Monday, April 20, 2009

Male depression and medical marijuana

Actually, it would probably be effective, but there's a more subtle connection. In the current New Republic Sherwin Nuland reviews a new book, Hysterical Men: The Hidden History of Male Nervous Illness, by Mark Micale, which chronicles just how long it took for doctors and psychiatrists to recognize that men as well as women can have depression and other severe mental or emotional disorders. Serious depression was long called hysteria, after the Greek word for womb, hystera. Properly buttoned-up (buttoned-down?) men couldn't have it. When men seemed mentally unstable other explanations were found. In most cultures of the past, proper men could not have that flighty women's disease.

The story that emerges is that cultural conditioning, except for a few exceptional thinkers, determines what most people are willing to consider as possible explanations for observed phenemona. As Nuland puts it, Micale documents "from approximately the end of the Georgian period until relatively recently, a story in which male physicians have returned to their earlier habit of bringing forth theories of female emotionality and mental frailty based on the close -- and obviously biased -- observation of women, while failing to acknowledge, or perhaps even to observe, that men of all social classes could be shown to suffer from the same ailments. Not from lack of evidence or cases to study did this situation exist, but for a complex of reasons personal and general, ranging from the anxieties of the individual male observers all the way to the growth and perpetuation of a reliable economic and civil order in nineteenth century society -- the political and cultural imperative of a patriarchal structure in which the image of stability and dependability of the rational, clear-thinking male was assured."

In other words, because of cultural/social assumptions, professional physicians couldn't see what was right in front of them, or maybe inside them.

What does this have to do with medical marijuana? Consider the only sentence then-drug-czar Barry McCaffrey ever quoted from the 1999 Institute of Medicine report on medicine and marijuana he commissioned after California passed prop. 215 in 1996: "For those reasons [cannabinoids in marijuana smoke, uncertain delivery of predictable quantities of numerous compounds] there is little future in smoked marijuana as a medically approved medication." Gen. McCaffrey ignored the fact that the report went on to say that until alternative delivery systems were developed patients should be allowed to smoke.

I contend that while there's a modicum of science in such statements, it's mostly cultural conditioning. As I discuss at some length in my book, "Waiting to Inhale," the paradigm of modern medicine includes pills (or shots) that deliver precise doses of single molecules. Within that paradigm smoking an herb seems -- well, so primitive, so shaman or medicine-man-like, so everything we scientists in white coats have moved beyond. There's value in the quest of such precision. But the test of a medicine shouldn't be whether it can be prescribed in precise doses but whether it works. The objection to smoking is far more cultural than scientific or rational.

That's my 420 contribution.

13 comments:

eltone said...

So the people will do what they know as best even though the government (gestapo) will spank us. Even Obama is afraid of the marijuana issue. Good God can't people see that the punishment does not fit the crime? In fact why is it a crime? Certainly not for the well being of the country and its people. WTF people marijuana is non-toxic and non-addictive. It is safer than 99.99% of all prescribed drugs and safer even then aspirin. The legalization of marijuana would collapse the Marijuana Black Market, i.e. crime would go down and our economy would boom just by legalizing a harmless herb that has a temporary psychoactive effect that is not harmful yet this herb can relieve so many symptoms from so many illnesses it is cruel and inhumane, not to mention stupid, to continue Marijuana Prohibition. That's the opinion of this senior citizen.

Call CareNet said...

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Dario said...

In any given year, women comprise the majority of the eighteen million Americans estimated to suffer from depression. One might ask why not typically twice that of women affected, as there are men. Is there a gender bias? Is depression more than a female problem? Are males was also affected but silently, with affective disorder? Gender roles and socialization lead to different symptoms of depression?
According to the prestigious psychotherapist Terrence Real, co-director of the University Gender Research Project at Harvard and author of the bestseller, "I Do not Want to Talk About It: Overcoming the secret legacy of male depression," the manifestation phenotype of depression varies greatly between the sexes. This means that while the depressed women tend to have symptoms such as diagnosis that reveals the social isolation, persistent sadness and hopelessness, mood swings, fatigue, insomnia and appetite changes, depressed men may well present a complete picture different affective disorder. For example, men may show increased irritability, restlessness, episodes of explosive anger, alcohol abuse, erectile dysfunction by taking Generic Viagra, inappropriate social behavior, abuse, and general trends in regard to their relations.

Real says: "Women more often expressed (depression) openly. Men, more often express a secret. Depression is covertly see the tracks of the defenses used by the man from depression." These defenses calls may include issues of race, alcohol abuse, drug abuse or gambling and womanizing, spousal abuse, or even "lazy" behavior.

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