Random Asides

Big Pharma

A topic which I’m sure will get me plenty of negative attention.

I believed for a long time that mental health drugs were bad, that all mental disorders were a lack of willpower. Then I got desperate.

My current impression is that some people really need chemicals to help them regulate, but that some people get put on more medications than they need, and that messes them up further.

The problem here, is I’m skeptical of both sides. Stopping medication clearly has serious side effects, but the medications themselves have serious side effects too. Many antidepressants cause weight gain for example.

I am very concerned about the way I observe psychiatrists to operate. (sample size 4 here) They pick their favorite drug for a condition, prescribe it. If it doesn’t work, increase the dosage. If that doesn’t work, add another drug. And they all have a different favorite drug. (for depression)

On the other hand, anti-drug is no way to go either. Psychosis is no fun, neither is deep depression. In my opinion it is better to manage symptoms with medication than an alternative of endless lethargy or what I imagine a manic or schizophrenic state is.

The problem I find is where to draw the line. If every single person is medicated, then what is the normal you’re trying to acheive? It’s personality destroying. But if nobody is medicated, many people who could otherwise lead happy and productive lives are left by the wayside.

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35 Comments

  1. I've had people close to me need drugs for depression. And it is indeed a real disorder that requires drugs.

    Fortunately, the doctors involved used the "give as little as possible" method and added other therapies to try to avoid over-medicating. It worked tremendously well.

  2. I think a large part of the problem is that the General Practitioners, from whom so many of us get our psychotropics, are inadequately trained.

    They will have a script of questions for the patient that they'll use to assess overall mental health. Often, these scripts come from the pharmaceutical companies themselves. The doctor will then, based on the patient's answers, prescribe a particular drug. Again, either the drug supplied by the pharmaceutical company, or the patient may insist on a particular brand that they've "heard about."

    But then, there is little, if any, follow-up. Is the medication working for you? Is it the right KIND of medication? Is the dosage correct? Unfortunately, this is almost never considered.

    I was once on Paxil, as an anti-depressant. But there was no follow up care. I complained to the doctor that rather than evening out my moods, Paxil simply made me groggy. I was rebuffed with "Well, there aren't any medicines that will leave you any less drowsy than Paxil."

    But he never explored what my trouble might have been after his initial "questionnaire." Did my brain produce enough serotonin? That would require one type of medicine. Perhaps my serotonin RECEPTORS were malfunctioning. That would require a different type of medication. What if it was a question of an entirely different chemical malfunction? And then, what about dosages? I am an "in-shape" fat man– think of Sammo Hung– Would the dosages required for me at 270lbs be the same for the average patient of 180 lbs?

    I really don't think a lot of doctors are trained sufficiently well.

    I am of course going on the assumption that most people will obtain anti-depressants and minor psychiatric drugs from their GP's.

    How this would have played out under the care of a p[roper psychiatrist, I don't know. Though I assume it would be much better.

  3. My understanding (which comes in part from having family on the professional side of the psychological field, and in part from reading, and in part from discussions with doctors and others) is that the current batch of "miracle" antidepressants (SSRI and similar families) (a) have few side effects, compared to previous families, (b) work real well, when they work, (c) are very patient-specific: one ssri might not work for Tom but will for Betty, and another might work for Betty but not Tom, and (d) there's not a way to tell which will work for whom without trying one, then the other.

    The "favorite drug" issue comes up mainly in the order an individual doctor will try the drugs, but there's not a "good" alternate procedure yet.

  4. I think there are many cases where people end up on antidepressants when they really don't need them. They're feeling low, overwhelmed, stressed out, so they go to the doctor, and get a permanent solution to a temporary problem. We all feel that way from time to time. But we don't all need a pill to fix it.

    There are other cases, like you describe, where people get the wrong medication for their specific problem, and when it doesn't work, more drugs and/or higher doses are piled on top of that.

    And trying to get off antidepressants is not easy. My wife has tried, and almost self-destructed.

