The sad problem is that a lot of the time the patient's mental condition will actually prevent them from realizing their mental condition. Because when you have a gaping hole in your head, it's easy for even a doctor from a Zoidberg-class medical school to see that it could be a problem. But there is no simple test for mental diseases. A good psychiatrist is worth his/her weight in gold at this point.

I'm a medical underwriter so I'm getting a kick...

But seriously, about 5 out of 10 applications for Individual and Family Health insurance have at least one or more child and/or parent on various anti-depressants. Whether it's an ADD/ADHD drug, or depression and anxiety drugs, schizo/bi-polar, brand name and generic, I see it all day long.

Laws don't permit me to decline parents who put their kids on these mind destroying drugs, but if I could, the next application with a 7 year-old on Adderall would be thrown in the trash. Then publicly shame them, violating HIPAA in the process.

Gyrfalcon: Skr: Anti-psychotics?
[www.sweetslyrics.com image 455x310]
Not necessary.

You sound like someone who never had a command hallucination.

Hey, just because the dogs barking down the street are telling me to kill my neighbors by using rawhides, doesn't mean I'm going to listen to them. Silly dogs may have a point about disposable death implements, but they lack style.

AbbeySomeone: I had to quit reading TFA after that part. I would be surprised if a child with a home chaotic enough to warrant foster wasn't somewhat disruptive.
TFA was horrifying to say the least.

I know someone who adopted a girl with a lot of issues related to a tumultuous childhood/foster care, but this lady makes no attempt to understand and expects the girl to act like a normal teenager. She vented to me so I know all of her side of the details. She tells the girl horrible things like she doesn't love her as much as her biological children(wtf?!) and that she is a biatch, etc.

Anyway, the girl is on a cocktail of meds and one of them is abilify. From what I've seen, it seems like the girl would be doing much better with serious therapy and an understanding family, but they keep trying to diagnose her with schizophrenia, bipolar, etc, instead. And she sure doesn't have the supportive, understanding family.

It's nuts. I don't know why these people decided to adopt. The girl seems pretty smart - she knows exactly what to do and say to completely rile her adoptive parents up.

Skr: Anti-psychotics?
[www.sweetslyrics.com image 455x310]
Not necessary.

Love it.

;)

Badafuco: I'm a medical underwriter so I'm getting a kick...

But seriously, about 5 out of 10 applications for Individual and Family Health insurance have at least one or more child and/or parent on various anti-depressants. Whether it's an ADD/ADHD drug, or depression and anxiety drugs, schizo/bi-polar, brand name and generic, I see it all day long.

Laws don't permit me to decline parents who put their kids on these mind destroying drugs, but if I could, the next application with a 7 year-old on Adderall would be thrown in the trash. Then publicly shame them, violating HIPAA in the process.

Bravo. That is child abuse.

Wow, that article is disturbing. Psychiatric drugs have their place, for sure, but the over-prescribing and misdiagnosing and excessive use in children is bloody scary. And those ads for Abilify kinda bother me because they all talk about how you might need to add it to an antidepressant when it isn't working. I can't help thinking those people might just be on the wrong antidepressant. If nothing is working, then fine. But if the first try isn't working, why not try something else before mixing these cocktails?

I spoke with my doctor about depression and anxiety a few months ago. Thankfully, she didn't just shove a prescription in my face and send me on my way. I've felt mildly depressed my whole life. It's never been severe, but it's always more or less been there. I've always been stressed and I eventually realized it was more anxiety than mere stress. I likely have social anxiety disorder. My doctor suggested I try some nutritional supplements. That's something you don't hear of too often. I'm taking vitamin B5 for anxiety, vitamin B6 because it helps with the production of neurotransmitters, vitamin D, although I can't remember the reason behind that one, and omega-3s for general mental health. She said prescription drugs were an option too but she certainly didn't try to force it on me. I wasn't sure if I wanted to give them a try, mainly because I'm weary of potential side effects. She gave me a prescription for Celexa and said that I could get it filled if I wanted to. I decided to try the vitamins first and they actually have helped. Obviously, they haven't made the underlying problems go away, but I've been somewhat calmer and less miserable, so I'm fairly pleased with the results so far. I've had a little more energy and motivation to try and get my life on track. I think I'm just going to stick with this for now. I probably don't need prescription meds at this point. But then, my symptoms are on the milder side. I imagine this solution wouldn't work so well on somebody with severe depression or anxiety. I just think it would be nice if more doctors would let their patients know about all of the options.


