You like being highly sensitive? I consider it a curse. It’s not that I don’t appreciate the trait; it’s that others have made it one.
The reason so many people, especially the elderly and women, are taking “psychiatric drugs” could be that doctors have no flipping clue how to treat most chronic illnesses.
And, sadly, the ones I run across don’t seem too interested in learning
I don’t disagree with your assessment of how people are treated in locked wards. It’s probably worse than I can fathom. However, I think you’re way off base when you state that the ‘general public’s negative perception of psychiatry…. is grounded in a realistic appraisal of psychiatry’s spurious concepts and destructive “treatments”.’
This may be the reason in the circles you travel in including here but, no, it isn’t.
The general public is afraid of people considered out of the ordinary, out of touch with reality, unstable, unpredictable and sometimes violent. Throw in a dose of judgement for others who are not able to support themselves and a disdain for those considered weak and to blame for their situation and that is gets you to the general public’s perception of psychiatry and psychiatrists (long considered as ‘crazy’ as the people in their locked wards).
I suspect that I what I wrote sounds harsh, and in reality it is, but I don’t think it serves well to attribute an understanding to the public which they lack.
A very hopeful article. Yet what are the parameters around the definition of “functioning” and the stops to be placed on blaming the victim if they still experience distress even after they are “accepted”?
And more importantly, how are medical conditions such as a thyroid storm or adrenal issues going to be ruled out? Medicine does a pretty poor job of that now and the move to acceptance doesn’t seem to point in the direction of making that any better.
Ted,
My comment at 12:22 am was in reply to you.
I appreciate your honesty and insight. It reminded me of the following quote from a psychiatrist given in reply to my question about what he thought of a colleague leaving a comment on his blog calling him an antidote. Note that none of us know each other; it is all on the web.
I am an antidote to naysayers because I (like my colleagues) have been wandering the hallways of a crummy psychiatric hospital all night long trying to take care of desperate problems and make sure the staff is safe. We are the ones worried more about the drunks, drug addicts and psychotics and what happens to them. By the time we see them nobody else wants them around. I am the last bridge to be burned and nobody has been able to do that yet.
Many here would say he is an egotistical jerk but I don’t read it like that. I accept people’s experiences here and accept his just the same. I don’t I see him as a savior, simply a human being, but I do think he interacts with those most have given up on.
Was red rice prohibited at one time? I just recently bought some.
Or did you mean red yeast rice which contains the same ingredient in lovastatin? If this, then I would wonder if the drug has nasty side effects, why anyone would want to take it as a non-controlled supplement.
Hi Duane,
It is intoxicates they don’t want you on.
Any drug to get you to be positive, shut up questioning their ridiculous practices, and not notice how they abuse you is all good.
I am positive that if Prozac came in an aerosol room spray, they’d be piping that stuff through the ventilation system.
John Smith,
You may wish to take a look at Dr. Nardo’s first article on the subject where you quotes Göran Högberg, PhD the man who originally picked apart this article.
The market should not decide this nor should gov’t. Both will turn on you in a moment.
It should be us deciding this.
I’m not sure I understand how the placebo response plays out in the real world when you have people who need to try multiple ADs to find one that works. Even with the poop-out effect confuses me. Seems odd that one day someone just decides to stop believing they work. Although that does have a bit more plausibility.
Nor does it seem to account for someone like me who doesn’t think any med or supplement works until proven otherwise by trial and error. I’m actually quite surprised when any of them do.
No, I don’t take ADs, but I have been through various sleep meds taken as needed, and I’m positive 5htp has an effect on the quality of my sleep/dreams.
They are also many of the same symptoms of a myriad of medical diseases but it appears that if you take this particular test, they are all of a sudden due to depression only.
Since Rebel will no longer discuss, I’ll just confirm my experience with sleep apnea. The treatments lag behind what is needed and they do extract a lot of money from the current ones they have. However, it is a very real condition and when you see that your O2 level is hitting 73% while sleeping you know something is very wrong.
Now if they would just pay attention to the cause of the other 50% of my arousals that are not tied to breathing events, I would be much further along. I personally think it is silent reflux and do the best I can with treating that on my own.
And back on topic, it will be a godsend if any physician pays attention to nutrition, and I hope and pray that gut-brain axis dysfunction is researched as fiercely as they do other common diseases.
Robert Whitaker,
I understand this is a niche question in the larger picture but I would appreciate your thoughts on something that I’ve wondered about for many years.
Why aren’t there more whistleblowers?
Did you discover influences on this and are they addressed in your book?
The closet I’ve come to an explanation so far is in a very recent article:
The following quote from the article addresses an institutional reform that I’ve only seen lip-service paid to, and frankly, I wonder if it is even feasible. Regardless, do you find any merit in it?
If an organization’s policy can be reformulated so that whistleblowing is regarded internally as an act of loyalty, then it will no longer contradict the evolutionary urge to be cooperative.
It’s not my intent to promote any drug, legal or illegal.
I see them all as a deal with the devil. You going in thinking, hoping, you’re going to get the better part of that deal but that generally is not the case except for some life-saving meds.
My reply was only to address the fact that advertising/placebo effect is not what is causing this. Advertising doesn’t help but there’s something else insidious going on here and it’s going to drive a legal, illegal or supplement market regardless.
“Society is the patient, and the mentally ill person is the disorder?”
You’re catching on now.
In this case I don’t think so.
After having been in corporate culture for even a brief time, you quickly realize it is a heart of darkness, and it’s easy to understand why people turn to these drugs in order to get an advantage or merely to cope.
The marketing of drug companies is tangential. The idea to use mental enhancement drugs is mainly spread by word of mouth including weirdo self-help gurus on the internet like the “bullet-proof executive”.
After that it is just people experimenting with these drugs that either convinces them to use them or not; no marketing involved.
That’s supposed to be “…a marker for physical illness…” in my comment above, although I suppose it could equally apply to a psychical illness as the neuropsychologist didn’t find any evidence of that either.
I was curious so I did some searching. The following quote was the closest I found to a direct statement regarding low levels of serotonin as a cause:
“These data indicate that low serotonin levels alone cannot cause depression. However, serotonin does have a direct effect on mood, and low levels of serotonin contribute to the etiology of depression in some depressed patients. ”
But in reading the 2005 PLoS Medicine article linked to in the post, it appears to support what Scott Alexander is saying at least as far as the medical community’s literature is concerned:
“To our knowledge, there is not a single peer-reviewed article that can be accurately cited to directly support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. ”
Of course that still leaves the question on why the marketing material was not attacked by the same community. There are many who are in my face with what “science says” and who willing mock those who question it, but here it was given a pass. I can only surmise that it was a matter of convenience for both physicians and patients.
With that said, I support learning from history and using that as a guide but not in dwelling on it to drive a point home. And this is only because I find the present to have enough issues of its own.
The most recent meme I have experienced with several physicians and one neuropsychologist (no psychiatrists involved since I’ve never seen one) goes as follows. I tell a physician about my fatigue > they tell me that haven’t found a marker for a psychical illness > they say antidepressants > I give them a WTH look > immediate words are “antidepressants are safe”.
Why are they saying that when it’s not in response to a question I’ve asked nor even the reason for my WTH look?
“So he must be incapable of determining the value of his own experience , which has negated his opinion all together.”
Wow. Unless I missed the sarcasm, do you have any idea who and what this sounds likes?
What you said, B.
Dr. Berezin, I too would like to apologize for welcoming you here with a challenging comment. It was about the impracticality of psychotherapy as mainstream. Even though I don’t see a way through that yet, after having read more of your work here and on your blog, I have to say you are one of the rarest of people I’ve come across; someone who has found their calling in life.
Your passion and love for your work is so striking and heartfelt that I can’t think of a better advocate for psychotherapy and I wish you well on your “call to arms”.
Amen, brother.
All of your points are valid.
I was merely pointing out that a semantic change alone is not going to erase the stigma of being perceived as unable, or worse unwilling, to handle the stresses of work/life. And, not just for the term major depression but also for PTSD, panic attacks, phobias or anything that is seen as an inability to cope.
Perhaps it is my impression of the traditional/Hollywood meaning of a nervous breakdown as being a fair amount of time that someone is incapacitated. That is not something you can hide.
I’ve had co-workers tell me they have gone home and cried every night, and I’ve come across more than one co-worker crying at work. As long as they go see their doctor or therapist and can still show up to work and can perform without accommodation, no one really cares that they have “depression”. But, take them out of work for a sustained period of time or ask for reduced duties and things start to change rapidly.
