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When I stopped hearing the voices in my head

theguardian.com

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Re: When I stopped hearing the voices in my head

#11

Post by khed »

troym wrote: post #8
kefka wrote: post #2

So the solution is to provide drugs that somehow deaden random neurons in somewhat random parts of the brain, and hope they don't cause massive side effects down the line? Just like that dental article a few days ago, doesn't the current psychiatric medicine seem like using a backhoe on a flower pot? Sure, you move the soil, but you trash the porch.

> So the solution is to provide drugs that somehow deaden random neurons in somewhat random parts of the brain, and hope they don't cause massive side effects down the line? The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? I share your skepticism of modern psychiatric medicine, and yet I think you m…

I am a physician. The few studies comparing long term antipsychotic use in schizophrenia have found that people do better with low/no medication. They are more functional, have fewer relapses and better quality of life. This is still a controversial view in psychiatry but the tide may be turning. Thomas Insel, the head of the NIMH, has stated

"antipsychotic medication, which seemed so important in the early phase of psychosis, appeared to worsen prospects for recovery over the long-term" in reference to these studies.

Re: When I stopped hearing the voices in my head

#14

Post by DanBC »

kefka wrote: post #9
ksenzee wrote: post #4

Earlier quoted context omitted.

It depends which medications you're talking about, and which conditions you're treating with them. A lot of them are more like using a shovel on a flowerpot. Still not precisely the right tool, but they get the job done and the porch is still in good shape.

Point well made. With my ex-fiancee, a psychiatrist had her on prozac and abilify. She had a complete breakdown in her senior year of university classes. They put her on a cocktail of stuff and weren't honest in their dealings (parents and doctor). She had quite a few voices and things in her head. And the drugs helped that, to a point. It was when she started getting tics that I investigated more, and saw the 3-5 pa…

That sounds like a horrible experience and it's not surprising that you feel the way you do about psychiatric meds.

You're right that many of them at the moment suck. They have long lists of side effects, some of the side effects are severe (reducing quality of life, sometimes reducing length of life).

At least in the UK there's some push towards patients becoming much more involved in their care. There's a bit of of focus on the informed part of informed consent. But we could do better here.

For some of the severe mental illnesses it's a tricky balance - do we medicate people or let them live with their illness? Mostly this should be up to the patient. If someone has the capacity to decide then they're allowed to "make the wrong choice".

And while the side effects suck they can be better than the illness, which can lead people to die by suicide or live miserable lives.

But if someone just hears voices, and is okay with them, doctors should not be pushing that person towards medication but towards crisis planning and advanced directives.

Re: When I stopped hearing the voices in my head

#15

Post by kefka »

troym wrote: post #8
kefka wrote: post #2

So the solution is to provide drugs that somehow deaden random neurons in somewhat random parts of the brain, and hope they don't cause massive side effects down the line? Just like that dental article a few days ago, doesn't the current psychiatric medicine seem like using a backhoe on a flower pot? Sure, you move the soil, but you trash the porch.

> So the solution is to provide drugs that somehow deaden random neurons in somewhat random parts of the brain, and hope they don't cause massive side effects down the line? The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? I share your skepticism of modern psychiatric medicine, and yet I think you m…

> The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"?

You mistake me for talking about the author. I was making commentary about the broad umbrella of psychiatric medicines.

Both I and my wife have taken those drugs, and the feeling in my body was that they deadened a part of ourselves. In my wife's words, "I still wanted to kill my self, but didnt have the will to do it." That's the deadening; feelings were 'grayer', tastes were bland, colors were muted.

> It would not surprise me if the patient had the same concerns as you and I, but was so desperate, so hopeless that they were willing to take the risk.

And I'm perfectly OK with someone with informed consent taking substances. And I consider making use of wikipedia and Erowid as part of that consent, as well as doctors in your stead. I'm also not OK with doctors covering up, glossing over, or blatantly lying about problems that can arise. And from what I've seen, the psychoactive drugs can cause all sorts of side effects, some short lived; others permanent.

My wife and I have had this discussion; Under what conditions would it be OK to forcefully administer psychiatric medicines? Our discussions seem to show no good way to handle this, as it goes from the men in lab coats prior to the 60s, to the abuse of patients ending in the 80s, to simple imprisonment now.

Re: When I stopped hearing the voices in my head

#16

Post by khed »

khed wrote: post #11
troym wrote: post #8

Earlier quoted context omitted.

