Originally written October 16, 2006 (Updated edits in bold red)
On the heels of discussing my cynicism about pharmaceutics and pharmaceutical companies (namely, psychiatric-related), I have a few questions regarding the approach of psychiatric evalutations:
1. Why aren’t people tested for biochemical imbalances?
2. Is there a way to determine from blood work or an MRI what kind of mental illness a person is suffering from (in conjunction with the patient’s psychiatric assessment)?
3. How do doctors know the appropriate dosage for a patient? Does s/he start a patient off on what is considered “normal” for an average person and then increase or reduce the dosage based on reactions and side effects?
4. How does a doctor know when to increase a dosage? (Figuring out when to reduce a dosage SHOULD be much easier.)
Psychiatry is an inexact science. For the most part, I think much of it — regarding medication, Freud, and now, the pharmaceutical industry — is a crock.
Now, I know medication works — it has revitalized my aunt, who suffers from schizophrenia, to a point where she can function on her own. (She basically went from living as homeless person in Canada to renting her own apartment and traveling the world now.) But I’ve also seen much of its terrible effects — my father, who was so drugged up, numb, and desensitized that he couldn’t do more than eat, sleep, and watch TV; another aunt who is so drugged up that my family refers to her as just “there,” just “living”; an 18-year-old patient in this hospital who is so doped on meds that her eyes fight to stay open, has slurred speech and falls asleep anyplace, anywhere; another patient whose eyes and feelings were dulled from the effects of lithium; and other patients who are so souped up on meds that they fall asleep anywhere at any time or walk around with droopy lids, half-alive.
A psych (the politically correct term now is “behavioral”) hospital has its place. I was suicidal and needed a protective environment to pull me out of that pattern of thinking. Even God took care of Elijah as he was isolated in the desert for about 40 days. (I Kings 19:1-8) But I view psych hospitals more as a testing ground. Psych doctors, really, don’t know what they’re doing any more than I do. (Ok, maybe a little bit.) Not to say they’re a stupid lot — indeed, they are very smart and often prescribe medications based on the symptoms a patient describes: lorazepam (Ativan) for anxiety; sertraline (Zoloft) for depression; lithium (carbonate, citrate, and orotate) for manic depression; risperidone (Risperdal) for schizophrenia. There are categories and classes these doctors must know and memorize. And they do.
But really, wouldn’t you find it a bit strange to tell your doctor some physical symptoms you were having and based on what you tell him, he gives you a diagnosis of cancer? And to top it off, proceeds to recommend chemotherapy without ever performing a biopsy or drawing a single drop of blood from you? No one would go to a doctor like this. So why must patients allow this in psychiatric practice?
Medicine, as we accept it today, works like this:
We experience symptoms, tell the doctor what we’re experiencing and based on what we tell the doctor, s/he makes a diagnosis (should be more of a hypothesis, but I digress), performs blood work and/or collects a urine sample to confirm the diagnosis (which would then lead to a conclusion).
Psychiatrists diagnose patients like they all walk around with the same common cold.
Don’t get me wrong; mental illnesses ARE real. But I don’t buy the argument that depression in the U.S. is as epidemic as the media (and some statistics) report it to be. In fact, mental illness is widely overdiagnosed in people (in general) and severely underdiagnosed in men.
A book I just began reading, Blame It on the Brain? by Ed Welch, puts forth an important observation:
“Mood swings that were once seen as a result of a bad day at the office, an afternoon battle with the children, or disappointment in relationships, are now viewed as the result of chemical imbalances in the brain, treated with antidepressant medications, or for those who want more natural assistance, St. John’s Wort and other herbs.”
I’m not a doctor so essentially my words mean nothing. But I’m a psychiatric patient and the future of my brain is at stake. I should be asking a lot more questions of psychiatrists and be more firm in demanding answers.