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Too many people take too many pills

economist.com

141–150 of 166 posts

Re: Too many people take too many pills

#141

Earlier quoted context omitted.

> That said, there are way too many people out there who have no experience with conditions which require medication, who seem to think that those things are a substitute for medication rather than a baseline that must be kept up alongside medication. It is complicated. Some people have mental health conditions which are always going to require medication. Some people have mental health conditions which are never goi…

I was hospitalized for two severe manic episodes in my late teens and was told I would have to take lithium for the rest of my life or I would inevitably end up back in the hospital. I did take it (and Zyprexa) for about nine months during my freshman year of college, got the fattest I've ever been, and spent almost the entirety of my free downtime zoned out in my dorm room. That summer after my first year of college…

> I don't know whether my brain was sufficiently re-wired by those 9 months of pills or what, but it's a bit strange to me that essentially every psychiatrist would have insisted something like this was impossible.

Bipolar disorder disappears in some people spontaneously. Around 10% of people who have a first bipolar episode will not go on to have a second one, even if they permanently discontinue medication. And some people who have a second episode will never have a third, even if they stop taking medication, although I don't have an actual statistic on that. Let's suppose it is 1% of all bipolar cases – which is a figure I just made up, but probably in the right ballpark. Since bipolar is around 1% of the population, people like you would be around 0.01% of the population. That sounds insignificant, but in a country like the US there would be over 30,000 people like you, and worldwide could be over 700,000.

I think the psychiatrists who told you this is "impossible" probably knew that it actually wasn't. It is just that it is rare, and they don't want to give patients and their families false hope or encourage non-compliance with treatment, so instead of telling you the truth that it is 10% or 1% or whatever of all cases, they tell you a "white lie"/"simplification" that it is 0%. 90-99% of the time, their lie turns out to be true for the person they told it to.

In terms of whether 9 months of medication "rewired your brain" – it is impossible to say. It is possible that without medication you would not have gone into remission, and would have had further episodes. It is also possible that you were always going to remit anyway, and still would have even without medication. Nobody really knows. The fact is, for just about all psychiatric disorders, our knowledge of what causes them, and how the medications work, is extremely incomplete, and we don't know enough to answer those questions in individual cases.

Re: Too many people take too many pills

#142

Slightly related: https://news.ycombinator.com/item?id=16252372 I noticed that taking pain-killers is a very common thing in american TV shows. The main protagonist (male hero) gets hurt, goes to the bathroom, hastily pours a handful of pills into his hand and pops them into the mouth. Not one, but a hand full of pills, cleary too many. I've seen it so much, I'm starting to wonder if it's a TV trope. I'm wondering if…

It’s definitely a trope, but it’s not product placement. It’s just old fashioned over-embellishment by Hollywood for the sake of drama. They do it for everything else, why wouldn’t they for self-medication?

Re: Too many people take too many pills

#143

Earlier quoted context omitted.

I'm being real. Lots of people work 10-12 hours a day. How are they supposed to shop and cook for only fresh and healthy food, as well as do 30 minutes of rigorous cardio per day, in the remaining four hours a day when they're not asleep? What if they have family obligations?

Most people do not work 10-12 hours a day. Those who do have far bigger problems than regular exercise.

I think it’s more common that you think. Very rarely does someone check in right at 9 and out right at 5. Add onto that a commute which might be anywhere from 30-60 minutes each way, and you are pretty close to that window.

Re: Too many people take too many pills

#144
post #87

Earlier quoted context omitted.

I'm being real. Lots of people work 10-12 hours a day. How are they supposed to shop and cook for only fresh and healthy food, as well as do 30 minutes of rigorous cardio per day, in the remaining four hours a day when they're not asleep? What if they have family obligations?

Most people don't work on weekends. You can do shopping and cook for entire week then. This is not a theoretical proposition, I've done that a lot.

If you have kids, particularly several, the weekend is usually completely packed with activities and obligations. I know can’t ever get any shopping done over the weekend.

Re: Too many people take too many pills

#146

Earlier quoted context omitted.

I’ll tell you what your doctor might not be telling you: - 30 minutes of cardio, 3x a week is a bare minimum. The more cardio the better, so consider endurance sports. - Resistance training is necessary too, and can be done at home with no equipment - Get at least 10 minutes of sunlight right after you get up or right after the sun comes rises, even if it’s cloudy, if possible - Don’t drink more than 2 drinks in a da…

I'll tell you what your doctor might not be telling you, doctors have the highest suicide rates of any profession. Should I trust them to tell me what is healthy? Retail managers have the lowest suicide rates. I don't trust them either.

Not sure where you're getting that, but the CDC indicates that oil and gas extraction workers top the list in terms of suicide risk- doctor suicide stats aren't high enough to even make the list.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm

Re: Too many people take too many pills

#147
post #120

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That's just like how shampoo companies advise you to "lather, rinse, repeat". It's a great way to boost sales, but besides being unnecessary it's terrible for your hair, your water bill, fish living downstream, and your wallet.

