Tragedy strikes, five children are dead, and a world is reminded that there is no such thing as an easy answer
If you’ve lived in a shoebox the last few weeks, completely oblivious to what’s going on in the world, then count yourself fortunate. And stop reading.
If you do watch the news occasionally, then you probably have already formed your own opinion of Andrea Yates, the Houston, Texas woman who methodically drowned her five children one by one in the bathtub on June 18 – the youngest was six months old and the oldest was seven.
She made a full confession to police investigators, describing in detail how her seven year old tried to run away, how she chased him down, and how much he struggled.
According to investigators, she was like a zombie relating the details, slow and spacey, almost devoid of emotion. There was no anger, no remorse, no fear for her life, nothing. In a state that exercises the death penalty more than all other U.S. states combined, her state of mind – or lack of a state of mind – could have a large bearing on what kind of penalty she can expect to face.
The prosecution has not decided to go for the death penalty, and the defense is leaning towards insanity, based on her own history of mental illness and postpartum depression.
They can make a strong case. Her family has a history of depression. One of Andrea Yates’ oldest friends started to keep a diary of her emotional decline. Yates attempted suicide for the first time in June of 1999, attempting to overdose on Alzheimer medication. As recently as this spring she put a knife to her throat while visiting her mother’s house and threatened to kill herself.
People were afraid she would end her own life, but they were never afraid that she would kill her kids – by all accounts, including her husband’s, she was an attentive and caring mother.
"One side of me blames her because she did it, but the other side says she didn’t because that wasn’t her," Russell Yates, Andrea’s supportive husband, told reporters. "She wasn’t in her right frame of mind. She loved our kids. Anybody that knew her knew that."
For herself, Andrea Yates told police that she thought she was a bad mom, that her kids were developing too slowly – Russell always joked that he wanted a basketball team.
According to the medical community, one out of every hundred women are diagnosed with postpartum depression. One out of every thousand are diagnosed with postpartum psychosis, and an even smaller percentage will actually do something about it, either seeking counselling or some sort of drug therapy until their hormonal balances are restored and they are out of the woods.
Instead of treating Yates like a fringe loon, however, a random stain on the fabric of motherhood, women that have suffered from some form postpartum depression are rallying around her in sympathy. While it’s extremely rare for a mother to go so far as to kill her own child or children, a growing number of mothers – including talk show host Marie Osmond (yes, of Donnie and Marie Osmond fame) and Newsweek reporter Anna Quindlen – admitted that they had at least thought about it. Osmond even wrote a book about it, called "Behind the Smile: My Journey Out of Postpartum."
Democratic Senator Ted Kennedy, not exactly an expert on women’s issues, is even using the Yates case to help push through a controversial "patients rights bill" that would give people the power to sue HMO’s (Health Maintenance Organizations) for prescribing the wrong treatment or medication.
Like millions of other North Americans, Yates was on behaviour modifying drugs. In her case it was Haldol, a powerful antipsychotic prescribed to people suffering from schizophrenia and manic states, and used to control aggressive behaviour. Whether she stopped taking her medication prior to the murders or was somehow taking it improperly is not known at this point.
But it’s intriguing, nonetheless. It’s intriguing to wonder how many people out there are walking the thin line between mental illness and the placid state that passes for sanity, under the illusion of control because they are taking medication.
Eric Harris and Dylan Klebold, the Columbine, Colorado teenagers who killed 12 students and one teacher, and wounded several others, were both on Luvox, a drug prescribed for obsessive-compulsive disorder and depression.
Joseph Wesecker, the man who shot and killed eight former co-workers and wounded 12 others at a Louisville, Kentucky printing plant before taking his own life, was on Prozac – a brand name anti-depressant – at the time.
While these cases are exceptions rather than the rule, it’s clear that prescriptions drugs are not a panacea for our problems.
These days we have an easy answer for everything – we have pills to treat impotence, hyperactivity, lethargy, depression, rage, and stress.
Pharmaceuticals are the recommended treatment in an increasing number of cases, and for the most part they have been effective – although not always in treating the fundamental problem, but in covering it up.
They cheer depressed people up, and slow hyperactive kids down enough to allow them to sit still for 40 minutes in the classroom. They give stressed out executives room to breathe, and calm angry people down. They help men and women out in the bedroom, which enhances self image and helps to alleviate a number of other problems and enhances.
