The Bipolar Burble recently received a couple of comments on the antidepressants and dependence / addiction post from Tabby. My response to her second comment ended up being so long I decided to put it in it’s own post.
Here is an excerpt from Tabby’s comments (edited for length). If you would like to read them in their entirety, please see here and here. (Symbol […] indicates removed text. Other ellipses are from the original text.)
Comment on Are Antidepressants Addictive?
I know of people who cannot go not 1 day without their medication and the medication not be a life saving med like a blood thinner but be a Anti-depressant. They become all anxiety ridden and panic filled because they just know that if they miss that 1 dose or those 2 doses for that 1 day […]
They can’t sleep and they get agitated and they get quite vile until they get that dose or doses. They resort to sobbing, they resort to melodrama of threatening suicide…
[…] I’m talking a cymbalta, or a lexapro. I work in a MH agency and we have patients call cause they’ve gone 1 day without their prescription. […]
I am also one with Bipolar and when your entire day, or entire life, is solely dependent on whether you took your pill or pills that 1 day… I dare to say, you have a dependence.
Now… you have blood clots and you miss 1 day of your blood thinner.. then we may have a major issue. You miss 1 day of your Seroquel, or your Cymbalta, or your Depakote… seriously, it will be okay… if not, use your psychotherapy techniques. Oh, that’s right… not too many actually do psychotherapy… it’s all the meds baby.
[…] I am well aware of the benefits of medication compared to no medication for those with Mental Illness. My point was – too many people seek out the comfort of the medication to handle their daily life’s issues […] than to try and work on figuring why they are having the problem in the first place.
Folks do not wake up, naturally, anxious. Something has to have occurred to trigger that emotion and anxiety is an emotion that triggers a physical response. Yet, too many run to the cabinet and down pills to “calm” the anxiety rather than try to do something else non-medicated that […] The first reaction is to kill the emotion/feeling… not to try and figure why it’s happening.
No therapy doesn’t work in all settings or all situations but if you never try, then it will certainly never work. In that your blogs are predominately med supporting… I could say that you mock those who try to use more psychotherapy than meds.
Seroquel and Depakote are not equivalent to Warfarin or some of the other medications needed for literal body functioning. Yet, if you have been on a med for a long period of time, for example Seroquel to put you to sleep every night.. and then suddenly you miss a dose or 2… YOU WILL HAVE SYMPTOMS. That’s med dependence and you’ll have a psychological dependence because you’ll become frantic wanting your med.
[…] Many folks suffer with their Bipolar symptoms, or any MI symptom, long before they ever take the 1st pill. So, the life-saving aspect is only a “feeling”.
I know the meds help but have they literally saved me? No. They take away the uncomfortable and the frightening… but they don’t keep me from dying. If they were the sole and only reason, then I’m a walking med cabinet.
Even folks that take a plethora of meds, every single day and swear on a stack of their most revered book… still kill themselves […]
Thanks Tabby for your response. I think your thoughts on the issue represent a perspective of many.
Antidepressants (and Mood Stabilizers) Are Not Life-Saving
Naturally, I would beg to differ. While yes, people live with a mental illness before treatment, and obviously, they don’t successfully kill themselves, that is not proof psych meds do not save lives.
There are two types of people (at least) for whom psychiatric medications are life-saving:
- Those who would have killed themselves if not been treated. (Often those who previously attempted suicide and failed.)
- Those for whom the medication keeps them from falling into a tremendously dangerous mood such as severe depression or mania which is unpredictable and can easily kill a person (or even those around them.)
In neither case can you “prove” whose lives were saved, but many of us on this side of the illness believe we wouldn’t be here but for the medication.
(Quick FYI on suicide. When autopsies are done of suicide victims it is almost always the case that they do not have a full concentration of psych meds in their system. They either didn’t take the drug or hadn’t taken it regularly.)
Mental Illness Isn’t a Physical Problem
You suggest a blood-thinner is a necessary medication because it fixes a physical problem. Well, so do psych meds. I’ve talked here many times about the biology of mental illnesses like depression. But on top of that, mental illnesses have many physical symptoms like:
- Headaches
- Join and muscle pain
- Hypersomnia / insomnia
- Eating far too much or far too little
- Cognitive and memory problems
- An inability to make reasonable decisions
- Delusions, hallucinations, psychosis
Those effects alone can lead to death, particularly the psychotic symptoms which can be present in mania, depression schizophrenia and other illnesses. These effects lead people to do things like jump off a roof. All of that sounds pretty physical and much of it life-threatening.
