Sunday, December 4, 2022

Comments by PrettyPurplePill

Showing 42 of 42 comments.

  • Thanks to the author for sharing this article. I am particularly interested in this kind of mea culpa because I have enlarged ventricles I believe as a direct result of years of antipsychotic use. This is particularly upsetting to me because I have never had a provider suggest that I needed these meds for any kind of psychosis at all. Even my “manic” reaction to antidepressants has been couched in terms of hypomania – bouncy and excited but completly connected to reality. I have never been disconnected from reality, no random sexual hookups, no outrageous spending, no gambling, never thought I was invincible, I’ve never had so much energy I stayed up all night. My insomnia that was thought to be mental in nature turned out to be sleep apnea. I’m having a hard time calling this kind of prescribing anything other than malpractice. So it helps when I read doctors who are publicly admitting to being so very wrong for so long.

  • Shook, you made an extremely good point and one that many patients have been shouting from the rooftop for years. The problem is not with the patient, the problem is with society. If an Amazonian (or African) or whatever tribal culture you point to does better than Joe in NYC, obviously, environment has a lot to do with healing. The answer is to change the unhealthy environment, not disable the patient. Westerb medicine blames the patient for altered states due to stress instead of blaming the entirely unnatural ways we live.

    I disagree entirely with the mental states where you say it would be grossly negligent not to medicate. This belief is exactly why I will never tell another mental health provider when I am experiencing distressing thoughts. Never ever. Providers like you can’t be trusted not to forcibly medicate us. Feelings are transient. disabling someone because they are honest about how they are feeling should be criminal. It is this attitude that keeps people from seeking the treatment they need.

  • Great article! I think it’s definitely important to be aware of how a service dog is affecting others in the environment. I think, at least at provider’s offices, it would be reasonable to ask not to be scheduled on the same day as someone who brings a service dog. Just allowing extra time for air exchange should help.

    I have never dealt with serious pet allergies but I’ve come to understand asthma differently as a result of a hospital stay half a decade ago. I was on a trauma unit in a well known private psychiatric hospital. I have asthma. I brought my inhaler with me. The first time I had an asthma attack, they refused to give me my inhaler. They said I was panicking. I freaked out. I survived, obviously. But I have also witnessed multiple other patients be refused their inhaler on the same basis. You have not seen terror until you’ve looked into the eyes of someone who can’t breathe and thinks they’re dying. However, that experience changed my view of my own asthma and how my anxiety fueled it. I haven’t used my inhaler in five years though I still keep an active prescription for it, just in case.

    That’s just food for thought and not meant to negate any of your points, obviously.

  • We do have one of these peer support organizations in my community with half a dozen drop-in centers throughout my state but the one time I decided to drop in and check the local center out, I was severely disappointed. While I sympathize with the needs of families, it was clear the place was being used to dump mentally challenged geriatric people during the work day. Not my scene.

  • Joe, I agree, I’d like to see the proof of that as well.

    “Sadly, our local Wellness Centers (nee’ Self Help Centers, nee’ Drop In Centers) are peer run largely in name only and despite almost a decade of data collection they can’t provide any evidence that they apply the Principles of Recovery or foster recovery.”

    We have a local “drop-in” place that is supposedly a peer run organization. When I found out about it, I had visions of a welcoming environment with couches and games and people to talk to – mental stimulation and that kind of thing. I showed up and found a single room in a strip mall shopping center filled with folding card tables and folding chairs and full of old people in diapers who were barely aware of the presence of other humans around them. I would have been the youngest person there by a couple of generations and also the most lucid by far. It seemed like a last resort type of place for families who couldn’t afford adult day care to dump mentally challenged relatives during the work day. It became quickly apparent that if I spent any time there, I would be helping the staff far more than my “peers”.

    I keep hearing about ‘peer support’ but there doesn’t appear to be any cohesive definition that can be applied to that term so I’m not sure how useful any statistics are that emerge from it’s use anyway.

