in your case, sure it did. It sounds absolutely barbaric. That would be the opposite end of the spectrum though, from the “swift kick in the ass is what they need” treatment plan down to “mandatory psych evaluation and meds.” But my context of psychiatrizing is different from yours - it originates from the patients’ perpective that something is wrong within themselves and they are the ones seeking the answers. When society takes on that job for the ‘common good’, well…the very unfortunate experience you had would be routine. (And I believe it was routine, years ago.)
I certainly don’t believe that to be the case! If I did, I’d hope to find a compatible, compassionate, wise, understanding person with the authority and knowledge to help me cope with it, and I hope you have found one.
But even though I do not believe myself to have a chronic incurable mental illness…
In the current New Yorker is a short column about…well, never mind, that’s not important…anyway, the columnist tells the story of a major league baseball player at bat who didn’t swing at a fastball. He waited for the ump to call “strike” or “ball” and when a second went by, he asked, “Well? Was it a strike or a ball?” The ump replied, “It isn’t ANYTHING until I call it, son!” The point (the columnist continued) was that the baseball player was thinking that the pitch was objectively either a strike or a ball, and was waiting for the umpire to say which; but by the rules of baseball, the ump’s decision (not instant replay cameras or dissenting opinions) determines the status of the pitch, so effectively the ump’s call CREATES the status by making the call.
I have been diagnosed by legally practicing psychiatrists as “manic-depressive”, and on another separate occasion as “paranoid schizophrenic”. I do not believe I “have these things” and I don’t in any way want to cheapen or insult the horrid impact of mental conditions that people suffer from by saying “It’s just a silly label that shrinks put on people who are unhappy or disturbing or disruptive or that they can’t understand”.
But there is no objective determination by which I could ever say “The doc is wrong. I am not a paranoid schizophrenic and therefore I don’t need to take these bloody meds”. Not then, in lockup. Not now. And not, God help us, if our esteemed legislators pass laws that make it permanently a part of one’s nationally-accessible record (like a police record) if one has ever been psychiatrically diagnosed.
In practice, you are as “mentally ill” as they say you are. Like the umps, they conjure that status into being.
Bah! I just wrote a long post, but on preview I see it’s no longer relevent. Doh!
Mental illness requires that a significant amount of history to be evaluated.
You can’t pick a univeristy freshman and say “hmm, suddenly he is irresponsible, he drinks way too much, sleeps all day and seems overly excited… He must be bi-polar” because, -well duh!- he just moved out of his parents’ house, lives with his frat buddies, and has discovered that if he skips class no school official is going to come looking for him, and it’s been frosh week! Party on, dude! He’s not bi-polar, he’s a dumbass who is enjoying his first taste of true independence in a party house. By Thanksgiving, after he’s seen his first grade of “F” he’s settled down.
Sure Dumbass has observable “symptoms.” They are observable for the first two months of school only. An anomaly, yes, but as far as the big picture goes, not of consequence.
Mental illness requires long-term observation. You evaluate a patient’s history, family history and then take into account age and physical health which is very important.
Misdiagnoses are dangerous. What if he’s not schizophrenic? What if it’s a brain tumour? Oh, she must have a despressive disorder, let’s give her anti-depressants – What? They made her manic and she jumped off a bridge??
ultrafilter you can have symptoms from other physical causes such as shock, a tumor, other physical brain damage like a boot to the head, some people even have big emotional responses as a result of allergic reactions. There are also physical illness not necessarily brain-related that bring on aberrant behaviour. My grandmother suffered a condition that caused the sheaths around her nerves to thicken, thus cutting off the electrical impulses (kind of like stepping on a hose and interrupting the flow of water). So she had symptoms that were very much like Tourettes, and she would have huge mood swings, cognitive disfunction and her motor skills were affected. She wasn’t mentally ill, but you’d really think she was psychotic.
I completely agree. I’ve had “mood swings” (a better term in this case would probably be “ups and downs”) for my entire life – when a pet died then I was sad, when G.I. Joe kicked the tar out of Cobra then I was happy, etc. It wasn’t until eight or nine or ten years ago that some of my mood swings became disconnected from life, i.e. that I began to have “anomalous” mood swings. The trick was in recognizing the anomaly, something that isn’t very easy to do when depressed.
However, even when I was on the meds, I still had my ups and downs. The meds eliminated my anomalous mood swings (at least, they eliminated the ones that weren’t very severe), nothing more. I can’t say if all bipolar sufferers have their ups and downs similarly untouched by their meds, though – IANA Psychiatrist.
