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Tuesday, February 02, 2016

Psychiatry does NOT Kill: Stupid Internet Videos Kill

Not everyone who hangs out their shingle
on the Internet knows what they are
talking about.

Okay, can you tell I'm angry? I just saw a video entitled "Psychiatry Kills". The premise is that the medicines psychiatrist give are all bad and you should get off them. The trouble is, rather than trust a highly trained physician with years of study and research behind him, you're going to trust a lot of anecdotal "evidence" from a group of people that the video says, quit all their meds "cold-turkey".


Here's what happens when you quit a psychotropic medication cold turkey.  First, you start going back into the depressed, panicked, schizophrenic or whatever state you were in that caused the medication to be prescribed in the first place. Second, the change in neurochemistry in the brain caused by the sudden stopping of your meds triggers all sorts of brain neuro-transmitters to either shut down or kick into overdrive giving you the equivalent of a very bad LSD trip.  So every story in this video (and no I'm not going to give you the link to some advice that can kill you, so don't ask), is based on someone doing what their doctor told them not to and in many cases probably because the person saw one of these scary videos about evil Big Pharma and decided some anonymous Internet video cares more about them than the physician you are paying to look out for your health.

Do psychotropic meds sometimes cause side effects?  YES.  You see, you can't peek inside the human skull when the patient is alive to see what's causing his mental problems. That would do more damage than good (remember lobotomies).  Diagnosing psychoses is a very much working in the dark process. We can only diagnose by observing behavior and listening to you tell what is wrong.

If you do a lousy job of telling the doctor what's going on in your head or if you spin the story to make it sound worse or sound not so bad, you will almost certainly get the wrong medication the first time out.  That's how psychiatry works. It's a partnership between patient and physician. He is not a magician. There are no magic words he can say nor magic pills he can give you, especially if he doesn't get good information from you. If you don't tell your physician what is going on, you probably are going to have a bad experience.

The truth is that the chances of the first medication you try working for you are pretty slim. That's because the causes of many mental disorders cause symptoms that look pretty much the same. One pill may work great for one kind of depression and be really bad for another kind of depression.

And yes, not every depression is exactly the same and cannot necessarily be cured by the same treatment.  I know people expect doctors to wave their magic prescription pad and cure their problems, but it's not that easy.

Think of the doctor/patient relationship as a collaborative research partnership.  Here's an example.  My grandmother's physician prescribed a powerful anti-biotic for an infection she had.  Just after she started taking it, she had a terrible panic attack. I was in grad school at the time and so the first thing I did was ask if she was taking any new medications. I'd never heard of an anti-biotic causing panic attacks, so I went down to the pharmacist to ask about side effects (this was pre-Internet).  Sure enough one of the side effects listed was panic attacks.

We called her general practitioner and he prescribed valium for her anxiety. It didn't work and the problem escalated. She was so freaked out, she was afraid to drink water. Fortunately, at school I had access to Medline and looked up some info on panic attack. A doctor in Shreveport had done some work on panic attacks and noted that anti-anxiety meds don't work on severe panic when used alone. He recommended pairing it with an anti-depressant and had shown good results with a combination treatment.  I went down to the doctor's office (his secretary wouldn't let me talk to him). I ambushed him as the office was closing, told him about my grandmother's problem and showed him the research I had found (he was not a psychiatrist, remember).  He said he'd take a look. He called me a couple of hours later and told me I was right. He prescribed an anti-depressant to go with the valium and once we convinced my grandmother to take it, she got better immediately and within two weeks, just like the research said, the panic attacks were totally gone and she was able to quit the meds as she should have.

Treating mental illness is a tricky process. There are no instant cures. If you are lucky and diligent to give the doctor good information, you may get the right treatment the first time, but don't count on it. If you have bad effects from the medicine, tell the doctor and he'll try something else. Trying a lot of different meds doesn't mean you've got a bad doctor. On the contrary it may be a sign that you have a very good doctor.

