I want to save the world ... with my pills.

July 10, 2007 9:07 PM

Will the Peace Corps disqualify me if I have to keep taking my antidepressant during my assignment?

I have completed the interview process, received a nomination, and have now moved onto the medical clearance stage.

I have recently begun treating a persistent, low-level depression with 10 mg of Lexapro. My prescribing physician is a psychiatrist, and he does not believe therapy is necessary (in me, the depression manifested itself as a kind of "emotional numbness" rather than sadness and feelings of worthlessness--now that I'm on the Lexapro, I feel much more engaged and take more pleasure in things). I feel great and am confident that my psychiatrist will clear me for service.

Lexapro is approved and available in the part of the world where I have been nominated, although I don't know if it's available in every country in that region.

Mefites, what are my odds?

posted by anonymous to health & fitness (12 comments total)

I'm at the same stage in my app, and have been researching medical clearances. Please email me, anonymous.
posted by gsteff at 10:32 PM on July 10, 2007

I don't think that you have to be concerned with getting the drug. The way that PC and other government programs work, you have a basic insurance program that can ship you drugs from the US. What is even easier is to get as much of your drug as possible before you go. Telling your insurance company that you're traveling for months will often get you a large supply.
posted by k8t at 11:14 PM on July 10, 2007

Just FYI, anon, I went through the peace corps process, and when I mentioned that I had seen a therapist literally 9 years before I applied (as a 13 or 14-year old teen), they had a bunch of extra steps in the process for me to go through, with written explanations and other stuff. They eventually decided I was sane enough to join, but it was quite a wrench thrown in the process. I'm not sure what they'd do if I had been currently in therapy or anti-depressants. They really take mental issues seriously. I guess that makes sense.
posted by bluejayk at 11:31 PM on July 10, 2007

Google "Leslie Mendez" and "Peace Corps". No word on whether or not she was accepted once she successfully sued to be allowed to reapply.
posted by availablelight at 4:10 AM on July 11, 2007

Honestly, they don't like it.

I would have suggested lying on your forms (I have personally done this successfully) and getting your psychiatrist to write you a high-level, three-month prescription that you could stretch over a year and/or reporting "new" depression once you were firmly entrenched in country. PC is much more willing to work with you on your mental issues once they sunk 50,000 dollars in getting your overseas and properly trained.

But since that boat is past, try to minimize the depression issue as much as possible. Get a confident note from your psychiatrist. Get a confident note from a psychologist, maybe two. You really need to get the professionals on your side in this one, and I'm not sure the family physician/psychiatrist's note is going to be sufficient. A note from a teacher or mentor or someone like that who has seen you deal with adversity would not be going overboard.

Also, it must be said that PC is not "challenging" in the way we all crave a challenge -- it's a discouraging, depressing, hard life that probably gains much of its allure from social glamorization of caution-to-the-wind humanitarianism. They send you all this propaganda that taps into that sentiment and makes you wanna go. The quitting rates vary per country (you might want to check the stats for your region), but a lot of healthy, happy, and normal people can't hack it and come home early. Don't underestimate yourself, but be realistic about your ability to cope with isolation, futility, and powerlessness before you ditch life here and move thousands of miles away. If you think you can do it (that is half of doing it), then great. I hope you get in.
posted by bluenausea at 5:04 AM on July 11, 2007

I agree with bluenausea, except I would add that if you seek treatment in country and the Peace Corps discovers the condition was pre-existing - and that you lied on your application - that is grounds for a termination. Happened to a woman in my country (it was a problem with her shoulder, not a mental health issue).

The third paragraph that bluenausea wrote is oh so true...
posted by handful of rain at 5:51 AM on July 11, 2007

Yeah, I want to nth the don't lie about it and then get caught. I think everyone who has spent time in the PC knows someone who got caught falsifying preexisting conditions, and it always turns into a big scandal. Getting sent home for lying is really embarrassing, and miserable for everyone to deal with, you most of all. I saw two cases where people lied about mental health issues, and then had to be medically evacuated at great difficulty; in one case several other people were needlessly put at risk. So don't treat this as a trivial issue to bypass, or think that PC is being irrationally stringent.

Any time you tick "yes" on any of the health forms, you will then have to do the additional paperwork that bluenausea describes. I can't believe that PC will disqualify on the basis of taking anti-depressants (they are just too common nowadays); their concern in your case may stem from your having just begun treatment, so your prognosis may not be as clear as they would like. A major concern, of course, is what happens if your depression or anxiety intensify mid-service, and you don't have easy access to the right kind of medical care? If you are a three day drive from the capital (where the PC medical staff lives, and the country's health care system is centered), and your lexapro isn't cutting it, and then the bus drivers go on strike and your supervisor starts harassing you and then your house gets robbed, what happens?