  • Regarding overdiagnosing – I’ve been watching the watering down and expansion of the autism diagnosis over the last 30 years. When I was a child, autism was very much associated with Rain Man. I didn’t know anyone diagnosed with autism throughout my entire childhood and young adulthood. In my thirties, the last eight years, suddenly I know multiple people whose children supposedly fall on the autism spectrum – and yet only one of them has symptoms that people would traditionally label autistic. One out of half a dozen kids. The others are high functioning bright kids without clearly perceptible behavioural issues of any kind. I’m talking sweet, kind, well-behaved, academically gifted children and the parents go on about how exceptional their autistic child is. I’d go so far as to say it almost seems trendy to have an autism spectrum diagnosis right now.

  • With all due respect, Julie, speak for yourself. Yes, we can blame our parents and society. I certainly do with very good reason. The things I experienced as a child at the hands of my mother and father would give Dave Meltzer nightmares. I’ve reduced professionals to tears with my story – people who thought they’d heard everything. I don’t tell it often because I prefer not to traumatize people. But the gist is that my father was a serial child molester and sexually violent sadist and my mother enabled him. My mother knew his taste for little girls before she *planned* my birth and then spent my childhood reminding how grateful I should be for having been a wanted child.

    Maybe *you* don’t blame *your* parents. I certainly do blame mine. The only time blame becomes an issue is if you get stuck there. I certainly did for a long time. I didn’t know how to make the leap from placing blame for the cause to beginning the healing to become who I am today. My parents are not to blame for the poor decisions I made when I was younger that have had a lasting impact on my life, but they certainly are to blame for the damaged neural processes that led to such extreme reactivity and poor decision-making skills to start with.

    Let’s not silence victims by telling them they can’t blame their attackers for the mental damage done to them. We wouldn’t tell a rape victim to not blame her attacker for harming her. Why do we tell child abuse victims not to blame their parents? The psychiatric abuses I endured were an extension of the child abuse that led me to psychiatry’s waiting arms. I will place blame where it is due.

  • Yeah, prisons are not good places for those labeled with smi. I know someone who has been in solitary confinement for years. To be fair, he is an extremely violent person who beat someone to death. He’t not reflective of most of the mentally ill in prison confinement. However, their methods of dealing with him are counterproductive in the extreme and they are clearly not interested in rehabilitating him. I fear his eventual release because the abuse he has experienced in confinement has reinforced his violent nature instead of treating it. Most sadly, I knew this person as a child and he was extremely traumatized – every abuse you can imagine, he probably experienced it. Watching his life unfold has been like having a front row seat to a case study in how trauma destroys lives. So yeah, a prison environment is no improvement for those with labels.

  • Agreed. Psychiatry threw the book at me and had no intention of ever allowing me to recover – DID, GAD, ADHD, Panic Dis, C-PTSD, MDD, Bipolar 1,2, and 3, Borderline – they just kept applying diagnoses and giving drugs, no matter how inappropriate. (I’ll own being a difficult patient but there is nothing evidenced-based about the 10 psychiatric drugs I was on at one point.) I wanted to try DBT but there are no Medicare providers who offer it in my state, so I went straight to the source and took a class offered by a local Zen Buddhist sangha – the same branch of Buddhism that Marsha Linehan drew her work from. Daily meditation has absolutely changed my life. Coincidentally, I was able to go off ambien after ten years nightly use when I was diagnosed with sleep apnea and started cpap therapy. Amazing how being able to breathe when you’re sleeping will cure insomnia!

    But as you said, there is no profit in curing a psych patient.

  • “AA, even when the prescriber doesn’t provide enough information on a drug, a good pharmacist (or pharmacist’s computer) will catch things like potential drug interactions and, if asked, will counsel you on the drug.”

    This is an illogical appeal to authority.

    “According to the Chicago Tribune, those “good pharmacists” are in the minority, with the best pharmacies making errors 30% of the time. That’s ONE IN THREE!”

