Psychiatry and Medicating the Mind

[Deleted]

Prozac, Zoloft, Celexa, Ritalin, Abilify--what's your opinion on them? I've seen mixed opinions on them all around: some say they're essential for certain people to live healthy lives, others argue that they do more harm than anything, another group says they're little more than placebos, and so on. Me, I've had a mixed experience with meds, so I'm not sure how to feel about them just yet.

What do you think? Are these medications effective? Are they ethical? Are they over-prescribed?

[Deleted]

A note on Ritalin; there has been a lot of controversy about this drug, but we actually know more about it than just about any other medication, and the consensus in the psychology community is that it is safe and can sometimes (but not always) be very effective in managing certain conditions like ADHD.

You've also got to keep in mind that these drugs are tested under the most ideal conditions - double-blind placebo control trials are the gold standard when it comes to medicinal research, but they don't really give the best picture of how effective the drug being tested would be when implemented on a large scale. For example, if you wanted to develop a drug to treat PTSD and you had a prototype you were working on. You've got ethics committee approval to do a drug trial so you recruit patients. Only instead of taking just any patient with PTSD, you must be very selective. The patient can't have any other psychological disorder, they must be of good health and a myriad of other criteria that must be met. This in itself is one of the bigger problems, because your average person might have lots of other problems as well as PTSD, so while your miracle new drug might work beautifully in the controlled environment of your lab, it's not going to be nearly as effective in the real world.

Because of this, a lot of drug trials have shied away from a placebo control group to a currently marketed and well-documented alternative medication. That way, instead of testing how good the drug is, you're testing how good it is compared with a drug that's already in use.

My personal opinion? Don't medicate unless it's necessary. As wonderful as medication is, there are always side effects, and pumping your body full of all sorts of chemicals just doesn't seem healthy to me. I choose to visit a councilor instead of a psychiatrist for my depression because I wanted non-medicinal ways to manage. If I had tried those methods and found them to be ineffective, I would have then explored the possibility of medication. Thankfully, that wasn't necessary. ^_^

[Breakingchains]

I've never had to be on medication, thankfully, but I think if the time came that I truly needed it, I'd take it. In some cases, I think it really is necessary. (Though as Sarn says, other avenues should be explored first.) There are people who are so depressed, for instance, that they cannot benefit from therapy or anything else until they have their moods artificially stabilized. And there are people who genuinely need to be on antipsychotics to prevent them from hurting themselves or someone else.

I won't say things aren't over-prescribed or over-diagnosed, because of course that happens. But I think some people have thrown the baby out with the bathwater - sometimes the meds, with all their side effects, are better than allowing the condition to run rampant. Doctors just have to be judicious and treat people on a case-by-case basis instead of throwing huge doses of Zippypills at every depression case that walks in the door.

[Dju]

I use Ritalin, I have a horrible time focusing during classes. It's as if I just disconnected and when I get back to myself, it's already over. Not to mention I had made many mistakes thanks to my distraction, and it caused me so much...pain. People yelling at me all the time, calling me names and saying that my brain wasn't well developed. It hurt so badly. ;-;
I use the 4 hours effective one only to go to school, and during this time I note down what I need to do on the afternoon and since then I haven't forgot anything. I believe people who are against Ritalin never really needed it, it's really tough having Attention Deficit. :/ It never really bothered me outside classes because I am interested in real life, so I never use it unless there.
But it makes me really mad when people without these problems start using it on tests to get accepted in college, since the number of students approved is limited. It's like cheating and it's disrespectful with those who can't afford it.

Not to mention that the medication was missing on our city because students began buying it without needing it. Now they raised the prices again.

[Tiger]

Well, one of the big problems with medicine, especially for psychological conditions, is that it's almost impossible to find something that works for everybody. The etymology of these conditions is so complex; when I was learning about them in greater depth, the focus was on the "biopsychosocial" model, which proposes that biology, psychology, and the social environment all play a role in the illness and its recovery.

For some people, the problem is primarily biological, so medicine may work - on the other hand, people have different body chemistry, and for some mental conditions, it's really hard to pin down what chemicals we're even supposed to me fixing and how much we should adjust them (L-dopa used to be hailed as a miracle drug for Parkinson's, but too much dopamine can cause schizophrenic symptoms).

