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The Challenge of Going Off Psychiatric Drugs

newyorker.com

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Re: The Challenge of Going Off Psychiatric Drugs

#31

Post by sixo »

nerdponx wrote: post #12
com2kid wrote: post #9

I generally am supportive of people seeking psychiatric treatment, but wow, this woman's case seems, in retrospect, rather mismanaged. It is like her doctors tried to medicate away an epiphany. Realizing that "the glittering balls and designer clothing has no real underlying substance" and being depressed that one's life is limited to such things, is not a cause for medication. It sounds like she was struggling to be…

Psychiatry should not be front-line treatment for most people. End of story.

I think a decent cutoff for when to defer to medication is when the problem becomes self-sustaining. E.g. you get anxiety about your anxiety, or your mania leads to disastrous actions that can't be emotionally handled in a normal state, or your depression causes you to fail at goals in a way that contributes to your depression.

At those points the cycle is the problem and needs to be broken.

Re: The Challenge of Going Off Psychiatric Drugs

#32

Post by boomboomsubban »

throwaway55254 wrote: post #11

This terrifies me. I've been trying to get up the nerve to talk to my doctor about my mental health for years now. I've been depressed on and off for a large portion of my life. I've always been really wary of pills though and reading things like this makes me worry even more. I wonder if the efficacy is actually there or if the withdrawal is worth it.

Talk to your doctor and get a recommendation/prescription for therapy, it has a higher efficacy than medication anyway. If medication is advised, set a time line immediately for when you want to be off it. Withdrawal usually isn't bad, though worrying about it makes it worse.

Re: The Challenge of Going Off Psychiatric Drugs

#33

Post by mrguyorama »

empath75 wrote: post #23
dmortin wrote: post #8

Does depression go away after a while if taking meds? Or does the person having depression need to take meds for the rest of his/her life to avoid relapsing?

Depends on whether the depression is situational. People don't like to admit that sometimes people are sad because their situation, and not because of something inherent to themselves. Sadness -- even persistent sadness -- can sometimes be a healthy response to an unhealthy environment, that drives you to try and change your situation for the better. The problem is when the sadness becomes the crippling kind that pre…

>Sadness -- even persistent sadness -- can sometimes be a healthy response to an unhealthy environment, that drives you to try and change your situation for the better.

Depression is sort of different than generic sadness as it DOES NOT drive you to improve your situation, due to the severe hopelessness it causes. It's the massive problem with depression, and why medication can be so helpful. Depression can cause you to stop functioning, even at your situationally reduced level, essentially fucking you over even worse.

As you show, it was an external event that kicked your wife out of her rut. Sometimes that required kick is helped by medication

Re: The Challenge of Going Off Psychiatric Drugs

#34

Post by mrguyorama »

transfire wrote: post #6

Prescription Cascade with psychiatric drugs is out of control. Seen it first hand. Had to step in and put a lot of pressure on doctors (and change doctors) to finally get my finance off the worst of the meds they had her on -- and finally "cure" her -- they just wanted to keep playing new drug musical chairs.

My mother spent 8 years trying drug after drug for her serious anxiety and chronic depression. The problem is that nobody has a strong understanding of how the different medications work to help, or even who they can help, so it often is that you have to just try until one works.

My mother eventually found one that works and is absolutely necessary for her to live a normal life.

Re: The Challenge of Going Off Psychiatric Drugs

#35

Post by clydethefrog »

LyndsySimon wrote: post #24
transfire wrote: post #6

Prescription Cascade with psychiatric drugs is out of control. Seen it first hand. Had to step in and put a lot of pressure on doctors (and change doctors) to finally get my finance off the worst of the meds they had her on -- and finally "cure" her -- they just wanted to keep playing new drug musical chairs.

I've had similar experiences with myself. After high school I was prescribed two drugs in combination (Lexapro and Abilify) that helped me deal with and get a handle on my (serious) depression, and that was really easy. When I told them that I hated the way they made me feel and wanted to taper off of them once I was stabilized... that wasn't so easy. At the end of the day I had to issue a sort of ultimatum: I was go…

The high mention of Abilify in the article and your comment makes me worried. I am currently on Abilify (10mg) for antipsychotic reasons. It seemed to be a "new generation" safer antipsychotic. Reading the Wikipedia article about it makes it sound a lot of research is unclear about the side effects.

https://en.wikipedia.org/wiki/Aripiprazole

Re: The Challenge of Going Off Psychiatric Drugs

#36

Post by mmjaa »

SketchySeaBeast wrote: post #28
mmjaa wrote: post #16

Earlier quoted context omitted.

