I want to hear more specifically from people who have been diagnosed and medicated.
Years ago when I was in university, I felt massively uncomfortable around people. I was also experiencing some weird para-psychotic symptoms, probably from the stress of being around people practically all the time.
They set me up with a therapist who misunderstood me time after time. She made the conclusion that because I was anhedonic and felt nothing about the past events in my life, I was depressed. I had also mentioned that I felt extremely uncomfortable around others. So I was diagnosed with depression and social anxiety disorder, and put on Celexa. I quit seeing the therapist, because I could sense she was used to students coming in sad about the loss of a loved one, or stress related to the pressure of school, etc. All of our sessions went nowhere.
I took the Celexa for three months and it had no effect on me. During that time, I had also realized I had been anhedonic for quite a while. My ups and downs were and are always short-lived. Given that alongside a long-standing sense of pessimism, I concluded I wasn't depressed, and was misdiagnosed.
The social anxiety disorder diagnosis was accurate, but I didn't need drugs or therapy for it. I have strong schizoid tendencies, and I just had to go and socialize more. It is no longer a problem for me.
Overall, the experience was a waste of time for me. But I know others who benefit from therapy...when they find the right therapist.
I would not say that mental health is handled wrong. I would say it is an imperfect science that will be very difficult (if not impossible) to perfect. There are good and bad therapists, psychologists, and psychiatrists, and the drugs prescribed work on mechanisms their designers do not yet fully understand. In the future it may be possible for a DNA or fMRI technology to tailor drugs for people, instead of rotating them on different pharmaceuticals that sometimes do more harm than good. But for now, this is what we have.
Mental health in the US is absolutely mishandled. While other medicines diagnose and prescribe medications based on relatively clear biological markers, psychiatry tends to play guessing games running solely off of a list of behavioural symptoms without investigating biomarkers or neurology and will keep prescribing medications until they "get it right". For example, if one presents to a general practitioner with a sore throat a throat culture is done to test for various diseases such as strep and mono. The medication distributed is then prescribed based on the results of the testing of that throat culture. Each of these diseases is treated differently.
These sorts of test to differentiate between conditions are not performed in psychiatry, even though we now have a fairly good idea of the biological markers that can distinguish between some of them. For example, someone presenting with lethargy and feeling "down" might be experiencing symptoms of PTSD, MDD, or BD, among other things to simply include a normal reaction to situational stress. All will be blanket prescribed an SSRI. Why is this bad? Firstly, some forms of PTSD are resistant to SSRIs and giving an SSRI to someone with Bipolar Disorder can send them in to a life-destroying manic episode. Additionally, SSRIs are only beneficial to 1/3 of persons with MDD who take it. For another 1/3 they do little to nothing and the other 1/3 symptoms become worse. In the four to six weeks that an individual will need to wait to see if the medication is the right one for them, a lot of damage can be done to the person's life.
Do we not have other, more scientific ways, or differentiating between these conditions? Of course we do. PTSD, especially combat related PTSD, shows reduced blood levels of cotisol during times when cortisol should naturally be spiking, while MDD shows just the opposite. If the biomarkers are different, the neuropathology is likely different, and yet they are still treated the same.
There are conditions where medication seems to be the only way to bring someone back from the edge, such as Bipolar Type I or Schizophrenia, when psychosis not only interferes with the person's daily life, but a glutamate surge can do damage to certain areas of the brain. Some medications are able to stop this, however they can potentially severe side-effects. Many anti-psychotics and mood stabilizers, though effective, often leave the individual having to choose between psychosis and feeling like a "zombie". Neither of these options is conducive to a fulfilling life.
Additionally, PDs themselves are resistant to medication treatments. This doesn't mean they won't try, leading to unnecessary sedation.
Often times diagnosis are cycled through and psychiatrists rarely listen when an individual disagrees. On a personal note, I've been cycled through several diagnosis and back again. My voice in the matter was not heard by doctors until I received a formal education in the matter. The living hell they put me through those first few years was unbearable. The good that came of it was my position now.
Although I still attend therapy sessions, I no longer take medication and have not for years. I've also been told that I will be able to take a break from the therapy soon, though it is likely due to a lack of anyone in the facility willing or qualified to work with PD. Whatever the reason, I'll take it. I did find the therapy to be beneficial once I started taking it seriously. The medications, however, certainly could have been done without and caused unnecessary strife in my life with horrific withdrawals when I finally did come off of them. The words of the psychiatrist who, after reviewing my file, made the decision to pull the prescriptions were: "You are now free to be you."
The real problem with the mental health field comes from it's practitioners seeing it as trying to find a cure for a disease as opposed to teaching people how to cope with their lives, working around the difficulties in ways that allow them to thrive. They're also too quick to assume they've found an answer, throwing pills even at five year olds who show a little bit of hyperactivity. It should be about strength and endurance, not ridding us of a plague.
