[Un]Settling In for the Long Haul: The Interplay of Complacency, Stagnation, and Psychotropic Drugs


As we age, we stop following our physical bliss.  The body is pampered rather than challenged.  It is told to be quiet, and becomes no more than a receptacle for the mind and spirit.  Life becomes a matter of creature comforts.  The challenge becomes its ability to withstand the effects of our bad habits.  We are no longer athletes.  We have become spectators.  This will never do . . . Life is not a spectator sport.  Only to the good animal come the peak experiences, the joys, the epiphanies.

– George Sheehan

At the age of 45, George Sheehan’s life had already been a smashing success by most societal standards. As an illustrious cardiologist and father of twelve, his days were full to the brim. But he began to feel himself settling into a comfortable existence, and with that came increased feelings of depression and disconnection. So he returned to his roots as a college track star, and began running laps around his backyard often with his kids in tow. At the age of fifty, he became the first man of his age or older to run a sub five minute mile. By the time he died of prostate cancer at seventy-four, he had published eight books on running and life while completing the Boston Marathon 21 consecutive times.

By the time most of us have gotten into our 30’s and 40’s, a certain order has started to take place. Many have begun to think of, or even plan for, retirement. Our insurance costs rise as our families and assets grow. Our schedules start to fill up with meetings and practices. Our homes often grow from the inside, and become meccas for entertainment, décor, and practicalities. We suddenly find that we need more space because our family grows in size or the stuff we acquire grows in mass. We look for ways to increase convenience and amusement in the midst of our busy lives. We often purge those practices that don’t seem necessary to get through the day. We tend to avoid areas that unnecessarily challenge us to think differently, remain flexible, and push the envelope. For us men especially, pride seems to emerge from our “man caves”, entertainment rooms, zero degree-turn riding mowers, and barbecue shrines. A time-honored tradition begins to take hold. Like George Sheehan, we start settling in for the long haul.

Much of this is the American dream, right? We have gotten through school, worked hard to get a job, and are forging ahead at work. We deserve the right to relax when the time presents itself. We have passed all the tests we need to get us to this point. Now, much of what we have come to know is that we need to start protecting what we have and enjoying where we are. We become complacent. Makes sense.

But a couple of things challenge this complacency. For many, one is children. If there was ever a time in your life that you needed to think critically, be creative, practice flexibility, learn new skills, remain in great shape, and have the ability to take on challenges, it is when those kids arrive. Personally, I have never known a period in my life that demanded it more. My children seem unaware that I have already passed all the exams. Settling in is not on their radar. They scream otherwise. They demand that I think “on my toes”, figure out the answers, endure long nights, and strive to find new ways to survive and recognize the beautiful sights they bring.

But when parents relegate their role to that of a full-time spectator, and take on the noble cause of maternal (and paternal) martyrdom, a critical balance often shifts. Spectating is a necessary and joyful part of being a parent; but being a full-time spectator, without personal pursuits and close attention to our lifestyle choices, often leads to declining health and increased negative mood. This in turn can make each day a greater struggle to renew and revitalize ourselves for the next, and for our kids. For mothers especially, this slide backwards often leads to depression, which remains one of the most robust threats to their children’s well-being.

But whether or not we have children, it is easy to find us in another spectator role. This is the role in which we watch our life passively go by, and increasingly find ourselves in pathways and states of being that we never intended. According to Erik Erikson and others, the psychosocial conflict from age 40 to 65 is generativity versus stagnation. It is the period in which adults often seek out meaning and purpose through raising their children and/or creating positive change at work. Failure to do this often leads to feelings of stagnation, depression, and despair.