I wish I worked in a place where people understand and empathize with someone having a bit too much to handle psychologically. In my current and former workplaces, Paternity leave is something still largely frowned upon. Now imagine time off for a break-down.
In current times, even though the term isn’t used very much, isn’t there the same amount of stigma attached to having a nervous breakdown as in calling something else?
In the working world it is looked upon as weak and fragile. I know in workplaces I’ve been in if someone was known to have a history of a “nervous breakdown”, it would not be looked upon favorably for hire, promotion or treatment as an employee.
I don’t recall if you’ve mentioned your profession or not, yet I know that Psychiatric Times limits comments to those who work in health care.
Also, you can reply to Dr. Frances on Huffington Post. I think all pf his articles are posted there. They use Facebook for comments.
Dr Berezin, how would incorporate psychotherapy for the working and lower middle classes?
For many there isn’t the time off from work or the money to spend on therapy even if it is only a co-pay. Most people struggling just want (and need) to be functional and many times I’ve seen where a short-term fix is chosen over what is best for the long-term in matters both psychological and medical.
I’m not sure how it is in medicine or academia but the business world is merciless. For those that fall behind, it reminds me of a boxer with an eye swollen shut; just put out a call for a doctor to slice the bruise, stitch the cut and wipe the blood out of his eye so he can get back into the fight. Why? So he can go out and get his head beat in even more? But fight is what he is taught to do, isn’t it. It is what we are all taught to do.
So until the world changes, I won’t hold my breath that either the eradication of psychiatry or the return of psychotherapy will solve the issues of people that need to support themselves and their families while not in prime working condition.
N.I.
You may be late, but not too late for me.
Unfortunately I don’t get the sense of a search for the truth from many of the regulars here. I think most who post here already think they’ve found the truth (for everyone) and when those who disagree with them threaten this truth, they are treated accordingly.
I don’t single them out on this either. I only speak of human nature. I’ve seen commenters as vicious as some here on other blogs where when the article questions the use of antidepressants for psychological or spiritual issues. Google “Depression is Selfish” for one such blog. The offense some take there is no less than here but on the total opposite side of the debate.
I also don’t think being “helpful” is some nice to have unicorn dream the way it seems to be brushed off here. “Helpful” literally can be the difference between living on the street or holding down a job.
I am not advising anyone to take meds to solve their current issues at the expense of the their long term health. Everyone has to make their own decisions, and unfortunately, do their own research. You should no more trust a random person on the internet than the doctor in front of you. Personally, I’ve never been one to trust doctors much, but then again, I haven’t been one to distrust them either. Ditto for people on the internet.
I follow my own path. And, even though you say you have to trust someone, to which I agree to a certain extent, I think the real answer is to trust yourself.
If the camping trip involved sleeping on the cold hard ground, I would think it wouldn’t be very helpful.
AA,
Nope, the questionnaire doesn’t rule sleep apnea in or out. It is used to assess the quality of sleep (doesn’t matter how many hours) – which is what I thought you were having a hard time explaining to them.
There’s a fair percentage of people with insomnia because of stress and another large percentage because of lifestyle and poor sleep hygiene. I don’t belong to either group. I know this because I was open to it being anything, and in that respect I used observation and experimentation to try and figure out what was causing my godawful fatigue.
I’m far from a hypochondriac but what I was doing is something I didn’t find my doctors doing. This would be what’s called a differential diagnosis. It must be extinct because I haven’t seen it in years. All I get is symptom treatment; with fairly poor results at that.
As far as my own journey, I don’t wish to go off on a tangent of sleep apnea, GERD and insomnia here. If so inclined you can reach me at [email protected]. I am kind of curious of your experience, but no issues if you’re not interested.
BTW, Xyrem is mentioned often on the sleep apnea and insomnia boards. Personally, I never paid much attention to it as it is ridiculously expensive. I did find something more “official” about it at the link below and it appears to help narcolepsy through the quality of sleep it provides, but readers can look into it; I won’t as it is not an option for me.
Well AA, here’s to you for gently correcting misguided notions on sleep issues. At least this thread didn’t devolve into warm milk, hot bathes and chamomile tea.
For someone with sleep apnea and silent reflux, having arousals (your brain wakes up, but you don’t) 92 times an hour during REM sleep and in non-REM sleep about 30 times an hour – I completely understand where you are coming from. It was driving me mad. And in my case, CBT almost sealed the deal.
I tried CBT sleep restriction therapy twice on my own and failed, so I went to the psychologist attached to the sleep clinic. We tried it one more time and he called it before I was going to. I thought I may need to just try harder. Um, no. He saw how it was just more sleep deprivation at that point and stopped it. And , thankfully he sent my PCP a note stating that I don’t have a mental health issue around sleep.
Not to lead this into a Sleep Apnea thread as there are some really good blogs out there for that, but your sleep clinic sounds a bit odd prioritizing how much you sleep. I forget the name of the questionnaire I am always given, but it asks questions about how tired you are and how likely you are to fall asleep doing things such as driving, watching TV, talking to someone.
And, for CPAP tolerance, have you tried nasal pillows? There is no way on earth I could tolerant a mask (tried it when I had a cold), but the nasal pillows are doable. Now I just have to work on the d_mn hose. I think I need a hanger for it to keep it out of my way.
“What kind of suicide do you want?”
How about neither.
AA, thanks for your reply; it was very kind.
I don’t tie the increase in suicide necessarily to the increasing consumption of drugs (both legal and illegal), even though I know they can have and have had extremely negative impacts on an individual basis. My reason being is that this country has been in downward slide for decades. All the promises, aka lies, of a Great Society being flushed down the toilet and a rapidly aging population that is increasingly marginalized.
Agree on the quickness to drug people, although the people I know that go on ADs do so for only one reason and that is to remain functional so they can feed their families. Personally, I avoid ADs like the plague. Tried some for sleep issues prn. That was problematic enough. If I saw no choice but to take them or live in my car and beg on the streets, I would probably take living in my car or off myself. Of course, I support no one but me so I don’t have to take that into consideration.
But, I have always wondered why does it have to come down to so few options?
Leah, I very much appreciate your reply. That is where I was headed. Our culture is brutal almost without exception.
The stories here pain me deeply, yet there are other stories of people who don’t visit and they are hurting too. I know there are answers here other than that we see now and that is what I am looking for. I can’t tell you how much it means to be given the knowledge of, and the directions to, places to get help outside of the current mainstream offerings, and that some others see the bigger monster facing us.
Non-treatment doesn’t work either.
A friend of mine who was a dentist, also a problem problem drinker, was often in a down mood. He was always very hard on himself and never thought he was disciplined enough or good enough to measure up to the standards in his head.
He never received any kind of treatment (medicinal, psychological, or spiritual) because he considered it all to be a load of crap and his problems as individual weaknesses. In his early ’30s he took his own life after receiving a DWI. The shame of it pushed him over the edge.
So, no interventions there and still dead.
Serves our “masters” to keep it this way, doesn’t it?
I only see the mental health system as bit players in all this. Powerful, but not really when you think about it. They could all be replaced with somebody and something else. Much worse most likely, because you can still find those who are helpful within it now. Take them out of the picture and what is going to be left?
I am no fan of the current lie, but there is a much bigger problem here than MDs.
AA, I apologize for the c0nfusion. I understood what you said and switched gears too fast there.
I know people who have gone to their GPs because they were cracking under stress and crying all the time and those who have gone to them for PSTD flashbacks. Yet, I have also known those who have gone to them for any number of symptoms but still out comes the Rx pad for antidepressants or any of a myriad of other meds.
My statements address both situations. Why go to a GP for emotional issues. And, why accept treatment from GPs for what they identify as emotional issues?
AA,
I understand what you are saying, but unless it is coerced, our decisions are still our own. And I know this is easier said than done; I’m in the middle of my own 2 year battle against short-cut medicine.
This comment was in response to Jordan’s.
Yours is a very well reasoned response. If you hadn’t prefaced with your first paragraph, I may have seen some large holes in it, but for now I mainly agree – particularly on the polarization part. Although that is still up to the individual to reside in that camp.
I don’t disagree. My comment was based on the fact that even if Rx numbers weren’t going up, we’d still have a population in need of relief just due to the way we live today.
About allowing only psychiatrists to prescribe these meds, wouldn’t hurt my feelings if it were this way. However, since that will not happen in my lifetime, how about people just stop going to GP’s for emotional issues.