Alonjar: I've had problems with depression in my life.... there were times that I just wanted to take meds so bad, and make it all go away... but I knew that if i started, I could never come off them again. Ive got good friends who seem very normal/happy, and tell me their meds have done them wonders... but I've also seen those same friends on the bad days, where they forgot or couldnt get their meds.... no thanks.

Most people just need to fix whats wrong with their damn lives rather than just letting a pill do all the work. You would be amazed at how simple things like a better diet and regular exercise can completely alter your brain chemistry in a very positive way... or simply saying "I'm doing something counter productive to what my actual goals are in life. I need to make CHANGES."

/But no one ever wants to work to change things... they just want change to happen all by itself.

You raise a good point, but it isn't that simple. My doctor and I talked about how everything effects everything else. Eating healthy can help you feel better, but if you feel like crap to begin with, you're just going to wanna eat like crap. If you're tired and unmotivated it's hard to force yourself to work out, but if you can get out and get some exercise, you're probably going to feel better. When a person is so depressed they can't get out of bed, don't expect them to just eat healthier and get some exercise to make it all go away. She mentioned that some people prefer to try to make the lifestyle changes first while others need some sort of push first, like meds and/or counselling. She also said that prescription drugs aren't a "magic bullet." You still have to do the work. It's just that sometimes they're necessary in order to get into the right mindset to deal with the things that are causing depression in the first place.


Trance750: CSB:

I was maybe in 2cd grade and had my father come to the school for a parent/teacher conference. The teacher said I was 'fidgety' and suggested I be put on ritilan'

My father gave her a real funny look and said 'Lady, if you can't handle a fidgety child, maybe you need to find another line of work'

WIN!!!!

YRThereSchool: I took Effexor for a year to treat what the doc called "generalized anxiety," which I guess is doctor-code for "NO you're not getting any Xanax, now get out of my office."

It did help my anxiety a great deal, but after a year, I was ready to get off the stuff. I'd gone through 10 months of counselling for PTSD and anxiety and I felt I no longer needed the medicine.

Little did I know the HORRORS of withdrawal from Effexor. I know, I know, CSB, but this is just to say: if you're considering starting one of these meds (I know Effexor isn't an anti-psychotic, but still) make sure and ask how easy it is going to be to get off the med.

I went through five weeks of Effexor withdrawal HELL. If I'd known about that, I'd have asked for something different.

Point is: you're in control of what your doctor prescribes. Just say no, kids.

I take generic Effexor. Helps my depression more than my anxiety, and I did know the major risks starting out. (I specifically do not want prior warning about minor side effects if starting a new prescription, because the power of suggestion is, well, powerful.) It works quite well for me, though the first few days on the stuff was hell. If and when I go off of it, yeah, that will be hell, too, but at least I can function now.

Yes, it's easy to say, "change your brain chemistry through diet and exercise," but when you don't have the energy to even think about starting to do that... Well, good luck.

Agreed about the improper prescriptions for anti-psychotics, though. Yikes. oO

as a psych nurse working inpatient, i can say that these medications are prescribed "clinically incorrectly" everyday as stated in the article.

I've been on various anti-psychotics and antidepressants for my bipolar for the past 10 years or so, and I wouldn't wish it on anyone who didn't absolutely need it. It's great when it works (and finding the right combination is a lot of trial-and-error), but the side effects are nightmarish.

Fun examples include rapid weight gain (50+ lb in 3 months), complete loss of short-term memory and inability to remember words, and being so completely dizzy and disoriented that I was unable to get out of bed for days without falling over my own feet.

Yeah, it sucks, but being crazy sucks worse. I tried diet and exercise, tried vitamins, did therapy, and even spent several years asking Jesus to fix my brain. In the end, I have a chemical imbalance, and the pills seem to help regulate it.