> So the solution is to provide drugs that somehow deaden random neurons in somewhat random parts of the brain, and hope they don't cause massive side effects down the line? The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? I share your skepticism of modern psychiatric medicine, and yet I think you m…

I am a physician. The few studies comparing long term antipsychotic use in schizophrenia have found that people do better with low/no medication. They are more functional, have fewer relapses and better quality of life. This is still a controversial view in psychiatry but the tide may be turning. Thomas Insel, the head of the NIMH, has stated "antipsychotic medication, which seemed so important in the early phase of…

This is a nice overview. https://www.ncbi.nlm.nih.gov/pubmed/23512950

Re: When I stopped hearing the voices in my head

#17

Post by DanBC »

kefka wrote: post #15
troym wrote: post #8

Earlier quoted context omitted.

> So the solution is to provide drugs that somehow deaden random neurons in somewhat random parts of the brain, and hope they don't cause massive side effects down the line? The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? I share your skepticism of modern psychiatric medicine, and yet I think you m…

> The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? You mistake me for talking about the author. I was making commentary about the broad umbrella of psychiatric medicines. Both I and my wife have taken those drugs, and the feeling in my body was that they deadened a part of ourselves. In my wife's wo…

> My wife and I have had this discussion; Under what conditions would it be OK to forcefully administer psychiatric medicines?

That's a significant interference with a person's human rights, so it should be done as a measure of last resort, after all other options have been tried, and with a bunch of checks and measures built in. The person should pose an immediate risk of significant harm to themselves or to other people, and the person should lack capacity to make the choice. The people making the choice should be senior, experienced, and well trained.

And after it's happened there should be some kind of case review to see if it can be avoided in future.

For example, if the person became distressed to the point they are rapidly tranquilised the case review would look at behaviours of other people that created the distress.

Re: When I stopped hearing the voices in my head

#18

Post by SCAQTony »

Book: "The Origin of Consciousness in the Breakdown of the Bicameral Mind" — https://en.wikipedia.org/wiki/Bicameralism_(psychology)#Brea...

Theory: The brain has two hemispheres: One does the talking and one does the listening. Sometimes we react because the "self" is the last to know or just reacts not realizing it is a self evaluation below our awareness. (Dog goes to bite your hand and you react.) We then try to assign order to that chaos with a reason such as "god[s]", or "spirit[s] warned us or made us do so.

Snippet: "..."... Leftovers of the bicameral mind today, according to Jaynes, include religion, hypnosis, possession, schizophrenia and the general sense of need for external authority in decision-making...."

Re: When I stopped hearing the voices in my head

#19

Post by Natsu »

DanBC wrote: post #17
kefka wrote: post #15

Earlier quoted context omitted.

> The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? You mistake me for talking about the author. I was making commentary about the broad umbrella of psychiatric medicines. Both I and my wife have taken those drugs, and the feeling in my body was that they deadened a part of ourselves. In my wife's wo…

> My wife and I have had this discussion; Under what conditions would it be OK to forcefully administer psychiatric medicines? That's a significant interference with a person's human rights, so it should be done as a measure of last resort, after all other options have been tried, and with a bunch of checks and measures built in. The person should pose an immediate risk of significant harm to themselves or to other p…

There are other things they can do to help compliance with treatment, like doctor-administered injections instead of pills. The thing is that even when people agree to treatment, they might forget their medicine and then be off in a psychotic episode and too detached from reality to take it.

I know this entirely too well because my mother was violently murdered by someone off their meds and the doctors managed to decide that nobody was at risk in spite of her telling them she feared for her life.

So I'd be more inclined to say that doctors have good reason to make sure people stay on their meds and to change treatments to ones where compliance can be better enforced whenever necessary.

Re: When I stopped hearing the voices in my head

#20

Post by kefka »

DanBC wrote: post #17
kefka wrote: post #15

Earlier quoted context omitted.

> The author didn't share a diagnosis, nor did he or she share the specific medication(s) that helped. Given that, how can you conclude that the drugs "deadened neurons"? You mistake me for talking about the author. I was making commentary about the broad umbrella of psychiatric medicines. Both I and my wife have taken those drugs, and the feeling in my body was that they deadened a part of ourselves. In my wife's wo…

> My wife and I have had this discussion; Under what conditions would it be OK to forcefully administer psychiatric medicines? That's a significant interference with a person's human rights, so it should be done as a measure of last resort, after all other options have been tried, and with a bunch of checks and measures built in. The person should pose an immediate risk of significant harm to themselves or to other p…

In so not to edit posts and context, our talks were about the current shoveling of the mentally ill in the prison system instead of treatment.

There was a recent reddit article in /r/news that talked about a Hawaiian prison that screaming, throwing feces, and other illness had taken over as the makeup of the prison. In general, we have collectively decided that there will be no/little support for the mentally ill, and that the jails and prisons will be the tool to stop them.

With the side effects as they are, how ethical is it to imprison them? They are ill, and we do not generally charge people if a legitimate illness causes a crime (no mens rea). And with the side effects, how ethical is it to force (by court) the drugs that 'cure' them?

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