    I have to concur. The severe interaction that I had was the direct result of a suggestion by my pharmacist to try a specific Rx-OTC drug combo. A friend was accidentally given a chemotherapy drug instead of the correct drug for her MS by the same pharmacy at a different location. Another friend’s daughter refilled a script for Concerta and was handed Seroquel instead. That was caught when a family friend asked “Is she psychotic?” at which point, the parent noticed the mistake and had it corrected. There is zero evidence to suggest that one should trust their pharmacist not to counsel you incorrectly or not to make mistakes. One recent study of pharmaceutical error claims, 75% of mistakes were due to either the wrong drug being dispensed or the wrong dosage being filled and 11% of the mistakes in the claims study resulted in the death of the patient. Pharmacists are just another tool in the Pharma-to-Patient drug pipeline. Moreover, their human mistakes could cost you your life.

  • “The paraprofessionals utilized in the studies were members of the communities they served, which appeared to enhance their effectiveness, and this may be difficult to accomplish in US settings.”

    I don’t think this would be difficult to accomplish in US settings. Don’t we already have this concept in the form of life coaching? Empathy and good advice are cheaper than Prozac and probably more effective. Seems like that would be a better use of insurance dollars than disabling people with drugs and long-term therapy.

  • I’ll just point out that that I have found some of the best information on this entire website exists hidden deep in runaway comment sections. I don’t necessarily agree that comment threads should *ideally* be on topic 100% of the time. The articles are great but (and?) there is a great deal of relevant information to be gleaned from reading the many off-topic but often poignant comments.

  • Julie, that is truly horrific. I am so sorry. I am grateful that I do not appear to be suffering any long-term physical ill effects from the treatments other than significant memory deficits which I attribute to the ECT and long-term antipsychotic use and inability to reliably structure my time effectively. And even that is improving . . . simply with the passing of time.

    I don’t yet feel comfortable sharing too many specifics – I’m still in the delicate time period of proving I’m not crazy without drugs, but I so so sympathize with the weight-gain. I had already had one surgery due to the excess weight and I was teetering on the edge of having gastric bypass surgery when a friend suggested I ditch the Seroquel – lost 100 lbs in four months after doing that and have kept it off. I remember the insatiable hunger – waking up in the middle of the night to make a meal – and the extra skin that I developed from the rapid weight gain from Seroquel and that I still have is a reminder that I never want to experience that again.

  • Thank you for this. It was a succinct and informative piece about addiction that largely reaffirmed concepts I already know that I think will help the less informed understand addiction a little better.

    “More intriguingly, a number of studies have shown that the belief that addiction is a disease actually decreases the odds of sustained recovery. AA has long overwritten the notion of self-generated change with that of vigilant control: once an addict, always an addict, so watch out!”

    What’s so sad is that AA/NA recovery model has such abysmal actual long-term recovery rates and yet these programs are court-ordered to those needing real help. The whole 12 steps concept of considering oneself powerless over their own behaviour and yet accountable to others for that behaviour sounds like blaming the addict while simultaneously reassuring them it’s not really their fault. How this approach helps anyone stop a negative behaviour is beyond me and I boggle at the mental gymnastics needed to actually succeed with this method. I once had a heated discussion with a fellow patient trying to claim their powerlessness over their addiction. And yet, their higher power wasn’t a powerful being such as God or Allah or Buddha. No, it was trees. They’re pagan, so the trees are responsible for keeping them from drinking. I don’t think the National Forestry Service is in danger of receiving mental health dollars anytime soon but it’s an interesting con that person is playing on themself.

  • “That part of Social Security Disability law is primarily concerned with physical disabilities. Mental disabilities (which as many of us know are frequently the direct result of “compliance with treatment”) are not even mentioned. Once a person has been found to be totally and permanently mentally disabled by the VA or SS, I can’t imagine any psychiatrist prescribing a drug with the expectation that that drug will enable the person to again take up substantial and gainful employment. And if our government tried to make the taking of that drug a requirement for receipt of disability payments for the above-mentioned permanent and total disability, civil rights lawyers would have a field day. The fact that a very few people, like Carrie Fisher, are able to comply with treatment and yet be gainfully employed does not generalize to the population of “seriously mentally ill” as a whole.”