I'm lucky to be under the care of a board-certified psychiatrist who did a full eval and keeps a close eye on everything when I visit once a month, but even then it's trying at best. I don't even want to think about going on this stuff with a family doctor for something that wasn't the absolutely best option.

Julie Cochrane: If you or a loved one is having problems with mental illness, you should not go to your pediatrician or family doctor. You should go to a board certified psychiatrist. If the patient is a child, you should go to a board certified pediatric psychiatrist. You should go to one of these highly qualified specialists to be initially examined and diagnosed even if you have to drive/travel to get to one.

I'm not sure how it works elsewhere, but I live in Canada and I don't think you can just call up a psychiatrist and make an appointment here. (If I'm wrong about that, feel free to correct me.) To my knowledge, you need a referral from another physician if you have to see any sort of specialist.


Cappalotti: I went to the doctor yesterday with severe stomach pain. After a few minutes of Q&A, he determined that I am suffering from stress/anxiety/depression. (simple stress maybe but the rest he pulled out of his ass.)
He gave me a month's worth sample pack of vilazodone, a new flavor-of-the-month drug a doctor buddy of his told him about. I told him that I did not want it and that doctors tried this pill-pushing crap with me before. (Effexor being the worst.) He said, "Just try it out. It can't hurt. If you don't like it after a couple of weeks, just stop taking it."
Idiot! That is the worst advice to give someone regarding antidepressants. I wanted to tell him, "I can think of something else you could give me to relieve some stress!"
I went back this morning to another doctor for a second opinion. After I told her what the first doc said, she referred me to a gastroenterologist but then gave me a prescription for both Prozac and Valium. Un-farking-real!

My mom has taken Paxil for anxiety in the past, as well as Nexium for acid reflux. (Not at the same time, I don't think.) She recently went back on Paxil for the second time. She went to the doctor complaining about stomach problems. She told her that anxiety can sometimes cause stomach problems, but on the other hand, if you really have stomach problems, it can make you anxious. Now that being said, you're doctors sound like morons.

*your

/apparently I'm a moron

Trance750: macadamnut: If you see a TV commercial for a drug whose side effects include "may cause suicidal thoughts" and then go to a doctor and ask to be prescribed this drug, you should kill yourself.

I've often wondered why an anti-depressant may increase suicidal thoughts. Is that what the pill is designed to counter?

The "suicidal thoughts" thing is well-documented to primarily affect teenagers. Not being snarky there either; it's just that the freaktacular hormones from puberty haven't finished tapering off yet. And combined with the fact that teenagers haven't learned to objectively analyze their own current mood, comparing against current stimuli. ("I'm feeling shiatty. Have I eaten a balanced meal in the last six hours? No? Could this just be low blood sugar? Or maybe the psychoactive medication I took this morning? Hmmmm.") The first makes it likely to have weird mood swings; the second makes it more likely that the little darlings will actually act on them. It's a good reason to only prescribe them to adults except in the really serious cases.

Also... I see a lot of horror stories, both in this thread and Out There in general, along the lines of "Me-or-some-random-friend-relative-guy-I-know took <fill in the name of antidepressant> and then decided to stop taking it, so I flushed them down the toilet / set them on fire / fed them to the cat / etc, and GOD I NEARLY DIED FROM WITHDRAWAL SO THIS DRUG IS BAD AND NOBODY SHOULD EVER TAKE IT."

You know, there's a reason why -- if you had spoken to your goddamned doctor first -- the trained medical professional has you taking slowly reduced dosages over a period of several weeks when it's time to stop. The things you've been taking change how the chemistry of your farking brain works! Suddenly altering the balance to deprive it of a neurochemical that it's accustomed to is just as upsetting and dangerous as introducing that much of a new chemical all at once would have been!

Serotonin reuptake inhibitors ain't like multivitamins, folks. Talk to your doctor before you stop taking them. Spread the good word.

burncheese: My mom has taken Paxil for anxiety in the past, as well as Nexium for acid reflux. (Not at the same time, I don't think.) She recently went back on Paxil for the second time. She went to the doctor complaining about stomach problems. She told her that anxiety can sometimes cause stomach problems, but on the other hand, if you really have stomach problems, it can make you anxious. Now that being said, you're doctors sound like morons.