When complacency and stagnation set in, our human nature, especially of today, seeks immediate promises of relief. And marketers know this. This is where psychotropic drugs, among other artificial endeavors, enter the equation. Recent statistics (e.g., NCHS Data Brief, 76, October 2011) indicate that in the United States, use of antidepressants has increased almost 400% among all ages from 1988. Individuals from 40 to 59 are the largest consumer of antidepressant medications. Twenty-three percent of women in this age group take antidepressants, making them the largest user of any age-sex combo. Females in general are 2.5 times more likely to take antidepressants than men, although statistics suggest that men disproportionally self-medicate in other ways, such as with alcohol (National Institute on Alcohol Abuse and Alcoholism. Women and Alcohol. February 2011). Less than one-third of people taking anti-depressants have seen a mental health professional in the past year. But this search for immediate relief extends beyond antidepressants. Last year, Abilify, an antipsychotic, stunningly became the number one seller (in total sales) for all pharmaceuticals, grossing nearly 6.5 billion dollars. Not just psychiatric drugs, all drugs. As it continues to be marketed for wider, adjunctive purposes, including anxiety and depression, it becomes just one more “answer” to the blues that middle aged Americans are increasingly reporting.

So, where does this leave us? Well, in some ways, it leaves us with a great opportunity if we choose to look at it in this way, although right now it seems rather depressing. We can certainly hang on, if we want. Or, we can begin to challenge the prevailing conventions. We can reassess what is most important to our vitality and what is most central to our contentment.

For starters, it seems that we can’t stop thinking and learning no matter what age we are. As John Wooden once famously said, “When you are through learning, you are through.” It sounds obvious, but by thinking and learning we are talking about the process of satisfying our curiosity by seeking out new knowledge and wisdom. Of reading about things we don’t know, and asking frequent questions about things that don’t make sense. Of seeking out new ideas, and understanding why we believe what we do and why we do what we believe. Simply put, we can never stop learning. George Dawson understood this. As beautifully detailed in the book, “Life is So Good”, he described his life of illiteracy until at the youthful age of 98, when he decided it was time to learn how to read. Reading for a release is great, but reading for curiosity can take you back to those days when everything was still new.

Our fitness can’t be something we finagle into our busy schedules. It can’t be an afterthought. Not only because kids require the greatest amount of endurance we will ever know, but so that the life we have is one that we choose. We are coached to plan for retirement by investing and saving money. But, how many of us have sat down with our financial planner, only to find out that the cheapest insurance goes to those who are healthiest? The single best predictor of our ability to think after fifty, and therefore have an opportunity to truly enjoy our golden years, is one thing: our physical health. No insurance policy in the world can guarantee this. Only we can try. And it doesn’t start magically the day retirement begins.

Which brings us back full circle, to another problem. It all makes sense, except for one thing: WHERE DO WE FIND THE TIME? The answer seems to lie in the very routines that we have adopted which many would say “get them through the day” (but may in fact do little more, or even the opposite). Let’s start with TV. The average adult American watches five hours of television a day. Although certain programs may be considered educational or thought-provoking, even these remarkably edited shows really require little more than finding the right channel (By the way, a check of the Nielsen ratings tells the true story).

This is just for starters. So, what if we do have more time than we think? And if TV is just helping us to survive, then maybe most of the time is better spent with something that will help us thrive. In 1966, Winston Churchill published a book entitled, “Painting as a Pastime”. It was a collection of paintings and writings from much of his life, which had certainly been one of great challenge and strife as the Prime Minister of England during and after World War II. It demanded constant vigilance, thought, energy, and flexibility. In the midst of it all, he resorted to painting as a way to rejuvenate his spirit and his mind. He once said, “Change is the master key…the tired parts of the mind can be rested and strengthened, but not merely by rest, but by using other parts. It is not enough merely to switch off the lights which play upon the main and ordinary field of interest; a new field of interest must be illuminated.”

There is great news about all of this. Our minds and our bodies are fully equipped to embrace this philosophy. Recent analysis of runners in the Boston Marathon found that the average runner in their mid 50’s was just as fast as those who were 18. By the way, George Sheehan set his personal best in the Boston Marathon of 3:01 at the spry age of 60. And while many of our cognitive abilities start to decline in our 30’s, our vocabulary skills continue to climb almost into retirement age.
In the United States, the average life expectancy for females is nearly 82 years of age. The average male lives to about 77. Seems kind of early to start settling in.

Just Thinking . . .


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.


  1. Painting is wonderful therapy. And as someone who has taught art to many children, and can visually tell the story of painting iatrogenic bipolar in my own portfolio. It’s amazing how much you can learn about what’s going on within a person, based upon the artwork they create.

