Sunday, March 28, 2004
Backword Dave has already done my job for me in picking apart the latest stupid rant against anti-depressants and other mental health stabilisers, taken from Saturday's Guardian. Drugs never did anything for me - I rarely took the many pills I was prescribed during my early teens, being too lazy, forgetful and suicidal - but I still get very annoyed at anyone who criticises these drugs without knowing anything about what it's like to need them or how much the risks and the side effects are really outweighed by the benefit for those they do help.
I also agree with Dave that the problem is that not enough is provided in the way of care to accompany the drugs prescribed. I would still be on pills today, but for the fact that I know it would mean having to see a psychiatrist every week again, talking about problems the doctor doesn't or won't understand unless they fit to a check box scheme. 'Can't leave the house? That's a tick for social phobia. Can't sit down for ten minutes at a time? There's your Attention Deficit Disorder. General malaise? That'll be the borderline personality at work...'
When I arrived at university I suffered the general sense of being suddenly set adrift that I think most people feel for the first few weeks. But it seemed worse than it was at the time, and given my history of manic depression I decided after either one or two weeks that I wanted to see a doctor. I was given an appointment the same day, and after fifteen minutes with the doctor I walked away with a prescription for a hefty dosage (certainly not the minimum she could have prescribed) of a new drug called Venlafaxine/Effexor. This is a strong drug, sometimes known to induce mania and not recommended in anything other than minimal doses for people who are potentially suicidal. Great - but this is what happens when people operate on checklists which their patients know better than they do.
For most people the problem works the other way - they're in genuine need of help, but too human to fit into the necessary checkbox. Some of them don't need drugs, or need drugs other than the ones they end up being prescribed - and this is often where some of the problems arise. Others end up suicidal but still unable to get the pills they need, forever consigned to 'borderline personality' (i.e. attention seeker) or some even less subtle category in the doctor's notes.
I'm not sure what could be done to change this, since doctors these days have to cover their backs far too much to give the really individual care many people need. But before we direct our attacks at the drugs which are keeping people alive, we need to look carefully at the mental health system which is not.
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