I believe I said (earlier in this very thread) that if you held a gun to my head and said I had to take one, it would be lithium. It does do no damage, at least (unless you OD on it; you have to monitor your levels closely, right?). But I think it is not true that it has no effect, emotionally, on people who do not have a mental pathology. I don’t know the fine details, but I know it masquerades as sodium, displacing sodium in some percentage of chemical interactions, and that the lithium version of those temporary (…I don’t know if they are compounds that are formed or if sodium / lithium is accessed only as a catalyst?..) uh, chemical situations, won’t “work” like the sodium versions.
The story reported by people who have been forced to take lithium involuntarily is a flattening out of peaks and valleys or of their emotional intensity. Lithium appaently does not fail to do this for people who are not mentally ill, and people I’ve known in the movement who were forced to be in lithium have said they felt as if they were watching a replica of themselves living and doing things and none of the events that transpired seemed very important to them because it was like watching them happen to someone else. Some also reported having problems with rebound when they got the opportunity to go off lithium, while others said they had no withdrawal effects at all. All the old guides for getting off psychiatric meds that are conventionally passed around within the movement say no withdrawal effects and no long term side effects and no permanent ones at all.
Interestingly enough, the psychiatrist who prescribed medication for me (in October) is working with a couple of other psychiatrists on a regime to help people get OFF of prescription medications. It includes Vitamin C, some sort of B complex, and fish oil.
shrug
Medication has helped me. I resisted it for years and years. I am incapable of being wholly objective about medication because it appears to have helped me very much. I’m still getting my opinions straight.
Tee, yes, we have attained a shared perspective here
There are people who, unlike me, were not whisked up by the psychiatric system when they had no interest in receiving help and then had help forced upon them, but who instead sought it out, miserable and unable to function and perennially suicidal in feeling if not active intent; but whose eventual assessment of the “help” they received from the psychiatric system is no more complimentary than my own.
Linda André, a local NY activist, was prescribed electroshock for her depression. They told her it would cure her. They lied to her about permanent side effects. Her memory of her own professional material was effectively erased and she was subsequently unemployable in her chosen field, and she says her “affect has been permanently flattened, as they say”, aka “I don’t really feel anything at all, ever”. Janet Gotkin wrote a great book, Too Much Anger, Too Many Tears, about seeking psych help for suicidal depression and having to lie to them about how freakin’ happy she was to escape from the cheerful little reward-and-punishment behavior-modification tank that the private insurance-paid psych institute she got herself into turned out to be.
Be all that as it may, critting the state of psychiatric treatment doesn’t negate the fact that help is needed and we as a society need to provide it, and to do a better job of making it available.
From my side of the table, the bigger priority is to stop forced treatment and insufficiently informed consent, and to help create room in people’s mental category system for “miserable to the point of being debilitated for reasons other than mental illness” and “disturbing and incoherent beyond the possibility of meaningful dialog for reasons other than mental illness” so that not everyone who exhibits these externally observable symptoms get treated for mental illness (even with their consent).
But I got into my own mess initially by wanting needing and seeking help myself and I have not forgotten what it’s like to be miserable and incapable of continuing, even if my reasons for being in that state were different from those of other people. I salute you all for all that you endure.
Still, it’s biological in origin. That’s what I was driving at. I thought that AHunter3 was claiming there were causes above and beyond biology (discounting external influences with simple cause and effect relationships).
AHunter3…it is people likeyou that encourage people that could really be helped by treatment not to seek it.
It is people like you that help perpetrate the stigma that goes along with mental illnesses.
ECT is only used for patients as a complete last resort. Did your friend tell you that? Did she bother to find out abiout the side effects of ECT on her OWN before consenting to the procedure? Patients need to also act as their own advocate. If you completely place your life in the hands of someone else, no matter how many degrees they have, you are a fucking idiot.
Anyway, I’m not discounting that biological causation can exist – whether all by itself or in combination with environmental causes. I believe it can.
What I am discounting is the notion that it is a good thing to assume (whenever you see these behaviors or other manifestations of incapacitating emotional stress and misery) that they are due to biological causes. Not that this couldn’t be the case. It could be. It could also be that the person is a shmuck who did something to bring such misery down upon himself but you shouldn’t assume that by default either. These are not good default assumptions. You should instead assume, until you have reason to believe otherwise, that miserable people are miserable because something happened to make them miserable; and that if the misery is debilitating and messes them up substantially and incapacitates them, that something hideous and horrendous happened to make them that way.
To do otherwise is to engage in a form of undercarpetsweeping at best and sometimes victim-blaming as well.
Yeah, like when your private insurance’s maximum inpatient stay is running out but they’ll pay for ECT. Really. Dead Seriously.
Actually the trend in psychiatry right now is to use ECT more and more often and the push is on to treat it as low-risk and use it a lot more liberally. And it is applied to people without their consent. I’ll link the protocols for doing so in various bins in NY State if you wish.
