A very entertaining Guardian article describes a 1970s experiment in fooling the psychiatric establishment:
Surprisingly, so the story goes, all eight were not busy the next month, and all eight – three psychologists, one graduate student, a paediatrician, a psychiatrist, a painter and a housewife – agreed to take the time to try this treacherous trick, along with Rosenhan himself, who could hardly wait to get started. Pseudopatient Martin Seligman says, “David just called me up and said, ‘Are you busy next October?’ “and I said, ‘Of course I’m busy next October’, but by the end of the conversation he had me laughing and saying yes.”
First, there was training. Rosenhan instructed his confederates very, very carefully. Five days prior to the chosen date, they were to stop shaving, showering and brushing their teeth. And then they were, on the appointed date, to disperse to different parts of the country, east to west, and present themselves at various psychiatric emergency rooms. Some of the hospitals Rosenhan had chosen were posh and built of white brick; others were state-run gigs with urine- scented corridors and graffiti-scratched walls. The pseudopatients were to present themselves and say words along these lines: “I am hearing a voice. It is saying thud.” Rosenhan specifically chose this complaint because nowhere in psychiatric literature are there any reports of any person hearing a voice that contains such obvious cartoon angst.
Upon further questioning, the eight pseudopatients were to answer honestly, save for name and occupation. They were to feign no other symptoms. Once on the ward, if admitted, they were immediately to say that the voice had disappeared and that they now felt fine.
The article’s author, psychologist Lauren Slater, decides to repeat the experiment in 2004. There are several differences – the doctors and hospital workers are far more humane nowadays, and where they once locked people up irresponsibly they now drug people irresponsibly.
I am prescribed a total of 25 antipsychotics and 60 antidepressants. At no point does an interview last longer than 12 and a half minutes, although at most places I needed to wait an average of two and a half hours in the waiting room. No one ever asks me, beyond a cursory religious-orientation question, about my cultural background; no one asks me if the voice is of the same gender as I; no one gives me a full mental status exam, which includes more detailed and easily administered tests to indicate the gross disorganisation of thinking that almost always accompanies psychosis. Everyone, however, takes my pulse.
There’s a lot more to Slater’s account – read the whole thing, is my rather cliched advice. The article is taken from her about-to-be-released book Opening Skinner’s Box, which I’ll definitely be keeping an eye out for..
Wow, wow, wow. Okay, as someone who is firmly entrenched in the medical-industrial complex (as a mentally ill person who has been diagnosed with about fifty different things from depression — which seems to be the default foundation that everyone builds on, determined by the highly technical symptom of being in the presence of a mental health professional — to schizophrenia. Though, the diagnosis of schizophrenia is nearly impossible to get, because the conventional wisdom is that those who are schizophrenic do not seek help and will do anything they can to avoid being helped. So, if you go in asking for help, you won’t be diagnosed as a schizophrenic, even if you do hear voices (which I do) or have visual hallucinations (which I also do), or have blackouts accompanied by violent behavior (which I also do). The galling thing is that when I had my most recent blackout, they wrote it up on my chart as “acting out”.
It seems they will bend over backwards to give you an SSRI, and I have met only a very few doctors who admit that SSRIs only work in very limited situations and for a very small subset of the population. For those whom it works, it works great, but they are far and few between. For many more, it is a very very dangerous placebo. For others (like me), it brings on psychosis and tremors. Yet they still push it, no matter the negative side effects, because again the conventional wisdom says that those negatitive side effects will eventually go away, even when I have direct evidence to the contrary. There is something going on, I don’t know who gets kickbacks, or if it is just a massive marketing campaign, but SSRIs are being pushed so hard on the doctors to be pushed on patients for everything from mild depression to some of the most dangerous mental illnesses to have where SSRIs can do way more bad than they can do good. It is completely irresponsible and people should be going to jail for it, not just be sued for malpractice (which makes me wonder if now that some more information is coming out about SSRIs being more dangerous than they originally thought they would be is part of the reason that pharma companies are pushing so hard for the caps on liability because they would literally be destroyed if the truth came out and they had to start paying for some of the irreparable damage they’ve done to so many people with their overzealous pushing of SSRIs).
