My following comments will probably anger some people, but if they do, then so be it. The medical profession today is increasingly being manipulated by the pharmaceutical industry. The influence is across the board, but today I want to focus on psychiatry after reading an article in the NYTimes. In this article, it talks about the increasing amount of psychiatrists who have moved away from talk therapy to prescribing pills for problems. It is proven that talk therapy is more effective than any of the pills people can take, but insurance is not willing to pay psychiatrists to talk anymore, just to pull out a pad and write a scrip for meds. I will personally not get into the efficacy of meds themselves, I will only state what the article has stated that talk therapy is more effective. This is not a new trend, however it is a sad turn of events when psychiatrists, who were once trained to spend 45 minutes to an hour with patients now average about 15 minutes. The article even cites one psychiatrist as cutting a patient off when she wanted to talk about her issues. There has been concern amongst psychiatrists for years now over the increasing influence of the pharmaceutical industry and their medications. There have been some medications that have assisted in the field, but overall, there has been too heavy a reliance on them. It seems like the insurance industry has caught on (or been influenced) and is now exerting control over the doctors' way of practicing. You could call these thoughts a conspiracy theory or reaching, but do a little research yourself. Follow the links and spend some time investigating what is actually going on.
How does this affect us. Well, according to a comment on another post, "people in this country are, for the most part, apathetic and lazy." This is a part of the problem. People would much rather spend 15 minutes with a doctor to get a prescription than 45 minutes to talk and figure out where the problem stems from and what they can do to correct it. So can all the blame be placed entirely with the insurance comapanies, pharmaceutical industry, and doctors? (I would like to say yes) But no, a good part of the problem lies with the patients that they deal with. This boils down to the age old problem, which came first, the chicken or the egg. Did insurance companies and the pharmaceutical industry start pushing doctors to prescribe more instead of talking turning patients into what they are today or did patients strive for more medications thus leading insurance companies and the pharmaceutical industry to push more pills on doctors? I tend to to lean towards the first option, but I am probably in the minority. People can say whatever they want - pills really help people get over their problems, they make life more manageable, they are sciences great contribution over the last 20 years. My opinion, its all bolox. People have relinquished their control over their own habits. Granted, for some psychiatric patients, medication MAY be necessary depending on your point of view, but for the majority of people, they are an easy way out. Rather than spend the time working with someone to figure out what the root problem is, most people opt for the pill to make life easy. Personally, I would never entertain letting any of these medications enter my body. Just look at the "possible" side effects of most of these prescriptions. For some people, they will do more harm than good, and you can never know who it will affect adversely.
So how is the medical profession as a whole going to change? They aren't unless people take a step up themselves and realize what is going on. A majority of people probably don't care and that is unfortunate. The most unfortunate part about it is that they will never know, because they choose to not to be aware of what is actually going on around them. There are many factors that come into play that most people are blind to, not because the information is not available, but because they choose not to look for it. The research is there to examine but there are so few people who will take the time to search it out. Rather, they will sit in front of the TV watching mindnumbing shows and lead their lives according to what others dictate. Harsh? Yes, but look around you and tell me if I am wrong. Once people start changing, the world will start changing and not a minute before. Ben Harper is wrong. We can not "wait on the world to change," we must be the change we want to see happen. Until we galvanize ourselves and realize that, the world will continue on as is, ad infinitum. So after reading this somewhat depressing ramble, do yourself a favor, (I am going to do the same), close your computer, go outside, and take a deep breath. The air is fresh, the sun is shining, and we all have another day to live and make a difference.
Alex…good topic…I am one of those who has been helped by psychiatric medications. (First I want to note that within my family…on mothers and fathers side…many have depression, anxiety, bi-polar and unfortunately, a number of suicides…so, can these tendencies possibly be in the genes or maybe a way of life handed down through the generations?) When my world collapsed a few years ago due to bad choices in life, I was diagnosed with acute depression and extreme anxiety…and yes, I contemplated suicide. I know how the darkness and overwhelming fear of anxiety feels. With the help of medications, intense “talking” therapy, and working very hard to change my thinking and habits…I have come out of the shadows and leading a wonderful life today. I know that medications did help……It took a very long time to find the medications that worked for me….but I actually could feel how they affected my depression, anxiety and “thinking”. Some were good, some were bad (even making me more suicidal) – Doctors say medications affect each person differently. I am aware of the side effects, but for me the depression and anxiety are more detrimental to my health and well-being. Today I am still in “talking” therapy to keep on top of my depression so I don’t regress, but mostly to continue working to change my life for the better. I respect my therapist….she has helped me immensely and cares about me. From experience, I agree that the pharmaceutical industry pushes doctors to prescribe the latest and greatest drugs to their patients. My psychiatrist (the 15 minute one) told me this himself. I am currently weaning off my medications….but will continue with them if I start sliding into that nasty dark hole. Alex, keep the blogs coming….they are very interesting. MF
ReplyDeleteI completely agree. This country is def over medicated. Granted there are some people that would benefit from or need to be medicated but the majority of people just use it to the mask their real issues. This is also one of the main reasons for prescription drug addiction in the US, it is way to easy to access. I went to my doctor a few years ago complaining about insomnia not only did he prescribe me sleeping pills but also threw in some antidepressants. This took all of ten minutes or so. For those of you that know me I am far from depressed and was quite amused at his diagnosis. Needless to say that I do not go to him anymore
ReplyDeleteGood post Alex. I agree with your opinion. Going along with talk therapy I wish people would address the "soul" piece of who we are. Medication is life saving in many cases but a band-aid in many cases as well. Dealing on a deeper spiritual level with depression and anxiety is extremely important. Our kids are learning a terrible lesson - quick fix rather than work hard. Family history has taught me this wisdom. Thank you Alex.