Actually all SSRI's and many psych meds can cause intestinal/stomach problems. For paxil this is a >5% incidence. This is because there are more neurons with serotonin receptors in your gut than in your brain. That said, sometime SSRI's can actually cure intestinal problems and are used for IBS and the like. So the process can be a lot more complex than what was explained to your mother and is quite maddening to figure out what is causing what; what is possibly a drug reaction, etc.

burncheese: My mom has taken Paxil for anxiety in the past, as well as Nexium for acid reflux. (Not at the same time, I don't think.) She recently went back on Paxil for the second time. She went to the doctor complaining about stomach problems. She told her that anxiety can sometimes cause stomach problems, but on the other hand, if you really have stomach problems, it can make you anxious.



Forgot to add in some trivia, you actually have as many neurons in your gut as a cat does in its brain. So you either think of it as your gut being smart or cats being retarded.

Cappalotti: I went to the doctor yesterday with severe stomach pain. After a few minutes of Q&A, he determined that I am suffering from stress/anxiety/depression. (simple stress maybe but the rest he pulled out of his ass.)
He gave me a month's worth sample pack of vilazodone, a new flavor-of-the-month drug a doctor buddy of his told him about. I told him that I did not want it and that doctors tried this pill-pushing crap with me before. (Effexor being the worst.) He said, "Just try it out. It can't hurt. If you don't like it after a couple of weeks, just stop taking it."
Idiot! That is the worst advice to give someone regarding antidepressants. I wanted to tell him, "I can think of something else you could give me to relieve some stress!"
I went back this morning to another doctor for a second opinion. After I told her what the first doc said, she referred me to a gastroenterologist but then gave me a prescription for both Prozac and Valium. Un-farking-real!

Your story is actually quite worrisome in my opinion.

If your fam prac referred you to psych, we'd probably refer you right back to the fam prac/IM to actually investigate your abdominal complaints, and if he refused to do a workup, we'd probably order it. Somatization, IBS, etc, are diagnoses of exclusion. When you rule out organic illness, you can then begin presumptive treatment for psychosomatic pain. If you are having severe abdominal pain, depending on where it's located, you should probably be ultrasounded, CTed, or scoped prior to considering a psychiatric cause. As far as increased stress/anxiety goes, the literature seems to indicate it increases the likelihood of several disease states acting up, so the presence of anxiety/new stressor is hardly enough to exclude other causes of abdominal pain.

And even if you did have somatic pain, a TCA is likely to yield superior analgesia relative to an SSRI, so I really have no idea what those clowns are doing. Are you sure you're not leaving something out? If not, whenever you see the GI doc, I'd omit the part where your GP told you it was psychosomatic. I've noticed a lot of somatic doctors tend to narrow their differential to "crazy person" whenever a person brings up a psychiatric history, condition, or suspicion.

I'm not going to tell you what to do, since I don't want to assume medical liability, and no one is really qualified to offer medical advice over the internet, but you really should have your abdominal pain worked up, especially if this is a new thing for you.

I take zyprexa(zydis). It was prescribed to me because I was harming myself and thinking about suicide. Had a lot of anger issues and couldn't cope with being a different person than I wanted to be. Main side effect is considerable weight gain. Despite that my life went from a living hell to almost perfectly fine in a matter of days after many months of suffering. It should be noted that I take the lowest dosage though, 2.5 mg a day. When I tried taking 5 at first it made me want to sleep 12-15 hours a day every day which is 50% more than normal.

namegoeshere: Mark E. Helm, a Little Rock pediatrician who was a medical director of Arkansas's Medicaid evidence-based prescription drug program from 2004 to 2010, said he had seen 18-month-olds being given potent antipsychotic drugs for bipolar disorder, an illness he said rarely develops before adolescence. Antipsychotics, which he characterized as the fastest-growing and most expensive class of drugs covered by the state's Medicaid program, were typically prescribed to children to control disruptive behavior, which often stemmed from their impoverished, chaotic or dysfunctional families, Helm said. "Sedation is the key reason these meds get used," he observed.


Helm said that antipsychotics, which he believes have become more socially acceptable, serve another purpose: as a gateway to mental health services. "To get a child qualified for SSI disability, it is helpful to have a child on a medicine," he said, referring to the federal program that assists families of children who are disabled by illness.