    Ok, I agree and that makes perfect sense logically. Still, how does one prove one is still disabled if one is no longer in treatment?

    This is kind of personal to me and that is why I am pressing the issue. The last therapist I saw (very briefly) both admitted that she moonlighted as a paid CDR examiner for the Social Security Administration and also stated quite explicitly that she didn’t believe *anyone* with mental illness should be receiving disability payments at all. “Everyone can contribute meaningful work” were pretty close to her exact words. There seems to be a strong political push to purge the system – and depending on which social channel you’re tuned into, those of us with so-called SMI are either mental defectives in need of coercive care or we’re malingerers gaming the system. Thanks to the massive amount of stigma from all quarters toward the mentally ill, sometimes I feel like I’m seen as both malingering and in need of forced treatment all at the same time. The act of recovery can put you in a precarious position of needing assistance while rejecting the most widely available and publicly acceptable “treatment” that exists.

    Subvet, I think one of the differences in your case is that you were still under the care of a physician willing to say you were still disabled, and you had treatment record showing you were doing something – even if it wasn’t psychiatric drugs. I am neither in the VA system, nor do I have the funds to pursue alternative care that Medicare doesn’t cover. That is why I say your situation is atypical. You were still under care. I am not. It doesn’t sound like HumanMusic is receiving alternative care either. I would venture to say that many, if not most, people who drop out of the traditional psychiatric system cannot afford cash-pay alternative treatments that Medicare does not cover. During a CDR, SSA looks at the last year of medical treatment to prove continuing disability. If you have simply dropped out of the system, what evidence can you produce to prove continuing disability? I have heard of too many in this situation to chock it up to NAMI fear-mongering.

    To bring the conversation back to topic, the ability of Carrie Fisher to stay in treatment and remain gainfully employed is a ruse in my opinion. This is purely speculation, but I wonder how long Fisher would have lasted gainfully employed as a drugged up checkout clerk or a telemarketer or a personal health aide making minimum wage rather than a pampered celebrity. No disrespect meant to Fisher, just, she isn’t who I think of at all when I think of someone living well with SMI because her lifestyle was so unlike those of us non-celebrities. Not that money buys happiness, but I’m pretty sure I could buy some coping ability if I was loaded with millions too. The fact that she blamed her street drug abuse on mental illness but claimed to need psychiatric drugs to be a good person, suggests to me that she chose one set of drugs over another simply because society told her that was what was expected of her. The fact that she continued to struggle despite being medicated tells me the legal drugs didn’t truly work for her. The fact that she called mental illness “like a virus” sounds like blaming biology for bad behavior that unfortunately further enables those who wish to view us as fundamentally defective.

  • “There is no requirement for you to cooperate with biological psychiatry treatments like drug treatment for you to collect Social Security Disability payments or Veterans Affairs disability payments. Once your psychiatric disability has been officially established, the agency concerned would have to have you examined by one of their own psychiatrists who would have to certify that (absent any fraud on your part) your “illness” no longer exists.”

    Actually, the debate is not over whether SSA requires compliance with drug treatment to receive disability, it is over how someone could possibly prove they continue to be disabled if they are no longer in treatment. The SSA’s focus on treatment compliance is because they do not consider people disabled if the treatment heals them (say, like taking insulin for diabetes). So if you stop treatment, you not only have to prove that you continue to be symptomatic, you also have to prove that you didn’t stop a treatment that made you substantially better.

    “Some say I gamed the system, but the system is a very dangerous game itself when “mental illness” is involved.”