They are a shortcut that is relatively inexpensive for health care providers to provide – the bottom line is important, no matter what else you might believe. Someone could go to three mental health sessions a week for 10 years and never be cured, but will respond immediately to their medication.
Pills also don’t call attention to the shortage of psychiatrists and therapists, or to the sweeping cutbacks to mental health services and studies. More importantly, they don’t require society to look deeper at the underlying issues and social pressures that are forcing people to accept simple solutions to complicated problems.
For example, Canadian doctors prescribed Ritalin (Methylphenidate) almost five times more in 1997 (652,000 prescriptions) than they did in 1990 (138,000 prescriptions). Almost half the prescriptions in 1997 were written for kids diagnosed with attention deficit disorder or attention deficit and hyperactivity disorder (ADHD).
Readers’ Digest Canada is currently hosting an online forum for parents to share their experiences with Ritalin, and with a few exceptions the input has been mostly positive – their kids are getting better grades, they are easier to handle, and they are eating and sleeping regularly.
The exceptions generally have to deal with dosage, effectiveness, a general objection to the casual way they were recommended and prescribed, or the child’s loss of creativity or sense of normalcy. In many of these cases, the parent took their child off the Ritalin, and found a new family doctor.
At the same time, there are doctors and nutritionists that swear up and down that many of these cases could be solved with a proper diet, exercise, discipline and more control over their television privileges. Herbal remedies, acupuncture, spiritual pursuits, and concentration sports like martial arts and gymnastics, have also been effective in many cases.
And not just for attention deficit disorder – there is growing evidence that natural treatments are effective in treating other forms of behavioural disorders and mental illness.
A 1999 Duke University study found that people who took brisk 30-minute walks or jogs three times a weeks recovered from major depression almost as well as those on medication (60 per cent verses 64 per cent). While the long jog didn’t perform as well as the quick fix, the relapse rate for people taking drugs was 38 per cent, verses just eight per cent for people who exercise. Even more surprising, subjects that took medication and exercised had a 31 per cent relapse rate.
It’s probably no coincidence that at the same time that Canadian fitness levels are at an all time low, especially among children, the number of people diagnosed with behavioural disorders and mental illness are at an all-time high.
A Globe and Mail/Angus Reid poll in 1999 found that 10 per cent of Canadians have taken medication to control depression, which can be further broken down to seven per cent men and 13 per cent women. Since most of these drugs were introduced (and popularized) in the 1990s, there are no comparable figures, but the general feeling is that many of these prescriptions are excessive.
According to the UN International Narcotics Control Board’s year 2000 report, "Up to 70 per cent of long-term use of psychotropic drugs is irrelevant and often prescribed for social reasons," i.e. job loss, the breakup of a marriage, low self esteem, teenage angst, and financial concerns – normal causes for depression and anxiety that are hardly new or unique enough to require prescription medication.
Yet Canada is one of the fastest growing prescription markets in the world, according to the Canadian Press. In 2000, Canadians bought nearly 291 million drug prescriptions at a cost of $11 billion – that’s almost 10 prescriptions and $365 for every person in Canada. High blood pressure was the number one reason Canadians visited their doctor in 2000, followed by depression. In 1996, depression was fourth on the list.
Whether more Canadians are depressed, or whether it’s just a case of more Canadians being diagnosed with depression is unknown – it’s likely a bit of both.
We can’t fix the world or get to the root of someone’s behavioural disorders, mental illnesses or emotional problems in the time it takes to digest a pill, but that doesn’t mean we should give up and get prescriptions.
At the same time, doctors aren’t being lazy when they prescribe a drug to handle mental illness and emotional problems – based on the information that’s available, the high success rates and the low risk of harmful side effects, these drugs are the right tool for the job. They also don’t write prescriptions based on the opinions of teachers and parents, but based on their own test results and discretion – if they prescribe something, you should probably take it. But you should also be aware that there may be working alternatives.
Some people argue that the dramatic increase in the number of patients being prescribed these medications is the result of pharmaceutical companies and hospital administrators with budgets. The truth is, however, that even a decade ago many of these drugs weren’t even around to prescribe.
Now that they are here, they are being used to the best of our ability. It just didn’t seem to work well enough for Andrea Yates or any of her five children.
