Psychiatrists: glorified drug dealers?

In My Humble Opinion
1

I’ve been seeing one of these fools on and off for a while now because I’m basically a loon, and have come to the conclusion that all they do is prescribe a drug they have access to and hope for the best.

The evidence that these sort of drugs work is thin on the ground and the trials are carried out by the companies that make them - what kind of assurance is that?

Of the three I have seen, they have little or no understanding of mental ill-health, preferring to think on the chemical level and ignoring social factors almost completely. If they do accept that the cause of your mental ill-health is primarily social, guess what? They want to treat you with drugs!

(Thats if you’re lucky like me - real bad cases still get electrocuted which I find barbaric).

Worst of all, they don’t even give you a tab like real dealers…

So has anyone had a good experience of psychiatrists? I’d like to know!

2

My short answer to the thread title: Yep.

Many years ago, I had a similar experience to what you’ve described. The psychiatrist saw me for twenty minutes every other week, wrote a prescription, and that was that. Long story short, the drugs nearly killed me–not as in an OD, but rather a nasty set of side effects that the doc failed to mention since “that hardly ever happens”–and once I’d recovered (and the temporary blindness lessened enough for me to find my bus stop unassisted), I went to her office and told her I wouldn’t be back. That’s when she started asking questions about my personal life. Too little, too late. She tried to tell me that I just needed a boyfriend (not by a long shot), and that I should give the drugs more of a chance to work.

Since then, I’ve handled life on my own. It’s not great, but at least I’m functional. (And I can see!)

3

As a future “drug dealer” I can only hope not. From what I’ve learned in my two years of undergrad work, drugs are good, but you also must talk. There are a lot of idiots in my classes. Maybe you guys wound up with them. Sorry, but a psychologist/psychiatrist is the same is anything else: there are good ones and there are ones that suck.

From what I can remember electroconvulsive therapy uses a jolt of electricity that is barely strong enough to run a microwave. This jolt lasts less than a second. Yes, there is Cuckoo’s Nest style shaking (that’s where the convulsive part somes in), but it does more harm that good by raising biogenic anime levels. Simply put, it gets you high and keeps you that way for about a month.

4

Try a psychologist. Most of them will refer you to a psychiatrist for prescriptions if drug therapy seems indicated*, but they have only their wits to work with, and will thus engage you.

Good luck!
*[sub]I believe New Mexico is the only state that allows psychologists to prescribe controlled medication.[/sub]

5

In my experience, since psychiatrists are MDs, they tend to be very quick to whip out the ol’ prescription pad. YMMV, Some Assembly Required.

6

While not really wanting to argue your point I just want to point out that a microwave draws a signficant amount of power. It’s no small thing.

7

I am seeing a psychiatrist and have had much the same experience that you had. However, I know a little about the system and know it is not really her fault. If the psychiatrist works for the hospital, then he or she is forced by the powers that be see as many patients in as short of time as possible. Get the patient in, make a diagnosis, write a prescription. Long term talk therapy is not usually the role of the psychiatrist although some do engage in it. If you want talk therapy, you should see a psychologist, a good counselor, or a social worker licensed in therapy. That is their job.
The job description of the psychiatrist is muddled in the public’s mind and I believe sometimes in their own mind as well. I have a condition that all of the talking in the world won’t fix. I need a psychiatrist to make that diagnosis, come up with the most effective drug treatment possible, and do long-term monitoring. As long as she does that, then that is her contribution to my care. I also have a Ph.D. psychologist that I see to talk about the social aspects of my condition. I want him to leave the drugs to her and her to leave the talk to him. That is the reason that they are two different jobs.

8

In my rather extensive, intensive experience with psychiatrists and psychologists, I’ve found that yeah, some want to whip out the pad and give you drugs to make you better right off the bat, whereas others are more “let’s try this, and if it doesn’t help we’ll get you on some meds.”

Keep in mind that from their perspective, the chemical imbalances in your brain that are causing whatever you’re seeking treatment for are what need to be addressed first. When my first shrink immediately said “Here, Zoloft. Take this.” I went “Whoa, without any sort of therapy or anything else first?” His rationale was “We need to get you to a more ‘normal’ baseline from which to work with first.” Makes sense I guess. But yes, some do first reach for the pad, where others recommend a psychologist.

