You cannnot equate a Medical Dr prescribing drugs to Psych Drs prescribing drugs. There are a lot of differences.
The medical drugs are for things that are scientifically tested for.
Mental illness is a whole different world. It is the wild west out there. They are finding new uses for drugs and advertising them at you. This is not analogous to insulin, for instance.
If you are an unhappy emoji they can make you into a smily one. That is not science.
I’m only saying that depression is relative. If you end up trying to get off benzos, or possibly remeron, or Gabapentin or some other drug, you may recalibrate what it is to be down and out.
And you may be offered one of these drugs when you only intended to be on another, but it went badly.
The disrespect comes from saying Psych Doctors are psychopaths, and other things you’ve said earlier. Your problem with Psych Doctors is your problem. The ones I’ve had dealing with have been professional and genuinely cared about the well being of their patients.
Do we know enough about SSRI’s to say they do not present problems after discontinuation, while not identical to benzos, that present a comparable negative impact? You can understand why I am skeptical of any doctor who makes such guarantees.
They have enormous amounts of training and experience.
However, the “diseases” they are trying to treat, massive uncertainty exists about what precisely is going on and why. There’s a horrid mess of neural circuits all firing into each other - we probably won’t be able to effectively diagnose and treat mental illness until possibly centuries in the future, when we have invasive analysis equipment that can actually track individual neuron firing chains and determine the flaws. A “brain debugger”. Making this problem harder, it isn’t static and neural circuits are modifying each other, changing the firing patterns of their neighbors which feeds back and changes the firing patterns of themselves, which feeds back into the neighbors…
So instead, they have a small catalog of pills. These pills are little better than whacking a malfunctioning machine with a sledgehammer, or spraying lubricant into a malfunctioning transmission, or leak stop into a radiator. Sometimes they work better than nothing - patients statically are less likely to be depressed if on SSRIs if they had severe depression. But like the example of a transmission, the only way to fix a malfunctioning transmission long term is to take the whole thing apart, replace the faulty and worn parts, and reassemble it. We can’t do that with the brain yet.
That’s why it’s all gut feel and inconsistent. Go to one psychiatrist, get a drug prescribed. Go to another, tell the same story, and that one probably prescribes something different. Every now and then you might go to one who sends you home without a script. And god forbid you try to take all the drugs at once…bad idea.
Honest psychiatrists will probably let you know they are just throwing darts blindfolded with only a vague hunch where the dartboard is. Dishonest ones will act like their medical degree + experience somehow overcomes the simple fact that the field they work in doesn’t know what it is doing.
Most of them aren’t psychopaths and genuinely believe they are trying to help. Kind of like that nice couple that stops after you have a car wreck and tries to bandage your wounds with torn strips of cloth. Better than nothing, but…
If you haven’t had any problems with them then that’s great but the problem with psychiatry is not located within me…Talk to people in the world. Do some research into Drug companies contacts with Drs and how the business gets done. Many times for them to be perfectly honest about a drug would be devastating in terms of liability and their career, and their whole profession actually. So it can’t be done, no matter how good the intentions of the Dr.
God wiling you won’t present a problem for them in your treatment. You’ll find out very quickly where you stand, and where their priorities are if that happens. They are guessing at what to do next all the time, and giving out drugs. (They are 20 minute appts, basically only good for prescribing, right?) They won’t be admitting to any mistakes in this lifetime. And they will always treat any new problem with a new drug. If the drug itself is the problem then it is a perfect negative feedback loop, and you will be the loser.
I’m not going to be saying there are no good psychs. But they regularly lie, and misrepresent effects and difficulties, and can be deathly bored with their job seeing patients for 20 minutes a shot, and this can affect your or your loved ones life tremendously. And they do it for systemic and business reasons, not necessarily reasons of their personal psychopathology.
Maybe, for some. It is (very sadly) a self selecting set. For those they have kept from suicide, they keep them from it. Those it didn’t work for, well they are not part of the sample set anymore.