    Yes, it does sound like your case is unique. I doubt it happens very often that someone goes into natural remission and is still considered disabled. And you don’t have to go to NAMI or other pharma front groups to get this info. There are plenty of disability rights and support forums where people come to complain about an unfavorable CDR determination after they have dropped out of treatment. And they get appropriately mocked because well, exactly HOW do you prove you’re psychiatrically disabled without being in psychiatric treatment? What observable metric are you using?

    Social Security Administration is pretty clear about compliance.

  • “And what of us? Welfare fraud. I feel that this is the worst of psych crimes. Taking us out of society. Putting us out of work. Calling us disabled. Many of us could have worked. Some needed a break. I, certainly, did not need a three-decade break. I can’t find a job due to this lengthy gap in my work history. It has been hard enough to lie and explain it away. I think the docs should PAY UP. It was inexcusable.”

    This right here. I believe I was funneled onto the disability system. My psychotherapist at the time told me I “needed a break” and “my brother is on the disability board and your application will go across his desk so it’ll be approved”. I don’t know what I’m more embarrassed about – the fact that I didn’t catch that as fraud at the young age of 23, or that I allowed that break to go on for 14 years under the guise of being a “compliant patient” even when their treatments created (seriously) crazy where it did not previously exist.

    “I agree, we did play some part in it, but mostly, it was the docs and therapists who continued to insist “You are….””

    The whole concept of compliance sets up a ‘good patient/bad patient’ dichotomy. “Trust the doctor.” “Do as the doctor orders.” “The doctor knows best.” “You’re ill.” “The doctor says you need this medicine.” These messages, which all fall under the logical fallacy of Appeal to Authority take wisdom and maturity to see through and resist.

  • “Maybe, just possible it’s the school system failing the child?”

    The sorry excuse for a public education system in this country is why homeschooling has grown exponentially. People are waking up. It used to be that homeschooling was heavily associated with conservatives and extremely religious. Now, I know people from all walks of life, all faiths, all income levels, all family types across the political spectrum who are refusing to send their children to be institutionalized in schools that more resemble prisons than educational settings.

  • I agree with oldhead, though still glad I read to the end. This resonated with me:

    “Or, this societal-political “psychotic break” can result in further deterioration, further “social-political illness,” transforming the United States from “friendly fascism” and bullshit hypocrisy about democracy to violent, boot-in-your-face fascism where truth tellers in the tradition of George Carlin are driven underground, way underground.”

    As a former Democrat turned Green turned How Can I Unregister To Vote Entirely, I agree with this ending wholeheartedly. The greatest tactic I saw in the 2016 election was not “How do I bring this voter to my side?”, rather it was “How can I silence and shame this idiot who disagrees with me?” Silence and shame are tactics the psychiatrically marginalized understand all too well.

  • HumanMusic, welcome. I sympathize. The Social Security Disability system basically requires you to be hooked on psychiatric drugs in order to receive disability even if you have a documented history of the pills not helping. Unfortunately, I’ve never heard of someone unmedicated who passed their review as that is usually considered non-compliant. (Someone chime in if I’m wrong, please!) However, there is nothing saying you have to take the pills that are prescribed, and few of them have blood level tests available. Hope that helps.

  • No, we’re really not talking about different surgeries. There was no medical need for my cervix to be removed. It was suggested as practical by my surgeon. I have to suspect that other women have also been told of the practicality of removing the cervix at the same time as the uterus. Most women I know who have had their uteruses removed, whether due to endometriosis, pelvic organ prolapse, or for menstrual issues now called PMDD, have also had their cervixes removed since it is billed as beneficial to the woman because she will no longer need PAP smears and it nearly eliminates the risk of later cervical cancer. So, yes though our surgeries started for different reasons, my outcome could just as easily have happened to you or any woman who has been advised to remove their cervix at the same time.

    Again, I am not attacking or questioning your individual experience. But I am rejecting your basic premise of extrapolating that to other women. The fact that I’m doing it using the same anecdotal type of evidence and hearsay you are should show you the illogic of trying to convince someone of your belief by implying that all the ladies you know who happen to have the same questionable diagnosis you have agree with you.

