Advice from the Trenches: I Need a Pill!

Dear C and Dr. B;

I’ve got a very high stress job. I know many people do, but recently the stress has gotten got to Red Alert; there’s been a lot of competition for a promotion that’s coming up for senior manager of my division. I heard today that I’m one of the three finalists and I would really like the promotion because it comes with a sizable raise. My problem is that trying to beat out the other two is going to be tough. The new position will be requiring a lot of overtime and the other guys are single and don’t have a 4 month old daughter at home and a wife who really needs help. To edge them out, I’ve been pushing myself to put in more hours than I really have energy or time for, and the additional stress is keeping me up at night and lack of sleep is dampening my mood overall. I’m losing the edge I need to win.

I went to my doctor and asked him if he could give me something to help me, and he didn’t think it was a good idea to just write me a prescription. First, he sent me to a shrink for a consultation. The shrink gave me advice — I need to learn some coping skills. He outlined some exercises for me to work on. He won’t give me anything. What the hell! I don’t have time for that, I don’t need another job right now. 

I am going to see another doctor my friend told me about who wrote him a prescription, no problem. My wife says I should listen to the shrink. What do you think?

Rocky 13

Dr. B says: There are always doctors who will prescribe drugs for everything; it’s the easiest possible fix. However, the easy answer may be the one that you want to hear, but it is not consequence free. The idea with any prescription is that the benefits of the drug outweigh the possible risks from side effects. Because of this, a good doctor won’t let a patient strong-arm them into prescribing treatments that are silly and inappropriate for that individual’s condition. For example, today I had a patient who weighed 400 pounds and wanted to undergo the medical procedures necessary to transgender. His family doctor was giving him estrogen, which, from a medical standpoint, is ridiculous – the #1 risk from estrogen is a heart attack and the patient’s weight was already risk enough!!!

If you are having problems sleeping, pharmaceuticals aren’t a good idea. If you take sleeping pills when you are running on empty, this also increases your risk of death. They aren’t meant for long-term use. You can get sleep rebound and end up driving into a wall like Patrick Kennedy did. 

Listen to your own doctor, he sounds like one of the good ones. 

C says: Last week, I was at dinner with family and friends in Taiwan and the topic of American treatments for depression and mental illness came up. My grandson shouted, “Take a pill! Take a pill!” in imitation of the US attitude toward any illness. The rest of the table felt: “if you feel depressed, maybe something is wrong with your life. You need to work to fix it. What is the pill supposed to do?” A two hour hot oil massage is the Taiwanese version of antidepressants. 

Rocky, you think you need a pill because we have all been trained to believe that we need a pill. There are numerous studies which show that if patients get an inert placebo they very often react exactly the same as if they’d been given the drug. In other words, the idea that it would cure them was more helpful than the pill. 

I am going to do you a great favor. First, I am going to give you a link to one of the most powerful happiness and sleep inducing videos ever made: It will change your life. Next, I am going to ask you a question, and if you can answer it, you will have the solution to all your problems: “Do you really want this job so badly that you are willing to make your current life a living hell in order to get it, and have a future where your family sits at home wondering where the hell you are?” Is this truly the life you hope for? 

Now go fix your life. The pills won’t do it for you.

You can visit Dr. B’s blog at

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