    I think, in the majority of cases, depression has some underlying cause that needs to be addressed. And antidepressants can be a useful tool to help people cope while they are addressing those issues. But too many people are using them as a crutch, or a permanent solution, when it's not needed, and then become dependent on them.

    One of my wife's friends got on an antidepressant because she told her family doctor that she was having suicidal thoughts. So the doctor wrote up a script. My wife found out about this, and thought she could do the same thing, and went to her doctor, and asked for a prescription, no questions asked. It should not be that easy. Now she's gone from one brand to another, having to spend money to pay for them, and she can't get off them because of the anxiety.

    Depression is very real, and very serious. And there are plenty of people out there who have it, and need antidepressants to cope. But I think it's being prescribed to too many people too easily, and a lot of people who are on them should seriously ask their doctor if they really need to be on them.

  5. I have a Master's Degree in psychology, and even I'm a bit leery of psychiatrists. I do tend to think that drugs are over-prescribed in our culture, though I couldn't tell just to what extent they're over-prescribed. They are, however, a necessary evil and are very effective when prescribed in moderation, wisdom, and common sense. I'm on a couple of very mild anti-depressants to regulate a sleeping condition I have. I'm fortunate to have a family doctor who follows the "as little as necessary" theory of treatment. In my case, the drugs are necessary for my health and daily functioning.

    I have read a handful of stories over the last few weeks, however, about people who, over the course of several years, have found themselves on five, eight, even ten or more different psychotropic medications. This, in my opinion, is a clear abuse, and any mental health professional should know better than to let treatment scale up to those kinds of levels.

  6. I think we're all on the same – and right – page here. I too think that there are mental disorders that require medication – but in some cases, medication is the easy, not-entirely-appropriate solution. Maybe more general education about both mental disorders and medications would help people better make (or help their doctors make) decisions about them.

  7. Oh, what a great post. As I mentioned elsewhere, I've always thought antidepressants were way over prescribed, etc., etc., then I ended up with postpartum depression, which was really scary, and opted for meds.

    The biggest problem that I've observed with myself and close friends, is the fact that you can go to pretty much any practitioner, get meds, and then proceed to go on without any sort of monitoring, checkups, or therapy. Everything I've read indicates that therapy coupled with meds is the treatment routine that is most effective in treating depression. I was also somewhat apalled when my OB wanted to just stick me on Prozac because my moods were a little wonky during PMS for a couple of months, which was due to hormone shifts associated with weaning my daughter. You'd think they'd give your body a chance to level things out on its own first.

    My younger brother did an honors thesis on his work with a psychology prof who was looking into the connection between meds and the brain's natural chemical balance. Exploring things like is little-"d" depression actually necessary for healthy brain function/cycles, and whether and how meds change the hormonal balance in the brain, etc. It's really interesting stuff.

    I too think meds are a necessary (and in many cases life-saving) thing, but that like a lot of other things they get used as a cure-all when there are a lot of other factors.

  8. I think the term "overprescribed" is a bit of a red herring. Overprescribe for whom? I'm not saying they are or aren't, only that without data, it's hard to say if that's true. Looking at rate of prescription doesn't work to that end, as there's an increased prescription as the social stigma changes and the drugs improve.

    I will just drop in the mix that no one thinks this way about meds that aren't for mental health. There are several treatment options for hypertension, several treatment options for diabetes, several treatment options for bacterial infection, several treatment options for arthritis.

    Frequently one patient goes through several treatment options to find the right one for them. Doctors prescribe their "favorite" one (which is exactly what I pay my doctor to do…use his expertise to inform his decision…) because the human body is a complex changing thing… it's not always one-size-fits-all. It's not even this-size-will-always-fit-me-now-that-I've-found-it.

    No one expects the above conditions to be treated with "willpower" (ok, there's some argument for hypertension and diabetes, if they're lifestyle induced) but we do expect to be able to control mental conditions. It's unfair, and I think can be detrimental.

