Note that most of those with strong opinions here are the least informed, or have a known axe to grind. Are there problems with psychiatric treatment? Yes, much as there are with any medical practice. However, the degree to which detractors paint psychiatry as going beyond completely useless into the degree of intentional maliciousness is just ridiculous. The vast majority of those who see psychiatrists have mental illnesses that cause them much difficulty in their day-to-day lives. We aren’t talking about people with psychological “issues”; we’re talking about well-known, well-described, but unfortunately not perfectly understood medical conditions. The reason that psychiatrists use medicine to treat these conditions is because they are, as stated, medical conditions – and our current best way of treating them is through medication. If there were a better way, it would replace the use of medication; this is how the science of medicine progresses.
On ECT (“electroshock” therapy): first, most of those talking about ECT have clearly gotten most of their information about the practice from watching One Flew Over the Cuckoo’s Nest. ECT is a “last resort” procedure, and is only done in times of acute, serious psychiatric breakdown. We’re talking about people who are going to kill themselves, or severely harm those around them, unless immediate action is taken. These are people who are completely unresponsive to medicine; obviously, other treatment is exhausted long before ECT is considered.
Also, the thing about ECT is that it is effective. The resultant neurological effects aren’t caused by “brain damage”, although the jury is still out on what ECT does from a physiological standpoint. For whatever reason, ECT acts to “reboot” the brain, and can cause improperly functioning portions of the brain to revert to more standard modes of function. Unfortunately, this will often not last, and ECT may need to be repeated. However, as said, we are talking about otherwise “lost cases”.
Talk therapy: can be useful in getting people to change their behavior, but generally not effective in altering people’s “feelings”. Talk therapy will not make an OCD sufferer stop obsessing and ritualizing. It will not make someone with severe anxiety stop having panic attacks. It will certainly not make someone with schizophrenia stop hearing voices. Medicine is used because it is effective, in many cases.
On bad doctors: I’ve met plenty of shitty doctors in my life. In fact, I’d say that the medical profession has more crappy practitioners than you would expect for a field with such a long and difficult training period. However, when you get a bad doctor, ditch them! The internet is a great tool; you can look up online to see if a particular doctor has had complaints filed against them. You can compare medical advice or prescriptions you’ve received to what other people are getting by participating in discussions online; if your doctor is doing something that seems very non-standard, you would do well to get a second opinion.
On “overprescription”: I have yet to see any numbers that cause me to believe this is a genuine phenomenon. Rather, this is something that everybody “knows” happens, and continues to repeat – giving the illusion of legitimacy. Check the many threads here on “Should kids be given Ritalin?” and see how many people preface comments by saying “Now, everybody knows that Ritalin is overprescribed”, or things to that effect.
On “wining and dining” by pharmaceutical reps: most of the extravagent perks that psychiatrists get from the pharm companies consist of trinkets like pens, pads, little refrigetor magnets, and so forth. Those of us who worked in the “dot-com” economy got bags of this crap as well. Obviously, there is marketing of pharmaceuticals, and obviously it must be effective up to a point or the companies wouldn’t bother with it. Honestly, though, do you really think a rational doctor is going to immediately start pushing a drug to those who don’t need it because someone gave him a little foam doodad and a few ballpoint pens? Or, for that matter, a “conference” and free meal? I know there are several MDs on the boards, and I’m sure they would tell you that the swag they receive from pharm reps isn’t going to make them quit their day jobs.
Anyway, this is running a little long, but I do think someone has to balance out a few of the negative comments (and misinformation) I’m seeing here. Hopefully, this is a start.
Signed,
occ
Not a psychiatrist. Not working for a pharmaceutical company. Been in therapy. Used a number of psychiatric medications.
Have relatives who’ve been through ECT.