THIS right here is the most horrifying part of all of this. Especially when children enter the foster care system and have no one to advocate for them. They display behavior completely normal for a child yanked from a chaotic environment and tossed in with strangers. They are misdiagnosed and drugged. Diagnosed kids mean more money, and drugged kids are easier to manage. However, children on hardcore antipsychotis who do not absolutely need them to function will NEVER develop normally. And once they have hopped on the medication roller coaster, good luck ever getting them off of it.

So you have just farked up a child for life because it is more convenient for the adults. Or more profitable.

So do you blame the drugs, the doctors, or the system? Remember it takes a village...

Were church-run orphanages such a bad thing?

Haven't read all the replies, but will share my not-CSS:

I have a son with ADHD, and it used to be pretty bad. The school insisted that I seek "treatment" for him, mainly by sending him home from school every time he started acting up (used to be about 3-4 times a week). I took him to a board-certified PEDIATRIC psychiatrist, who prescribed him Abilify (at night to help him sleep) and Focalin (during the day). He was six and in kindergarten. At first, his behavior improved. Then he began to have problems with severe VIOLENT behavior (which had never been a problem before) - beating up classmates, bullying, etc. He would be fine one moment and then just fly into a violent rage. So we went back to his psychiatrist. His psychiatrist upped his dosage of the Focalin. He did better for a little while, and then after about a week or so, he started getting more violent and talking about suicide. Went back to the psychiatrist, who upped his dose of Focalin AND his dose of Abilify. Less than a week later, he tried to kill himself by jumping headfirst from the top of the tree (about 20 feet). He was okay, but he had to be hospitalized in the psych unit (I think he was 7 by this point). While hospitalized, his psychiatrist upped his Focalin & his Abilify and added Klonopin to the mix at night. Then he seemed to behave okay (like a zombie!) but he started having obsessive-compulsive tics. He developed facial tics and started doing things like lining up toothbrushes in the bathroom based on color or size. Then he started plucking his eyelashes out.

I tried taking him off his meds, re-configuring them, etc., while working with a new doctor to wean him off. The school started calling daily. They said, "Did he forget to take his medicine today? He's really having trouble concentrating." I told them he was on a new regimen with a new doctor. They said, "Well you're going to need to take him home until he gets re-adjusted to his meds because we can't handle him being so hyper right now." They literally told me to keep him home for two weeks so that he could adjust to being without the meds that were making him crazy.

So I said screw this and we began homeschooling. He's been medication-free for almost 2 years now and he's two grade levels above his age range in his schoolwork, probably because I let him actually wiggle, stand, walk, and move around while he works. His eyelashes have grown back, he hasn't had a violent outburst in YEARS, and he acts like a normal 8-year-old boy.

Peh. Benadryl and Colt 45 work just fine for me.

MemeSlave: Were church-run orphanages such a bad thing?

Yes.

Doctors prescribing anti-psychotics like candy?

And yet these are probably the *same* doctors that will let someone linger with a bad cough and sinus infection for 2-3 weeks because "it *might* be a virus."

/rage

The 4chan Psychiatrist:
Your story is actually quite worrisome in my opinion.

If your fam prac referred you to psych, we'd probably refer you right back to the fam prac/IM to actually investigate your abdominal complaints, and if he refused to do a workup, we'd probably order it. Somatization, IBS, etc, are diagnoses of exclusion. When you rule out organic illness, you can then begin presumptive treatment for psychosomatic pain. If you are having severe abdominal pain, depending on where it's located, you should probably be ultrasounded, CTed, or scoped prior to considering a psychiatric cause. As far as increased stress/anxiety goes, the literature seems to indicate it increases the likelihood of several disease states acting up, so the presence of anxiety/new stressor is hardly enough to exclude other causes of abdominal pain.

And even if you did have somatic pain, a TCA is likely to yield superior analgesia relative to an SSRI, so I really have no idea what those clowns are doing. Are you sure you're not leaving something out? If not, whenever you see the GI doc, I'd omit the part where your GP told you it was psychosomatic. I've noticed a lot of somatic doctors tend to narrow their differential to "crazy person" whenever a person brings up a psychiatric history, condition, or suspicion.