My uninformed opinion is that a combo of the two are probably the best, in cases where meds are needed. Drugs + counseling seems the best way to go. The drugs will keep the chemicals in balance, but you still need to deal with the underlying issues.

I’ve never actually taken the antidepressants prescribed for me so I dunno, they may have been right.

9

The psychiatric profession is very, very heavily lobbied and wined and dined and favor-curried by the pharmaceutical reps.

I am hardly an apologist for psychiatrists, but in fairness to them they don’t have much in their toolkit except medication. Their conferences are virtually sponsored by and catered by the pharma companies who distribute literature and samples and push the idea that their newest and greatest will do a better job than the dusty old pills of yesteryear.

wolfman

The jolt creates a seizure and does permanent brain damage, which is not an unfortunate side effect but is the means by which it “works”.

You don’t get wheeled in for “a” shock, incidentally. Shock treatment is done as a series. They electrocute your brain over and over, day after day, leaving you in an increasingly hazy fog of disorientation and scrambled memories. Then they release you (with permanent memory loss, impaired cognitive function, flattened affect, and nightmares about the experience) and then, as you say, you buzz along with the false euphoria generated by neural damage for a month or so before it wears off.

Oh, and they still do them on an involuntary basis.

Hardly an improvement over pharmaceuticals, even hideous ones like Prolixin and Haldol.

Then there’s psychosurgery. Stick a wire down into the brain tissue and cauterize a bit of it. SO much more civilized than the old ice-pick lobotomies of the 1950s, don’t you think? ::shudder::

10

AHunter3:

Thank you for the information. First off, its’ Wolfian. Wolfman is a whole 'nother cat (pun intended). No problem, I get confused too sometimes.

I think there is a “new” version of ECT that does what I described. I think you are thinking of old school electroshock therapy. I could be wrong and/or my source maybe biased. It was a 200 level undergrad course. Maybe in grad school they will go into more side-effects.

As for psychosurgery, it is mostly used on seizure patients now and it does wonders. People who used to be paralyzed by shaking can now lead productive, non vegetable-like lives. Psychology has come a long way from the 1950s Cuckoo’s Nest style where trouble-makers have their brains scooped out to spend the rest of their days in a Jimmy Carter-like calm (thank you, MST3K for that reference). Of course there are still problems, just look at the first two posters, but nothing is perfect.

PS Yeah, the microwave analogy seemed a bit off to me too. Maybe its’ the lightbulb in the microwave. The point, its’ a relatively mild shock.

11

As someone who works in medical research (some sponsored by drug companies, some by government grants), and participates in our medical center’s institutional research review board, I will note that most of these studies have their data collected and analyzed not by the drug company, but by an independent data monitoring agency of some sort. Thus I feel pretty confident that it can be difficult for companies to lie about the effects that their drugs have.

12

Really? That’s not how it worked for me. No memory loss (apart from immediate post-zap), no impaired cognitive functioning (actually, it was improved!), emotional affect was restored and not one nightmare. YMMV of course.

13

I’d say if you say it about psychiatrists, you have to say it about the entire medical profession.
One of them quacks has my Dad hooked on blood pressure drugs, and some other crap to keep his diabetes under control.

But seriously.
We have seen a rise in the past few years of designer mood drugs. For some people they’re life savers. For others they do no good at all.
If you’re dissatisfied with the effects of the prozac or whatever the doc has you on, don’t take it.

At least it’s not as addictive as crack.

14

I had an excellent psychiatrist in Denver that really helped me. We had a cocktail of meds going but soon reduced it to one, ritalin, that really helped me.

He did a lot for my mental thoughts, not just the chemical issues. Ask your primary physician for a doc he/she recommends, the medical community is pretty tight in most places so I assume your general practioner should be able to recommend one for you.

If not a psychologist (as suggested) can work with your primary physician to prescribe what is appropriate.

15

After I confessed to my parents that I wanted to commit suicide on Christmas Eve, 2001, they took me to a psychiatrist. He prescribed me some good drugs. They made me happy, and basically saved my life, despite the side effects.

So yes, I have had a good experience with a psychiatrist. In fact, if it wern’t for one, I would likely not be posting this right now.

16

Hey, medication works for some people. Like me.

My life is not messed up, my parents are still married and I live with them, I don’t do drugs or drink, I am not in an abusive relationship, I was never sexually, mentally, or pyhsically abused. However, I am clinically depressed, just because the chemicals in my brain are messed up.