Mental Illness is “Just” a Feeling
I can’t comment on how you experience mental illness, but it certainly isn’t “just a feeling” for me. On top of whatever physical symptoms I may have the feelings themselves are completely out of control. Being driven to slice your wrist with a razor blade is not simply a “feeling.” Driving with your eyes closed isn’t just about a “feeling.” Spending $10,000 that you can’t afford on clothes you don’t need isn’t just a “feeling.”
And on, and on, and on.
While spending what you earn in four months on clothes may not kill you, it sure may kill your life.
You Do Not Just Wake Up with Anxiety
Certainly, you can feel that way, but a person with an anxiety disorder would likely beg to differ. Anxiety may be the sign of a troubled marriage, a bad dream or Starbucks running out of scones, but it may also be a real, organic mental illness, like any other.
I Mock People Who Do Therapy
[push]I’ve done more therapy than anyone I know.[/push]
Um, no, I really don’t. I don’t mock people for it in the slightest. I think it’s a good idea. Some people have problems that can be solved through quality therapy. You’ll get no argument from me on that.
As for non-medication treatments, I have talked about many. Light therapy, triple-chronotherapy, the importance of strict schedule, the importance of sleep and so on and so forth. This week, in fact, on Breaking Bipolar I talked about six areas to increase mental wellness that are not pharmacological.
I Need Psych Meds to Function so I’m a Walking Medicine Cabinet
If you say so.
As you’ve mentioned, you draw a line between psych meds and other meds which you deem “acceptable” to be necessary. That’s your call. But a mental illness is just an illness and medication for it is just as critical as it is for any other illness.
I’d say the distinction there is not fair, accurate or supported by data.
People on Antidepressants Are Dependent
In the non-disordered sense of the word, yes, people are physically dependent on antidepressants. Like all people on all long-term medications.
As for psychological dependence, well it’s a grey area. For psychological dependence the drug must produce pleasure for the user. Antidepressants do not produce pleasure; they treat an illness and reduce pain. This makes them very different from a drug like cocaine, which does produce pleasure.
For me, Natasha is right. “Fear is OK as long as we treat the fear rationally and fear makes us pay attention and investigate things. But we can’t live there as living in fear isn’t rational at all.” Although I am a boy (but not totally a boy because my heart is like in a girl = bisexual), I actually tried to be dependent to meds as my weaknesses even when my sleep disorder attacks me. But it was not good to my health and it gave me a hard time. Moreover, it was crucial to my mind and body.
I think that this is an important issue to talk about maybe for some perhaps feel some fear of being dependent on meds. Weighing the pro and cons with medical personnal can help both parties to understand how the other is seeing the issue and perhaps create a better working rapport. However, historically speaking there was a time when meds were unavailable for many medical issues not just mental ones. Though there were attempts at treatment it now comes across like torture. The ice baths, insulin injections, orbital frontal lobotomy, chains, trappanning (sp?), and total isolation. The best some could hope for was to live out their lives in places like Bedlam. Which to me isn’t really living a life. i’ll take a med anytime over much of those things. I might be a little off but not that much of a glutton for punishment. So while fear maybe an issue behind some reasoning. We need to get to the basis of what is behind the thoughts about the meds is crucial. Education about what they do, the side effects, and why they are needed is important. It can help dispell some of the anxiety associated with meds. People sometimes also feel not sick thus quitting. There are examples of many people even celebs who quit meds for different illnesses and not always mental issues. A lead singer of one heavy metal band (can’t remember which one right off- 80’s group I believe) is a diabetic taking insulin by injection. They quit taking it simply because they didn’t think they were ill along with other reasons. It didn’t take long for the value of why the med was needed was apparent. Remembering what things were like prior to taking the med is important. What things we were unable to do or the quality of life we had. Once the med started doing it’s thing what changed? Did we experience lessened of many of the more troubling aspects? They can treat some side effects with other meds if needed. So figuring out the real reason is essential. The reason we tell ourselves but not anyone else.
For some psychological dependence can develop maybe because they associate certain things/emotions with that med. I have a friend on Geodon who I believe is that way. She experiences anxiety, depression, physical symptoms, as well as a constant trying to find ways to get it. However the med does help her with her MI a great deal. Recently she started volunteering and joined a book club. So there are positive aspects that perhaps outweigh the negative ones. And as far as side effects again weigh the pros and cons WITH the medical team. I can tolerate some side effects as long as I see some positive results. So together people can make the decision to continue the med or not.
Being afraid isn’t bad but hanging onto or clinging to like a life perserver definitely is.
Hi Debra,
You bring up many interesting and well thought-out points.
I just wanted to reiterate your last statement. Fear is OK. As long as we treat the fear rationally, fear makes us pay attention and investigate things. But we can’t live there as living in fear isn’t rational at all.