  9. Personally, my experience with psychiatrists hasn't been that bad (if you except the parts where it was my own attitudes causing the problem). When it became obvious a certain medication wasn't working for me, I was switched to a different one rather than adding another. Now, personally I have a case of severe and obvious Clinical Depression (with capital letters). The most obvious result of it is that any extreme of emotion manifests as depression. It was at the point where even happiness caused me to get depressed for no reason. It's clear there's something wrong there, and it would be a failure of any psychiatrist not to diagnose that and attempt to treat it.

    However, I can't honestly say how these psychiatrists I've known treat less-clear cases. Do they get prescribed meds as well? I know my mother and sister are also on the same medication, and their conditions aren't as severe as mine. Whether they truly need it I can't say. This is the type of thing where compiling anecdotes may give clues to the real situation, but you'd need a real study to find any real data.

  10. It's all about finding a good, thoughtful doctor *who specializes in the disease or disorder that's being treated* and working with that doctor as a team.

    A doctor who isn't a psychiatrist has NO business prescribing psychological drugs, in my opinion. Even if somebody needs drugs, the doctor needs to be qualified to assess whether the patient still needs to be on the drugs after a while.

    Also, a family practice doctor has no time to help with behavioral/cognitive changes that research shows are necessary for a successful and lasting change.

    Looking at it from a non-psych perspective: I can take drugs to lower my cholesterol, or I can change my lifestyle (stop smoking, eat less cheese, exercise). The drugs are easier, but the lifestyle changes are often just as effective. But say I like cheese. Then taking a pill is easier than giving up brie. But, it could be that I make the changes, give up the brie, but it's not enough. In that case, I may need the LIPITOR, too.

    In general, I feel people should be more involved and empowered in their health care and that the current medical system disourages this, discourages any kind of mental health therapy in general. You got strep throat, not your fault, here's this pill. Treating mental health like strep throat reduces its stigma. You've got anxiety, it's not your fault, your brain chemistry is just out of whack, here's this pill.

    Compare that to: You've got anxiety, you need to go talk to somebody about it on a weekly basis, take time off of work, and it will probably take several months before you see positive change. I am not and would never to blame people with psycological issues, but a lot of therapy is realizing that, yes you do have control over some things, you can change things, and learning coping strategies for those times and areas you don't have control over.

    Personal anectode time: I chose to go on an ADD medication 2 years ago, and I was extremely resistant to it at first. But after talking to my therapist, I realized that it would probably help me. And the medication really helps me focus and has made my life a LOT easier. But what's also helped is working with my therapist to try to change my way of thinking about and doing certain things. I've got a good team of people that I work with, that I feel comfortable with.

    I've also seen a good friend strugle significantly to find someone competent to medically and psychologically treat his bipolar disorder.

    Hope this makes sense; there was a lot I wanted to say on this subject, and I was trying to be sorta brief (though I'm sure it doesn't seem like it).

  11. @ flygrrl

    Right there with ya. I ranted and railed for months when I first saw the ad for "Sarafem," e.g. Prozac re-named to treat Pre-Menstrual Dysmorphic Disorder, because of the fear that doctors would try to medicate all women with PMS (I can be melodramatic at times).

    Me: "You know what Sarafem is?"

    Friends (in unison): "The highest choir of angels!"

  12. a.real.girl said, in part:

    I will just drop in the mix that no one thinks this way about meds that aren’t for mental health. There are several treatment options for hypertension, several treatment options for diabetes, several treatment options for bacterial infection, several treatment options for arthritis.

    I totally agree with you on this point, however I think the trouble comes in that diseases like diabetes, hypertension, bacterial infection, have very clear, discrete diagnostic criteria whereas mental disorders are more of a spectrum and there are a lot of grey areas. As Rav Winston noted, it seems that often doctors prescribing antidepressants are neither trained in the areas of mental disorders, nor do they go through a very rigorous process to diagnose or follow up. This is purely anecdotal, but in my personal experience and that of a number of friends and family members, being prescribed antidepressants is as easy as walking into a doctor's office (pick your favorite specialty, or GP, OB, etc.) and saying "I feel blue." No doctor would hand you meds for bacterial infection without a culture, or insulin without a full battery of diabetes testing and there would be lots of follow-up.