Sarn's points on drug trials are very good ones. Even control groups in laboratories don't always work very well, since you can't ethically or legally start with a group of healthy people and "give" them the same disorder, so you've already got a mixed basket.

Dju makes a good point, too, about people without ADD/ADHD who use Ritalin as an energizer. People do sell the drugs, and it's not only really unfair to those who need it to focus, but it's not exactly healthy to be using medication you don't need.

Generally, I would take the stance that you have to be cautious with medication, but I do understand that sometimes, there's not much choice. A lot of studies show that with most disorders, it's the best approach is a treatment that's biopsychosocial - it involves some medication, but also therapy and the development of coping strategies, but on the whole, it should be a very case-by-case basis.

Also, I feel like I should double-check; is anyone offended by my use of the word "disorder" when referring to mental conditions? I don't mean it any more offensively than when I talk about a physical condition, like my own disorder, but I feel like when it involves the mind, people might take it more personally =/

[Deleted]

Tiger, yes, I would appreciate if you didn't use the word "disorder". I consider Asperger's to be part of my personality.

About medications...I've taken Selexa for several years to "calm me down", my mom says. Though sometimes I wonder if my personality is...fake and it's just a medicine I take. I just hope that I would be the same person without it and I wouldn't turn into a selfish brat who slams other people's beliefs. Because that's not who I want to be.

[Dju]

Nah, I don't mind you using the word 'disorder'! ^-^ Even though I am thankful I have Attention Deficit because it made me who I am, it is a disorder and accepting it is part of it ^-^

Sae, I understand your problems with the medication. I was scared of starting using Ritalin because I thought it would change my way of thinking, but it turns out it makes no difference to my personality at all. XD I am who am, and no chemistry can change that, sometimes we must admit there is a bilogical thing getting in the way fo being who we are, and medicine can fix it. The best part of using it, it's that I can do whatever I want after classes because I already had finished my responsibilities there, I don't have to worry or feel guilty like I used to for not paying attention.

And no. Using medication doesn't turns you into a selfish person. That was offensive. XD; So sorry Sae, I misread it! So sorry!

[Stal]

Just a quick note, various conditions are classified as disorders. It's a clinical definition without judgment attached to it. Meriam-Webster defines disorder as "an abnormal physical or mental condition <a liver disorder> <a personality disorder>". As most of these are considered to be abnormal (" deviating from the normal or average"), it's an entirely acceptable word to use.

The word itself has a slight social stigma attached to it, but it's a good word for discussing such matters and cases. Tiger, I wouldn't worry about the use of the word.

EDIT - Dju, I think Sae was saying that if she were to go off her medication she hopes she wouldn't turn into that (i.e. the medication is preventing her from being so)

[Dju]

Sept 4, 2011 10:02:28 GMT -5 Stal said:

EDIT - Dju, I think Sae was saying that if she were to go off her medication she hopes she wouldn't turn into that (i.e. the medication is preventing her from being so)

OOH! I am SO sorry, Sae! ^-^;

*headdesk* Read Dju. Read carefully before you post something like that. >.<

[Deleted]

Sept 4, 2011 10:02:28 GMT -5 Stal said:

Just a quick note, various conditions are classified as disorders. It's a clinical definition without judgment attached to it. Meriam-Webster defines disorder as "an abnormal physical or mental condition <a liver disorder> <a personality disorder>". As most of these are considered to be abnormal (" deviating from the normal or average"), it's an entirely acceptable word to use.

The word itself has a slight social stigma attached to it, but it's a good word for discussing such matters and cases. Tiger, I wouldn't worry about the use of the word.

EDIT - Dju, I think Sae was saying that if she were to go off her medication she hopes she wouldn't turn into that (i.e. the medication is preventing her from being so)

I was about to post that, thanks Stal. xD 'Disorder' is probably the most politically correct term you could use and still have people understand what you're talking about, and as someone with a psychological disorder I'm happy to use it freely. ^^ Actually, I have to. It's part of my coursework. *chuckles*

Chains, you basically said what I was thinking better than I can articulate. ^^

[Deleted]

Dju, it's okay. I understand. I've misinterpreted a lot of stuff, actually (most of it spoken).

