I was in therapy much of the time that I was also seeing a psychiatrist, and that moderated the influence the psychiatrists had on my own opinions of what was wrong with me or what was effective. The therapists were doing the work, every week, for an hour or two. The psychiatrist saw me less often, every three months at one point. I became inclined to judge the efficacy of the psychiatrist’s work solely on whether the medications were helping. Their opinions on other matters pertaining to my depression carried little weight with me. Something that struck me was how little agreement there is between psychology and psychiatry in the causes of depression and other conditions. A psychiatrist once told me that psychologists were confused about some aspect of mental illness or other. I don’t remember exactly what it was now. I do recall my trust in both psychiatry and therapy slipping at that moment. Sadly, I do not believe that I benefited from therapy much, either. The therapist I spent the most time with was trained in the Rogerian tradition, which essentially is, “Life sucks.” I say, “And?” He replies, “And nothing. Life sucks. End of story.”
I read an article by that author which had some good insights. I can’t remember the name of it now. However, Mr. Hari has a history of fabrication in his journalism, so I am inclined to take anything he says with a grain of salt.
Reading the article by Schwartz reminded me of a therapist who struggled more visibly with her own internal protective mechanisms than most therapists I had met. Her inability to master her more negative impulses often impeded her ability to help, even though it seemed she wanted to. This paralleled one of her observations about me, though. She said I was like a person in a sinking rowboat who wants to get ashore, but bats the people away who are trying to help. In my case, it was because I had gone ashore in the past and it was no better than drowning. In her case, she may have needed more affirmation from her clients than was appropriate.
I psychiatrist said that medications can appear to be ineffective during periods when things are going worse for me. At the time, I was in the military, working in a job for which I had no aptitude, which resulted in my being screamed at and called stupid regularly. Those were not happy times.
I was experiencing psychotic episodes prior to being on any kind of medication. At the time of the episode I describe in the essay, I was on half a dose of carbamazepine, and taking no other medications. It is possible that anticholinergic toxidrome was responsible, but I think that my extreme emotional turmoil at the time contributed more to its development. My issues in general are more related to trauma than biology, I suspect, psychosis included. Thank you for sharing the information on toxidromes. It was interesting reading.
Your description of your experience with Wellbutrin reminded me of Joseph Heller’s novel Catch-22. As if I weren’t suspicious enough of a profession that now appears to have embraced the novel’s portrayal of the Army Air Corps as a blueprint for how it should conduct itself.
I psychiatrist once objected to my sense of humor, labeling it “sarcasm.” It is often lost on people in positions of authority, like psychiatrists, that things do not occur in a vacuum. My “sarcasm” was enabling me to cope with his failure to listen to me. If he had been listening, the sarcasm would have been unnecessary.
I will probably write about my experiences with VA Voc Rehab in more detail at some point.
As I experienced the roller coaster of feeling bad and then better, I realized that the common thread when I was most depressed was people. The more I was able to escape from people, the better I felt.
I did look at my files. They reflected the psychiatrist’s frustrations that the medications they had chosen weren’t working. They never blamed me or themselves. I believe most of them were sincere in their desire to help. Psychiatrists face two problems. One is that the substantial gaps in scientific knowledge constrain their ability to help. They may have known for decades that antidepressants are bogus, but I don’t believe they continue prescribing them out of malice, but because a better solution hasn’t been found. (At least from my experience with therapy, which was a train wreck also.) The second is that they turned themselves into one trick ponies by limiting their services to prescribing medication. They have no choice but to push pills, even as evidence against antidepressants grows, because that is the only club in their bag. I am oversimplifying a bit here; psychiatrists may still be able to contribute to the treatment of conditions like schizophrenia. It is also worth noting that because patients have the right to examine their own medical records, providers typically don’t write things down that they wouldn’t want the patient to see. That tends to limit the usefulness of medical records for the purpose you describe. They are unlikely to record evidence of actual malfeasance in any case.