    And I do recommend using art as a form of healing, and even as a diagnosis tool. For example, it’s blatently obvious from looking at my work that prior to drugs I had a cerebral, conceptual approach of layering representational images, with the goal of creating a style of my own, that visually represented my philosophy of life.

    Then when I was put on antipsychotics – which made me ungodly ill almost immediately – I was hardly able to do anything but throw paint at canvases. The works are “painterly,” but obviously terribly chaotic. When one’s work goes from orderly to completely chaotic, a doctor with a brain in his head should be able to comprehend the drug, that created the chaos, is not benefiting the patient.

    And this same thing is true with children. I was working with a group of children, we were painting tee shirts. Most the children’s paintings were representational and inspiring. But two of the children I was working with were stigmatized and on drugs. Their paintings were filled with chaos and dark menacing imagery.

    Later that evening the child’s grandmother and I were talking, she told me one of the boy’s had recently been hospitalized. We did a quick drugs.com check on his “meds.” And sure enough the child was on drugs with major drug interaction warnings, and the symptoms he was hospitalized because of, were the symptoms warned of on the drugs.com site. But no one in the hospital caught this problem, they blamed the father instead.

    But my point is what and how a person chooses to paint can be not just a wonderfully therapeutic endeavor, but also an effective diagnostic tool. To contine regarding my work, after I was weaned off the antipsychotics, my paintings go on to reflect the super sensitivity manic psychosis phase of my iatrogenic illness. And now, years after getting off the drugs, my work has gone back to more of an exploration of my original approach.

    But it can be effective to use art to help assess whether the stigmatizations and drugs are working. If you see chaos, the drugs are not benefitting the patient. If you see order, hope and inspirational imagery, the child or adult is likely doing well.

    James, forgive me for rambling about the art stuff. Thank you for this article. I totally agree it’s important to take care of oneself, and not become a full time spectator in life. I know my hour a day of exercise while being drugged helped save my life. I’m so glad I did not believe my doctor when he claimed it was a “sign of mania.”

    And, perpetual learning is a wonderful gift. I’m grateful I have researched and am medically able to explain how doctors “created” “bipolar” (anticholinergic intoxication poisoning) in me. But it is heartbreaking for me to learn over a million children had “bipolar” iatrogenically “created,” in the exact same way I was made sick (ADRs from an antidepressant misdiagnosed as bipolar).

    But I’ve researched enough now, that I’m to the point I think a reality needs to be pointed out to the mainstream medical community. It’s wrong to make people sick with drugs for profit – doing such is not morally acceptable behavior. I believe we’d have a much better and healthier society if the doctors could get out of the business of “creating” mental illnesses in people with their drugs. And move towards “creating” paintings or something else instead. Iatrogenically “creating” “mental illnesses” in other human beings is NOT proper medical care. Might you consider passing my concern on to your friends behind the white wall of silence, please?

    Report comment

    • I agree that painting is wonderful therapy. I do watercolor studies occasionally but because of the intensity of the medium, I often get frustrated. Lately, I’ve taken to simply painting simple things with my four year old grandson. Today, we painted a box that we are converting into a puppet theater.

      Report comment

    • Thanks for taking the time to reply, and it was neat to hear how painting has become so therapeutic in your life. I appreciate your emphasis on the idea of promoting health through natural endeavors, as I very much agree that there are an infinite number of ways to sustain health and well-being that are available to us every day with no prescription needed. If you go on my column at http://www.stmarys.org/articles, you will see that I am constantly promoting the research that supports this idea, and ways that we promote positive well-being and good relationships through our daily practices and timeless pursuits. Writing and endurance training happen to be two of my favorites, which happen to support each other very well.

      Report comment

  2. Hi James,

    As usual, another great inspiring article to get us off our “buts” as more and more health articles stress how critical exercise is to our overall health for all ages. Exercise is equally critical for children for health and relieving stress, so called depression and other problems. Yet, many children lack exercise due to elimination of outdoor recess and gym (though gym can be torture for certain bullied, overweight kids) and/or less than ideal safe areas where they live to run and play. Rather than the First Lady dwelling on junk food and new food labels, perhaps she might focus on neuroleptic induced obesity in children and others and creating safe play areas/parks for children to run around and have fun as we used to do in my generation. Of course, safe places for adults to walk, run and bike ride would be great too.