    I would like to see more data on the long-term effects on the brain of SSRI's (and I think some of that is starting to be out there now that there's a longer track record with these drugs) so that a more accurate cost-benefit analysis could be done for individuals before going the meds route. I just have a hard time believing that mental illness is so rampant (I think the number of people in my immediate circle of friends and family who are on some type of SSRI approaches 60%), and if it is, then what on earth is causing this epidemic in the first place?

  13. I have "Idiopathic Hypersomnia," which is practically the same as Narcolepsy. I've lived with it for over 10 years, and it's not a deadly condition, unless I fall asleep behind the wheel or something equally dangerous.

    Narcolepsy is often mistaken for depression or ADD, and thankfully it was correctly diagnosed in me, so I don't have to go through treatment for either of those. However, it's actually treated a lot like either of those. I've been on about a half-dozen each of anti-depressants, stimulants, and sleep-aids.

    So far, nothing dramatically bad has happened as a result of any of these, but I am a little concerned what the plethora of drugs are doing to me.

  14. This is more or less on topic.

    Doctors are certainly wined and dined and variously compensated by the big drug companies to write prescriptions for their newest and greatest (and most expensive) drugs. I often think that many doctors allow themselves to fall into that trap of thinking that something must be better because it's newer. Some doctors don't consider the cost of name brand drugs either. For example, I was prescribed Aciphex for my reflux, but found out that simple generic omeprazole (Prilosec OTC) was just as effective as the brand name drugs and less than half as costly without taking insurance into account. The cost to me on my drug plan dropped from $30/month to $5/month.

    One of my favorite sources of information is Consumer Reports' Best Buy Drugs. http://www.crbestbuydrugs.com This is a free public information project from Consumer's Union, the publisher of Consumer Reports. Consumer's Union accepts no advertising so as not to taint their independence. Ratings have been completed for 33 disorders and the full reports are very thorough. These reviews are conducted by teams of physicians and researchers at several medical schools under the auspices of the Drug Effectiveness Review Project (DERP). DERP is a first-of-its-kind 15-state initiative to evaluate the comparative effectiveness and safety of commonly used prescription drugs.

    This has started sounding like an advertisement for Consumer Reports, so I'll stop now. But seriously, if you're going to see a doctor about a condition and think you may be prescribed a drug as treatment, look at the report from http://www.crbestbuydrugs.com before you go.

  15. Part of the problem is the insurance crisis. I do volunteer work at an outpatient house for people with long term mental illness. Many of the people that come for help have insurance that covers only 12 visits a year. 12 visits paid for people with severe bipolar disease!

    The GP has to often take on a role they do not want. But, with no other choice and quality of life and indeed safety in question, they will do their best (or worst). Vermont has the lowest people/psychiatrist ratio of any state. My guess is that it's because little quirks or not being "normal" is accepted. There is less pressure to be perfect and more freedom to be yourself. However, there are still people with very real very bad mental illnesses.

    Look at Brittney Spears, everything is being blamed for her mental illness, but no one seems to be saying "hey some people have severe mental illness". Hearing voices, inability to sleep, eating disorders, deep depression…there is still a rush to blame the upbringing or person. It's "control yourself" rather than "let's see how we can manage this". At the out patient house where I volunteer we often say "you know, if you simply wait until you are 'cured' you will be waiting a long time. Let's talk management so you can live as full a life as you are able." For some, working part time is as good as it is going to get, even with medical help.

    This whole idea that you can "cure" all mental illnesses is sadly not a reality. Like diabetes, managing is very important. Sadly, the GP does not have time for this. The outpatient house where I work is such a lifesaver, though I can not tell you how hard it is to raise money for a home that helps "crazy adults". One of my fellow volunteers is bipolar. She teaches full time, and volunteers and raises a son. BUT, she is also over $100,000 in debt. Because her insurance only covered EIGHT visits a year. She said screw it and took out a loan and got the help she really needed to get her "balance" back in her life. She will be on meds her whole life, but now she has the tools to keep on top of things.