I'm not going to tell you what to do, since I don't want to assume medical liability, and no one is really qualified to offer medical advice over the internet, but you really should have your abdominal pain worked up, especially if this is a new thing for you.

Thanks for the advice.

The first time I went to the GI doc (last Oct.), he poked my belly twice then sent me away with Prilosec. It helped a little bit but then the symptoms started flaring up again. When I saw the doctor yesterday, he immediately focused on the "anxiety/depression" angle and decided to give out the SSRI.

When I saw the second doc this morning, she agreed that I need to see the GI again but this time made sure to order the endoscopy. I was just amazed that she thought it was also a good idea to give me yet another SSRI along with diazepam.

I know some of those drugs can be helpful to those that truly need them, but when I go in with terrible stomach pain and heartburn lasting several months, I would rather have the tests taken to find out the actual cause than to just be given psycho drugs right off the bat.

The medical system is a huge mess.

Felgraf: Turns out: Veeerrrry ADHD. Although I'm not sure the form I have is so much a disability as it is just a different neurological wiring. I think I take the 'hunter in a farmer's world' approach, as that's how it tends to manifest for me: It's not that I can't pay attention or I'm off daydreaming, it's that I can't tune out external stimuli. Which, while making me more aware of my environment...
... Is not really helpful when you're in a classroom. (Though I also suspect it's a spectrum 'disorder'.)

Had both ADD and ADHD, undiagnosed but the problems and benefits have been obvious throughout my life; it even shows up strongly on both sides of my family, some of whom used it to succeed and others who drank themselves into a stupor. I wish I knew how I have managed to calm it down over the years, but exercise definitely helps and maybe diet does too. Physical AND mental exercise is important. The drinking helps too, just like it helped my dad, but his example is definitely not how I want to spend my life.

/ADD is a tool, like any other.
//Days like last Thursday just remind me of where I came from and why I drink.

Personally, I believe that with such a large percentage of the population dependent on psychoactive pharmaceuticals, a true "zombie apocalypse" will occur if or when any civil emergency becomes so great as to break down the systems of distribution upon which we rely.

The "Brain zaps" of withdrawal will then make much of the population completely insane and out of control.

When I was a little kid, and thye were trying to figure out what was wrong with me, and how to deal with it, they tried all sorts of drugs. they gave me mellaril one time which made me sleep for 3 days straight. for (what is now known as) ADHD,
they tried ritalin, tofranil, and stelazine. then we sought another opinion. that doctor tried synthyroid, which took care of the underlying issue- not enough
thyroid production. after that I did fine. But they wonder why I tried weed, and
all the other illegal drugs. because they tried drugs on me, why not try a few on my own. these days weed is the only one I like, and mostly when I don't feel good.
all the antidepressant and antipsychotic meds kinda scare me- have friends who
are taking them, and don't like how it changes their personalities. If I get depressed, it's time to go outside and ski, or take a hike, or bike ride, or go
fishing, or go do something fun. I'm way too busy to dwell on depressing thoughts
in a dark room. we got by without antidepressants and antipsychotics all
this time, I see no reason to try 'em now. Crazy tho I might be....

Minerva8918: Unlike what some people may believe, not all bipolar people are crazy, manic one second and then depressed the next.

Nearly everyone confuses bipolar with "crazy ex syndrome," which is usually a combination of histrionic, borderline, and narcissistic disorders, nothing to do with bipolar at all. I have no idea how that came to be, but it mainly seems to come from movies.

Movie writers are generally idiots and assholes.

namatad: awesomeness!!! I hate when people with this problem dont want to be ADDICTED to their meds. LOL. WHO CARES.
Can you function now? the NEEDING the med isnt a problem!!!

Yeah, seriously. Speaking from experience, though, stubbornness and distrust is a classic symptom is nearly every mental disorder, since everyone around you is different and can't understand.

Julie Cochrane: Bipolar disorder, like a number of other mental health problems, is heavily genetically influenced. In children, it can be extremely difficult to tell the difference between bipolar disorder and ADHD. The biggest concern there is if you give the kid Ritalin or Adderall and the kid has the genes for bipolar, you can trigger off the kid's first full-blown manic episode and make the kid much worse than he was before you drugged him.