    Since you specialize in helping children, I thought I would share this special issue from Scientific American with articles on dealing with children’s anxiety with calming techniques and other seemingly natural techniques. If you can’t access the articles directly for lack of membership as in my own case, many of the authors and techniques can be accessed via googling.


    Report comment

    • Some of the calming techniques that work well for my grandson may work well for others. My grandson loves attention and since he is young, he is often oblivious to danger he also doesn’t always understand when his distraction puts me or both of us at risk. Usually positive attention, sometimes even a hug will calm him down; if I explain that safety is important, he will calm down even more.

      Calming techniques are essential for everyone’s safety. They should be teaching this in school. When I was in eighth grade, my public school taught guided meditation until the right wing Christians got upset and nixed meditation in the Portland Public School system.Pity. Some kids don’t know how to regulate their moods, thoughts, and activities because their parents/guardians don’t model self regulation and they don’t learn it in school. Calming oneself is important. the nervous system can be very elastic but one must know how to tap into one’s elasticity. Leaning how to transition between activities is important.

      When kids wrestle or are loud in play, they need to transition down for a nap or bedtime. Bathtimes are calming and are best scheduled after physical play or one of those computer games that get kids worked up. After bath time, nix the TV in favor of puzzles, books, and board games. If they balk at the word ‘bath’ , make the walk to the bath into a game, or involve them in choosing bath toys. Explain why plastic spiderman can go in the bath, but teddie can’t swim.

      Usually, a loud tantrum builds up over time; the best way to deal with tantrums is to prevent them. To prevent them, established routines are a godsend. Even in the most well run households tantrums are inevitable.

      My grandson’s odd tantrums are usually after he fails to attract desirable attention when the adults in the household are experiencing a busy day. To compensate, he uses negative attention. Once, he threw an expensive robot down the stairs, breaking it. Once, he took a VHS cartoon and pulled out the magnetic tape, tying it into a Gordian knot. Both times, he regretted those actions and the punishment was built in; no need for a time out because he knew how dumb it was once he realized he couldn’t watch his favorite cartoon anymore. NO need to over react when youngsters misbehave. Their
      misery is usually short lived and being miserable is punishment enough.

      I could be stirring a boiling pot, threading a needle with great difficulty, or reading an instruction manual with tools spread out all over the floor; young ones sometime have the worst timing when it comes to reminding the household that they are the center of the universe. Since I am a caregiver for multiple family members, and I have creaky joints, I can be quite cranky. Depending on what my grandson does, a time-out may definitely be called for, howl as he may. But some things are very calming and have the
      ?effect of dissolving a negative behavior before it gets to the level of a time-out.

      One thing that is very calming for both of us is to establish a mutual understanding of which activities grandma engages in that can always be put down and resumed later. Even if I am enjoying reading Mad in America on the sofa, or doing paid professional labor involving my computer, I will nearly always stop what I am doing to focus on my grandson. Since he knows this, it is very calming for him and he rarely abuses the privilege.It’s amazing how little time little ones need for a calming ‘security’ check in with the caregiver. Once they ‘check in’ they are as right as rain, but the check-in has to be genuine and involve two way communication. Kids are smart and know when you are not giving them your undivided attention. Undivided attention means stopping what you are doing completely, facing them, looking him in the eye and being prepared to engage with him and listen. If it is genuine, it doesn’t matter how long it is.

      My sister is a beloved teacher in a large charter school and the other teachers always send her the most difficult to calm children. She has been working at the same school for thirty years. I think that the psychosis she experienced as a young adult is what makes my sister so gifted and insightful with kids. Once, she had to deal with a five year old girl who was experiencing rage that was ‘off the charts’ she gently dabbed a cold wrung out washcloth at the base of the cerebellum and it had an immediate calming effect. Since that time, the same student will periodically self regulate herself by coming to my sister’s classroom when she needs ‘the wet cloth.’