If you can swing it, and depending on your field of study, all you need is an online degree program, a laptop and someone’s wireless connection.
For all those who wish to intellectualize the debate, please consider this. Absence of coercion is the absence of something. Not sure we all agree on what, but from what I gather from those that write here it is the removal of coercion on philosophical grounds and/or because of the harm it may cause. Or may not, cause – you can not predict whether coerced psychiatric care will harm or help a given individual no more than any other mortal. And I don’t mean “odds of X happening”.
Therefore, please do not pretend (and I know that not all of you do) that it is the presence of something. The something being, the intent to provide or the means, opportunity, or provision for, the care of another human being in distress.
Many here talk of how to get society on your side. Even though I can’t speak for all members of society (I am quite libertarian compared to most) I can say this as a random member of the public who is not an ex-patient or a worker in the psychiatric system – if you wish to get society on your side you may wish to prioritize the presence of something over the absence of something.
For the alternatives, I’d say you need more practitioners or better PR or both, probably both. Maybe it’s my location; I come from the land of Drs Szasz, Breggin, and ironically Pies, but there still aren’t a lot of alternatives in this area in medicine or pysch.
Governments are into control, I agree there, and they control a lot more than psychiatry. But I don’t think they wish to be in the mental health business except that the public expects them to be, so the public as a whole doesn’t have to deal with it.
A random conversation last week at work among a bunch of 20 somethings about giving money to the homeless. Usual conversation about scam artists and them using money to buy liqueur. And then one of them says “I don’t give money to beggars; that is what I pay taxes for”.
From experience I know that many think this way. And, it is the same with mental health; most of the public pays zero attention to the issues unless some horror story on the news grabs them. But even then, they don’t look into; just follow whatever the talking heads are saying, and then after a short time they go right back to not paying attention and thinking they are good people because that is what they pay taxes for.
I understand. Who could support what was done to you. It is because very few are paying attention that this type of thing goes on and on.
Part of the reason I was so blunt with you was because I’ve seen many comments which present that abolishing coercive psychiatry or psychiatry as a whole is the real issue, and once it is gone then the fight is done. I respect people having this viewpoint and even more so for honestly stating that they do; it just doesn’t happen to be a viewpoint that I respect as it is a dangerous one. Nature abhors a vacuum, and society does too. Unless something else is born that will provide a place for that anxious person to go to get help and not abuse, well , I have no faith in society as a whole to do the right thing in its absence.
Call me naive, but I’m one that looks for a third way, not the two sides generally found in this debate. I’ve come to the conclusion that the answer most likely lies in those closest to the situation taking care of their own.
For an example from medicine, a couple of days ago I read that there is an effort to crowd-source research into CFS/ME. It burns me that people have to pay for it, in effect, twice. Once by supporting Corp Med and taxes to government (both of which are too incompetent, insensitive and corrupt to pursue real research into CFS/ME) and again with our donations. But, I am really happy that people are not wringing their hands waiting for them to do the right thing anymore and are just going ahead and funding the research themselves.
But, I don’t expect miracles out of anyone though. Maybe just a little more talk of what works to help those who need it and where they can go to find it.
boans, you present some strange analogies that I could draw illogical conclusions from. From your train of thought, I shouldn’t grab a child about to run out into the road lest I put my hands on them.
I think your argument can stand on its own merits without resorting to convoluted debate tactics that solve for as much as arguing over how many angels can fit on the head of a pin.
I don’t agree with forced treatment on moral grounds. But I also find asking others to participate in your demise morally indefensible as well. If there is someone too anxious to leave their home will you be picking outside of it to prevent others from interceding on their behalf while they quietly starve to death. Or will you take upon yourself to feed them for years or until whenever they get better.
Francesca, while I concur with your position in regards to Dr. Lawhern’s thoughts, I think asking cannotsay2013 the question who he has helped personally is not appropriate because it is a personal question, the concept of help is subjective. and for that the answer will always be unknown to us unless those he has helped decide to answer your question here.
As someone who lived all of my adolescence dirt poor but managed to dodge the system, everything you said is correct.
The powers-that-be choose to focus on the individual in order to deny the societal problems that were supposed to all magically disappear with the War on Poverty or the trickle down of wealth.
Btw, I didn’t know “decontextualizing” was a word, but that is what is happening, and I think I will use this word from now on.
You may be thinking big, but you are not paying attention to history. The freedom fighters only did half the battle, hence 200 yrs + and we still deal with the fallout.
They come cheaper than psychiatrists and write for the same pills; that is all that matters.
I wasn’t clear. I mean those here become the people who others reach out to.
Which is why I hope you all grow bigger networks of folks to reach out to.
****Don’t read this if you are subject to triggers****
I have several issues with CBT and one of them is that if things can get better, they can also get worse. One never knows.
I just work at it one day at a time and don’t particularly expect anything except that I am coping at the present moment.
Heaven’s no, not a crime. Is that more of this rhetoric thing I keep hearing about?
Just kidding.
It wasn’t the anesthesiologist; just one of his peeps – an OR Tech. After I was a “criminal” in the OR, I ended up being a curiosity in post-op. They just had to know what paradoxical reaction I had after taking Versed because they had never heard of that before.
A few months later when I underwent a colonoscopy without sedation, I moved to being a mild amusement. But, when I hit two endoscopies without it, then I became A HERO.
See, it is all about perspective. That is why I am not often offended by insults on the internet. I have too much adventure in my real life to be concerned with strangers.
And, it is also all about who you get as your doctor (and other providers). So, I hope you find a good one soon.
I’ve been reading blog comments for close to seven years. In that time I have only read apologies from a handful of people. Dr. Hassman happens to be one of them.
You never know who is going to end up being reasonable once you get over the strife.
You’re right. There is a certain attitude in large areas of the medical field. In my case, most doctors were ok; I had more trouble with staff. One OR tech glared at me with hate because I wasn’t getting conscious sedation. Must have thought I was a drug addict or he just didn’t want me to remember him; I don’t know.
Take care of yourself. You’re the only one with a vested interest in your health. And, if possible, always take someone with you to the hospital. I worked in them for 13 years, and it was my advice to everyone I knew undergoing any type of procedure.
Says nothing about truth, does it?
I’ve read almost the same statement in comments on psych boards and they mean it literally. For those, it may even be true in their own lives.
Dr. Healy writes good prose. But I’d say the subject doesn’t need rhetoric; it is serious enough on its own.
Art in a discussion like this? Words mean things.
I agree it is a pointless discussion on what is the most abusive relationship in the world. Which is why I was kind of surprised that Dr. Healy was quantifying it as the “greatest”. Perhaps if he had stated it more simply like along the lines of what you wrote about the state (and I add by society as a whole) it wouldn’t have appeared to so rhetorical.
That is fine but it wasn’t his point. Dr. Hassman is speaking of prevalence of abusers not exchange.
Everyone has the choice to be disrespectful or not. It does not depend on your opponent, and it does not depend upon the argument. Make your own choice.
I will tell you that on this blog I saw one of the most childish displays of disrespect ever on a blog. I very much appreciated that they deleted the comments.
Francesca @ July 13, 2014 at 9:30 pm.
Very well stated.
I didn’t get to respond to boans before your comment, so I’ll just comment here.
Pointing fingers at others was not Dr. Hassman’s point at all. He responded to a somewhat overly melodramatic claim that when doctors meet patients it is the greatest mismatch in power between two people and the easiest place on this earth for an abuser to flourish.
Dr. Hassman gave what he sees as other examples of this that are more prevalent and more unequal.
I personally don’t believe Dr. Healy can back up his claim and that no one can substantiate the worst of either case, because quite honestly it varies.
I recall the days when feminists were shrieking that the most unequal relationship was marriage. To make these kind of statements appeals to followers but doesn’t do much for an onlooker trying to decipher what is going on.
One small suggestion. You can read what he thinks about prescribing practices at his blog. It’s not like he is mysterious about it.
I see the issue with attacking psychiatry as a means to reach the public failing because it leaves a vacuum. It isn’t like slavery where it is freedom vs being owned as the struggles of people don’t go away if psychiatry goes away. So, does the public look to the medical community which has an infrastructure in place no matter how pathetic or to MIA which has slim offerings other than bashing psychiatry. I think if you are able to get some grass-roots real care for people, they would beat a path to your door. If you wish to stick with the slavery analogy, think underground railroad.