For the OP, the above discussions are so very typical. Mental illness is one of the most difficult areas, and the one where progress in understanding and treatment slowest. It is a just plain hard problem. You will have a set of people for whom even the best known therapies are just not much use. And possibly worse, no clear understanding of why. Yet there are also a great many for whom the existing therapies are anything from a lifesaver, to something that makes life bearable.
Where discussions get difficult is that whereas it is clear that one size does not fit all, opinions become very strong, and very strong in the direction of personal experience. What worked for me must work for you, and what didn’t work for me can’t possibly work for you are common. And for the latter there are no end of really unfortunate life stories.
I will criticise modern medical service, in that it doesn’t encourage long term engagement with practitioners. One of my maxims in life is that you need to find a good general practitioner, one that you trust, is sensible, and you get along with. And you need to stick with them. Where things don’t work is that in modern western society, once you are past the usual set of childhood maladies, you can go for decades with nothing more serious than a bad cold. The odd non-serious acute problem can be dealt with with a single visit to any doctor - to stitch up a cut, or the like. So many people are unprepared for a chronic or serious condition that needs longer term care. For mental illness this is particularly bad. And suddenly they get shunted into a system they have no support in. Care can easily be below par - and the stories of perfunctory consultations and simplistic drug therapies not surprising. But also, some people’s illnesses are refractory to the most concerted care.
One of the surprises of more modern physiology is how varied the chemical pathways are in individual humans. Whereas we thought that everyone pretty much operated in the same manner, with the same chemicals triggering the same processes in each person. It doesn’t happen that way. People have a diversity of pathways operating, and between two otherwise healthy people, they may respond to illnesses and drugs in quite different ways. The litany of possible drug side effects is a clear example of the problem. Some drugs work pretty much the same way in almost everyone. Some turn out to be useless in some people. And some turn out to be a really bad thing in some people. But, until you try, you won’t know which people.
Drad Dog maybe your problem is the US medical system? not the Doctors or the Drugs. Something which I agree is fatally flawed. I’m not in the US and my friends who saw Psych Doctors had much longer appointments than 20 minutes before starting on SSRI / SNRIs.
There’s no maybe. I’ve expressed myself on this sufficiently above. There is a systemic problem, and you can’t separate this from the drugs, and the Drs quite obviously. The problems I see would not be solved by seeing these Drs for more time. That’s only part of a huge dysfunction.
I’m only saying that you should enter these things with eyes open, Drs can be lying, misinformed, or whatever…Drugs can be really nasty, and research is for sale. It’s not a good recipe. If you like it, great. But it’s not a problem that comes from me or is only seen by me.
Getting adequate mental health care, or getting any at all, can be well beyond the reach of a lot of people. Modern “managed health care” practices have reduced psychiatric care down to those quickie 20-minute drug-dealing appointments with the 3-month follow-ups, much criticized in several posts above. Psychiatrists have been reduced to pill vending machines.
The mental health care available at my HMO organization is paltry and perfunctory, at least their outpatient services. (I wonder how they deal with cases of actually seriously ill schizophrenics and other psychotics.)
All the talk about the need for adequate and conscientious psychiatric treatment, far exceeds the actual availability of the same for a great many people.
None of that is relevant to the original post. No one disagrees that its impossible for most people to get adequate mental health care.
SSRI / SNRI can be a very useful tool for many people both short and long term. But yes, anyone considering taking them should do a lot of their own research and not only listen to what their doctor says. My friends found the CrazyMeds forum very useful for a lot of detailed discussions about long term side effects. http://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage
Drad Dog, those posts are not relevant to this discussion. If you want to start a thread on corruption in the pharmacological industry do that in Great Debates forum.
Because the stuff you are spouting might influence someone that needs help to not seek it out. SSRI’s are not worthless and if they stop working on one particular individual there are other options that can work: SNRI / Tricyclics and SARIs. The last thing a depressed person needs to hear is that all Psych doctors are evil and in the pay of big Pharma.
Sounds like paranoia to me, but then I’m not a psych doctor so what do I know?