      We are not only medicating children with drugs; we are medicating them food and television. The best calming techniques are engaging with them in fun activities and by communicating with them honestly. If our society would start to do right by our children, we would do well by our adults who are in mental or emotional distress.

      Report comment

      • Oh, and another comment to underscore how much children need and value time spent with adults. My grandson got a bad start with his oral hygiene. His mother put a milk bottle in his mouth to soothe him and put him to sleep everymight with the result that his front baby teeth became horribly rotten.

        Needless to say, toothbrushing would elicit tears and dread. I don’t think my grandson was in physical pain when brushing, but his parents somehow got into that loop of anxiety that parents often get into–probably the pressure and guilt they must have felt every time they had to peer at those severely decayed teeth. Anyway the anxiety colored the activity and it made my grandson dread toothbrushing

        But soon, toothbrushing and flossing became a time of joy and excitement. I got into this routine of rewarding my grandson every time he brushed his teeth perfectly. Toothbrushing is a complicated activity for a three year old. So we broke it down into the minutiae and insisted that he make an effort to do every detail to the best of his ability.

        We made a grab bag. And he got to put his hand into the bag and pull out a prize. But first, he had to do the toothbrushing from start to finish: wet the toothbrush, squish the toothpaste onto the toothbrush, turn the faucet water off when not in use, have an adult brush his teeth for 2 minutes without wiggling, swish and spit several times, put the cap back on the toothpaste, mete out the floss, and clean up the sink.

        Since it didn’t make much sense to buy candy which leads to more cavities; I had to find non edible prizes but they had to meet the minimum standard for safety and appropriateness. After a while, it began to get difficult to find anything less than $10 that would meet the standards. Since we were brushing after every meal and he was coming to our house for three overnight visits/week, it quickly became apparent that this was an extravagant approach and set a bad precedent. Were we going to reward him with expensive toys every time he had to do something that was good for him, such as eat his veggies?

        Finally, I knew that I couldn’t afford to keep up this ritual even though we had both come to love it enormously.

        So, one day, I put the grab bag high above the vanity in the bathroom, stuffed as usual with multiple prizes but beside the grab bag, I placed his favorite quiet games, a puzzle, bubbles, a favorite book, etc. and to mix it up I even put in some of my favorite board games even though they are not age appropriate (Scrabble, for instance) I began to tell him you can have anything in this bag or I will spend 20 minutes doing one of those activities with you.

        He hasn’t opened the grab bag once in months even though there is some cool
        stuff in there! He always chooses the time playing with me. And that is fine with me. I enjoy my twenty minutes of playtime with him. Oddly, he often selects Scrabble or cards which are both hopelessly sophisticated for him but we make up our own rules and it ends up being just as fun.

        Anyway, I just wanted to share how a routine that once caused anxiety and dread turned into a joyful activity and children love to be rewarded with quality time with an adult!!

        Report comment

      • “We are not only medicating children with drugs; we are medicating them food and television.”

        This is a critical point, and one that I think few really understand the gravity of it all, but I appreciate you indicating here. As I have already alluded to here, and certainly talk much about on my column, poor nutrition and media/technology immersion have become two of the biggest threats to the vitality of our youth, and our population as a whole. If you are curious about more about my thoughts in these two areas, check out three series I wrote in 2013 (January, April, and September) at http://www.stmarys.org/articles-1. Almost everyday in my office, parents acknowledge struggling to maintain healthy practices in both, and if negative trends in these areas are not curbed, I worry that the long-term on our population could be tremendous.

        Report comment

  3. One more thing! Our family does group music a lot to provide a balance for all the computers and televisions. My husband and daughter both happen to be musically gifted on the piano, guitar, etc. but families don’t have to be talented to enjoy music together. My grandson has his own drum and tamborine and he chimes in vocally whenever we do a group sing along . We value his crooning even if we can’t understand a word he is singing. My son has a pair of bongos and is self taught. Nearly everyone can play a basic drum. Drum circles are very enjoyable, even for those with no musical training.