This is from a random member of the public with Adjustment Disorder being the only label assigned to me. I took it in stride because it allowed insurance to pay for several psychologist’s visits, and it assisted me in getting my medical doctors to take my physical health seriously instead of just shoving antidepressants at me. I only call this out because I wanted you to know what perspective I come from; I have no skin in this battle from either education or experience.
What do you think of people that have been through it, taking care of their own?
Sometimes I think that is the only way. After people see it working, then they will believe there is an alternative.
I see a great benefit in having primary care physicians in a community mental health clinic as from what I have read the medical care of those with mental illness diagnoses is very poorly delivered. However, I am having trouble believing that a few mental health personnel scattered in a primary care clinic would have the same effect. The reason for this is when I read the stories of those labeled with mentally illness going for care, their physicians see their diagnosis and either want nothing to do with them, but refer them to behavioral health or they think the patient’s symptoms are all due to their mental illness.
I know a psychologist that was working in behavioral health within a pain clinic who is now in private practice. He was uncomfortable with the way patients were being treated as he did not believe the majority of them were displaying psychosomatic symptoms. If he wasn’t working in private practice, but for a clinic that employed him, would he have told me he found I exhibited no psychological issues, but thought my fatigue was due to a physical illness? I really don’t know.
Please explain why you think this would not happen in an integrated primary care setting.
Your article was a good one on discussing the subject of death and acceptance of it, yet it find I find equally disturbing on some level. It is the fact that in this country we are so far removed from life and death, we have talk about it like it was a college course or something.
I didn’t grow up on a farm, but close to it, and saw animals be born and die, at a fairly early age. It was well before age 10 that I understood the finality of death. After, having numerous beloved (they’re all beloved at that age, aren’t they) pets die, mostly run over on the road, I can say that I learned to handle grief much earlier and much better than my peers.
In the absence of seeing death first-hand, it is a good thing that we share with children what it is. In this culture, it seems we protect them from death much more than things that are not inevitable such as drugs, promiscuity and violence.
In case anyone is thinking that pets are not the same as people, yes, I understand that and I am not equating them. What I mean is that seeing death at an early affords you an opportunity to come to terms with well before your adult life. And, hopefully it is a pet or two and not a person in your life that teaches you this.
Jonah,
I have only marginally followed the exchanges between you and skybluesight. Even if I did follow them well, I wouldn’t weigh in on them anyway; it is between you and him.
All I will say is that searching for validation from everyone you converse with on the web is a “fool’s errand”. No, I am not calling you a fool. I mean it is not a pursuit that can be realistically achieved, and even if you did achieve it through some miracle of random sampling, what would you gain from it? Maybe it’s better to disagree and to teach or learn something than to just discuss things with those that already agree with you.
For the comment where I wrote that it was in response to the “entire” post, maybe it would have been better stated if I had used the term “theme” or “gist” of the post. skybluesight nailed it once again when he wrote “The post he referred to is about far more than you, it is to everyone, another way of looking at some things – where you are involved it is personally impersonal.” I was reading it as a generic “you”, not that it was personal to you, and that it was directed at a mindset. If you happen to have that mindset, so be it.
The following is what I took from his comment on Jan 22 at 6:01. I have tried to use the simplest analogy possible, skybluesight can correct me if I am wrong.
There are two forces on either end of a rope, the psychiatric community and those they label/treat/ostracize. They are engaged in a constant battle, with a little ground being won and lost on both sides all the time. But that isn’t the real fight. skybluesight saw that the tug-of-war was inside of us, between healthy and unhealthy. So, he dropped the rope and found a way to heal. He probably drew on all kinds of people and experiences to do so.
The tug-of-war is no longer his battle. A man not pulling on the rope doesn’t define himself in the world that exists on either end of the rope. Not the one of the psychiatric community on a mission to force people to be well, nor the one where people exist in a world where their definition of themselves, and even their healing, is in response to what the psychiatric community isn’t. What would happen to you if the whole psychiatric community disappeared tomorrow? Would you still be clinging to the rope, lost without the forces that would pull against you, stuck in unhealthy?
Can’t you see how free he is now he is not in that war? So, I don’t expect it goes over well with him when others ask him to take up the rope again. I think it is awesome that he is trying to show others the way he took to healing and freedom. It makes a whole paradigm shift in thinking, from a world where you are acted upon and react, to one where you win your battles inside of yourself.
skybluesight – You’re very welcome, and of course I was sincere, life is way too short not to be 🙂
Stephen, thanks for the reply.
Two of my friends are both certain they no longer need antidepressants, yet they are afraid to attempt to get off of them because of what their psychiatrist and their therapist, respectively, are telling them. They are told things like, “if you go off of them and try to go back on you may need a higher dose” or you’ve been on them 10 years, I don’t think it is advisable to stop”.
I can’t say what they are being told is wrong given the withdrawal effects, yet they are not being fully informed of anything about these drugs. I am glad you got off of them.
My comment above was in response to skybluesight’s entire entry on January 22, 2014 at 6:01 pm.
Your words are very insightful, and you may have just turned a few people’s world views upside down. Or outside, in, as the case may be.
If you are willing to share, I am curious to know they why behind your friends saying “Because I am afraid not to take them!”
Is is because they are afraid of the withdrawal symptoms, themselves without the drugs or their doctors?
Fred, thanks for your reply! Unfortunately, your link takes me to an expired domain, yet no worries; I’ve read about mercury before this.
I don’t think that any one thing explains the symptoms of mental illness or autoimmune disease, nor do I believe in a grand conspiracy. However, I don’t doubt your experience with mercury.
Personally, I would like to see more research being done. Not on brain disease, but on diseases that affect the brain. Madmom touched on this in her first paragraph.
I understand this research wouldn’t apply in cases of trauma but it is the other side of your coin. Sick individuals with “mental illness” symptoms basically left to rot on psychiatric drugs while their medical conditions go untreated.
I am very surprised that physicians so easily dismiss their history when there is ample evidence of conditions thought to be psychological (asthma, ulcers, syphilis, to name a few) are in fact proved to be caused by physical illness.
Likewise, all the healing peer support in the world would not help those with physical illness, except of course learning how to cope with the disability it brings and with being labeled mentally ill.
I don’t suppose I’ll see much money spent on this type of research. I know they redirected money on CFS research, just because, I guess it is all in the sufferers heads anyway.
This and so much more!
I don’t think diagnosis is being performed for most things in a GP’s office. It is treat a symptom and move on to the next patient. And “Oh, why aren’t you grateful that I just gave you something for your symptom? Stop insisting on finding out what is wrong with you now that this will take care of everything.”
I suppose they need something for the chart and that is when the psychiatric label comes into play. It all the more damaging when powerful psychotropic drugs are prescribed and the label that gets attached to it follows a person like a specter.
I made a decision long ago (based on working in a general hospital, in addition to watching what has happened to friends) to vet any diagnose and/or treatment given to me by any medical provider. We have a gift in the internet; even though it can lead you in the wrong direction sometimes, and if not used with caution, dangerous, it still can be very beneficial if used judiciously. I read a quote somewhere that doctors have hundreds of patients and you only have one. Physcians are the experts, yet ultimately it is your responsibilty for your own health.
I know that GPs are prescribing the majority of antidepressants. However, I don’t follow your conclusion that patients are asking for them. I think it is rather the opposite. And, both of our cases demonstrate this. I keep having to refuse to take prescriptions for them as well as you do.
I am sure GPs, NPs, whomever, mean well, yet they don’t have the time or ability to figure out what is wrong with you so they offer what they think will relieve your symptoms, however misguided.
I agree with the 15 minutes. For the patients bragging about antidepressants, what circles do you travel in? No one I know would request antidepressants from their physicians, and I’ve only had one person happily tell me they were on ADs. They did it because they thought it would be the answer to my problems. Not so much.
In my case, I am about out of patience with GPs trying to prescribe them to me for my fatigue issues. The fatigue is a result of hypothyroidism and sleep deprivation from apnea and silent reflux, yet still the prescription pad comes out for the dammed things.
You like being highly sensitive? I consider it a curse. It’s not that I don’t appreciate the trait; it’s that others have made it one.
The reason so many people, especially the elderly and women, are taking “psychiatric drugs” could be that doctors have no flipping clue how to treat most chronic illnesses.
And, sadly, the ones I run across don’t seem too interested in learning
I don’t disagree with your assessment of how people are treated in locked wards. It’s probably worse than I can fathom. However, I think you’re way off base when you state that the ‘general public’s negative perception of psychiatry…. is grounded in a realistic appraisal of psychiatry’s spurious concepts and destructive “treatments”.’