And bluenausea's comments on the stress of PC bear repeating. It can be tremendously isolating (socially more than physically -- you are surrounded by people, have no privacy, and yet can feel totally alone), and then you get to layer irritating US bureaucratic requirements (PC being part of the US foreign policy system) on top of how things work in your host country. Although the good times are really good, your low points will be really low. There were lots of times I considered quitting, and I really loved it, had a great job, had lots of friends, etc. Anecdotally, I knew of people who induced medical problems (eg not taking anti-malarials, pregnancies, etc) because they wanted to go home but were too embarrassed to just straight-up quit. I don't mean to be all gloom and doom -- I loved the PC and am always suggesting to people that they apply -- but it's not just a big exciting adventure, either.
posted by Forktine at 7:01 AM on July 11, 2007

I worked for a British NGO and shared a house with PCV's. They're a great bunch of people but I would agree with bluenausea and Forktime's comments.

There are other problems many of them had, including not having much to do. I remember one day we got a PCV turn up at our house in a terrible condition - we put him on suicide watch and spent three days trying to calm him down and figure out what happened to him. Essentially he was in a very remote location with one other PCV and they didn't get on.

He had a breakdown and ran off to visit us because my housemate was a 'freind' of his during training.

We reported that he was with us and needed help to the country HQ and after a couple of days an assistant turned up in the Land Rover. They were furious with him for going off-site ( don't know why, one PCV near us hadn't been in his village for months!) and I was outside when I overheard a radio call between the very fragile PCV and the Country director, who was berating him for leaving his site and accusing him of letting the Corps down.

They took him to the nearest airport and flew him to the capital and sent him straight home in disgrace.

Three weeks later he killed himself.

Two months later PC held a memorial service for him for the new intake and praised him for his dedication to the Corps.
posted by quarsan at 10:16 AM on July 11, 2007 [1 favorite]

Quarsan, I think you just convinced me to do something else. Thanks.
posted by lilithim at 10:19 AM on July 11, 2007

quarsan, were you in the VSO? We were always kind of jealous of the VSO in my country - they always seemed to have better working arrangements.

FWIW, I was in a country where the attitudes of the top-level country directory (American) fell toward the end of the spectrum you describe. That will vary from place to place, and the best thing you can do as a potential PCV is to seek out people who are serving in the country now or who just left, and ideally someone who left early for whatever reason. That will tell you quite a lot.

My mom was in the Peace Corps in the 1970s, and she recalls her country director as having the attitude of being will to do ANYTHING to help his volunteers - whatever he could do to support them he would do. My experience was that my administrator was into the rules, plain and simple, as well as a very short list of things the Peace Corps was accountable to volunteers for. That's it, and you can pick up a plane ticket home if you don't like it.

But the point is that this varies so much from place to place. The single best thing you can do to prepare yourself is to find people currently in country or who have left within the last year or so.
posted by handful of rain at 1:45 PM on July 11, 2007

I think I should apologise for the last post. It is something that affected me deeply, but it wasn't as helpful as it could have been. It was very frightening to sit with someone who had completely lost it for three days. He did seem to improve a lot and we helped him understand what had happened to him, but I also saw him regress whilst the Director screamed at him over the radio.

lilithim, many people with depression can manage it to a large extent and are aware of 'downturns'. If you can do this, then you could do it. Don't lie and talk to professionals before going to the Corps.

To put it simply, if you have a professional and supportive organisation you should be ok. If not, then you don't want to be there regardless of health issues.

Working in Africa is mentally exhausting and affects people at a deep level. On my last stay at this placement there was a famine and a malaria outbreak that meant 25% of the under 5's in the village died in three months. It was horrific and the fear in the whole community, the scenes in the local hospital and watching my neighbours kids die did something to me and I took a short break from sanity.

handful or fain, I was on a contract with a great NGO not on VSO. I met a fair few VSO and, individually, they were good people, but I'd rather meet a group of PCV's than a group of VSO.

Peace Corps just parachute people into somewhere and leave them to it, some sink, some swim and very rarely, someone drowns. Many of the villages around us actively didn't want PCV's which, to put it mildly, hampered their effectiveness. They also had no real plan. I met the guy who designed their program, who said it was a 7 year program and he didn't expect to see any results before year 6!

VSO get qualified and experienced people to fill vacancies requested by the host country, so they have real jobs to do.
posted by quarsan at 5:15 AM on July 12, 2007

Peace Corps just parachute people into somewhere and leave them to it

Not true - PCVs have 3 months training (including cultural understanding) before they go to their sites.

As for whether your medical diagnosis will keep you from PC - definitely possible. And what everyone said about the difficulty/loneliness/depression of being a PCV - that's definitely true, so you need to be able to deal with that. My 2 years in the PC were full of highs and lows - hardly ever just flat. Which was partly what I loved about it, of course.
posted by Amizu at 5:01 PM on July 12, 2007