There's always room for misunderstanding when it comes to a diagnosis, as the diagnosis itself is found through passive self-assessment of the patient through questions and the doctor's means of making connections with those results. The patient's story is likely to have a lot of holes, especially if they aren't entirely aware of the differences between themselves and others, aren't entirely lucid, giving out descriptions of signs and symptoms that may point in the wrong direction, and the doctor from having to make those connections is prone to all sorts of error as well, both through pre-assumption, coming to a conclusion too fast when not all the details and context are laid out, and from predisposition from past patients and their own experience in the field.
They've tried to put me on meds multiple times, first for depression, then for ADD, and then a cocktail of them for my actual diagnosis. My folks turned it down and when the time came that it was purely up to me I turned it down as well, for all three of us had seen what these pills do (especially my father, another misdiagnosis victim who dealt with meds as a result for it temporarily), what the side effects are, how people end up strung along a train of legal addiction, powerful withdrawals, and a worsening of their own pre-existing symptoms from the meds conditioning the body and mind to not try as hard to fight it. The younger the age it starts, the more developmental problems there are and the more that their experiences train them to believe that all problems can be solved with a one step bandaging of it as opposed to developing a tolerance against strife.
I've been friends with med poppers all my life, the younger it was, the more that it was about "performance" and "fear". Many of them seemed to prefer my company over more "normal" people, and so many of them reflected some really deep issues that were clearly not being touched upon. You'll see ADD and Bipolar thrown around often, but they're usually not the case. You'll see "Depression" assumed to be from an organic source, but more often than not it's from the doctors overlooking context. As I said at the start, people need to see this closer to strength and endurance building of the mind, a means of teaching tenacity, of adjusting their learning curve so that they can keep up, not something you can just cure with medicine, the latter making for potential addicts with so many problems.
I've seen it fuck with too many people's lives, with their potentials. It's been less horrible to see from people who've begun meds in their 20s, but it's still medically barbaric. There should at least be an age limit to these things, but even then, things like seeing a chronically depressed person feel "happiness" through a pill for the first time in their lives... is scary to me, as they will always have that to look back on in a maladaptive way. Mental Health is something worth studying and measuring the patterns of, and genuine therapy can help many people who need that sort of outlet, but pills are a fucked up byproduct of this kind of study that should be handled as a rare, last resort, not an assumptive outcome from the local medicine man, from a legal and corporately funded drug dealer who buys their own hype.
Turncoat stated: source post
There's always room for misunderstanding when it comes to a diagnosis, as the diagnosis itself is found through passive self-assessment of the patient through questions and the doctor's means of making connections with those results. The patient's story is likely to have a lot of holes, especially if they aren't entirely aware of the differences between themselves and others, aren't entirely lucid, giving out descriptions of signs and symptoms that may point in the wrong direction, and the doctor from having to make those connections is prone to all sorts of error as well, both through pre-assumption, coming to a conclusion too fast when not all the details and context are laid out, and from predisposition from past patients and their own experience in the field.
That's my point. It's too imprecise during a time when biological markers and individualized treatment rules all other medical fields. We have biological markers for some of these conditions though they are not being used. Additionally, medication should only be used as one of many tools, primarily to assist bringing individuals who are otherwise unable to a point where they can work on the development of the coping mechanisms that you touch on. Medication alone is often not effective and is too heavily relied upon.
While I agree that it's imprecise, I'd say that the real problems root from peer pressures and impatience.
For myself, my diagnosis was found eventually, but it took years to figure out and accept from it not being a mainstream disorder, and from the darker more obvious symptoms not appearing until my early 20s. The means of trying to get me to take meds when they didn't even really know what was wrong with me was purely based on performance and fear, this idea that I wasn't "good enough" and that "he'll just get worse", while if I had taken their advice, I'd have ended up even worse through their proposed solutions for disorders that made for blatant false positives.
For my father it was even worse. Even with him having done some research, it was even more limited back in his time. He originally went out to try to figure himself out, use a doctor as a resource, only to be misdiagnosed as ADD and Bipolar, being given meds that'd improve his work performance after having talked to him... once, maybe twice? They didn't understand his portrayal of his symptoms, as he didn't understand them either, accepting some of the crazier things as normal enough to not bother talking about, resulting in them going towards a faster more convenient answer instead of continuing to explore what's going on. The meds they gave him amped him up, gave him increased focus, but he got worse in many other ways before finally having a med-induced stroke. Naturally he quit, spent a large amount of time looking further into what the meds story is actually about, and when I came along he and I discussed it a lot from how normal it became to see people on pills. It's also because of this that I didn't have my life thrown away or otherwise irredeemably damaged, unlike so many other unlucky people I've crossed paths with.