Psychiatrists may prescribe drugs too often, but they were a god-send for me (I had just been diagnosed and was leaving for a family vacation in three days–which is enough to give someone a panic attack even if the are in good mental heath–and if I had not had anti-anxiety medication, I cannot imagine how hellish it would have been).

I’m an advocate for medication for depression, but if you want someone to talk to, definately get a psycologist.

17

A few scattered points:

–Studies I’ve read have shown that in moderate to severe depression, drugs + counseling is a bit better than drugs alone, which is far better than counseling alone, which is somewhat better than no treatment at all. I’ll try to dig up those studies.

What I deal with more often in primary care internal medicine is mild, chronic, long-term depression, often in older people. These are folks that never had a breakdown or thought about killing themselves or anything dramatic like that, but when you probe you find that they get little to no joy out of life, they feel hopeless all the time, etc. I think of this as “compensated depression”, in that they have the tendencies that we refer to as clinical depression but they’ve had them for so long that they lead a tolerable, if not joyful, existence. My experience is that when these folks experience a major life stressor, like an illness or the loss of a loved one, they decompensate in a big way.

Can drugs help those people? For some of them, absolutely; I’ve seen several of them get a new lease on life after starting an SSRI. Then again, drugs won’t help some of them feel better at all. Others may have some resolution of their depressive symptoms, but they’ve had them for so long that they’re uncomfortable with the change, so they don’t really feel any better.

Note: this is all my own clinical experience, and I’m rambling.

–Re: the “overprescription” of medications–would those who cry out about meds being overprescribed rather we went to the other extreme and refrained from giving meds to someone whose life would benefit greatly from them? Ideally, you’d just give medications to those who would definitely benefit from them, but it isn’t reality.

Granted, the majority of the psychiatric pathology I see and treat is mild to moderate depression and anxiety, but if I think a patient’s life might be improved significantly by a medication, and I feel the potential side effects are mild and self-limited, I will offer the medication. Why shouldn’t I? The patient doesn’t have to take it, and if it doesn’t work, he can stop it.

So yes, I overprescribe psychiatric meds, and I wil continue to do so. The greater crime would be to underprescribe them.

–One of my best friends is a psych resident who has been known to lurk around here. I’ll see if she’s interested in popping in and offering her insight.

Dr. J

18

I’m not advocating NOT prescribing them, they can be quite the help, especially if paired with counseling. What troubles me is the “Feeling a little blue? Have a Paxil!” attitude I’ve sometime experienced. I just have some qualms about messing with brain chemistry for things that could be treated otherwise.

19

I’m not questioning your experience, but over the forty years that I have had my struggles with clinical depression, I have never had that experience. Sometimes other physicians have been known to take a more casual approach.

Some anti-depressants take six weeks or so to take affect. So if you appear to have the symptoms, the psychiatrist will often get you started right away. (Clinical depression can be a terminal illness.)

My understanding is that if you are not depressed, the medication will not make you “overly happy.”

I have had really truly totally rotten psychiatrists three times over the past four decades. But I have also had two who are excellent. I continue to see one of them once a month for twenty minutes. During that time he checks to see how my life is going and how I’m relating to people in the present. He has to shift my medications from time to time. The twenty minute session seems to be a trend, I think, in treating depressed patients.

But I had already had years of experience exploring my past. And that was helpful to me too. If you are not getting what you need from a psychiatrist, tell her or him and see what happens. If you don’t get the talk therapy that you feel you need, look elsewhere. Sometimes medical universities can provide low cost psychiatric help. Also, talking with a psychologist can often do the trick, but insurance is not as likely to cover these sessions.

If you do decide to stop taking your medications, please do that only under a doctor’s supervision. Going cold turkey can have a terrible effect.

I don’t blame the OP for being wary given the circumstances. But I owe my life to a good psychiatrist and the appropriate medications.

Meta-Gumble, you refer to yourself as a “loon.” I hope that you can stop being so derogatory about yourself. There are lots of us who need help and it takes courage to seek it. More likely than not, the disease you have is not your fault. Don’t blame yourself and don’t give up.

My experiences with ETC were forty years ago and similar to that of AHunter3. But I don’t think that people these days have so much trouble with it.

20

If I don’t get some anime or manga every once in a while, I have fits of OCD.