– Natasha Tracy
Also, it is a scientifically proven in clinical trials, that the majority of peoples depression gets better from a placebo. In other words a sugar pill can cure this biological disease.There is empirical evidence that CBT is effective for the treatment of a variety of problems, including mood, anxiety, personality, eating, substance abuse, and psychotic disorders.
How many other diseases can be cured by psychotherapy or sugar pills?
“While the reports on the WHO studies state that course and outcome of schizophrenia are more favourable in developing countries, further investigations in Japan, Hong Kong and Singapore also demonstrated a more favourable course and outcome of this illness than in Europe and North America” [OGAWA et al. 1987; LEE et al. l991; TSOI & WONG l991]. from: http://www.mentalhealth.com/mag1/wolfgang.html
How many other diseases outcomes, are a direct consequence of location?
“Unipolar depression makes a large contribution to the burden of disease, being at third place worldwide and eighth place in low-income countries but at first place in middle- and high-income countries. Effective treatments for depression are available, suggesting that this burden could be reduced.” World health organization report 2004
If this disease is biological in nature then what is so amazing about money that causes the diseases to be more prevalent ?
What other diseases are directly effected by social circumstance?
“‘but at first place in middle- and high-income countries. Effective treatments for depression are available, suggesting that this burden could be reduced.’ World health organization report 2004
If this disease is biological in nature then what is so amazing about money that causes the diseases to be more prevalent ?”
Money is a huge trigger, albeit external. It cannot be determined that people in wealthier countries are depressed only due to the circumstances of their finances, considering the complexity of humanity. I myself know external factors can exacerbate issues already present, latent or otherwise (also known as triggers). ‘Tis true as well that we in the states have a tendency for over diagnosis and over medication. Plenty of people here in the states, even and possibly often people financially at ease, turn to others to solve their internal problems, refuse to take responsibility for their own emotional states, and expect something (like money) to cover up and/or solve their troubles. In a country where money is prevalent, other things will be prevalent, too. Why not depression? It IS pretty depressing sometimes in the States. :O
On another side, who did that research? The WHO? Where did they get their numbers? From psychologists and psychiatrists? The very people over diagnosing and over medicating? Wow. 2 sides to every story. ‘Tis a wash to me.
Not only is class/money a major trigger there are other factors that socioeconomic status effect.
Firstly, people who get depression, or another mental illness, often become lower class because they are unable to work. I see this constantly. It makes sense that a greater proportion of lower-income people / homeless would have a mental illness. It’s one of the main problems groups try to address.
Additionally, people of lower income tend to have very poor diets and the missing nutrition can induce depression. While we know that no diet will _cure_ depression, we do know that vastly unhealthy diets can cause it and make it worse.
– Natasha Tracy
” Moreover, while it could be (quite possibly is) drug related, it was never seen in the clinical studies and its incidence is nowhere close to common”.
I take it you are referring to the clinical trials funded directly or indirectly by pharmaceutical companies. Selective publication of clinical trials — and the outcomes within those trials — can lead to unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio. Also: “Another troubling adverse effect of SSRI antidepressants is increased suicide first reported by Teicher in 1990. According to David Healy (Let then Eat Prozac), the original clinical trial data was manipulated by moving the suicide cases from the treatment arm over to the placebo arm of the study. This manipulated data was then submitted to the FDA who conveniently looked the other way. This disturbing information was presented at a Cornell University Mar 25, 2009 talk by David Healy”. http://www.wellsphere.com/genetics-article/jama-says-ssri-antidepressants-are-placebos-by-jeffrey-dach-md/955437
Hi Ben,
The information is actually post-market, in other words, it was reported by doctors and then the FDA. The drug company has to expose it given FDA regulations. This is common and is how many drugs get pulled from the market.
– Natasha Tracy
Seems there may be selective publishing here: curiously enough exactly what pharmaceutical companies do.
“(Quick FYI on suicide. When autopsies are done of suicide victims it is almost always the case that they do not have a full concentration of psych meds in their system. They either didn’t take the drug or hadn’t taken it regularly.)”
This implicates drugs as much as vindicates them. It is just as likely the person commited suicide due to intolerable withdrawal, as opposed to relapsing condition. This is precisely the problem: people such as myself cannot stop drugs due to insufferable withdrawals, not because they are life savers.
I suffer from severe GAD- if you want to call it that- but in no way do i find it stigmatizing that people criticise the quality of the treatment. If the cure is worse long term than the so called disease, i would like to know, for example:
A few years ago one of Glenmullen’s patients who was taking Prozac developed a tic—the tongue darting in and out of the mouth—that persisted for months after the drug was discontinued. That sent Glenmullen to Countway Library. He found reports of tics and other neurological side effects, like drug-induced Parkinsonism, associated with SSRIs. “The tics include lip smacking, lip puckering, fishlike kissing motions, and pelvic thrusting,” Glenmullen says. “They are involuntary, disfiguring, and can be very noticeable—and may persist long after the drug is stopped. This is the dread side effect in psychiatry, and it can indicate brain damage. Such reactions are not rare. Neurologic agitation is estimated to occur in 10 to 25 percent of patients, and muscle spasms in 10 percent.”