    Quality if life is also very important. The drugs out there are very imperfect. But right now they are the only game in town. If it gets someone off a couch or keeps them from commiting suicide, hey a few extra pounds are a mnor pay off. What is the suicide rate for people under age 30? certainly meds can often make a depressed person feel well enough to frankly, get up off the couch and kill themself! Psychiatry is a very young science. It doesn't have the history. And horrible mistakes have been made.

    I would never do a Tom Cruise and say to anyone "don't take drugs!" Walk a few miles in their shoes and the shoes of their families.

    I know many people that think even if SSRIs will one day hur their health, being able to enjoy life and family is a trade off well worth it. And we can only hope that more money will be put into better drugs and treatments. And frankly, a really ill person needs 2-3 visits a week until they are stable. This can take months. But the pay off is fantastic when it can happen. Only the wealthy or those willing to go into serious debt can afford the treatment they need.

  16. I've had a lot of experience with medication and psychiatrists. I've been taking medication since, hmm, first grade I think. I am currently taking medication for ADHD, Anxiety/ Depression, Allergies, and a chronic Inner Ear condition. I have had really bad experiences with medication and I have had pretty positive experiences too. I was lucky to go to a psychiatrist who I could get along with and I have seen him off and on since fifth-grade.

  17. As someone who has dealt personally with depression and is currently in med school (and potentially will become a psychiatrist) I'd love to chime in. But I'm busy at the moment and I'll have to jump into the conversation much later this evening.

  18. Just wanted to say that this is a great conversation thread. Everybody's coming up with thoughtful, well-reasoned, insightful stuff. Of course, not surprising considering where we are posting ;) , Still, I'm very impressed.

  19. I have schizoaffective disorder (a severe illness featuring symptoms of both schizophrenia and bipolar disorder), which is currently under control with medication and therapy. I also work as a peer counselor for an organization that helps people with mental illnesses live independently in the community.

    It's not a black and white issue. I would be completely nonfunctional without my meds, but it took six years to find the right combination of medications. One doctor had me on nine different ones at the same time! It was ludicrous. And I was too sick at the time to thing logically about it.

    The biggest hurdle for people with brain disorders is that one drug doesn't treat everyone the same way. It's not like you take an aspirin and your headache goes away. Someone earlier in the comments pointed this out, and they're right.

    Also, doctors frequently don't really listen to patients. I told one doctor I was hallucinating, and he suggested I get my eyes checked! I hear stories like that all the time from people with mental illnesses.

    So… yeah. Some people need meds. Some don't. Some are overmedicated, some aren't medicated and need to be. It's too complex to make blanket statements.

  20. I went to a psychiatrist four years ago. Mainly because I was getting panic attacks every day in high school, and finally decided to do something about it….right when high school ended. She diagnosed me as being depressed and having panic disorder. I went on Zoloft for awhile on a small dosage, and it didn't do anything at all. eventually, she got tired of me just sitting in therapy awkwardly and not saying much, so she told me to come back when I was ready. So, I wasn't able to get the medication anymore, and I was convinced it didn't do anything, anyway.

    I still have the exact same issues, but I really really don't want to go on drugs. I just don't. I know I should get into therapy again, but again, I really don't like therapy. Is that completely irrational?

    Is it possible to just fix these problems on your own? Why do I have to get on drugs? Is it not possible to stop getting so panicky without medication? I don't consider myself severely depressed. But then again, I don't know what a 'normal' person feels like most of the time…

  21. I'm inclined to believe, on the strength of rather little data and almost all of it anecdotal, that there are several aspects to the discomfort that a lot of people seem to have with psychiatric medications and their effects on people.