    Dancing requires very little equipment. Sometimes, we have all three generations dancing on the living room floor to the stereo. People make fun of our old fashioned stereo and our vinyl records but even our kids with all their Apples and Ipods, get in stitches watching their dad strut his ridiculously funny Mick Jagger moves from the seventies. Eventually they can’t resist showing us the more modern moves. Technology is cool but you don’t need it to enjoy music!

    Report comment

  4. I once went several years without dancing. All work and no play. Then recently, I had the funnest time dancing with my husband last month at a blues jam. It was a wonderful natural high and made me remember that I’ve been a couch/computer potato too long

    Report comment

  5. I like to use the “big guns” of the exercise world, just an hour a day of weightlifting and the stair master changes everything, like magic. Then the feeling of wellness and strength makes me more motivated for things in life .

    I was a psych med waste-oid and miserable beyond words , wellness ain’t found in a bottle.

    Report comment

    • Almost forgot, I also don’t wear shoes unless I absolutely have to and store them in the car just in case , it didn’t take long before going without them to become the new normal and did not feel like a major handicap at all like it always kind of did, it’s like you learn to walk correctly, balance and the ground stops feeling too rough. Now wearing shoes feels wrong. This started a few years ago after moving to warm climate. There are dozens explanations online for why going barefoot is more healthy, don’t know whats myth or fact but it does make make me feel more healthy like they say.

      Report comment

    • Dirt bike riding / motocross is still the best natural high I know of, besides that one thing of course , I think a few hours a week of getting some kind of motorsports high, boat, bike quad what ever would work better than any SSRI. I would get a bike if I still lived near open country.

      There are so so many ways better than those pills to feel better that actually work.

      I still can’t believe I fell for that serotonin scam that got me so screwed up.

      Report comment

    • My daughter is civilly committed to the mental hospital in my state. The most therapeutic activity they offer is a group outing to go swimming at a public pool. The same hospital in a different part of the state has equine therapy. Not all patients have access to these but its a good start. Both hospitals have treadmills but not very good spaces for outdoor walking. Of the physical outlets they do offer, lot of patients cannot take full advantage because they are so doped up most of the time.

      The patients are taught that they have a biological based disease and a lifelong disability even though the number one reason for their disability is lethargy, low libido, and lowered cognition due to overmedication. They have group therapy to help patients make healthy choices such as routine exercise and good diet but the number one barrier to their achieving the goals of good health is the sedating, dopapine inhibiting drugs they are forcde to take. Dopamine is the motivation and ‘reward’ system of the brain. If this system is dismantled and the executive decision making decision making functions of the brain are impaired how the heck is one supposed to carry out the hospital’s recommendation to exercise and make healthy food options?

      Most patients on my daughter’s ward end up watching television or sleeping. Most are obese. Some have advanced diabetes, blindness, missing limbs, and tardive psychosis. At group therapy the number one goal is for them to learn how to ‘manage their disease’ and accept their ‘disability’ Sometimes this group brainwashing goes under the mane ‘medication management therapy’

      There is never any group therapy for grief management or PTSD or overcoming the trauma of having one’s rights taken away. The phone psychologists always cowtow to the psychiatrists and rarely even look deeper than a patient’s medical records, none of which is written by the patient or even in accordance with the patient’s perception of their history. Psychologists rarely meet privately with patients, the psychiatrists do fifteen minute med checks one time per week with their patients, and peer counselors are a luxury with a caseload of about 100 patients per peer counselor.

      What would be even more helpful is if the hospital staff would support patients like my daughter who want to live med free, to come off psychiatric medications safely, and encouage patients to engage in focused physical activities to provide relief from the rebound psychosis and akathesia that always follows withdrawal. The lack of honesty in recognizing withdrawal symptoms after the brain has been chemically altered by D-2 receptor blockages for years is unforgiveable.

      Report comment

      • Madmom,

        It is criminal what the psychiatric industry is doing, I totally agree. I’m so sorry your daughter is locked up. Are you trying to get her back home? When you talk to her doctors and explain the damaging long run effects of the drugs, how do they rationalize forcing her to stay on them?

        Report comment