It is funny Tabby mentioned being mocked for holding a different opinion, and ridiculed for a lack of understanding. I see a almost fanatical religious belief in the power of medication on this site, with people ridiculing those who do not share their belief. I know why this view of medication panaceas is held; if it were not the placebo effect would be washed out. The same placebo effect has everyone claiming they would not be alive without drugs, a common claim everywhere.
Quite simply, in an objective way tabby is right, to many people rely on medication. This is evidenced by the fact that 1 in 10 americans have taken an SSRI, even though they are no better(according to JAMA report, jan5) than a sugar pill in all but those with severe depression. Oh – and it should also be noted that the test for depression is not biological but rather a test based on the questionairre called the “hamilton depression score”.
You can keep pounding the biological depression drum, but until an objective test is performed by a doctor, science is not buying. This is why they are mental disorders and not mental diseases.
“There is no blood or other biological test to ascertain the presence or absence of a mental illness, as there is for most bodily diseases. If such a test were developed…then the condition would cease to be a mental illness and would be classified, instead, as a symptom of a bodily disease.” —Dr. Thomas Szasz, Professor Emeritus of Psychiatry, New York University Medical School, Syracuse
“Psychiatry makes unproven claims that depression, bipolar illness, anxiety, alcoholism and a host of other disorders are in fact primarily biologic and probably genetic in origin…This kind of faith in science and progress is staggering, not to mention naïve and perhaps delusional.” —Dr. David Kaiser, psychiatrist
“I believe, until the public and psychiatry itself see that DSM labels are not only useless as medical ‘diagnoses’ but also have the potential to do great harm—particularly when they are used as means to deny individual freedoms, or as weapons by psychiatrists acting as hired guns for the legal system.” —Dr. Sydney Walker III, psychiatrist
“No biochemical, neurological, or genetic markers have been found for Attention Deficit Disorder, Oppositional Defiant Disorder, Depression, Schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling or any other so-called mental illness, disease, or disorder.” —Bruce Levine, Ph.D., psychologist and author of Commonsense Rebellion
“Unlike medical diagnoses that convey a probable cause, appropriate treatment and likely prognosis, the disorders listed in DSM-IV are terms arrived at through peer consensus.” —Tana Dineen Ph.D., Canadian psychologist
It is a joke that you all complain about being stigmatized, when many people seem to be doing the same to Tabbys perspective. I see personal attacks but not alot of scientific substance. You all preach compassion and understanding, none of which is evidenced towards Tabby, simply because she does not tow the pro psychotropic line. And yes i do understand severe anxiety and depression and took drugs for ten years.
A fact is a simple statement that everyone believes. It is innocent, unless found guilty. A hypothesis is a novel suggestion that no one wants to believe. It is guilty, until found effective. ~Edward Teller
ben,
you quote: “No biochemical, neurological, or genetic markers have been found for Attention Deficit Disorder, Oppositional Defiant Disorder, Depression, Schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling or any other so-called mental illness, disease, or disorder.” —Bruce Levine, Ph.D., psychologist and author of Commonsense Rebellion
Curious: what about autopsy reports of schizo brains?
Hi Meredith,
Lots of differences have been found in the brains of people with mental illness including using methods like autopsies. However, our knowledge is still in its infancy and we only have a small sampling of brains to go on. I’d say that mentally ill brains are heterogenious meaning that some brains will show some signs while others with the same illness will show others.
– Natasha Tracy
I thought so. I was just referring to the use of “no” meaning none. I thought I had heard about some autopsies done and some look into the brain as much as we can at this point. Thanks.
Ben,
You have a point. Withdrawal could contribute to some suicides although I’ve never seen any evidence to suggest this was the case.
I don’t know who Glennmullen is but I did look up the information on Prozac. According to its maker, there have been reports of dyskinesias (like a protruding tongue) since the drug was released to the market however there is no evidence that it is drug related. Moreover, while it could be (quite possibly is) drug related, it was never seen in the clinical studies and its incidence is nowhere close to common. http://www.rxlist.com/prozac-drug/side-effects-interactions.htm
If you could link to whatever you’re quoting, that would be helpful because those numbers sound blatantly wrong but without seeing them in context, I couldn’t say for sure.