Here is some advice for those of you with mental illness who are taking or considering taking psychotropic meds like anti-depressants, anti-anxiety or anti-psychotic medications:

  1. If you need psychotropic meds see a psychiatrist: If the problem is severe, you may need to see a psychologist too. A psychologist will test you to find out what's wrong. A psychiatrist handles medication.  Either may send you to a counselor for talking therapy if that's appropriate.
  2. Trust your physician:  Take the meds as he or she tells you to. Don't fiddle around with the dosages or times you take them. Doing that can cause some side effects or mess up what the drug is supposed to do.
  3. Choose a treatment partner:   Your spouse is the best or a parent or adult child who lives with you. That person needs to know what you are taking, why you are taking it and go along on doctor visits to provide a 3rd party report to the psychiatrist as to what your behavior is really like. They WILL see things from outside that you don't see from inside your rattled brain.
  4. Trust your partner! Your partner will tell you when you are going off the rails. It's the hardest thing in the world to trust someone to tell you your behavior is erratic. You probably don't want to hear that and you may be so screwed up that you think your partner is out to get you. You need to know that this may happen. It's the illness, not necessarily the meds. It could be both if you have the wrong medication too.  Here's where you have to use cold rational thinking to overcome your feelings. If you are mentally ill, you cannot trust your feeling.
  5. Don't self-medicate:  Pot may make you feel "mellow", but it may also have some nasty interactions with the stuff your doctor gave you. Illegal drugs are notoriously irregular in their strength and dosages and pushers are a real hazard to your health. My son wound up 3 days in a coma because he believed pot had no dosage limits and smoked his whole supply wrapped up in papers his helpful dealer had treated with PCP. It nearly killed him.  That's why you don't self-medicate.
  6. Call the doctor if there is something wrong or give your partner permission to call on your behalf: When you are having an "episode", you cannot trust yourself to act in your own best interests. People who trust their own judgement when they are mentally ill are the ones who kill themselves or do something monumentally stupid that they wind up in jail or worse. You need someone who will get you to the help you need and you have to keep reminding yourself that you trust that person, no matter what you feel emotionally.
  7. Don't switch doctors:   Too many people switch doctors the first time their medicines don't work and then complain because the new doctor gives them the same medication.  Each mental illness diagnosis has a protocol that doctors follow. You give Medicine A first and then Medicine B if that doesn't work and then Medicine C and so on. Change doctors and he's going to start down the same protocol list.  Stick with your doc till the two of you figure it out. If you find a physician that will listen to you when you tell him what's wrong, then stick with that doctor. You've found a jewel.
  8. NEVER QUIT COLD TURKEY:  Every damned story in the "Psychiatry Kills" video was of someone who belonged to a group which quit their meds cold turkey and they all had suicidal ideation, homicidal thoughts and really twisted urges. No wonder. THEY QUIT COLD TURKEY. The warnings that come with the medicine say never to quit cold turkey. It can be fatal.
  9. Don't believe everything you see on the Internet:  There are some wonderful resources there. Mayo Clinic, Johns Hopkins and other reputable information sources have a wealth of material about every disease imaginable. If you see some hysterical warning on Facebook, skip it. Search out the information for yourself. Avoid the independent websites. Hook up with social media groups to share stories and learn how other people handled their disease, but be careful of quack cures and hysteria. Your doctor studied all those years because she wanted to help people. Besides, killing your patients is not a very good way to make a living. Dead people don't pay for doctor visits.
  10. Remember that you are unique:  No two people are alike and there is no "blood test" or X-ray for mental illness. Even MRIs and CAT scans can diagnose your mental illness on their own. It's a long and complex process.
  11. Don't make big decisions when you're not thinking clearly:  If you or a loved one is struggling with mental illness, make it an agreed upon thing that you don't make big decisions when you're having an "episode". Always let your treatment partner be the one to be the final word on whether you are up to it or not. That's hard to do, but it's the best way to regain control of your world. By deciding not to make impulse decisions when you aren't at your best is very wise.
Finally, remember that fear, paranoia, sadness, elevated mood and rage are all components of various mental illnesses.  They come with the territory. Apologize in advance to your loved ones. You may say stupid things that you regret later, but which, at the time, seem like they simply must be said. Build around you a circle of loved ones who know what you are going through and who you trust to be on your side when you are in trouble. You want people who won't let you go to the casino when you're manic, because they know you'll bankrupt yourself if given a chance.  You want doctors who have enough experience with you to piece together a correct diagnosis and who trust you to tell them what's really going on in your head. Not every general practitioner is good with medications for your mental health. If you need medication support, go to a psychiatrist who is expert in treating mental illness and build a partnership with him or her in helping you reach stability.


Tom King
© 2016

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