This may be the reason in the circles you travel in including here but, no, it isn’t.
The general public is afraid of people considered out of the ordinary, out of touch with reality, unstable, unpredictable and sometimes violent. Throw in a dose of judgement for others who are not able to support themselves and a disdain for those considered weak and to blame for their situation and that is gets you to the general public’s perception of psychiatry and psychiatrists (long considered as ‘crazy’ as the people in their locked wards).
I suspect that I what I wrote sounds harsh, and in reality it is, but I don’t think it serves well to attribute an understanding to the public which they lack.
A very hopeful article. Yet what are the parameters around the definition of “functioning” and the stops to be placed on blaming the victim if they still experience distress even after they are “accepted”?
And more importantly, how are medical conditions such as a thyroid storm or adrenal issues going to be ruled out? Medicine does a pretty poor job of that now and the move to acceptance doesn’t seem to point in the direction of making that any better.
Ted,
My comment at 12:22 am was in reply to you.
I appreciate your honesty and insight. It reminded me of the following quote from a psychiatrist given in reply to my question about what he thought of a colleague leaving a comment on his blog calling him an antidote. Note that none of us know each other; it is all on the web.
I am an antidote to naysayers because I (like my colleagues) have been wandering the hallways of a crummy psychiatric hospital all night long trying to take care of desperate problems and make sure the staff is safe. We are the ones worried more about the drunks, drug addicts and psychotics and what happens to them. By the time we see them nobody else wants them around. I am the last bridge to be burned and nobody has been able to do that yet.
Many here would say he is an egotistical jerk but I don’t read it like that. I accept people’s experiences here and accept his just the same. I don’t I see him as a savior, simply a human being, but I do think he interacts with those most have given up on.
Was red rice prohibited at one time? I just recently bought some.
Or did you mean red yeast rice which contains the same ingredient in lovastatin? If this, then I would wonder if the drug has nasty side effects, why anyone would want to take it as a non-controlled supplement.
Hi Duane,
It is intoxicates they don’t want you on.
Any drug to get you to be positive, shut up questioning their ridiculous practices, and not notice how they abuse you is all good.
I am positive that if Prozac came in an aerosol room spray, they’d be piping that stuff through the ventilation system.
John Smith,
You may wish to take a look at Dr. Nardo’s first article on the subject where you quotes Göran Högberg, PhD the man who originally picked apart this article.
http://1boringoldman.com/index.php/2012/02/22/significant-i/
I freely admit, it is over my head.
The market should not decide this nor should gov’t. Both will turn on you in a moment.
It should be us deciding this.
I’m not sure I understand how the placebo response plays out in the real world when you have people who need to try multiple ADs to find one that works. Even with the poop-out effect confuses me. Seems odd that one day someone just decides to stop believing they work. Although that does have a bit more plausibility.
Nor does it seem to account for someone like me who doesn’t think any med or supplement works until proven otherwise by trial and error. I’m actually quite surprised when any of them do.
No, I don’t take ADs, but I have been through various sleep meds taken as needed, and I’m positive 5htp has an effect on the quality of my sleep/dreams.
They are also many of the same symptoms of a myriad of medical diseases but it appears that if you take this particular test, they are all of a sudden due to depression only.
Since Rebel will no longer discuss, I’ll just confirm my experience with sleep apnea. The treatments lag behind what is needed and they do extract a lot of money from the current ones they have. However, it is a very real condition and when you see that your O2 level is hitting 73% while sleeping you know something is very wrong.
Now if they would just pay attention to the cause of the other 50% of my arousals that are not tied to breathing events, I would be much further along. I personally think it is silent reflux and do the best I can with treating that on my own.
And back on topic, it will be a godsend if any physician pays attention to nutrition, and I hope and pray that gut-brain axis dysfunction is researched as fiercely as they do other common diseases.
Robert Whitaker,
I understand this is a niche question in the larger picture but I would appreciate your thoughts on something that I’ve wondered about for many years.
Why aren’t there more whistleblowers?
Did you discover influences on this and are they addressed in your book?
The closet I’ve come to an explanation so far is in a very recent article:
http://www.washingtonpost.com/posteverything/wp/2015/01/23/why-are-there-so-few-whistleblowers-blame-evolution/
The following quote from the article addresses an institutional reform that I’ve only seen lip-service paid to, and frankly, I wonder if it is even feasible. Regardless, do you find any merit in it?
If an organization’s policy can be reformulated so that whistleblowing is regarded internally as an act of loyalty, then it will no longer contradict the evolutionary urge to be cooperative.
It’s not my intent to promote any drug, legal or illegal.
I see them all as a deal with the devil. You going in thinking, hoping, you’re going to get the better part of that deal but that generally is not the case except for some life-saving meds.
My reply was only to address the fact that advertising/placebo effect is not what is causing this. Advertising doesn’t help but there’s something else insidious going on here and it’s going to drive a legal, illegal or supplement market regardless.
“Society is the patient, and the mentally ill person is the disorder?”
You’re catching on now.
In this case I don’t think so.
After having been in corporate culture for even a brief time, you quickly realize it is a heart of darkness, and it’s easy to understand why people turn to these drugs in order to get an advantage or merely to cope.
The marketing of drug companies is tangential. The idea to use mental enhancement drugs is mainly spread by word of mouth including weirdo self-help gurus on the internet like the “bullet-proof executive”.
After that it is just people experimenting with these drugs that either convinces them to use them or not; no marketing involved.
That’s supposed to be “…a marker for physical illness…” in my comment above, although I suppose it could equally apply to a psychical illness as the neuropsychologist didn’t find any evidence of that either.
I was curious so I did some searching. The following quote was the closest I found to a direct statement regarding low levels of serotonin as a cause:
“These data indicate that low serotonin levels alone cannot cause depression. However, serotonin does have a direct effect on mood, and low levels of serotonin contribute to the etiology of depression in some depressed patients. ”
J Psychiatry Neurosci 1993 Nov; 18(5):235-44
http://www.biopsychiatry.com/nutripsych.htm
But in reading the 2005 PLoS Medicine article linked to in the post, it appears to support what Scott Alexander is saying at least as far as the medical community’s literature is concerned:
“To our knowledge, there is not a single peer-reviewed article that can be accurately cited to directly support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. ”
Of course that still leaves the question on why the marketing material was not attacked by the same community. There are many who are in my face with what “science says” and who willing mock those who question it, but here it was given a pass. I can only surmise that it was a matter of convenience for both physicians and patients.
With that said, I support learning from history and using that as a guide but not in dwelling on it to drive a point home. And this is only because I find the present to have enough issues of its own.
The most recent meme I have experienced with several physicians and one neuropsychologist (no psychiatrists involved since I’ve never seen one) goes as follows. I tell a physician about my fatigue > they tell me that haven’t found a marker for a psychical illness > they say antidepressants > I give them a WTH look > immediate words are “antidepressants are safe”.
Why are they saying that when it’s not in response to a question I’ve asked nor even the reason for my WTH look?
“So he must be incapable of determining the value of his own experience , which has negated his opinion all together.”
Wow. Unless I missed the sarcasm, do you have any idea who and what this sounds likes?
What you said, B.
Dr. Berezin, I too would like to apologize for welcoming you here with a challenging comment. It was about the impracticality of psychotherapy as mainstream. Even though I don’t see a way through that yet, after having read more of your work here and on your blog, I have to say you are one of the rarest of people I’ve come across; someone who has found their calling in life.
Your passion and love for your work is so striking and heartfelt that I can’t think of a better advocate for psychotherapy and I wish you well on your “call to arms”.
Amen, brother.
All of your points are valid.
I was merely pointing out that a semantic change alone is not going to erase the stigma of being perceived as unable, or worse unwilling, to handle the stresses of work/life. And, not just for the term major depression but also for PTSD, panic attacks, phobias or anything that is seen as an inability to cope.
Perhaps it is my impression of the traditional/Hollywood meaning of a nervous breakdown as being a fair amount of time that someone is incapacitated. That is not something you can hide.
I’ve had co-workers tell me they have gone home and cried every night, and I’ve come across more than one co-worker crying at work. As long as they go see their doctor or therapist and can still show up to work and can perform without accommodation, no one really cares that they have “depression”. But, take them out of work for a sustained period of time or ask for reduced duties and things start to change rapidly.