As for neurobiology, I have written quite a bit about the neurobiology of depression: https://natashatracy.com/mental-illness/depression/neurobiology-depression-%e2%80%93-depression-brain/ I haven’t gotten around to the other disorders just yet but here’s some information on the genetics of bipolar: http://emedicine.medscape.com/article/2004136-overview
– Natasha Tracy
hello
Hi Natasha and all,
Thanks to everyone who has stuck up for those of us living with an anxiety disorder. Mine started suddenly and I pretty much went from someone working full-time, going out with friends etc. to someone who couldn’t leave the house or stay on my own. My thoughts were irrational, yet I didn’t know it at the time.
Medication and cognitive behaviour therapy have both been important for my recovery.
It’s a shame that stigma and discrimination still exist within our communities, but I’m hopeful that will change as we share our experiences with one another.
Cheers,
Jennifer
Hi Jennifer,
Thanks for commenting, I was hoping someone with anxiety disorder would pop by.
Yes, as much as we all want understanding, we often don’t understand each other. It’s ironic. It’s like people who can’t stand discrimination against one race and yet stigmatize another. Humans, go figure.
I can’t say as I truly understand the overwhelming feelings of anxiety that people with anxiety disorders have. My anxiety can be “bad” but I wouldn’t characterize it as crippling, so I suspect there’s no comparison.
I do understand, though, what it’s like to have your brain betray you. And that, I think, describes any mental illness and so in that way, we’re all one big unhappy family.
Thanks for chiming in.
– Natasha Tracy
I am of the personal opinion to do whatever it takes to achieve one’s goal of relative wellness as it is not important what the therapy maybe, so long as it helps.
In view of the past several comments the readers might also find the following NY Times article of Dr. Marsha M. Linehan’s personal experiences of interest as it relates to these recent discussions.
Expert on Mental Illness Reveals Her Own Fight
http://www.nytimes.com/2011/06/23/health/23lives.html
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com/
I was not tuned in yesterday (a day at the beach), Herb, but a friend inboxed me that article directly. How funny!
Yes, I’m familiar with this woman’s story.
For anyone who hasn’t read it, it’s the story of the woman who came up with dialectical behavioral therapy (DBT). Interest story and woman.
– Natasha Tracy
Tabby has obviously never experienced psychosis. I admit it is sometimes fear that puts my pills in my mouth. I can talk through my childhood issues or the collateral damage of bipolar disorder, in fact it works great to alleviate some of my guilt. No amount of talk however seems to have any effect on my pathological mood cycle.
Tabby sounds resentful of herself and seems to be projecting it on other people with her venom. I crave wellness, not meds, it is offensive to suggest otherwise.
Jake
Hi Jake,
“No amount of talk however seems to have any effect on my pathological mood cycle.”
That’s what I find too. That’s what mental illness is, essentially. If talk fixed it, many of us would be better.
– Natasha Tracy
Indeed! We would not only be better, but we wouldn’t need medication. It is only because of my being on medication after so many years of floundering and suffering that I can do any talking that is successful. And I am better because of both, but because of medication first.
Meredith,
“It is only because of my being on medication after so many years of floundering and suffering that I can do any talking that is successful.”
This is an excellent point. Therapy doesn’t tend to work unless you’re cognizant enough to really take part. There’s actually literature on this (don’t have time to dig it up). While therapy is known to change the brain in healthy ways (really) that doesn’t happen from the depth of an illness.
– Natasha Tracy
Tabby
I am sorry you feel these responses are an attack on your opinion. Obviously you’ve had to deal with many difficult situations. However, those of us who have gone through severe mental illness, may have a somewhat different perspective on some things. I’d like to share my personal story and some things I learned along the way. I went through severe depression with strong suicidal thoughts. Luckily I did not go through with commiting suicide, even though I was close. This was when I was already in therapy, both medication and psyvhotherapy, but neither were helping yet at that time. At some point was put on Cymbalta and besides personal experience with it I also did a lot of online research, because I was afraid of the side effects and withdrawl (that reseach did not exactly help relieve my anxiety). In any case, the Cymbalta lifted me out of my suicidal state and actually brought me into remission surprisingly fast. This certainly cured me from the believe that it is just a placebo effect (previous treatment was ineffective). Also, most issues that I thought I needed therapy for (self-worth and such) simply disappeared. What we found out though, is that I metabolize the drug much faster than usual. Meaning that after 24 hours my levels are really low. If I take it a few hours late, I already start to notice withdrawl effects. And I don’t mean anxiety, depression or any thing you deem treatable with psychotherapy methods. I mean strong physical effects; dizziness, brain zaps, nausea. Don’t know what would happen next as I’ve never missed a dose beyond a few hours. I always get my prescription filled in time. But I can understand that some people forget sometimes. And with so many people on these medications, many people forget sometimes. We are all just human, and those still struggling with their illness have many things to worry about daily. So yes, sometimes people need the prescription really fast. Did you know that people have landed in the emergency room from not taking it for one ot two days? You may call this a dependence, which is true to some point. And people should really take care notmto miss doses and appointments. But it happens. And all things considered, for many it’s still the best option. I simply needed an SNRI to live, no amount of psychotherapy would have helped. Of course, I might have slowly struggled through for months without medication, distroying my career and relationship in the meantime. I much prefer the medication (with some psychotherapy). I am still scared of the day when I will start coming off, but I want to in a few months, because I need to know if I can now be ok without, as the major life factors that led me into depression have changed. Also I have some sideeffects that I don’t want to have to live the rest of my life with. So I just hope a slow taper will work…! Luckily I have a good psychiatrist and good insurance.