ReplyDeleteI believe that a big part of the problem is that everyone is looking for the quick fix. They don't want to sit in an office and talk about their life for hours. They would instead rather have a medication prescribed which just covers up the symptoms.
ReplyDeleteAs far as the insurance issue goes, I think that part of the reason insurance companies don't want to pay for talk therapy with an MD psychiatrist is because these days you can get the same thing from a clinical psychologist (without the prescription powers) for a lower price which appeals to insurance companies for obvious reasons. These individuals can often talk you through your problems and for the more basic issues (depression and anxiety for example) can have a cooperating nurse practitioner or doctor write the prescription.
Where I tend to deviate from your opinion is when you seem to lean towards the opinion that talk therapy does the same thing as medications, and that medications are never necessary. In talking to effective therapists, most of them seem to try and talk you through issues first and then, if necessary, resort to medications. This is the proper course of action. There are certain psychiatric issues that are more than just mental issues. Some of them become an actual physical ailment. Here are three examples:
1)PTSD. When an individual suffers an emotional trauma, such as a sexual assault or battle experiences, their brains learn to handle it by actually rewiring themselves in order to cope. There are some actualy physiological changes that take place including altered breathing patterns where the individual begins to breathe more shallowly and more rapidly. Medications are not necessarily the first option, but sometimes they need to be considered as an option, they work the same as depression so I will only type that once below. But in addition to medications, there are other options. There is an evolving therapy now called EMDR which through eye movements and other exercises, the brain is actually reprogrammed, but this does not solve everything. An effective therapist will consider meds (sometimes including a referral to a psychiatrist), but often only as a last resort.
2)Depression. Depression is an actual physical ailment. Though brought on by some sort of emotional trauma like with PTSD, it similarly results in physical changes, just usually manifesting with more mild symptoms than PTSD. The brain is an electrical system, and signals are transmitted through nerves. There is a gap between every nerve, and a neurotransmitter is required to carry the message across the gap. Serotonin is the neurotransmitter which carries happy thoughts (at the most basic level). When a person is clinically depressed, the nerves do not effectively reuse the serotonin resulting in a decreased level of serotonin usage which in turn results in depressed feelings.
ReplyDeleteEnter SSRI's. Selective Serotonin Reuptake Inhibitors. These allow the brain to bring serotonin levels back to a normal level.
When someone is clinically depressed to the point that SSRI's are indicated, they bring about two results. Both require continued therapy to deal with the deeper issues. In one scenario, the SSRI's quickly jumpstart the brain, and are not necessary for more than a few months. Similar to a normal car battery. They get the system going, then it continues to move on its own. On the other hand, you have the case, similar to hybrid cars, where the SSRI's (the battery) is necessary long term in order to help the brain function at optimal efficiency.
3)Bi-polar. This is a clinical condition that requires treatment for the rest of an individual's life. in order to control the manic highs, and depressive lows, so that an individual can function normally, it is necessary to get treatment for the rest of their life. Even after years of treatment (combination of therapy and medication), if one were to stop the treatment, they go back to the manic highs and depressive lows making it difficult for them to function and maintain a normal life. Hopefully they can find an absolute cure at some point, but genetics is only beginning to evolve.
The point of this is not to counteract what you have said because I agree with you for the most part, but instead I only seek to point out that there are instances in which 'talk therapy' doesn't do the whole job.
I agree Pete, meds are necessary for some cases (and I did mention this in the first paragraph). Your insights are great. There needs to be more done to research into alternative ways (as you said) to re-wire the brain after traumatic events. As you also said, a lot of it has to do with nerves. Ever hear of chiropractic? I know you have, but it deals with aligning your body so that it can heal itself. Thats a whole other blog post waiting to happen...
ReplyDeleteI agree. I feel like the whole side of holistic interventions that involve methods which don't involve injecting or ingesting synthetic chemicals into our bodies should be researched more.
ReplyDelete