Oh god I was given zoloft when I was 14 for severe clinical depression. Within a week I had my first manic episode but also within a few days of taking the zoloft I had started to see bugs that didn't exist. fark zoloft that shiat made me crazy,so does alot of meds I've found out.

foxyshadis: Nearly everyone confuses bipolar with "crazy ex syndrome," which is usually a combination of histrionic, borderline, and narcissistic disorders, nothing to do with bipolar at all. I have no idea how that came to be, but it mainly seems to come from movies.

Probably because the general public knows very little about personality disorders. People have heard about (though don't necessarily understand) all the biggies - bipolar disorder, schizophrenia, depression, anxiety, OCD, ADD/ADHD, etc. PDs are a little more obscure. I can see why people, with their often limited knowledge, would confuse things.

burncheese: I'm not sure how it works elsewhere, but I live in Canada and I don't think you can just call up a psychiatrist and make an appointment here. (If I'm wrong about that, feel free to correct me.) To my knowledge, you need a referral from another physician if you have to see any sort of specialist.

Only if you want the state to pay for it. If you have the money, you can feel free to call around until you find a shrink accepting new cash patients... shouldn't take long, really, most docs prefer cash to insurance. But if stress over money is part of what is driving you to one, that obviously isn't an option.

I don't understand the strange concern we have in our society about several things. One is our obsession with sleep. What happened before we had Ambien, Xanax, Ativan etc? I guess folks took a shot of booze or just suffered, or did we actually work for a living or what?

The second is our obsession about suicide...if some asshat wants to suck a 45, let them; don't dope them

burncheese: I'm not sure how it works elsewhere, but I live in Canada and I don't think you can just call up a psychiatrist and make an appointment here. (If I'm wrong about that, feel free to correct me.) To my knowledge, you need a referral from another physician if you have to see any sort of specialist.

You really need to get that referral if the physician is trying to put you on any kind of psychiatric drug. That's just my opinion, but the reason I hold that opinion is because psychiatrists have a lot more training in the side effects and interactions and details of specific psychiatric medicines, and all the things that can look like one malady but really be something else--they have a lot of in-depth training with regard to prescribing those very strong medicines that general doctors or doctors in other specialties just do not have.

I know that in a national managed care system things can be different there from how they are here, but the fundamental issue remains that these are strong medicines with potentially serious side effects and you don't want someone only half-trained mucking about prescribing them for you.

Alonjar: I've had problems with depression in my life.... there were times that I just wanted to take meds so bad, and make it all go away... but I knew that if i started, I could never come off them again. Ive got good friends who seem very normal/happy, and tell me their meds have done them wonders... but I've also seen those same friends on the bad days, where they forgot or couldnt get their meds.... no thanks.

Most people just need to fix whats wrong with their damn lives rather than just letting a pill do all the work. You would be amazed at how simple things like a better diet and regular exercise can completely alter your brain chemistry in a very positive way... or simply saying "I'm doing something counter productive to what my actual goals are in life. I need to make CHANGES."

/But no one ever wants to work to change things... they just want change to happen all by itself.

That's because some people are at a higher level of depression than you and actually need those meds instead of diet and exercise.

/I really, really hate people who say 'oh, I was just fiiiine when I did X! Even if your condition is ten times as severe, why can't you just do X, you lazy slob? Everything would be perfect if you did!'.
//It really does not help anything and it makes you an asshole.
///I'm glad you're okay, though, and that you didn't need medication.

The only drug anyone really needs is Datura.
stop saying it sucks
it's actually the best drug in existence (next to secks)!!!

The_Homeless_Guy: burncheese: My mom has taken Paxil for anxiety in the past, as well as Nexium for acid reflux. (Not at the same time, I don't think.) She recently went back on Paxil for the second time. She went to the doctor complaining about stomach problems. She told her that anxiety can sometimes cause stomach problems, but on the other hand, if you really have stomach problems, it can make you anxious. Now that being said, you're doctors sound like morons.