Sorry about my long rant, I just felt personally affected by your statement of people on Cymbalta being “too weak” to live without it for a day.
Take care
Leah
P.S. Natasha, thank you so much for your blog, your writings reflect so much of what I think/felt. I guess unfortunately one has to go through a severe episode to understand these issues.
Hi Leah,
Thanks for sharing your story. Your “ranting” is OK around here.
Good luck in trying to wean off meds over time. Remember though, the goal is to be better, not to be med-free just to say that you are.
When you’re ready to taper – Go Slowly. Much more slowly than you think you need to.
Here is some great information about tapering off antidepressants: http://psycheducation.org/bipolar/StoppingAntidepressants.htm
Read it. It’ll really help. (It’s technically for bipolar but the same goes for antidepressants in general.)
– Natasha
Dear Tabby,
I don’t know whether or not your comment about “totally eviscerate” you or your opinion may have been directed toward me but in any event I’ll make it perfectly clear that I come to these forums to read and learn and in turn when I fell it appropriate to share my experiences, readings, research and knowledge approaching 5 decades from the standpoint of a caregiver and health care advocate.
I also attempt to respectfully disagree when what I read appears to me to be incorrect and/or misleading statements of fact or catchall/generalization opinions.
I thank you for clarifying the basis for some of those opinions as illustrated by your personal experiences. I can empathize with the difficulty and stresses you must endure in your job position and note that as a former facilitator for DBSA, rules were established for our meetings and participating members were expected to comply with those rules. One of the rules was being on time for the meetings or the doors would be locked. Upon occasion several participants were politely not admitted for tardiness as a courtesy to other participants. We also stressed that participants were responsible for their own actions both at our meetings and in their personal lives. Disruptive individuals upon occasion were asked to leave. I might also add in all these years, Joyce my spouse, has fortunately not had medication shortage emergencies or have my spouse or I been late for any medical appointments. I will add that upon one occasion one of my spouse’s former psychiatrist consistently ran inordinately late with his appointments; one time approaching 2 hours that we left his office. He saw fit to bill for our cancellation to which I billed him for the loss of my time. Since my bill was considerably larger than his he then saw fit to have his office staff cancel the charge and we moved on to a more considerate health care professional.
I won’t go into your discussion regarding working for a major health insurer other than to state I am opposed to these organizations practicing medicine as one of many points. There is also no need for a psychiatrist or anyone in my opinion to be nasty which also illustrates the fact that despite their training they’re not deities and in fact just individuals as we all are. I often state when a physician hangs out his/her shingle to practice it doesn’t state if they graduated first or last in their class and that there are doctors, good doctors and better doctors and it is incumbent upon the patient and/or his/her support persons to seek out the better physicians.
I am also cognizant of the fact that the job market is extremely tight and knowing the nature of many of these illnesses if I wore or my spouse in a similar situation I would consider positions with somewhat less stress.
I wish for you to also note that amongst my advocacy for patient education, hope and persistence, when asked, I would always first encourage prospective patients to seek out the least invasive therapies first. That would include the various talk-therapies disciplines, holistic approaches, physical exercise etc., etc. before proceeding on and/or in conjunction with medications, etc.
I also wish to add that I am in agreement with you that most of these neurological illnesses cannot be definitively or quantitatively diagnosed by blood tests, X-rays and/or various imaging techniques although investigative work is being studied in those areas. What remains is diagnosing via symptomology and hopefully the treating physician is attentive to what he/she hears from the patient and that there is a respectful collaborative effort between the two.
I acknowledge and respect your choices of therapy regimen and extend my best wishes to you as I do for all those challenged by these most difficult of illnesses to treat. At the same time I wish all the best to you and all those reading my thoughts for the good you would wish for yourselves.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com/
Well, nice to know my reply to a blog post made a blog post and one in which to totally eviscerate me and my opinion. Which, by the way, you as a blogger also do daily.