I was in therapy much of the time that I was also seeing a psychiatrist, and that moderated the influence the psychiatrists had on my own opinions of what was wrong with me or what was effective. The therapists were doing the work, every week, for an hour or two. The psychiatrist saw me less often, every three months at one point. I became inclined to judge the efficacy of the psychiatrist’s work solely on whether the medications were helping. Their opinions on other matters pertaining to my depression carried little weight with me. Something that struck me was how little agreement there is between psychology and psychiatry in the causes of depression and other conditions. A psychiatrist once told me that psychologists were confused about some aspect of mental illness or other. I don’t remember exactly what it was now. I do recall my trust in both psychiatry and therapy slipping at that moment. Sadly, I do not believe that I benefited from therapy much, either. The therapist I spent the most time with was trained in the Rogerian tradition, which essentially is, “Life sucks.” I say, “And?” He replies, “And nothing. Life sucks. End of story.”
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I read an article by that author which had some good insights. I can’t remember the name of it now. However, Mr. Hari has a history of fabrication in his journalism, so I am inclined to take anything he says with a grain of salt.
Reading the article by Schwartz reminded me of a therapist who struggled more visibly with her own internal protective mechanisms than most therapists I had met. Her inability to master her more negative impulses often impeded her ability to help, even though it seemed she wanted to. This paralleled one of her observations about me, though. She said I was like a person in a sinking rowboat who wants to get ashore, but bats the people away who are trying to help. In my case, it was because I had gone ashore in the past and it was no better than drowning. In her case, she may have needed more affirmation from her clients than was appropriate.
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I psychiatrist said that medications can appear to be ineffective during periods when things are going worse for me. At the time, I was in the military, working in a job for which I had no aptitude, which resulted in my being screamed at and called stupid regularly. Those were not happy times.
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I was experiencing psychotic episodes prior to being on any kind of medication. At the time of the episode I describe in the essay, I was on half a dose of carbamazepine, and taking no other medications. It is possible that anticholinergic toxidrome was responsible, but I think that my extreme emotional turmoil at the time contributed more to its development. My issues in general are more related to trauma than biology, I suspect, psychosis included. Thank you for sharing the information on toxidromes. It was interesting reading.
Your description of your experience with Wellbutrin reminded me of Joseph Heller’s novel Catch-22. As if I weren’t suspicious enough of a profession that now appears to have embraced the novel’s portrayal of the Army Air Corps as a blueprint for how it should conduct itself.
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I psychiatrist once objected to my sense of humor, labeling it “sarcasm.” It is often lost on people in positions of authority, like psychiatrists, that things do not occur in a vacuum. My “sarcasm” was enabling me to cope with his failure to listen to me. If he had been listening, the sarcasm would have been unnecessary.
I will probably write about my experiences with VA Voc Rehab in more detail at some point.
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As I experienced the roller coaster of feeling bad and then better, I realized that the common thread when I was most depressed was people. The more I was able to escape from people, the better I felt.
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Thank you. I submitted another essay. I don’t know if the editors will accept it or not.
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I did look at my files. They reflected the psychiatrist’s frustrations that the medications they had chosen weren’t working. They never blamed me or themselves. I believe most of them were sincere in their desire to help. Psychiatrists face two problems. One is that the substantial gaps in scientific knowledge constrain their ability to help. They may have known for decades that antidepressants are bogus, but I don’t believe they continue prescribing them out of malice, but because a better solution hasn’t been found. (At least from my experience with therapy, which was a train wreck also.) The second is that they turned themselves into one trick ponies by limiting their services to prescribing medication. They have no choice but to push pills, even as evidence against antidepressants grows, because that is the only club in their bag. I am oversimplifying a bit here; psychiatrists may still be able to contribute to the treatment of conditions like schizophrenia. It is also worth noting that because patients have the right to examine their own medical records, providers typically don’t write things down that they wouldn’t want the patient to see. That tends to limit the usefulness of medical records for the purpose you describe. They are unlikely to record evidence of actual malfeasance in any case.
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Thank you. 🙂
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