Also, the main reason I don't like the term "disorder" attached to me is because it makes me feel like I'm not a whole person. It's just a personal feeling of mine, but I don't want to be referred to as "having a disorder" - I think it will make people as a whole think less of me, and as a stereotypical mental patient rather than a person. Now, I don't think this way at all, this is just a personal fear of mine.

[Deleted]

I know how you feel on the "disorder" stuff, Sae, though I do agree with Sarn that it's the only word that fits. :\ The stigma surrounding disorders really bugs me. Inevitable, I guess.

Now, for my anecdotal moment: I was "diagnosed" with ADD. My psychiatrist thinks I have it; my therapist disagrees, as did the people at High Focus. When it was first suggested that I might have it, I thought "oh hey this fits", but after a time...no. It doesn't fit. There may be overlaps, but even so I don't think I have it. This was probably caused by bad experiences with ADD medication: Vyvanse almost made me underweight, Adderall screwed with my sleep schedule, and both made me really irritable. Not to mention the mood dips in the evening. Whether I have ADD or not, the medication was bad for me. Prozac was also bad for me. It sent me into the biggest rut of my depression, and I was on it for up to two months. It just did not work for me.

Zoloft and Abilify haven't done any harm, fortunately. ^_^ I can't wait for the day when I no longer need them.

[Deleted]

I think I get what you mean, Sae. I don't like being labelled either. Especially not with a word that -could- have a negative meaning. Clinical or not. But be as it may, it is still the right word to use and I would prefer that to many other 'slang' terms.
I am a HSP, and only just recently found out. Befor then, I would get severely hurt, to the point of agressive, if someone referred to me as being 'emo'.

But that aside.
I am a firm believer that medication should only be used scaresly and only if it can help the person to live better alongside their disorder.
Though, conditions like 'depression' and 'anxiety' and the like, should never be covered up with medication and left at just that.
Medication does not solve the problems that causes the malfunction in the brain and should be sorted out through therapy. The medication in this case should only be an aid to be -able- to take the necessary steps towards recovery.
Disorders like ADHD, Aspergers, Autism... disorders that are not curable, should be medicated if it helps the person to get more out of life.

I was never a big fan of doctors who just prescribe medicine as if they were giving away candy.
I don't have an opinion on the brands of meds, since I have no personal experience with any. But since my doctor said I had a mild depression, I told myself that I would not take -any- meds for it. I can get it sorted without it.

A friend of mine has a heavy depression, and the meds she is taking helps her cope. But it has also made her gain weight. A side effect that doesn't exactly -help- with her depression =/

[Stal]

Despite the fact I pointed out the disorder word being fine, I truthfully think that too many things are labelled disorders that really aren't.

ADD and ADHD are good examples. Too many kids have been labelled with it when they're just being normal kids. And there's a tendency to medicate things that are actually normal behaviors simply because it's not convenient or understood by the parents. Yes, there are legit cases, but I think there's many more tendencies to put labels on everything and every behavior and then come away as it's abnormal and thus should be medicated.

Still, there are things to be said for the medications helping those afflicted deal with any ill effects. As well as understanding more about yourself. Although then there's times people hide behind those labels as a defense of allowing themselves to be certain ways without working through some of the associated problems.

It's all very murky.

[Deleted]

Sept 4, 2011 12:24:56 GMT -5 Stal said:

Despite the fact I pointed out the disorder word being fine, I truthfully think that too many things are labelled disorders that really aren't.

ADD and ADHD are good examples. Too many kids have been labelled with it when they're just being normal kids. And there's a tendency to medicate things that are actually normal behaviors simply because it's not convenient or understood by the parents. Yes, there are legit cases, but I think there's many more tendencies to put labels on everything and every behavior and then come away as it's abnormal and thus should be medicated.

Still, there are things to be said for the medications helping those afflicted deal with any ill effects. As well as understanding more about yourself. Although then there's times people hide behind those labels as a defense of allowing themselves to be certain ways without working through some of the associated problems.

It's all very murky.

Both the DSM and ICD have firm criteria for the diagnosis of psychological disorders. While they're by no means foolproof (what is, really? xD) they're at least specific. Some people get a false diagnosis, unfortunately, but they're at least a step in the right direction. The misdiagnosis usually happens on the part of parents who think their child's misbehaviour must have a psychological cause. Unskilled or self-diagnosis is the problem, methinks.