"I was reminded of the incident last week when news reports emerged that Eli Lilly had reportedly urged primary care doctors to use the drug for elderly patients with symptoms of dementia. The company has denied promoting the drug for off-label uses.
The reports highlighted for me the crucial role that internists and other primary care doctors play in screening for psychiatric illnesses but also in knowing when to refer these patients for proper treatment. Although psychiatrists are not always available and not all patients are willing to see them, doctors must carve out our areas of expertise in keeping with our training and experience, and depression and psychosis are simply not my areas as an internist.
I tell [patients] that this cost-benefit decision [of prescribing medicines] should be made in conjunction with the patient's psychiatrist, not solely by an internist placed under pressure by a salesperson."
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Furious Seasons also linked to this NYT article. The story is astounding in the picture it paints about discrimination in the workplace against diabetics. If this is a physical illness, how much more so would discrimination be with a mental illness?
After countless absences (sick days) and a 1.5 month medical leave, I finally came clean to my boss about my initial major depressive disorder diagnosis. Considering that I work at a company involved with medicine — one of the fields is psychiatry — I hoped that she'd be somewhat understanding. I was afraid that she wouldn't; she'd been somewhat of a — um, how do I put this nicely — rude and insensitive boss in the past. So this took a lot of courage and prayer on my part to do. Praise God that a light bulb kind of came on in her head and once I returned to work again, she considered it a fresh start and put the past behind us. Now she treats me like her best employee. (Which I'm not, but hey, I'll take what I can get after her previous attitude.) Not saying that this favorable situation will happen for everyone who comes clean to his or her boss about mental illness but if a person is promptly fired after disclosing such a problem, it's possible to sue the company and obtain restitution. At least in the state of Pennsylvania, I was told that I could at least collect unemplyment. It's likely that if this job was my only source of income (my husband brings home the bacon), I wouldn't have disclosed anything for fear it would be too risky. A person needs to gauge his or her individual situation and the risks.
Okay, I'm on a Furious Seasons trip, apparently. Hey – I did it with Spikol! Blogger Philip Dawdy wrote an article, "Psyched Out" back in 2004 for the Seattle Weekly that covers the stigma mentally ill people face when trying to re-adapt to the "real" world. The story of Rodney Plamondon really touches me because of seeing first-hand what schizophrenia can do to a person. Excerpts worth noting:
"Often you get kicked right out of the mainstream, no matter how solid a citizen you were before it all went bad.
What are you going to do about that?
You have three choices: kill yourself, lead a featureless existence, or fight back and extract some measure of revenge on that which laid you low. Rodney and I rejected options one and two. Option three is no cakewalk. It takes years of determined effort before you see light at the end of the tunnel, and as you feel your way along, you've got to do it all on blind faith that something good might happen. After 15 years, I'm finally beginning to see a faint glow.
"Meds often leave the human being behind.
That complicates an already complicated situation for someone like Rodney. …
They've fallen. They won't ever get up. Tilt. Game over. Families disown them. Lovers leave them. Employers fire them. Friends peel away. We demand that they get jacked up on meds and leave, to handle the detritus of their lives. They get worse, they stabilize, they get worse all over again.
"I'd go home in the afternoon and plunge into bed and sleep four hours… Later, I'd awaken for a few hours, read, eat, and go back to bed. In the morning, the school kids would tease me about my shaking hands. They insisted that I'd been drinking the night before. I didn't dare tell them about the lithium that caused the trembling. Nor did I tell colleagues. It was 1993, and being public about mental illness with an employer was a ticket to unemployment."
It's sad that being an alcoholic is more socially acceptable and more likely to keep a person employed than a mental illness. Some people say that substance abuse is a mental illness, but it's not. Illnesses are like a disease or a condition, if you will; they are a lifelong condition that must be dealt with me. Substance abuse can be stopped or "cured" with treatment. Forever. Mental illness is NOT like that. Anybody who "stops suffering from mental illness" has either experienced a miracle or is still suffering from a mental illness — delusion and hallucinations. Mental illness has no cure.