I wish I worked in a place where people understand and empathize with someone having a bit too much to handle psychologically. In my current and former workplaces, Paternity leave is something still largely frowned upon. Now imagine time off for a break-down.
In current times, even though the term isn’t used very much, isn’t there the same amount of stigma attached to having a nervous breakdown as in calling something else?
In the working world it is looked upon as weak and fragile. I know in workplaces I’ve been in if someone was known to have a history of a “nervous breakdown”, it would not be looked upon favorably for hire, promotion or treatment as an employee.
I don’t recall if you’ve mentioned your profession or not, yet I know that Psychiatric Times limits comments to those who work in health care.
Also, you can reply to Dr. Frances on Huffington Post. I think all pf his articles are posted there. They use Facebook for comments.
Dr Berezin, how would incorporate psychotherapy for the working and lower middle classes?
For many there isn’t the time off from work or the money to spend on therapy even if it is only a co-pay. Most people struggling just want (and need) to be functional and many times I’ve seen where a short-term fix is chosen over what is best for the long-term in matters both psychological and medical.
I’m not sure how it is in medicine or academia but the business world is merciless. For those that fall behind, it reminds me of a boxer with an eye swollen shut; just put out a call for a doctor to slice the bruise, stitch the cut and wipe the blood out of his eye so he can get back into the fight. Why? So he can go out and get his head beat in even more? But fight is what he is taught to do, isn’t it. It is what we are all taught to do.
So until the world changes, I won’t hold my breath that either the eradication of psychiatry or the return of psychotherapy will solve the issues of people that need to support themselves and their families while not in prime working condition.
N.I.
You may be late, but not too late for me.
Unfortunately I don’t get the sense of a search for the truth from many of the regulars here. I think most who post here already think they’ve found the truth (for everyone) and when those who disagree with them threaten this truth, they are treated accordingly.
I don’t single them out on this either. I only speak of human nature. I’ve seen commenters as vicious as some here on other blogs where when the article questions the use of antidepressants for psychological or spiritual issues. Google “Depression is Selfish” for one such blog. The offense some take there is no less than here but on the total opposite side of the debate.
I also don’t think being “helpful” is some nice to have unicorn dream the way it seems to be brushed off here. “Helpful” literally can be the difference between living on the street or holding down a job.
I am not advising anyone to take meds to solve their current issues at the expense of the their long term health. Everyone has to make their own decisions, and unfortunately, do their own research. You should no more trust a random person on the internet than the doctor in front of you. Personally, I’ve never been one to trust doctors much, but then again, I haven’t been one to distrust them either. Ditto for people on the internet.
I follow my own path. And, even though you say you have to trust someone, to which I agree to a certain extent, I think the real answer is to trust yourself.
If the camping trip involved sleeping on the cold hard ground, I would think it wouldn’t be very helpful.
AA,
Nope, the questionnaire doesn’t rule sleep apnea in or out. It is used to assess the quality of sleep (doesn’t matter how many hours) – which is what I thought you were having a hard time explaining to them.
There’s a fair percentage of people with insomnia because of stress and another large percentage because of lifestyle and poor sleep hygiene. I don’t belong to either group. I know this because I was open to it being anything, and in that respect I used observation and experimentation to try and figure out what was causing my godawful fatigue.
I’m far from a hypochondriac but what I was doing is something I didn’t find my doctors doing. This would be what’s called a differential diagnosis. It must be extinct because I haven’t seen it in years. All I get is symptom treatment; with fairly poor results at that.
As far as my own journey, I don’t wish to go off on a tangent of sleep apnea, GERD and insomnia here. If so inclined you can reach me at [email protected]. I am kind of curious of your experience, but no issues if you’re not interested.
BTW, Xyrem is mentioned often on the sleep apnea and insomnia boards. Personally, I never paid much attention to it as it is ridiculously expensive. I did find something more “official” about it at the link below and it appears to help narcolepsy through the quality of sleep it provides, but readers can look into it; I won’t as it is not an option for me.
http://reference.medscape.com/drug/xyrem-sodium-oxybate-343073
Thanks for the info., Chaya.
Well AA, here’s to you for gently correcting misguided notions on sleep issues. At least this thread didn’t devolve into warm milk, hot bathes and chamomile tea.
For someone with sleep apnea and silent reflux, having arousals (your brain wakes up, but you don’t) 92 times an hour during REM sleep and in non-REM sleep about 30 times an hour – I completely understand where you are coming from. It was driving me mad. And in my case, CBT almost sealed the deal.
I tried CBT sleep restriction therapy twice on my own and failed, so I went to the psychologist attached to the sleep clinic. We tried it one more time and he called it before I was going to. I thought I may need to just try harder. Um, no. He saw how it was just more sleep deprivation at that point and stopped it. And , thankfully he sent my PCP a note stating that I don’t have a mental health issue around sleep.
Not to lead this into a Sleep Apnea thread as there are some really good blogs out there for that, but your sleep clinic sounds a bit odd prioritizing how much you sleep. I forget the name of the questionnaire I am always given, but it asks questions about how tired you are and how likely you are to fall asleep doing things such as driving, watching TV, talking to someone.
And, for CPAP tolerance, have you tried nasal pillows? There is no way on earth I could tolerant a mask (tried it when I had a cold), but the nasal pillows are doable. Now I just have to work on the d_mn hose. I think I need a hanger for it to keep it out of my way.
“What kind of suicide do you want?”
How about neither.
AA, thanks for your reply; it was very kind.
I don’t tie the increase in suicide necessarily to the increasing consumption of drugs (both legal and illegal), even though I know they can have and have had extremely negative impacts on an individual basis. My reason being is that this country has been in downward slide for decades. All the promises, aka lies, of a Great Society being flushed down the toilet and a rapidly aging population that is increasingly marginalized.
Agree on the quickness to drug people, although the people I know that go on ADs do so for only one reason and that is to remain functional so they can feed their families. Personally, I avoid ADs like the plague. Tried some for sleep issues prn. That was problematic enough. If I saw no choice but to take them or live in my car and beg on the streets, I would probably take living in my car or off myself. Of course, I support no one but me so I don’t have to take that into consideration.
But, I have always wondered why does it have to come down to so few options?
Leah, I very much appreciate your reply. That is where I was headed. Our culture is brutal almost without exception.
The stories here pain me deeply, yet there are other stories of people who don’t visit and they are hurting too. I know there are answers here other than that we see now and that is what I am looking for. I can’t tell you how much it means to be given the knowledge of, and the directions to, places to get help outside of the current mainstream offerings, and that some others see the bigger monster facing us.
Non-treatment doesn’t work either.
A friend of mine who was a dentist, also a problem problem drinker, was often in a down mood. He was always very hard on himself and never thought he was disciplined enough or good enough to measure up to the standards in his head.
He never received any kind of treatment (medicinal, psychological, or spiritual) because he considered it all to be a load of crap and his problems as individual weaknesses. In his early ’30s he took his own life after receiving a DWI. The shame of it pushed him over the edge.
So, no interventions there and still dead.
Serves our “masters” to keep it this way, doesn’t it?
I only see the mental health system as bit players in all this. Powerful, but not really when you think about it. They could all be replaced with somebody and something else. Much worse most likely, because you can still find those who are helpful within it now. Take them out of the picture and what is going to be left?
I am no fan of the current lie, but there is a much bigger problem here than MDs.
AA, I apologize for the c0nfusion. I understood what you said and switched gears too fast there.
I know people who have gone to their GPs because they were cracking under stress and crying all the time and those who have gone to them for PSTD flashbacks. Yet, I have also known those who have gone to them for any number of symptoms but still out comes the Rx pad for antidepressants or any of a myriad of other meds.
My statements address both situations. Why go to a GP for emotional issues. And, why accept treatment from GPs for what they identify as emotional issues?
AA,
I understand what you are saying, but unless it is coerced, our decisions are still our own. And I know this is easier said than done; I’m in the middle of my own 2 year battle against short-cut medicine.
This comment was in response to Jordan’s.
Yours is a very well reasoned response. If you hadn’t prefaced with your first paragraph, I may have seen some large holes in it, but for now I mainly agree – particularly on the polarization part. Although that is still up to the individual to reside in that camp.
I don’t disagree. My comment was based on the fact that even if Rx numbers weren’t going up, we’d still have a population in need of relief just due to the way we live today.
About allowing only psychiatrists to prescribe these meds, wouldn’t hurt my feelings if it were this way. However, since that will not happen in my lifetime, how about people just stop going to GP’s for emotional issues.