I've seen so many other lives either harmed or ruined because of how quick they jump to a diagnosis and a poorly devised solution. If they had some actual patience, they'd see where things are false positives, matters of context, part of a bigger picture that simply carried similar outward symptoms. They expect so much out of their patients who themselves don't even know what's going on, and then they trust the doctor's findings because, hey, it's a doctor, leading to a really shitty feedback loop.
Turncoat stated: source post
The real problem with the mental health field comes from it's practitioners seeing it as trying to find a cure for a disease as opposed to teaching people how to cope with their lives, working around the difficulties in ways that allow them to thrive. They're also too quick to assume they've found an answer, throwing pills even at five year olds who show a little bit of hyperactivity. It should be about strength and endurance, not ridding us of a plague.
Not only this, but we live in a society where people seek drugs, instead of trying to work out their problems. Pharma pours tons of money into marketing. Instant gratification is becoming more and more expected as technology improves, and someone might see an ad on TV and think, "that sounds wonderful, I'm going to go see a psychiatrist." Many others decide pharmaceuticals will be their only hope, because they run into practitioners like what you've described.
Well basically with ADHD. I don't get much I just get meds if I want which I am not even recommended to take. I did have to strip and get my heart tested to get these meds so I feel like I earned it. I get extra thirty minutes on tests which can be useful. In first year there was on exam the teacher made very long and everyone said they did not manage to finish. I was one of the handful of people who did manage to finish because of my extra time. It relieves some stress as well I think.
While I agree that it's imprecise, I'd say that the real problems root from peer pressures and impatience.
I would add an unwillingness to change the way that things have been done for decades and the difficulty of disseminating the most recent research and tests to clinicians. Current methods are obsolete. That patients continue to be diagnosed and treated in the ways they currently are is outdated and barbaric. The current generation of dinosaurs is fighting extinction but it can't last forever.
For myself, my diagnosis was found eventually, but it took years to figure out and accept from it not being a mainstream disorder, and from the darker more obvious symptoms not appearing until my early 20s. The means of trying to get me to take meds when they didn't even really know what was wrong with me was purely based on performance and fear, this idea that I wasn't "good enough" and that "he'll just get worse", while if I had taken their advice, I'd have ended up even worse through their proposed solutions for disorders that made for blatant false positives.
My diagnoses still get switched on me ten years later and that's not even considering that adolescent diagnoses aren't mentioned anymore. Early on in my adult treatment I made the suggestion that there isn't anything wrong with me and i might just be an asshole. I still hold to this.
In the meantime, I've had venlafexine, trazadone, seroquel, lithium, paxil, nortryptaline, and depakote shoved down my throat with threats of repercussions for "non-compliance" (ie, informing them that the medications were either not working or making me feel worse). Even though the drugs made me groggy, or caused mood swings, or made me unable to sleep... No fucks were given by the doctors, who they rotated me through almost as much as they rotated me through diagnoses. Blood tests were done to check drug levels to ensure compliance... But they couldn't do any other tests? The entire time the ever-looming threat of rehospitalization was held over me to keep me inline.
And what was learned from this? That there are far bigger assholes with far less empathy than me out there, but they get away with it because they have a title.
For my father it was even worse. Even with him having done some research, it was even more limited back in his time. He originally went out to try to figure himself out, use a doctor as a resource, only to be misdiagnosed as ADD and Bipolar, being given meds that'd improve his work performance after having talked to him... once, maybe twice? They didn't understand his portrayal of his symptoms, as he didn't understand them either, accepting some of the crazier things as normal enough to not bother talking about, resulting in them going towards a faster more convenient answer instead of continuing to explore what's going on. The meds they gave him amped him up, gave him increased focus, but he got worse in many other ways before finally having a med-induced stroke. Naturally he quit, spent a large amount of time looking further into what the meds story is actually about, and when I came along he and I discussed it a lot from how normal it became to see people on pills. It's also because of this that I didn't have my life thrown away or otherwise irredeemably damaged, unlike so many other unlucky people I've crossed paths with.
It's good to know that your father's experience saved you from something similar.
I've seen so many other lives either harmed or ruined because of how quick they jump to a diagnosis and a poorly devised solution. If they had some actual patience, they'd see where things are false positives, matters of context, part of a bigger picture that simply carried similar outward symptoms. They expect so much out of their patients who themselves don't even know what's going on, and then they trust the doctor's findings because, hey, it's a doctor, leading to a really shitty feedback loop.
The doctors expect a lot from their patients in that they expect them to be able to describe symptoms in a way that can be understood by the doctors themselves, which is not always the case. Too little time is spent with patients in addition to this. 15-30 minute visits are not enough time to gather information without additional, biological tests. We don't rush other diagnoses. Why are we rushing these?
And of course patients trust the doctors to know what they're doing. They have advanced degrees and are supposed to be up to date on the latest research. Unfortunately, the research bit is often not the case. The responsibility should be placed on the doctors to conduct proper evaluations based upon the most current information that is available.
All this being said, I need to back out of this thread.
#triggered