    This will be my last comment because I’m not interested in an argument over whether a woman should be allowed to have parts of her body removed. That is a distraction. You have yet to provide clear evidence that PMDD is real or that major surgery with the possibility of severe complications should be a first line treatment.

  • The problem here is that I challenged your assertion that surgery should be considered a first-line treatment because your struggles would have been prevented if you’d gotten it as a first resort instead of a last. It is extrapolation of your own circumstances, and so I responded with my own story that countered your conclusion and you seem to have taken it as a personal attack. I never questioned your, or any woman’s, right to control their own bodies. I never would. I questioned the logic that your situation can or should be applied universally. I still think that jumping to hysterectomy is a dangerous suggestion to make considering that there is and continues to be fairly widespread legitimate debate about the existence of PMDD to begin with – that it is an extreme form of PMS, something modern research continues to debunk as a Western cultural phenomenon.

  • “I would like for grown women to be treated like grown women who have ownership of our bodies”

    I think you read more into my comment than I actually said. I too believe that women should have ownership over their own bodies. I had to fight tooth and nail for my tubal ligation at the age of 24. Even after finding a doctor to agree to perform the surgery, I had to wait 30 days after signing a state-mandated consent form. In the 14 years since, I still do not regret ending my ability to reproduce. So, yes, I understand this very well from a feminist perspective and I do think that women should be allowed to do whatever they want to their own bodies. However, that has to come with informed consent – something that happens too infrequently, whether it be for a pill or a major operation.

  • “You seem to be suggesting that death by suicide is preferable to the possibility of life without sex. I’ll just let you reflect on that and draw your own conclusions.”

    Excuse me? I never even came close to implying anything of that nature.

    I think you laid the case out very well that women don’t receive fair treatment in medicine. I don’t think you made an argument at all that hysterectomy and oophorectomy are the best treatment for a disorder that has only been found in Western women. And even then, the science behind it is so flimsy that the treatment existed before formal acknowledgement of the disorder even existed.

    I’m thrilled for you that your symptoms abated with surgery. As to whether your experience should be extrapolated to indicate that hysterectomy is the best answer, for that I am deeply skeptical.

  • I’m appalled at the suggestion that hysterectomy be considered the ideal treatment of menstrual difficulties. When we start treating male hormonal issues with castration, I’ll reconsider. Part of healthcare equity is making sure that women aren’t led down the road of easy answers. This piece uses emotional arguments of women not having their medical needs met in order to support that hysterectomy is a good solution to this issue. That’s simply not good logic.

    After my hysterectomy – and the resulting four revision surgeries in five years to repair my permanently damaged vaginal cuff, I warn women against this surgery. There are other ways. Just as it worked for you, it has been a nightmare I regret. I cannot have sex anymore. I will never have sex without severe pain and bleeding again. I was not warned about this possibility, nor did I know how many women end up with intractable pain after hysterectomy – yes it is underreported.

    Yes, women should be treated equitably in medical matters. No we shouldn’t jump into having our ladyparts cut out. There are real risks. They should not be denied just because the surgery itself is unlikely to kill you.

  • My IQ has been formally tested by psychotherapists on three occassions.

    At age 13, during a psychiatric intake at a private hospital, after being tested at 2am, the doctors announced to my parents that I was above average at 104! My parents were appropriately dismayed, thankfully, and never judged me for a 2:00 AM IQ score.

    At age 14, during testing for the Honors program in middle school, I was tested during daylight, non-crisis hours and found to be 119.

    At age 26, as part of psychological testing for college, it was calculated by my current PsyD to be 129.

    However, my last test was before I spent years on antipsychotic medication. I can say for certain that during the time I took Latuda, I could not even sit for a test. I attempted to once but the questions were maddeningly confusing – especially sequence-prediction. I would be curious, at this point, at nearly 38 and off meds entirely, to find out what’s left of my intelligence. I’d like to think that I could still bring in a solid 120.

