Category: choosing a treatment

Why My Mental Health Opinions Aren’t Just About Me

Let me share a little secret with you – I don’t agree with all mental health treatment. I don’t agree with all the decisions doctors make. I don’t like all the available treatments. I have had very bad experiences with some mental health treatments. I have had some very bad experiences with mental health care professionals.

But I still talk about them. And I still think they are right for some people.

Why?

Because my story isn’t your story.

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Dr. Oz Show – The Shock That Could Save Your Life – Electroshock Therapy for Depression

As many people know the Dr. Oz show, did 30 minutes today on electroshock therapy. I’m going to talk a little about the Dr. Oz show’s representation of electroshock therapy and add a few additional facts.

First off, the Dr. Oz show is a source of entertainment, like anything else on TV, so he added drama that wasn’t particularly necessary. That is the way of the show, and TV, however. Specifically, the show started off with scenes of electroshock therapy being given pre-1950 which is when you see people having convulsions in the bad old days before people were anesthetized during treatments. This is not the best way to start a show that is supposed to educate about current treatment, but he does balance this later on.

The Good About the Dr. Oz Show

I was impressed really. They did do a lot of things right and they did share a lot of facts about electroshock therapy, now known as electroconvulsive therapy (ECT). What the Dr. Oz show did right:

  • Represented the modern procedure accurately and even showed the procedure being performed
  • Mentioned repetitive transcranial magnetic stimulation (rTMS) as an alternative therapy (rTMS uses magnetic waves rather than electricity)
  • Stated that almost all insurance companies cover ECT (to the best of my knowledge this is true)
  • Spoke that it should be used judiciously
  • Placed it in a reasonable historical context
  • Tried to reduce stigma and fear and increase awareness around the procedure
  • Mentioned memory loss (twice) as a side effect

The Bad about the Dr. Oz Show on Electroconvulsive Therapy (ECT)

As with all things in life, nothing is perfect. Some things you should know that weren’t altogether accurate about the show:

  • Only talked about right unilateral brief-pulse ECT – while this is considered the most modern form of ECT it is not the only type. Before getting ECT you need to know what type you are getting in order to accurately judge the risks.
  • Stated that ECT “reset the chemical messengers / receptors” in the brain – the truth is we don’t know exactly how ECT works, we only know that it does. It’s likely it works in multiple ways but “resetting chemical messengers / receptors” is mostly just a simplified concept and not medically accurate or at the very least, not medically complete.
  • Didn’t mention the other side effects of ECT – while memory loss is generally considered the most concerning, other side effects are also possible.

Altogether, I thought it was a good show, and if a tad flamboyant, represented ECT well but there are other things you should be aware of.

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Laura’s Law – Assisted Outpatient Treatment – Follow-Up

Well now, that was quite the number of impassioned comments. I did realize that by writing about Laura’s Law (Assisted Outpatient Treatment) there would be some contention, but I didn’t realize quite how much. Thanks to everyone who wrote in well clear, thoughtful comments. (For those whose comments weren’t of that ilk, please review the comment policy here at the Bipolar Burble.)

Due to the number of responses, I have been unable to address them each individually, but I would like to point a few things out in general.

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Laura’s Law – Forced Treatment, Saved Lives

Some of you may have heard of Laura’s Law in California or Kendra’s Law (similar) in New York. These laws, and similar laws across 42 states, allow for court-ordered treatment of mental illness as a condition of community living.

In other words, they strong-arm people into treatment and this could be seen as treatment without consent. (It’s hard to argue consent when your ability to live outside a locked facility is in jeopardy.)

And this is a very good thing. It is saving lives (among other things).

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Free Drug Samples – Do they Cost More in the Long-Run?

I was recently made aware of an article on MSNBC which alleges free drug samples provided by doctors actually end up costing the patient more money over time. This, of course, is completely counter-intuitive, and I, not in the habit of taking health information from news sources, looked it up.

And yes, it is, in fact, the case that some studies indicate that those who get free drug samples from their doctor actually end up paying more money in the long-run.

How can this possibly be?

Glad you asked.

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Why Aren’t Lifestyle Changes Frontline Treatment for Depression?

Many people complain about overmedication. They lament that the first thing doctors do is prescribe a medication for depression or another mental illness rather than suggest lifestyle changes like exercise and meditation.

This is often true. Doctors, including psychiatrists, often prescribe medication over suggesting lifestyle changes when a mental illness like depression is diagnosed. 

And that’s a completely reasonable thing to do.

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Bipolar Disorder – When to Get Off Antidepressants

I try not to give medical advice here because I am not a doctor. But so many people ask me about this I felt I had to address getting off antidepressants without withdrawal. So many people with bipolar disorder (depression and others) need information about getting off psych meds and they are not getting it from their doctors.

This is the first in a three-part series:

  1. When to Stop Antidepressants in Bipolar Disorder
  2. How to Stop Antidepressants in Bipolar Disorder While Minimizing Withdrawal
  3. How to Stop Taking venlafaxine (Effexor) and Desvenlafaxine (Pristiq) – as they are particularly nasty to get off

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Mixed Bipolar Disorder – How to Treat Mixed Mood Episodes

In the final installation of my mixed moods series, I talk about how to treat mixed moods in bipolar disorder. If you need a refresher on mixed moods in bipolar 1 or bipolar 2, see the first three articles in this series:

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I write a three-time Web Health Award winning column for HealthyPlace called Breaking Bipolar.

Also, find my writings on The Huffington Post and my work for BPHope (BP Magazine).

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