I am not a clinician. I am the woman, who sits behind the glass, that answers the telephone as it rings all day from patients who didn’t call the psychiatrist 3 days BEFORE the med prescription ran out demanding their prescription be filled RIGHT NOW or, they’ll do ______ fill in the blank. I am the woman, who sits behind the glass, that folks come walking in 30 minutes late for their appointment… a appointment scheduled for them… and then gets pissed because the psychiatrist won’t see them and they demand they be seen RIGHT NOW.
I also worked for a call center for a major health insurer, authorizing prescriptions for subscribers. We’d get calls, all live long day, from the nastiest PSYCHIATRISTS who would demand that their patients prescriptions be authorized RIGHT NOW and would go off on all the melodrama of why. We got patients that would call multiple times a day, demanding their prescription – for which they ran out sometimes a week earlier – NOW and then sob into the phone of how they were all anxious and hyped up.
I know, for certain, that mood CYCLES do not need a trigger and emotions, in and of themselves, can happen without a known cause to the person feeling it. HOWEVER, not every single “feeling” or emotion needs to be killed with a medication that if a therapeutic measure… was at least first tried… might would actually be decreased enough to be tolerable.
I’ve struggled and suffered with Bipolar since I was a very wee child and I’ve taken many many many many many meds over the years. Even on the meds, I still suffer from the mood swings and emotions. It’s called “refractory”, by the way. I could max out on meds, and have, and find myself semi-vegatated but, I choose not to anymore unless it is a true honest life or death emergency.
I do, by the way, take 2 meds and only 2 meds and only to the point where I still have some ability to function and focus and do my job. I tend to have psychotic symptoms on sporadic occasions, by the way.. so the higher the med, the more, I have difficulty functioning.
I am left, quite literally, to try and get through whatever it is going on in my brain and mind first, try to work it out in a therapeutic manner before I run and pop an extra pill to get me through the day. I try.
Issues and problems being.. oh I don’t know… family, finances, health, home repairs, elderly parents who may be sick, toxic friends, a job for those who work… the therapist who may have ticked you off at your last therapy session.. the psychiatrist who wouldn’t work with you on getting your benzo refilled cause you are having increasing anxiety.
By the way… I SO KNOW anxiety and I know how utterly bad it feels to feel as if your skin is crawling off your bones… the fear that swims just underneath that threatens to swallow you whole and I so know the deep darkest suffocating grip of depression for which the only focus it has is to take you literally out.
Your blog post was if taking a Anti-Depressant would cause addiction or dependence.. that is what I was replying on.. my opinion. Like it, hate it, but in that I respect your views… and I did… it was disappointing to know that my opinion was pasted up on the blog as a blog for others to essentially “mock” and ridicule.
I’ve had doctors, Neurologists, and Psychiatrists all tell me in the past many many years that because there is no “medical” test to show them that the meds actually do anything to regress the illness(es)… they have to go solely and completely on how the meds make their patients “feel”. If the patient “feels” the med is helping them and believes the med is helping them… then, as they’ve told me repeatedly, who are they to argue?
Natasha,
“Thanks Herb. It’s always nice to know I remain worth reading in the long-run.” — Natasha
That’s an excellent point.
I’ve also known John about 15 years by way of his informative and skillful writing and commentaries via the Internet which “remain worth reading in the long-run” too and through some personal correspondence through the years. He’s also a published author. His biography I’ll leave up to those who have interest in researching other than he’s reasonably well educated both academically and in issues of mental health both from his personal experiences as well as research, readings and his years of interviewing many of the front-line health care academics and professionals.
It’s a number of years that I’ve been following your quality commentaries. Time does fly by, at least for me.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com/
Dear Natasha,
If by some chance you and/or your readers are not familiar with the writings of John McManamy I think it worthwhile to read some of his recent entries as he returned from the 9th International Conference on Bipolar Disorder.
http://knowledgeisnecessity.blogspot.com/
Like you, his writings are spot on in my opinion.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com/
Hi Herb,
Thanks for the link. Honestly, I don’t have a whole lot of time for other blog reading, but I’ll try to check it out.
– Natasha Tracy
“I am well aware of the benefits of medication compared to no medication for those with Mental Illness. My point was – too many people seek out the comfort of the medication to handle their daily life’s issues and problems than to try and work on figuring why they are having the problem in the first place.” — Tabby
Well here we go again. As a very, very long time support person and health care advocate to my spouse I learned that her illness has nothing to do with “daily life issues and problems” and more to do with a malfunctioning within her brain. Unlike Tabby, I am well aware of the “potential” benefits of medication while also knowing full well the potential serious side-effects of these very same treatments. What is important to my way of thinking is for one to be reasonably educated in their pursuit of wellness while maintaining hope and persistence.
