficult to work marijuana usage into a Purim-fest. Know what I mean?
:-) I'm not sure what the best answer is here, except to educate, watch
for any who get caught, and offer help rather than judgment.
Get the kids to help you. They must be told that it is not "ratting on
your friends". It is "saving you friends." But first they have to know
that the danger is real for them. To make the danger real, they need
models. They need to see Jews who are willing to show themselves as
recovering alcoholics and addicts. This gives them two implicit
messages: 1. alcoholism/addiction is in our community and 2. Recovery is
possible. These few volunteers need not be in the immediate community.
Fear of being exposed as an alcoholic keeps many Jews from seeking help.
That is why I changed my name in this forum. It's not because I fear
exposure. I fear that YOU will not seek help because you might believe
that I will expose you. But if I am careful with my personal anonymity,
certainly I will care for yours.
My rabbi saw my posting on this email list and phoned me. "Is that you?"
"Of course it's me!" I laughed.
How did he know to call me? It's because I told him long ago that I am a
member of Alcoholics Anonymous and I have taken him along to AA meetings
to show him what it is about. I am one of those people in the Jewish
community who doesn't mind being out front. But I realize that others
will want to remain in the shadows. Fine. I will be out front. Let them
see me. If this is the worst I must go through it is a small repayment
for my past misdeeds which were many and horrible. No need in listing
them here.
Initially alcoholism and addiction begin with a small failure on our
part, but our continuing usage is a matter of unalterable changes in our
body and a strange mental quirk that sets off an avalanche of
consequences that we are unlikely to stop no matter how hard we try on
our own. In such a case, only G-d can save us. Exactly how that happens
is different in every person, but it must begin by helping each other.
Izzy (not my real name)
<Izzy@...>
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End of Volume 54 Issue 10