If you can swing it, and depending on your field of study, all you need is an online degree program, a laptop and someone’s wireless connection.
Somehow I think there is more to this.
Jonathan – This. 1000 times.
Recent article on the subject
http://www.usatoday.com/longform/news/nation/2014/07/21/mental-illness-law-enforcement-cost-of-not-caring/9951239/
For all those who wish to intellectualize the debate, please consider this. Absence of coercion is the absence of something. Not sure we all agree on what, but from what I gather from those that write here it is the removal of coercion on philosophical grounds and/or because of the harm it may cause. Or may not, cause – you can not predict whether coerced psychiatric care will harm or help a given individual no more than any other mortal. And I don’t mean “odds of X happening”.
Therefore, please do not pretend (and I know that not all of you do) that it is the presence of something. The something being, the intent to provide or the means, opportunity, or provision for, the care of another human being in distress.
Many here talk of how to get society on your side. Even though I can’t speak for all members of society (I am quite libertarian compared to most) I can say this as a random member of the public who is not an ex-patient or a worker in the psychiatric system – if you wish to get society on your side you may wish to prioritize the presence of something over the absence of something.
For the alternatives, I’d say you need more practitioners or better PR or both, probably both. Maybe it’s my location; I come from the land of Drs Szasz, Breggin, and ironically Pies, but there still aren’t a lot of alternatives in this area in medicine or pysch.
Governments are into control, I agree there, and they control a lot more than psychiatry. But I don’t think they wish to be in the mental health business except that the public expects them to be, so the public as a whole doesn’t have to deal with it.
A random conversation last week at work among a bunch of 20 somethings about giving money to the homeless. Usual conversation about scam artists and them using money to buy liqueur. And then one of them says “I don’t give money to beggars; that is what I pay taxes for”.
From experience I know that many think this way. And, it is the same with mental health; most of the public pays zero attention to the issues unless some horror story on the news grabs them. But even then, they don’t look into; just follow whatever the talking heads are saying, and then after a short time they go right back to not paying attention and thinking they are good people because that is what they pay taxes for.
I understand. Who could support what was done to you. It is because very few are paying attention that this type of thing goes on and on.
Part of the reason I was so blunt with you was because I’ve seen many comments which present that abolishing coercive psychiatry or psychiatry as a whole is the real issue, and once it is gone then the fight is done. I respect people having this viewpoint and even more so for honestly stating that they do; it just doesn’t happen to be a viewpoint that I respect as it is a dangerous one. Nature abhors a vacuum, and society does too. Unless something else is born that will provide a place for that anxious person to go to get help and not abuse, well , I have no faith in society as a whole to do the right thing in its absence.
Call me naive, but I’m one that looks for a third way, not the two sides generally found in this debate. I’ve come to the conclusion that the answer most likely lies in those closest to the situation taking care of their own.
For an example from medicine, a couple of days ago I read that there is an effort to crowd-source research into CFS/ME. It burns me that people have to pay for it, in effect, twice. Once by supporting Corp Med and taxes to government (both of which are too incompetent, insensitive and corrupt to pursue real research into CFS/ME) and again with our donations. But, I am really happy that people are not wringing their hands waiting for them to do the right thing anymore and are just going ahead and funding the research themselves.
But, I don’t expect miracles out of anyone though. Maybe just a little more talk of what works to help those who need it and where they can go to find it.
boans, you present some strange analogies that I could draw illogical conclusions from. From your train of thought, I shouldn’t grab a child about to run out into the road lest I put my hands on them.
I think your argument can stand on its own merits without resorting to convoluted debate tactics that solve for as much as arguing over how many angels can fit on the head of a pin.
I don’t agree with forced treatment on moral grounds. But I also find asking others to participate in your demise morally indefensible as well. If there is someone too anxious to leave their home will you be picking outside of it to prevent others from interceding on their behalf while they quietly starve to death. Or will you take upon yourself to feed them for years or until whenever they get better.
Francesca, while I concur with your position in regards to Dr. Lawhern’s thoughts, I think asking cannotsay2013 the question who he has helped personally is not appropriate because it is a personal question, the concept of help is subjective. and for that the answer will always be unknown to us unless those he has helped decide to answer your question here.
As someone who lived all of my adolescence dirt poor but managed to dodge the system, everything you said is correct.
The powers-that-be choose to focus on the individual in order to deny the societal problems that were supposed to all magically disappear with the War on Poverty or the trickle down of wealth.
Btw, I didn’t know “decontextualizing” was a word, but that is what is happening, and I think I will use this word from now on.
You may be thinking big, but you are not paying attention to history. The freedom fighters only did half the battle, hence 200 yrs + and we still deal with the fallout.
They come cheaper than psychiatrists and write for the same pills; that is all that matters.
I wasn’t clear. I mean those here become the people who others reach out to.
Which is why I hope you all grow bigger networks of folks to reach out to.
****Don’t read this if you are subject to triggers****
I have several issues with CBT and one of them is that if things can get better, they can also get worse. One never knows.
I just work at it one day at a time and don’t particularly expect anything except that I am coping at the present moment.
Heaven’s no, not a crime. Is that more of this rhetoric thing I keep hearing about?
Just kidding.
It wasn’t the anesthesiologist; just one of his peeps – an OR Tech. After I was a “criminal” in the OR, I ended up being a curiosity in post-op. They just had to know what paradoxical reaction I had after taking Versed because they had never heard of that before.
A few months later when I underwent a colonoscopy without sedation, I moved to being a mild amusement. But, when I hit two endoscopies without it, then I became A HERO.
See, it is all about perspective. That is why I am not often offended by insults on the internet. I have too much adventure in my real life to be concerned with strangers.
And, it is also all about who you get as your doctor (and other providers). So, I hope you find a good one soon.
I’ve been reading blog comments for close to seven years. In that time I have only read apologies from a handful of people. Dr. Hassman happens to be one of them.
You never know who is going to end up being reasonable once you get over the strife.
You’re right. There is a certain attitude in large areas of the medical field. In my case, most doctors were ok; I had more trouble with staff. One OR tech glared at me with hate because I wasn’t getting conscious sedation. Must have thought I was a drug addict or he just didn’t want me to remember him; I don’t know.
Take care of yourself. You’re the only one with a vested interest in your health. And, if possible, always take someone with you to the hospital. I worked in them for 13 years, and it was my advice to everyone I knew undergoing any type of procedure.
Says nothing about truth, does it?
I’ve read almost the same statement in comments on psych boards and they mean it literally. For those, it may even be true in their own lives.
Dr. Healy writes good prose. But I’d say the subject doesn’t need rhetoric; it is serious enough on its own.
Art in a discussion like this? Words mean things.
I agree it is a pointless discussion on what is the most abusive relationship in the world. Which is why I was kind of surprised that Dr. Healy was quantifying it as the “greatest”. Perhaps if he had stated it more simply like along the lines of what you wrote about the state (and I add by society as a whole) it wouldn’t have appeared to so rhetorical.
That is fine but it wasn’t his point. Dr. Hassman is speaking of prevalence of abusers not exchange.
Everyone has the choice to be disrespectful or not. It does not depend on your opponent, and it does not depend upon the argument. Make your own choice.
I will tell you that on this blog I saw one of the most childish displays of disrespect ever on a blog. I very much appreciated that they deleted the comments.
Francesca @ July 13, 2014 at 9:30 pm.
Very well stated.
I didn’t get to respond to boans before your comment, so I’ll just comment here.
Pointing fingers at others was not Dr. Hassman’s point at all. He responded to a somewhat overly melodramatic claim that when doctors meet patients it is the greatest mismatch in power between two people and the easiest place on this earth for an abuser to flourish.
Dr. Hassman gave what he sees as other examples of this that are more prevalent and more unequal.
I personally don’t believe Dr. Healy can back up his claim and that no one can substantiate the worst of either case, because quite honestly it varies.
I recall the days when feminists were shrieking that the most unequal relationship was marriage. To make these kind of statements appeals to followers but doesn’t do much for an onlooker trying to decipher what is going on.
One small suggestion. You can read what he thinks about prescribing practices at his blog. It’s not like he is mysterious about it.
I see the issue with attacking psychiatry as a means to reach the public failing because it leaves a vacuum. It isn’t like slavery where it is freedom vs being owned as the struggles of people don’t go away if psychiatry goes away. So, does the public look to the medical community which has an infrastructure in place no matter how pathetic or to MIA which has slim offerings other than bashing psychiatry. I think if you are able to get some grass-roots real care for people, they would beat a path to your door. If you wish to stick with the slavery analogy, think underground railroad.