    I suspect that most psychiatric patients are not well educated about their condition – including patients with no cognitive impairment. I believe that people educated about their health conditions are better able to make decisions about treatment, and to recognize ineffective treatment. I suspect the complexity and, in some cases, mysterious etiologies, of psychiatric illness contributes to this problem, as does the fact that we really don't have a theory for the mechanism of action for a number of relatively popular psychiatric drugs. In essence, what I'm saying is that I suspect a lot of people put up with less effective treatment, for themselves and for others they know, because they don't know anything about the disease being treated or their options for treatment.

    I also think that Orac, the SkepDoc, Steve Novella, and others have shown us that the entire medical field is subject to a certain amount of woo invading their largely evidence-based discipline. My suspicion is that psychiatry, due to the same factors I mentioned above – complexity and mysterious etiologies – and due to diagnostic criteria that are a lot less objective than for disorders that are well established as biochemical – anyway, my suspicion is that psychiatry may be more susceptible than most medical specialties to being invaded by woo. I suspect many practitioners are engaged in less than ideal diagnostic and treatment practices because the evidentiary basis for a lot of what they do is not as concrete as, for example, the results of a blood test.

    Finally, I have to say that I think that some of your phrasing is contentious:

    "My current impression is that some people really need chemicals to help them regulate…."

    Everyone needs chemicals. Everything we do, everything we experience, everything we think, feel, touch, taste, and screw, requires chemicals. We ALL need chemicals. In fact, that's really all we are – walking, talking, pooping chemical factories.

    Referring to drugs as "chemicals" is a tactic that deniers of evidence-based medicine use to cast doubt on the effectiveness of scientific medicine, and demonize pharmaceuticals as the products of large, smelly, polluting, ugly, industrial plants of chemical manufacturers. I can see around this and engage with what you are saying, but seeing this meme here makes me pretty uncomfortable. I think that one thing we need to do as skeptics is avoid playing into the hands of the denialists – which means we need to avoid adopting their own linguistic framing, which is pre-loaded with anti-evidence sentiment.

    Using the term "chemicals" when "medication" is meant also sends the message that people who take medications are moral failures. The implication it raises is that someone is possessed of such poor judgment that they are pouring dangerous, dirty industrial products into their body in a way that no responsible person would. The reality is very different. People taking medication are for the most part people with real problems who are engaging in evidence-based behavior in an attempt to cure what ails them. I think skeptics need to adopt language that recognizes this, and extends compassion to such people, even if the facts show that what they are doing is ineffective.

  22. I think the difficult part of prescribing psychiatric drugs is that everybody responds differently. In the past few years I have been good friends with a few people with Bi-polar disorder. They had really good doctors, with weekly check-ups and blood tests, and their prescriptions were constantly changing as the doctor tried to find the perfect combination and dose for that person. A lot of doctors probably don't have the time, and a lot of people definitely do not have access to such good doctors. In that case, the doctor will prescribe a broad anti-depressant that works well in a large percentage of people. It's better to over prescribe to some than to ignore someone with a life-threatening condition.

  23. the big problem is all those commercials for pills. seriously, the power of suggestion is very powerful, and if you're getting the message that not being as stoked about everything in your life as you used to be (to paraphrase every antidepressant commercial) is equal to clinical depression, and that it's all just your brain chemicals, and talk to your doctor about this, well, you'd probably rather believe this than that you are gettin older/going through a rough patch.

  24. @fuzzbucket1,

    I don't think any of us, with the possible exception of the commenter who is studying to be a psychologist, can answer the question of whether or not you should be in therapy.

    However, I can tell you from personal experience that not liking therapy is a very common experience. You are bringing up stuff that is uncomfortable, and learning to be more comfortable with it. Beliefs are challenged. It can be a lot like skepticism that way.

    But, from my experience, you will be better off for it. But it doesn't make the process any easier.

    I have some anxiety issues, have had a few panic attacks. My therapist recommended a book to read and use at home as a supplement: The Anxiety and Phobia workbook, by Edmund Bourne. This is something that you can read through on your own, at your own leisure, that gives lots of information about the underlying causes of many anxiety disorders, how they differ, and different strategies you might use to work on them.