I also think it more appropriate had Tabby addressed her personal experiences and uses of medication and how she handles her “daily life issues and problems” rather than telling me about “too many people seek out the comfort of the medication…” or thinking that all those with serious mood disorders have “daily life issues and problems”. In addition to my spouse there are individuals who’ve I personally sat with and/or collaborated with for many years that do not neatly fit into Tabby’s characterization.
For some 4 decades my spouse and her doctors had gone through the pharmacopeia of medications in an attempt to stabilize, control and or gain remission over her illness having nothing to do with life’s issues. I’ll also point out that my spouse has gone off and on numerous psychotropic medications as well as benzodiazepines over the years without difficulty and/or dependency issues without ever thinking of drugs as a comfort. To boot her illness has been controlled by a therapy having nothing to do with medications.
Once again Natasha, I’ll compliment you on the fact that in my opinion your blog and your thoughts offer one of the few sites offering balanced perspectives as it relates to the numerous issues surrounding serious mood disorders and their treatments.
As always, I wish you wellness and all the good you would wish for yourself.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com/
Hi Herb,
Yes, we go again. And still.
Tabby isn’t completely wrong. Some people do seek out the comforts of medication too easily. Some people would be considerably better served looking at the problems inward. I could say that about half of the people who drink after work, however. You’re absolutely right that people treating an illness do not, de facto, fall into that category. Of course, we are not immune to it either.
“Once again Natasha, I’ll compliment you on the fact that in my opinion your blog and your thoughts offer one of the few sites offering balanced perspectives as it relates to the numerous issues surrounding serious mood disorders and their treatments.
As always, I wish you wellness and all the good you would wish for yourself.”
Thanks Herb. It’s always nice to know I remain worth reading in the long-run.
– Natasha Tracy
Of all the alarming things in Tabby’s comments, and there are many, this is by far the most disconcerting to me:
I work in a MH agency and we have patients call cause they’ve gone 1 day without their prescription.
I find it disturbing that someone who has such a poor grasp of mental illness earns their living at a mental health agency. I’m crossing my fingers she’s not a clinician.
Hi Holly,
I try not to make judgments about who knows what but I agree whole-heartedly.in the hope that isn’t a clinician’s viewpoint.
– Natasha Tracy
Very well done. I couldn’t believe the line about waking up with anxiety. When I was really anxious (before meds and early on in my med regime), I would suddenly feel anxious. I would scrounge around in my head and body and surroundings for something that triggered me. Anxiety was something that came to me without triggers sometimes. Wow. I’m amazed again at how narrow-minded some people can be.
Thanks Meredith.
I think anxiety is a pretty dangerous symptom, actually. There’s nothing like bugs under the skin to make you want to grab a razor blade and cut them out.
I’m not an anxiety expert, but I am a mood expert, and I know, from the very bottom of my brain that moods to not need triggers. Yes, for the “normal” person they do. But for me, they definitely don’t. And actually, thinking about telling someone with anxiety otherwise, kind of makes me mad. We, bipolars, are clamoring for acceptance, the least we can do is accept other people.
Narrow-mindedness is one of the few universal human traits ;)
– Natasha Tracy
You are right on, Natasha … no need for me to add any points to your response because you said everything I was thinking.
I’m really surprised and dismayed at Tabby’s comments given she says she is also bipolar; her biggest problem might be a lack of education about her own condition. I’m glad she feels like she doesn’t need the medication; perhaps that’s another type of bipolar I don’t know about.
I wish we could point to an MRI or a defect and say “there’s the part that is broken. Fix it.” I can’t say how many times I have thought people would accept my condition and be more understanding and sympathetic if I substituted “bipolar” with “cancer” or “lupus” or some other known disease. Tabby sounds like just another person proclaiming that mental illnesses are all “in my head”. This point of view is harmful to millions of people.
Hi Rob,
I do find it odd that someone with bipolar disorder said some of those things, but each person has their own experience of the disease. Sometimes people get locked into the way they experience an illness and assume it is _the_ way. But mental illness isn’t like that. We’re all different. However, it would be nice if we could empathize with others through the differences rather than calling them “melodramatic.”
We all want a definitive test, trust me. I’ve lamented about it many times. It seems like it would give us the validity and respect we deserve. All I can say is that scientists are working on it. Until then, we have to fight prejudice the old-fashioned way: with compassion, education and understanding.
– Natasha Tracy
“We all want a definitive test, trust me. I’ve lamented about it many times. It seems like it would give us the validity and respect we deserve. All I can say is that scientists are working on it. Until then, we have to fight prejudice the old-fashioned way: with compassion, education and understanding.”
Brilliant…the only other thing I would add to “compassion, education and understanding” is patience.
Craig,
An excellent addition and such a continuing challenge.
– Natasha Tracy