This is from a random member of the public with Adjustment Disorder being the only label assigned to me. I took it in stride because it allowed insurance to pay for several psychologist’s visits, and it assisted me in getting my medical doctors to take my physical health seriously instead of just shoving antidepressants at me. I only call this out because I wanted you to know what perspective I come from; I have no skin in this battle from either education or experience.
What do you think of people that have been through it, taking care of their own?
Sometimes I think that is the only way. After people see it working, then they will believe there is an alternative.
I see a great benefit in having primary care physicians in a community mental health clinic as from what I have read the medical care of those with mental illness diagnoses is very poorly delivered. However, I am having trouble believing that a few mental health personnel scattered in a primary care clinic would have the same effect. The reason for this is when I read the stories of those labeled with mentally illness going for care, their physicians see their diagnosis and either want nothing to do with them, but refer them to behavioral health or they think the patient’s symptoms are all due to their mental illness.
I know a psychologist that was working in behavioral health within a pain clinic who is now in private practice. He was uncomfortable with the way patients were being treated as he did not believe the majority of them were displaying psychosomatic symptoms. If he wasn’t working in private practice, but for a clinic that employed him, would he have told me he found I exhibited no psychological issues, but thought my fatigue was due to a physical illness? I really don’t know.
Please explain why you think this would not happen in an integrated primary care setting.
Your article was a good one on discussing the subject of death and acceptance of it, yet it find I find equally disturbing on some level. It is the fact that in this country we are so far removed from life and death, we have talk about it like it was a college course or something.
I didn’t grow up on a farm, but close to it, and saw animals be born and die, at a fairly early age. It was well before age 10 that I understood the finality of death. After, having numerous beloved (they’re all beloved at that age, aren’t they) pets die, mostly run over on the road, I can say that I learned to handle grief much earlier and much better than my peers.
In the absence of seeing death first-hand, it is a good thing that we share with children what it is. In this culture, it seems we protect them from death much more than things that are not inevitable such as drugs, promiscuity and violence.
In case anyone is thinking that pets are not the same as people, yes, I understand that and I am not equating them. What I mean is that seeing death at an early affords you an opportunity to come to terms with well before your adult life. And, hopefully it is a pet or two and not a person in your life that teaches you this.
Jonah,
I have only marginally followed the exchanges between you and skybluesight. Even if I did follow them well, I wouldn’t weigh in on them anyway; it is between you and him.
All I will say is that searching for validation from everyone you converse with on the web is a “fool’s errand”. No, I am not calling you a fool. I mean it is not a pursuit that can be realistically achieved, and even if you did achieve it through some miracle of random sampling, what would you gain from it? Maybe it’s better to disagree and to teach or learn something than to just discuss things with those that already agree with you.
For the comment where I wrote that it was in response to the “entire” post, maybe it would have been better stated if I had used the term “theme” or “gist” of the post. skybluesight nailed it once again when he wrote
“The post he referred to is about far more than you, it is to everyone, another way of looking at some things – where you are involved it is personally impersonal.” I was reading it as a generic “you”, not that it was personal to you, and that it was directed at a mindset. If you happen to have that mindset, so be it.
The following is what I took from his comment on Jan 22 at 6:01. I have tried to use the simplest analogy possible, skybluesight can correct me if I am wrong.
There are two forces on either end of a rope, the psychiatric community and those they label/treat/ostracize. They are engaged in a constant battle, with a little ground being won and lost on both sides all the time. But that isn’t the real fight. skybluesight saw that the tug-of-war was inside of us, between healthy and unhealthy. So, he dropped the rope and found a way to heal. He probably drew on all kinds of people and experiences to do so.
The tug-of-war is no longer his battle. A man not pulling on the rope doesn’t define himself in the world that exists on either end of the rope. Not the one of the psychiatric community on a mission to force people to be well, nor the one where people exist in a world where their definition of themselves, and even their healing, is in response to what the psychiatric community isn’t. What would happen to you if the whole psychiatric community disappeared tomorrow? Would you still be clinging to the rope, lost without the forces that would pull against you, stuck in unhealthy?
Can’t you see how free he is now he is not in that war? So, I don’t expect it goes over well with him when others ask him to take up the rope again. I think it is awesome that he is trying to show others the way he took to healing and freedom. It makes a whole paradigm shift in thinking, from a world where you are acted upon and react, to one where you win your battles inside of yourself.
skybluesight – You’re very welcome, and of course I was sincere, life is way too short not to be 🙂
Stephen, thanks for the reply.
Two of my friends are both certain they no longer need antidepressants, yet they are afraid to attempt to get off of them because of what their psychiatrist and their therapist, respectively, are telling them. They are told things like, “if you go off of them and try to go back on you may need a higher dose” or you’ve been on them 10 years, I don’t think it is advisable to stop”.
I can’t say what they are being told is wrong given the withdrawal effects, yet they are not being fully informed of anything about these drugs. I am glad you got off of them.
My comment above was in response to skybluesight’s entire entry on January 22, 2014 at 6:01 pm.
Your words are very insightful, and you may have just turned a few people’s world views upside down. Or outside, in, as the case may be.
If you are willing to share, I am curious to know they why behind your friends saying “Because I am afraid not to take them!”
Is is because they are afraid of the withdrawal symptoms, themselves without the drugs or their doctors?
You might like this book http://www.amazon.com/Road-Less-Traveled-Timeless-Edition/dp/0743243153 if you haven’t read it already. Yes, it is by a psychiatrist but he writes a lot about suffering in it.
Fred, thanks for your reply! Unfortunately, your link takes me to an expired domain, yet no worries; I’ve read about mercury before this.
I don’t think that any one thing explains the symptoms of mental illness or autoimmune disease, nor do I believe in a grand conspiracy. However, I don’t doubt your experience with mercury.
Personally, I would like to see more research being done. Not on brain disease, but on diseases that affect the brain. Madmom touched on this in her first paragraph.
I understand this research wouldn’t apply in cases of trauma but it is the other side of your coin. Sick individuals with “mental illness” symptoms basically left to rot on psychiatric drugs while their medical conditions go untreated.
I am very surprised that physicians so easily dismiss their history when there is ample evidence of conditions thought to be psychological (asthma, ulcers, syphilis, to name a few) are in fact proved to be caused by physical illness.
Likewise, all the healing peer support in the world would not help those with physical illness, except of course learning how to cope with the disability it brings and with being labeled mentally ill.
I don’t suppose I’ll see much money spent on this type of research. I know they redirected money on CFS research, just because, I guess it is all in the sufferers heads anyway.
This and so much more!
I don’t think diagnosis is being performed for most things in a GP’s office. It is treat a symptom and move on to the next patient. And “Oh, why aren’t you grateful that I just gave you something for your symptom? Stop insisting on finding out what is wrong with you now that this will take care of everything.”
I suppose they need something for the chart and that is when the psychiatric label comes into play. It all the more damaging when powerful psychotropic drugs are prescribed and the label that gets attached to it follows a person like a specter.
I made a decision long ago (based on working in a general hospital, in addition to watching what has happened to friends) to vet any diagnose and/or treatment given to me by any medical provider. We have a gift in the internet; even though it can lead you in the wrong direction sometimes, and if not used with caution, dangerous, it still can be very beneficial if used judiciously. I read a quote somewhere that doctors have hundreds of patients and you only have one. Physcians are the experts, yet ultimately it is your responsibilty for your own health.
I know that GPs are prescribing the majority of antidepressants. However, I don’t follow your conclusion that patients are asking for them. I think it is rather the opposite. And, both of our cases demonstrate this. I keep having to refuse to take prescriptions for them as well as you do.
I am sure GPs, NPs, whomever, mean well, yet they don’t have the time or ability to figure out what is wrong with you so they offer what they think will relieve your symptoms, however misguided.
I agree with the 15 minutes. For the patients bragging about antidepressants, what circles do you travel in? No one I know would request antidepressants from their physicians, and I’ve only had one person happily tell me they were on ADs. They did it because they thought it would be the answer to my problems. Not so much.
In my case, I am about out of patience with GPs trying to prescribe them to me for my fatigue issues. The fatigue is a result of hypothyroidism and sleep deprivation from apnea and silent reflux, yet still the prescription pad comes out for the dammed things.