I do occasionally repeat and it does make a difference, but you only need 1/10th as much shampoo the second time.

I’m curious. What does the second iteration accomplish? Is it dirt and grease that is embedded in your skin? What kind of job do you have if you feel comfortable answering?

Re: Too many people take too many pills

#148
post #101
post #95

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> With the toxin they put in Tylenol (to prevent abuse) ...acetaminophen itself is what kills your liver in an overdose, there is no "toxin they put in tylenol"

Got it upside down. Acetaminophen is added to opioids to prevent rec use and abuse.

That explains...a lot actually.

Some studies out there linking acetaminophen to reduced empathy.

Re: Too many people take too many pills

#149

Earlier quoted context omitted.

I'm being real. Lots of people work 10-12 hours a day. How are they supposed to shop and cook for only fresh and healthy food, as well as do 30 minutes of rigorous cardio per day, in the remaining four hours a day when they're not asleep? What if they have family obligations?

My experience was that I was scheduled 12 hours a day, the reality is that we all commuted 1h both ways and turnover often took 30-45 minutes. We were bussed in, and we arrived 15-20 minutes early. To put the final little bit in, we also had to commute to the bus depot. Whatever extraneous time I had was spent in the shower. While I did manage to eat decently I also had the benefit of years of working in kitchens and…

I had a general comment about toxic materials but I'm putting it here because I'm very familiar with this type situation:

>Beyond diet it's physically taxing, especially considering that my industry, and every industry touching it worked some variation of swing shifts and if not that, 24/7 on-call. That alone is extremely taxing and has prolific long-term implications. Alcohol and drug abuse are commonplace, whether licit or illicit substances. And there's a huge emotional layer to it as well, if that isn't obvious. Mind you these are the people paid by the companies that keep your lights and heat on, transport all your food and fuel...

Looked at your profile and see your admission from "someone who sorta bootstrapped from a pretty shitty starting position"

Really there's not much difference between overwork to recover more completely from disaster, compared with ambition to make faster progress when opportunity exists.

This is the kind of situation where things like drugs are never the answer, seems like sometimes the toxic effects of chemicals are on steroids when the "setting" does not allow for much recovery between toxic exposures. If the medical benefit were not clearly in excess of the toxic load or significant side-effects I would not want to take the pill.

Each pharmaceutical is like any other consumer product. It didn't used to be as bad when mass-marketing direct to patients was still widely recognized as too unethical for serious consideration.

Once a consumer product reaches the most satisfying rapid market saturation on its own merit, the main way to continue the bonanza is to create desire among the nonengaged consumers who don't actually need the product but who can be convinced that it might be nice to have anyway for some reason or another. By then anybody with any interest at all knows it's already popular and accepted.

Then after the drugmakers and insurers got into a fortuitous spiral (for the corporations) on prices the incentive got even more extreme. Even though the insurers have to pay more for each dose, they just raise the premiums and "everybody wins".

Plus there are still really not enough doctors to go around but it used to much worse. However in the 21st century I think doctors are much more likely to recommend a simple pill (or more than one these days) rather than a more complex treatment.

Also when doctors were spread much thinner people went to them much less often, long ago it was like only going to the doctor when you needed to be cured of a cold or flu or broken arm or something.

So they got the exam, took one bottle of medication, got over the cold, and they were cured.

Then it was discovered there was no cure for the common cold. OTC approaches to treat symptoms proliferated with mass-media television and it was seen consumers would continuously purchase more pills on their own initiative to treat the same disorders which had not had that scale of returns in the form of doctors' prescriptions.

The prescription-industrial complex was going to have to advertise to compete.

Attitudes began the gradual change to continuing visits and ongoing treatment for more & more conditions, not just the things that would be expected to require a continuing lifetime of medication, such as insulin.

And a whole generation of doctors who have been influenced by very persuasive drug companies that have carefully built a reality distortion field where any tendency to discontinue medication once prescribed has been de-emphasized like never before.

>I opted for vegetarianism

I don't think the full risk is known when it comes to steroids in meat or pesticides in vegetables, but looks like vegetarians these days are more conscious of avoiding toxic additives than average, so this may be the safer move for that reason alone.

Re: Too many people take too many pills

#150
post #87

Earlier quoted context omitted.

Most people don't work on weekends. You can do shopping and cook for entire week then. This is not a theoretical proposition, I've done that a lot.

If you have kids, particularly several, the weekend is usually completely packed with activities and obligations. I know can’t ever get any shopping done over the weekend.

That's completely by choice. My parents didn't do any of that with me. That wasn't really a thing in my generation (growing up in the 80s and 90s in Polan).
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