Psychiatry Exposed

[Minimalist]

there is indeed a link between suicide and antidepressants

Of course. Antidepressants are prescribed for people who are depressed to begin with. You can't save the whole world, boss. But that doesn't mean you sit there doing nothing, either.

[Jackalope]

The calculated risk for suicide among depressed patients who were treated with antidepressants was 141 per 100 000 person years and, among the untreated, 259 per 100 000 person years (i.e., 1.8 times higher among the untreated).

For another sobering eye-opener -

Bipolar disorder results in 9.2 years reduction in expected life span, and as many as one in five patients with bipolar disorder completes suicide.

9.2 year reduction in expected life span. One in five completes suicide. Put in another perspective, about the same percentage of people with post-traumatic stress disorder *attempt* suicide as the percentage of bipolar disorder who *complete* suicide. Those are the sobering numbers that I contemplated after receiving my diagnosis (I have both). Oh hell yes, I'm going to do whatever it takes to not be the one in five.

Here's another factor to consider with respect to the phenomenon of "anti-depressants (and other psychiatric drugs) causing suicidal thoughts". There's a correlation, there is no identified causal link.

Anecdotally, when I was in the first few years of treatment, I thought about suicide far more frequently than I ever had. I was on meds, but I attribute that not to medication, but the fact that during therapy, it was necessary to confront my triggers, past traumas, and come to terms with some horrible aspects of my past behavior - without having learned how to cope with such things prior.

[Rayaan]

Of course. Antidepressants are prescribed for people who are depressed to begin with. You can't save the whole world, boss. But that doesn't mean you sit there doing nothing, either.

But are antidepressants actually any effective against depression at all? Some studies say yes, while others suggest that it's most likely just a placebo effect. And yet some studies indicate that they make one's mental conditions even worse than before. So the whole antidepressant thing is very sketchy.

There’s a group of people for whom antidepressants in general work awfully well, but there’s also a group for whom they don’t work well and they can become either violent or suicidal. The problem again comes back to the role of the doctor. If doctors can’t see that drugs may be good and may be bad, that they can be useful and problematic — if they aren’t experts and can’t handle a bit of complexity — they’re going to go out of business.

http://healthland.time.com/2012/03/28/mi...rmageddon/

[Nine]

I'm not completely against the meds, I am against the way that psychology/psychiatry are currently integrated with the medical world. With most common problems most see a doctor with little experience with mental health issues who will probably give them some cure all anti depressants. Most people don't actually know they are mostly just to manage symptoms and not all that reliably.

Everyone is different and most people won't have severe mental illness where every day is agony but more mild issues that can actually be effectively cured or dept with by learning a few coping mechanisms, learning triggers and adding some new habits to daily life. Instead people are given pills to deal with the symptoms as the actual causes fester in the background. For severe tearing your hair out mental illness I'm 100% for using everything at your disposal.

I'd like to see the whole thing changed in the next 5-10 years because the current system is fucked and could be made better without too much hassle.

[Jackalope]

I'm not completely against the meds, I am against the way that psychology/psychiatry are currently integrated with the medical world. With most common problems most see a doctor with little experience with mental health issues who will probably give them some cure all anti depressants. Most people don't actually know they are mostly just to manage symptoms and not all that reliably.

Definitely. General practitioners are woefully unprepared to deal with mental illness - and the only tools at their disposal is the RX pad and the referral.

Therapy is effective. Therapy is also expensive, and difficult (for the patient, particularly).

A large part of the problem is the system, as you noted. I have no idea what it's like in the UK where you live, but I do know what it's like here, and it sounds like we have similar models.

One other leg of the problem is the patients - who doesn't want a quick cure-all pill that's cheap and easy, instead of having to go through all that hard therapy?

We're probably more on the same page than first glance might suggest. :p

You're absolutely right regarding treating "run-of-the mill" depression (though I hate characterizing it as that, I don't want to diminish anyone's experience with mental illness - but we do need to distinguish acute typical cases from the chronic difficult profound cases, they are *very different*). Many if not most in the former category will benefit *most* from behavioral therapy, and may not need meds at all, or just for a short time.

Sadly, the common approach is to have the GP just throw pills at the problem.

[Minimalist]

So the whole antidepressant thing is very sketchy.

Maybe an even better question would be: why the hell are we so fucking depressed?