Actually all SSRI's and many psych meds can cause intestinal/stomach problems. For paxil this is a >5% incidence. This is because there are more neurons with serotonin receptors in your gut than in your brain. That said, sometime SSRI's can actually cure intestinal problems and are used for IBS and the like. So the process can be a lot more complex than what was explained to your mother and is quite maddening to figure out what is causing what; what is possibly a drug reaction, etc.

Interesting.


Julie Cochrane: burncheese: I'm not sure how it works elsewhere, but I live in Canada and I don't think you can just call up a psychiatrist and make an appointment here. (If I'm wrong about that, feel free to correct me.) To my knowledge, you need a referral from another physician if you have to see any sort of specialist.

You really need to get that referral if the physician is trying to put you on any kind of psychiatric drug. That's just my opinion, but the reason I hold that opinion is because psychiatrists have a lot more training in the side effects and interactions and details of specific psychiatric medicines, and all the things that can look like one malady but really be something else--they have a lot of in-depth training with regard to prescribing those very strong medicines that general doctors or doctors in other specialties just do not have.

I know that in a national managed care system things can be different there from how they are here, but the fundamental issue remains that these are strong medicines with potentially serious side effects and you don't want someone only half-trained mucking about prescribing them for you.

I don't think every case of mild depression really warrants a visit with a psychiatrist. From what I understand, they tend to be very busy and it can take a while to get in to see one. So, if the family doc is capable of dealing with certain cases, that's probably a good thing. The trouble is, they seem to try to do too much sometimes. They take on more than they really are capable of. Maybe some of them don't realize they're beyond their limits. Maybe others just won't admit it. I agree that some of these drugs are very powerful and should not be prescribed by just anyone. If a patient is truly experiencing psychotic episodes, I can't imagine why any GP would try to handle that on their own, but it probably happens. Ideally, the GP should be able to point someone in the right direction though.


shortymac: The biggest problem with mental health is that most people go to their GP and get prescribed anti-depressants, but without no follow-up with a psych. If you had a heart condition, your GP would prescribe you some meds but then you'd have a follow-up with a cardiologist.

As I already said, I think it depends on the situation. If it's a simple case the GP can take care of, there still should be follow up, even if not with a psychiatrist.

shortymac: Why don't we do this with mental health? I work at a mental health hospital and this is one of the biggest concerns we have. Drug therapy is a powerful tool BUT is only one part of the solution. Learn coping skills, diet, exercise, and cognitive behavioral therapy are also needed for complete wellness.

Probably because there just aren't enough psychiatrists to see every person with mild anxiety or depression. But, there are still psychologists/psychotherapists too. If the psychiatrists are all too busy/lazy to sit down and talk and get to root of the problem, and would rather just hand someone a prescription and send them away, at least somebody else can step in. Plus, some people don't want or need the drugs anyway.

burncheese: I don't think every case of mild depression really warrants a visit with a psychiatrist. From what I understand, they tend to be very busy and it can take a while to get in to see one. So, if the family doc is capable of dealing with certain cases, that's probably a good thing. The trouble is, they seem to try to do too much sometimes. They take on more than they really are capable of. Maybe some of them don't realize they're beyond their limits. Maybe others just won't admit it. I agree that some of these drugs are very powerful and should not be prescribed by just anyone. If a patient is truly experiencing psychotic episodes, I can't imagine why any GP would try to handle that on their own, but it probably happens. Ideally, the GP should be able to point someone in the right direction though.

The real problem is when the GP thinks he's just looking at a case of mild depression but because of his lack of experience doesn't catch the warning signs that he may be looking at a case of bipolar type 2 or a case of bipolar type 1 where the patient never came to the doctor when manic.

Or, there's another lovely little wrinkle of weird and rare (I guess rare) "new" bipolar subtype where SSRIs make the patient psychotic (knew someone this happened to).

The problem is not when the GP is dealing with a mild case of depression, it's when the GP thinks he's dealing with a mild case of depression--and it turns out to be something else.

Unfortunately, there are no easy answers. And it's nobody's fault that there are no easy answers.

As we do a better and better job of getting people diagnosed properly, we'll have better and better patient family histories, which will really be an aid to doctors in making their preliminary diagnosis.

Like I said:

Be afraid.

Be very, very afraid.

;)