Former University of Manitoba professor Fred Shane says it’s important for doctors to listen to their patients before prescribing psychiatric drugs
Psychiatrist Fred Shane has written a book to help people keep their cool in the midst of chaotic change
Veteran North Vancouver psychiatrist Fred Shane has a friendly demeanour and a great sense of humour, even while raising serious concerns about the widespread use of medications for mental illnesses. During a recent interview at the Georgia Straight office, the former University of Manitoba professor says that 15 percent of middle-age people in North America are on antidepressants. In his view, the situation has gotten out of hand because these pills are being marketed as some sort of “magic bullet”.
“They’re over-prescribed,” he says bluntly. “I think people tend to be kept on them too long. And, of course, most of the prescribing is being done by family doctors.”
Shane acknowledges that many general practitioners are inundated with patients, which creates its own set of challenges. He also suggests that their training “isn’t of a nature where they can really sit down and make a determination” whether or not a patient should be prescribed these medications. In addition, he notes, there’s a tendency for physicians to keep trying different antidepressants if the person doesn’t show improvement within four or five weeks, even though other alternatives, like “talking therapy”, might make a difference.
“I think every generation of psychiatrists are different,” he says. “Now, we’re into the era of the brain. You pick up psychiatric texts, and you see pictures of X-rays and scans of the frontal lobe. You know, it’s very reductionist, because I come from a school where talking to people has always been very important—although I believe in medication in the right situation.”
Shane emphasizes the importance of listening to patients’ voices. And he has written a new e-book, Keeping Your Cool Thru Your Mid-life Meltdown available on the Keeping Your Cool website, which reflects this approach, offering insights into many of the struggles that people encounter between the ages of 40 and 65. When asked why he wrote about this subject, he quipped, “That’s the one that popped up in my frontal cortex.”
Winnipeg-based illustrator Chris Chuckry, who worked on a Marvel comic issue featuring President Barack Obama and Spider-Man, provided artwork for Shane’s book. It opens with a short chapter about a 54-year-old man describing his anxiety over his diminished sexual desire. This is followed by “therapist’s notes”, in which Shane offers his analysis of the situation. From there, he moves on to other intriguing tales covering a broad range of topics. One woman talks about her kleptomania. A man reveals that he’s having an affair in cyberspace with a woman who lives 1,000 miles away. A different patient describes her distress over not having a partner and feeling guilty over her love affair with her sex toy. There’s another section on battered-women syndrome, which is an area that Shane focused a great deal of attention on during his academic career.
He even includes a story about a woman coping with the suicide of her husband, and another tale about a couple dealing with a son who became a lying, cheating drug dealer without a conscience. Each vignette is accompanied by therapist’s notes, offering Shane’s take on the situation.
“I think what I have done may be helpful to a number of people, taking them into the world of the psychiatrist—what happens in that world, in the conversation, so to speak,” he explains.
While he acknowledges the importance of treating mental illness, he is concerned about a growing tendency to “medicalize” human experiences. He says this “fine line” was crossed in the past when B.C. doctors would charge fees to the Medical Services Commission to “treat” homosexuality.
“For many years, it was considered a perversion—disorientation of sexual gender,” he declares. “Here’s a human condition that they turned into a disorder. So I wrote the powers that be. It disappeared.”
It’s a good thing that this was dealt with before a pharmaceutical company could invent a pill to treat it. But don’t get the impression that Shane is always opposed to prescribing drugs. With a laugh, he sings the praises of Viagra, which he calls a “good thing”.
“I will tell you that in Freud’s time, if a guy got Viagra, it would have saved him 20 years in psychoanalysis,” he says with a chuckle.
Follow Charlie Smith on Twitter at twitter.com/csmithstraight.