[The Grand Nudger]

Like you, I'm not comfortable calling something "run of the mill depression" However, when I'm on the same pills that some coddled beach whore who watched her chihuahua die is on...something tells me that one of us is not receiving competent care. Something tells me that watching human beings disintegrate no more than a few feet away from you might be a little more potent than watching a dog die of old age. So, again, somebody is getting dicked. It's hard to imagine that it's the girl with the chihuahua - but fuck it, maybe it is. \Hell, she's likely to be getting that shaft as well...if I'm getting the shaft.

We aren't fucking doctors. We ought to be able to trust those that -are- at least a little bit more than we do. I don't want to wonder whether or not the medication that;s recomended to me is effective, I want to know it is. I certainly don;t care if the medication recommended to me translates into an extra weekend in bimini for the man who recommended it - and between you me and the wall..I'd probably assassinate the fucker in bimini, who engages in this shit - with a smile on my face, if that's all it amounts to.

This shit needs to be taken out of the hands of the private sector. They've demonstrated clear incompetence - and it's important. There's more incentive to sell us something than there could even possibly be to fix anything......that's a problem.

[Nine]

Definitely. General practitioners are woefully unprepared to deal with mental illness - and the only tools at their disposal is the RX pad and the referral.

Therapy is effective. Therapy is also expensive, and difficult (for the patient, particularly).

A large part of the problem is the system, as you noted. I have no idea what it's like in the UK where you live, but I do know what it's like here, and it sounds like we have similar models.

Yeah, same deal more or less. GP's can prescribe basic anti-depressants and put you on a multi year long waiting list for a specialist.. Private specialists are few and far between and usually expensive.

One other leg of the problem is the patients - who doesn't want a quick cure-all pill that's cheap and easy, instead of having to go through all that hard therapy?

I imagine most have no idea about what they actually get from therapy either. It doesn't help here that you can wait 2-3 years to get to see a therapist even then you might only have 6 weekly sessions or something.

We're probably more on the same page than first glance might suggest. :p

You're absolutely right regarding treating "run-of-the mill" depression (though I hate characterizing it as that, I don't want to diminish anyone's experience with mental illness - but we do need to distinguish acute typical cases from the chronic difficult profound cases, they are *very different*). Many if not most in the former category will benefit *most* from behavioral therapy, and may not need meds at all, or just for a short time.

Sadly, the common approach is to have the GP just throw pills at the problem.

I think we are on the same page. I'm not sure how clear I was in my first post. I got wall of text carries away.

I think the worst thing about acute issues is most can be dealt with for good if sorted quickly with few if any meds. Like any wound not treating it quickly and correctly is just inevitably going to make things worse.

[Jackalope]

Like you, I'm not comfortable calling something "run of the mill depression" However, when I'm on the same pills that some coddled beach whore who watched her chihuahua die is on...something tells me that one of us is not receiving competent care. Something tells me that watching human beings disintegrate no more than a few feet away from you might be a little more potent than watching a dog die of old age. So, again, somebody is getting dicked. It's hard to imagine that it's the girl with the chihuahua. Though, of course, she's likely to be getting that shaft as well...if I'm getting the shaft.

We aren't fucking doctors. We ought to be able to trust those that are at least a little bit more than we do.

No argument here.

I would observe that everyone has differing capabilities in the coping department, or so my therapist tells me, and that unresolved trauma accumulates. Most people can compartmentalize that shit (no, not what you experienced, perhaps not even what I have), but there comes a time when the bin's full and you reach a breaking point. Chihuahua girl may just be a drama queen.

Your point is well taken, however.

[Little lunch]

I've been on antidepressants twice and had better results the second time round in conjunction with therapy. (Social worker and anger management).
The drugs bought me back to earth, the anger management taught me about the consequences of my actions and the social worker helped me to understand that not every bad thing that happens in my life is my fault.

I just wish I could have got it all under control before I burnt all the bridges down.
Lack of understanding is a problem. Not one of my remaining friends or family have ever researched depression. They're ignorant. Anything I tell them is an just an excuse for my behaviour. I will always be an arsehole or just plain crazy to them.

I try to keep a check on the rationality of my thoughts and am ready to recommence antidepressants if need be because I believe the key is to get in early.
Fortunately I've been normal for two and a half years now and am hoping I never have to touch them again.