On Eye Glasses and Anti-depressants

There’s probably a good chance you’ve heard the analogy of insulin and anti-depressants. But what about the eye-glasses one?

The Diabetes Analogy

On the off-chance you haven’t heard the insulin one, it goes something like this:

Person A is struggling with the decision of whether or not to go on medication to manage their depression. Person B says “if you had diabetes would you be questioning whether or not to go on insulin, or would you just say ‘yup, I have an illness, and there is a medication to help me manage it along with other lifestyle changes’?”

It’s a useful analogy. It certainly helped me when I was struggling with my decision to go on antidepressants. With the all-too-common feelings of guilt and failure and a million other things that get mixed in there. Where the analogy falls short is it’s still not a thing people see every day. When you’re dealing with something with a stigma as overwhelming as it is with mental illness, and layer on top of it that you are talking to someone who is in the midst of a mental illness issue, so their brain is fucking with them already, it can still fall short.

But Now We’re Expected To Just Suck It Up For Everything

I’ve noticed in recent years that the analogy has been shifting to things like “if you had cancer…” because it seems diabetes has become laden with its own stigma and assumptions. Hell, even with cancer some people are celebrated for ‘soldiering through’ without doing radiation or chemo. Our society seems to have developed a strange hero-complex. There seem to be a lot of people out there who think everyone should be able just to buck up and fight all illnesses with the power of their mind.

That’s not the majority of people (I hope), but those seem to be the folks who make a lot of noise and get a lot of attention. Humans have a tendency to gravitate toward negative things anyway, but if you are already in a compromised position and not feeling great about yourself, those negative things are going to feel like all the voices around you. When you’re vulnerable, it starts to feel like that’s how everyone feels and you start to believe it too.
So, the insulin analogy has lost some of its oomph.

The Glasses Analogy:

Enter a new (to me) analogy. The eyeglasses analogy.

I say new, but in truth, it seems to have been floating around forever in the ADHD community. I read it a couple weeks ago and have been thinking about how powerful it is since then. While it seems especially apt for ADHD, I feel like it applies to pretty much all mental issues that can be supported/treated with medication.

In ADHD circles meds get referred to as “eyeglasses for the brain”. I suspect that people worked hard to come up with a great simple analogy because they needed to be able to succinctly explain to kids why they had to take a pill every day when their friends didn’t.

I started looking into this because of a quote posted on FB of someone¹ paraphrasing their doctor’s response when they expressed doubt about going back on antidepressants. It went like this:

“I wear glasses. Can I manage without glasses? Well, yes, probably. I could squint a lot, constantly move up close to anything I want to see, take the bus or a taxi if I want to go anywhere. I could just accept that I’ll never be able to see eagles flying in the sky or whales jumping out of the ocean.

But why? Why try so hard to manage life when I could just put on a pair of glasses? No one would ever suggest a near-sighted person should just work harder. No one would say ‘Maybe that’s just your normal’ to someone that needs glasses. They would say ‘Let’s go to the eye doctor and get you a prescription so you’re able to see again.’

You shouldn’t have to try so hard.”

Now this, this is a fantastic analogy. Not have people virtually forgotten that needing glasses is a disability, but no one thinks that getting glasses is wimping out or giving up too easily. Glasses are just tools you need to function in almost the same way as someone who does not need glasses.

And, I think that nuance of “almost” is essential. Ignoring the whole cost and access issues for a moment, because that’s a whole other kettle of fish, it’s important to realize glasses aren’t a magical panacea that will solve all your vision problems. You will still have to do things to take care of yourself and make accommodations.

Depending on your prescription level, when you take a shower you don’t know if you’re using shampoo or conditioner, so you make accommodations for yourself, most commonly by moving the bottles apart and memorizing where they are. And, who can forget those moments of foggy sight when you walk inside on a cold day. Or, maybe you’ll be at a loss because your asshole kid thinks it’s hilarious to move your glasses from the specific spot you always leave them since unless they’re there, you’re screwed given that you can’t see to look for them (sorry mum…). Plus, let’s not forget the all-too-important regular eye exam to see if your prescription has changed.

Welcome to medication for mental illnesses, including ADHD. I’m going to speak directly to antidepressants because that’s where my experience is. Antidepressants have helped me get to a place where I can do the things I need to do to move forward with my daily life in a relatively ‘normal’ way. They also brought me to a place where I could do the other work I needed to do to treat my depression because they don’t do the job for me. Like eyeglasses, which don’t do the reading for people, or the seeing for people, antidepressants don’t do all the healing for me. They just bring me to the place where I can actually do the work.

The challenge, as always, is with stigma. It’s so pervasive it stops us from helping ourselves. When the world looks fuzzy and are told we need glasses we get glasses². But when our brain feels fuzzy and we’re told medication can help we push back. No one judges your moral character because you need medical aid to be able to see clearly physically, they only do it when you need medical aid to be able to see clearly metaphorically.

[1] Sourcing the quote has been difficult, but it seems it was pretty active in 2015, off of a Tumblr account called http://webreakthenwebuild.tumblr.com/ — This is now an active account, but searching it doesn’t reveal the quote at all, and contacting the current site author has proven fruitless.

[2] I think it’s important to point out that when I talk about access to things like eyeglasses and medication, and diagnosis for that matter, that’s coming from a place of extreme privilege. There are loads of folks who don’t have access to any of these things, and that is abhorrent.