    However, my short answer is that medicating bright people into a stupor is a crime against humanity and almost certainly results in some long-term loss of cognitive abilities.

  • When I told friends that I was tapering my psych drugs, by far the most common response was, “we’ll be here for you when you come to your senses and go back on the meds”. Based on my experience successfully withdrawing, I now recommend to others that they test the waters first before telling people their plans. Ask questions like “what would you think if I were to attempt to go off meds?” If they respond positively, consider adding them to the list of people “in the know”. Anyone who gives an equivocal or negative response to that question should not be told until well after the successful withdrawal is complete. It’s very sad that we need to consider that not everyone will be supportive, but it is a fact.

  • “I don’t think Big Pharma is losing any sleep over all this. They’ll get their $$$, especially with the GOP in control.”

    I’m a die-hard liberal but I’d like to urge people to keep some perspective about partisanship. Mental health issues are not a Red v Blue issue. At least not anymore. We need to remember that the Democrats pushed us under the bus with the 21st Century Cures Act. It passed both houses of Congress with overwhelming Democratic support, Vice President Biden personally lobbied for it, and President Obama said he was looking forward to signing it. While the Right tends to see mental distress in terms of poor character development, an awful lot of educated liberals who worship at the altar of science have bought into the idea that mental distress is a medical (brain chemistry) issue and that lack of access to psychiatric treatment is the actual problem, not overtreatment. We need to be careful to identify the villains correctly and not just villainize “the other side”. I think this perspective is in line with the rest of your comment about the tendency to villainize “the other” and that is where the true problem lies. It’s just that we mental patients are “the other” to all sides.

  • Personally, I am expecting to read a lot more stories about police shooting people in mental distress, which will likely serve to reinforce the public perception of mental patients as dangerous, then leading to more restrictive laws advocating forced treatment. Mental patients are being set up. I can only thank goodness I saw the writing on the wall and successfully withdrew from the drugs already. Many will not be so lucky. I don’t know what the answers are. Perhaps those of us who are ahead of the curve can make an effort to reach out to those in distress to try to avoid the extreme outcomes many are predicting.

  • Thank you for hearing me. I, too, would hope that most of us have at least one person we can be honest with without fear of repercussion. However, I would argue that many of us ended up caught up in psychiatry’s dragnet precisely because we didn’t have the social support we needed, or trusted the wrong person with information about our internal thoughts. So perhaps it would be helpful for patients to have some guidance on how to better determine who they can trust. Specifically, what questions to ask of the potential support person to ascertain whether they are willing to support the distressed person in a way that the individual being helped has determined to be actually helpful. It’s also important to remember that those of us who struggle with trust issues or even paranoia did not become this way in a vacuum. I don’t know what the answers are. I only hope to provide food for thought. Thank you again.

  • I’ve been waiting for this article since the election. Finally somebody saying more than “the sky is falling!”

    I certainly agree with the suggestion to close down social media accounts. But I’m not sure I agree that people should reach out. In fact, I suggest something radical. Do not reach out. Do not call suicide hotlines. Do not tell your doctor or therapist what you are thinking, especially if you suspect that thinking is disturbed. When people ask how you are, take a deep breath and lie through your teeth if you must. But do not tell anyone you are struggling – most especially during drug withdrawal. Anything else leads you back to psych drug dependence. If I had done otherwise, during the horrors of withdrawal, I would have been hospitalized and again pumped full of drugs. I learned the hard way to lie to the doctors (and friends and family) about how I was really doing. Even those on psych drug withdrawal peer support websites seem to see themselves as authorities and if you do not follow their somewhat arbitrary titration rules to the letter, you will find yourself with a sudden lack of support there too. So lie. Do not tell anyone save perhaps those you actually live with, what you are going through. This may be the new version of fake it until you make it, but we’re left with little other options in our current society if we want to keep both our freedom and any remnant of our sanity. Asking those with a history of psychiatric disturbance to reach out *and* trust that telling the truth won’t hurt them is asking too much of them.