>I agree that it's under-discussed. I think the reason its under-discussed is that there is a collective group-think which functions as overwhelming (to the individual) reinforcement: "there is no other way available to solve this problem than the mass sale and consumption of pharmaceuticals". The moment someone proposes a non-pharmaceutical (read: profitable) solution to many of these ills, they are shut down by the…

Therapy is also a long lasting, lucrative approach. I think you're confusing consumerism with the long standing idea that we should be able to solve everything with a pill. It's evident in the older generations insistence that if they could just have that one surgery for their knees, or that round of antibiotics for their cold, their lives would be 100% better.

Consumerism: the protection or promotion of the interests of consumers

I think there are very definitely market forces at work, keeping people in the mindset that pharmaceuticals are the only 'real' effective solution to their ills - when so, so many other alternatives are available. I don't doubt that chemicals can make peoples lives happier - I see it all the time.

What I resist, however, is the notion that individuals should subjugate themselves to collective will just because everyone says pharmaceuticals are the way. Maybe strengthening ones resistance to groupthink and collective-derived thought processes is also an effective way to strengthen ones mental health .. alas, this point of view is too often overwhelmed by the very mob it serves to service, however ...

Re: The Challenge of Going Off Psychiatric Drugs

#37

Post by stronglikedan »

com2kid wrote: post #9

I generally am supportive of people seeking psychiatric treatment, but wow, this woman's case seems, in retrospect, rather mismanaged. It is like her doctors tried to medicate away an epiphany. Realizing that "the glittering balls and designer clothing has no real underlying substance" and being depressed that one's life is limited to such things, is not a cause for medication. It sounds like she was struggling to be…

> Medication cannot make people happy.

But it can allow one to find happiness. Depression is a chemical imbalance, and not everyone can overcome it on their own - especially if left untreated for extended lengths of time. The medicine helps people get back into balance, so they can start to work on their happiness again, whatever that may be.

Re: The Challenge of Going Off Psychiatric Drugs

#38

Post by limeblack »

GlenTheMachine wrote: post #10

I am on Klonopin and Remeron. My diagnosis is anxiety, but really it's insomnia. I had a horrible, multiple-year episode of insomnia that started in my early thirties. For about three years I got maybe one night a week of decent sleep. I was mentally and emotionally out of it; I'm kind of surprised I still have a job after that. A few years in, I found a psychiatrist who was willing to experiment and we discovered th…

Check out http://survivingantidepressants.org I'm active on the site. Fair warning some people stop sleeping coming off of Remeron others are fine. Sometimes the withdrawal is multi month delayed.

Re: The Challenge of Going Off Psychiatric Drugs

#39

Post by com2kid »

SketchySeaBeast wrote: post #27
com2kid wrote: post #25

Earlier quoted context omitted.

For most people, psychiatry is overkill, sure sure. But heck, look at the diagnostic criteria for Bi-Polar, > The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. That line about "marked impairment in occupationa…

The definitions can be more easily met when you consider "Cause significant distress" or "reduce the quality of, social, school, or work functioning" - that's much larger, and people can be visibly firing on all cylinders, but if they report reduced quality or distress, then it meets those criteria.

But as the article made clear, the drugs were reducing her performance at school!

This is one area where I think the ADHD community has pulled ahead, good doctors will, when someone starts a new treatment, do weekly check-ins[1] with how one's quality of life is going across multiple metrics. Mood, self image, social life, and work/school performance.

The fact this isn't done for all forms of psychiatric treatment is shocking and sad.

From a non-medical perspective, Cognitive Behavioral Therapy is good in that it tries to help people find fulfillment, or at least come to peace with themself.

[1] Proper ADHD treatment is supposed to be provided by a psychiatrist and psychologist working in tandem and communicating with each other. Unfortunately the % of times this is actually done is most certainly way under 1%. Not even going to get into the insurance issues around this...

Re: The Challenge of Going Off Psychiatric Drugs

#40

Post by com2kid »

stronglikedan wrote: post #37
com2kid wrote: post #9

I generally am supportive of people seeking psychiatric treatment, but wow, this woman's case seems, in retrospect, rather mismanaged. It is like her doctors tried to medicate away an epiphany. Realizing that "the glittering balls and designer clothing has no real underlying substance" and being depressed that one's life is limited to such things, is not a cause for medication. It sounds like she was struggling to be…

> Medication cannot make people happy. But it can allow one to find happiness. Depression is a chemical imbalance, and not everyone can overcome it on their own - especially if left untreated for extended lengths of time. The medicine helps people get back into balance, so they can start to work on their happiness again, whatever that may be.

Literally the next sentence I wrote:

> They can only create the possibility for happiness for those who need some extra help.

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