A side effect that is difficult to avoid when one’s goal is to encourage people who could be really destroyed by treatment to be wary of it.
In a good medical and therapeutic environment, such as system is already in place.
For example, in our second year of a brutally high-stress academic program, a good friend of mine became untterly and totally incoherent. He was wide-eyed, looked frenzied and was throughly unable to form sentences. We’d been working in the studio for five days straight and he’d had no sleep for three. His diet had consisted entirely of junk food and coffee and though he was working like a madman (no pun intended), he realized that he would not meet his deadline – if he failed this, he would be kicked out of the program.
Yes, he became a “disturbingly incoherent, babbling maniac”. The prof sent him to counseling services and they gave him a note to excuse him from the class and allowing him to skip an exam. He didn’t need psychiatric treament, he didn’t need medication – he just needed sleep, a good meal, and a chance to calm down, reprioritize and get his faculties together. No more.
Diligent healthcare professionals should recognize the difference. Often they do. There are categories that are as simple as “stressed out and over-worked; needs holiday.”
I had a reply typed up to the same quote of AHunter3, and it got eaten. So, in brief:
I agree w/that too, but it looks like the mainstream trend is going toward treating the symptoms of mental illness without a definitive diagnosis. I already mentioned that this kind of alarms me - the way prescriptions are handed out by GP’s, among other things - and it leads to the atmosphere of (slight, not to be mean) derision and misunderstanding which likely prompted the OP.
It may open the way to more litigation - the kid in Eats_Crayons’s post, would his parents have sued if he took his own life or something? “My son was a babbling, incoherent maniac and you people said to Get More Sleep?!” That sort of thing.
I’ll take your word that there are disturbing trends going on in psychiatry, but I’ll bet you that most honest-to-goodness cases of depression probably don’t have to go anywhere near a psychiatrist’s office nowadays.
Just to clarify: he was 33, not a “kid” and old enough that it was unlikely for it to be the onset of a mental illness. The doctors did evaluate him carefully and it was clear that he was suffering from acute stress. Hit the nail right on the head.
Abuses and misdiagnoses happen. Particularly in a crisis situation. The point is, he did go to get help and he was evaluated correctly.
My general sense is that in public institutional bins, they are happy to kick you out and let you fend for yourself on the street with a token referral to outpatient that isn’t very tailored to doing much more than counting “service units”. (I’m sure excellent exceptions exists here and there though); that private institutions are often the creepiest (very intensely personal treatment, but often atrocious abuses of power and authority, and as I said before they get paid by people’s insurance companies so they have an interest in keeping you in at least until the maximum insurance coverage period expires); and that one-on-one relationships with individual shrinks runs the gamut from people who care deeply about your welfare and concerns (my girlfriend’s shrink is her de facto primary-care physician – definitely the best doctor she’s got) to people who are dangerously bad news and who have a license to have you locked up if you don’t do as they think you should with your life.
As Witch has said, the best defense against mistreatment by the system is to be informed and to be proactive in seeking out a person you can really work with, one you can trust not to abuse power.
I’m glad to hear about more accurate and cautious diagnoses in cases such as reported by Eats_Crayons. I only see the other side of things (people generally get involved in the movement after having had a really bad time of it with psychiatry, as you’d expect) and I guess the nature of any political activism is to stress the evil nature of whatever you’re up against and why it’s of ever-increasing importance to organize and lobby and fight against them and so forth!
I dislike mental hospitals/mental wards. You can read why here if you wish.
I think, however, that the distinction must be made between seeing a psychiatrist and being institutionalized. I have never met anyone who was “put away” by their psychiatrist without a family member initiating it, or anyone who was forced into any treatment, so I can only conclude that it is pretty rare except in extreme cases. I have had the police come for me three times. Twice they just tried to calm me down and then left. Once they took me to a mental hospital for an evaluation. We waited in the room for about 20 minutes, then I talked to a doctor for about 15 minutes, then the cop took me back home and life went on.
No problem. That particular academic program has quite an age range of students, so you have 18 year old first year students working alongside first year students that are ten years older.
Question (and this may open a whole other can of worms):
Does the privatized (and somewhat capitalist) nature of the U.S. healthcare system have any affect on psychiatric diagnosis and proper treatment?
I do mean this as an honest question.
For example, in MPSIMS Welby describe an incident in which his family was in crisis and needed counseling. They had to wait for the paperwork to be cleared by the insurance company, and then the insurance company denied approval for psychiatric testing. So not only did they have to wait, but they were also denied an assessment.
So, that incident got me wondering about the evaluation and admittance procedure. Can someone describe this in a nutshell?
