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I used to work in a relatively quiet pharmacy in a small suburb. There were prescriptions but there was also some time to enjoy the job and to talk to customers.
People with mental health problems have my sympathy and I try to offer
moral support. As pharmacists we can talk to them about their medication,
but I wonder how many of us do in reality. Earlier this year an article in The Pharmaceutical Journal (8 May, p576) stated that pharmacists are
not generally a source of information about antidepressants and that
they play a limited role in depression. As for schizophrenia, these patients
are forgotten people.
One can tell patients that there is a lag phase before antidepressants
establish their effect and not to join the French Foreign Legion before
this therapeutic response; to watch for side effects like dry mouth and
constipation and if these are troubling them discuss a change of drug
with their prescriber. Also, as we know from studies, we can tell them
that courses of antidepressants should continue for at least six to nine
months.
What really interests me, though, is a couple of non-pharmacological
approaches. The first is a novel idea called bibliotherapy, started in
a library in Huddersfield. The idea is to encourage patients with depression
to read novels, and this seems like a good thing to me.
The second is something that has been part and parcel of my life for
over 20 years. It is a type of meditation called Sahaja yoga. Sahaja
yoga is a pluralistic faith and its founder was Shri Mataji Nirmala Devi.
She was awarded the United Nations Peace Medal in 1989.
When I worked in the pharmacy I used to pass written details of this
yoga, which is without charge, to patients if they were interested. It
helped that regular weekly meetings took place in a town nearby and the
fruit and vegetable shop next to the pharmacy displayed a poster. The details
included a brief outline of some of the vocabulary used — kundalini,
meaning the Holy Spirit, chakras, and brahmandhra, meaning hole to God
at the top of the head. They also mentioned a website, www.sahajayoga.org.uk,
and an Ayatollah’s letter of recommendation. I believe that is
quite a courageous letter if you consider that his reputation might be
impugned by more orthodox views. In Russia there has been medical research
into Sahaja yoga — medicine for a new age indeed.
Something that ties in neatly with both reading and Sahaja yoga is a
quotation from James Joyce: “God spoke to you by so many voices
but you would not hear.” Religions speak through many different
voices and languages and in Sahaja yoga there is a wonderful harmony
and incorporation of different faiths.
James Joyce is a useful lead-in to patients with schizophrenia, especially
as Schizophrenia Ireland names its awareness day Lucia Day, after Joyce’s
daughter, a long-term sufferer. Some critics think that Lucia’s
mental state differed only in degree rather than essence from that of
James Joyce. Carl Jung, the psychologist, famously remarked on Joyce’s
ability to cope with the same problems as his daughter, and Harriet Shaw
Weaver, one of Joyce’s supporters, said there was something medicinal
for the soul about his work. Cascades of light do indeed come from ‘Ulysses’ and
scholarly research continues into his work, including the mysterious ‘Finnegans
wake’. Joyce died before explaining this last work fully and we
must look to the scholars for more insight. The website www.jamesjoyce.ie is a good resource for those interested in Joyce.
I hope I added value to my patients’ prescriptions.
— Contributed
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The
Pharmaceutical Journal