    Lots of simple, straightforward worksheets and exercises to do, and you can pick and choose which chapters you want to take a look at.

    Don't mean to sound like a commercial, but perhaps that book might be a good start for you as you decide whether or not to try therapy. But again, you must think about it and do what you think is right. I'm admittedly no expert, this is just what's worked for me.

    http://www.amazon.com/Anxiety-Phobia-Workbook-Edm

  25. My hope is that diagnostic techniques for mental illness begin to approach those for more obvious physical illness. Using fMRI scanning studies have shown that some mental health issues could be diagnosed, or even pre-emptively detected. For instance, at a recent conference they examined those at high risk from schizophrenia, from childhood through to adulthood. They discovered that, not only was there a detectably different pattern of activation in schizophrenic brains, but that this pattern developed over time from a slight initial difference, to the more marked difference as symptoms began to show in the schizophrenic subjects. This would seem to indicate that drugs to change this pattern of activation to a more normal one, could be administered and then brain activity monitored to directly observe their effects, possibly even to the point of indicating required changes in dosage.

  26. Hey fuzzbucket1, go get help, you don't have to live like that. It might take time but I belive that the meds will help. I've had anxiety where I was very scared, everyday, for no reason, then I got help. Sure there are cases where meds are over prescribed, but what about all the peole that it helps. After taking the meds for a couple of months the dread was gone, I was no longer scared for no reason, I was relaxed (not spaced out like a zombie-that's a myth) and I did feel "normal". It's better to try than to not try. Good luck

    Kriss

  27. Well, one word:

    antibiotics.

    If doctors can't even be relied on to properly prescribe "normal" medication for clearly defined illnesses and afflictions, how can they possible be trusted to do any better when attempting to treat hazy, ill-defined, gray area stuff like mental disorders?

  28. krissncleo, did you ever just try some xanax? it did absolutely nothing for me, and i can't understand why. i think it discouraged me from seeking help and getting on something like paxil or zoloft. ah well. i know that's silly, and i really need to get some help.

  29. hmmmm… showed your post at the Granite State Monarchs outpatient clinic. Staff and patients were ready to lynch you and thought you either completely lacking in empathy or living in a cave. I was like "no wait, she says some people NEED medication!"

    , one out of four of us will suffer a major depression in our lifetime.

    That's big odds.

    And oddly, historically, mental hospitals have been true snake pits full of people not faking it for "attention". Straight jackets aren't really fun attention. The new meds are very imperfect, but for so many, it's the only game in town. The patients at the clinic said, "at least there IS a game now. Before, we would have been simply locked away."

    Reading "The Yellow Room" or even "The Bell Jar" and you get a feeling of how real mental illness can be. It's a hell on earth for many and thankfully most people are more open about having a mental illness. The days of "oh just pull yourself together why don't you!" seem to be passed. Except somedays it still comes out, but I would say usually it's someones grandmother or an older person with the old prejudices against mental illness saying it. The younger generation seems to get it, or at least to be more open about it. Remember, in my moms day "mothers little helper" was Valium. So this fear of over perscription isn't "new". Neither is the "just pull yourself together!" view. It's a team effort for anything, and drugs aren't a cure all. I've never met anyone that was cured simply by drug use. But with insurance capping spending, and the inability of people to pay for the mental health they need…well pills are cheap and therapy is not. It's not the big bad doctors, it's a system that doesn't allow people to spend the TIME and money needed for their illness. Sadly, insurance companies don't believe any more than some people that mental illness is a real illness.

  30. A topic which I’m sure will get me plenty of negative attention.

    I don't know about negative attention, but it'll currently get you attention, as it seems nearly everyone these days is chronically medicated. And appropriately opinionated about the subject(s).

    From GP Xanax prescriptions to psych doc depakote or lithium regimens, it's rare to find someone not on a daily psychotropic. At least in my sphere of friends and family.

    Science. We just need to watch the scientists, and hold them accountable. And that includes (and maybe particularly special attention is due to) the GPs.

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