I haven’t read the article yet, and I’m not sure I’ll be able to… it might cause some triggers to be set off in me and I don’t need that right now. But I can totally confirm the portion you’ve quoted, in the sense that medical health professionals are completely irresponsible, to the point of being extremely dangerous to the health and welfare of their patients.
It makes me very very frightened to know that I am at the mercy of these people.
What are SSRI’s?
To the article… I’ve been diagnosed with a variety of things, but have obstinately refused medication of any kind. My dad is tied to his drugs, now, because of the sheer number of pills he’s been on. He has an intestinal disease that causes him a great deal of pain, but he was also depressed when he started seeing doctors so they thought he was making up his pain. When he started drinking (because red wine helped with the pain) this only confirmed their diagnosis of depression with psychosematic pain, so they upped his Xanax (nasty stuff, that).
Years later, they found out that there really was something wrong with him, but by then he was so chemically addicted to all the shit they gave him that withdrawl is almost entirely out of the question (not to mention the emotional dependence).
So, three cheers for the medical establishment.
SSRIs (selective serotonin ) make up one of the major categories of antidepressants and include Paxil, Zoloft, and Prozac. They work by affecting serotonin levels in the brain, regulating mood, emotions, sleep, and appetite, among other things.
I have to put in a bit of a defense for antidepressant medication. I’m taking bupropion (not an SSRI), and I don’t like to think how I might be feeling without it. I’m functional and happy, and I don’t regret my decision to treat my depression with drugs.
Which isn’t to say that doctors aren’t too quick to suggest them; I was really amazed how easily I got a prescription. For some reason I thought it would be harder than spending five minutes answering a few subjective questions. I’m not particularly comfortable with the diagnosis process; as long as you know your way around the symptoms and have an appointment, anyone could pick up a prescription.
Oh, don’t get me wrong: I think that anti-depressant medications are a good thing. I’ve known a fair number of people for whom they’ve worked wonders. Having seen my friends before they were on medication and after, I’d rather they be on medication.
My problem with the medical industry is with, as you mentioned, the very no-brainer diagnostic process. I could walk into most any doctor’s office, say I’m depressed, recite a couple lines from commercials on TV (if that), can get myself some anti-depressants. That’s not a good thing.
As to my own decision not to take medication: it’s a personal choice that applies solely to me. I wouldn’t advocate for anyone else to not take medication. I have just chosen not to take it.
Just before I had my son, the nurse practitioner from the ob’s office called to run me through a survey. It was obvious from the first question that it was a screening for depression. That is, to identify who might be at risk for postpartum depression.
Long and short of it, I wish I had never mentioned the fact I was ever depressed in my life. I had to ( have to) convince them everytime I talk with them that I am okay, not depressed. It is a year later, and the first question I was asked the other day was about my depression…I haven’t been depressed in years and then it was more situational not chemical.
The hospital gave me a little bag of pills when I left- a variety of OTC things, I am actually surprised it didn’t include Prozac or another antidepressant.
It is sad that I had to spend more time convincing them that I wasn’t depressed ( I wasn’t) instead of them spending the time figuring out that I had a severe infection when I left the hospital.
I’d like to echo sam’s sentiment… I went through the same thing just before my family doctor, who wanted to start me on them in the 6th month of pregnancy, “Just in case”.
I’m the only person in my biological family who is not and has never been on anti-depressants or anti-psycotics, although I’ve been offered/pushed towards both.
The anti-psycotics thing was unreal… I was seeing a therapist and described a nightmare I had had (I was at the time involved in a court case against a violent ex-roommate) and her immediate response was to write me a perscription, because “obviously I was having trouble distiguishing between reality and fantasy”.
Um hello? I said it was a dream! Dream = fantasy, right? Or is that something they don’t teach in psychiatry school?
sorry, just had to get that vent out ;-)
Yeah. Just agreeing w/ all so far. Anti-depressants are wonderful & life-savers for those who need them. But are TREMENDOUSLY over-prescribed. For tons of things for which there isn’t even the slightest possibility that they are indicated.
My anecdote:
A couple of years ago I was suffering from extreme intestinal distress. It was so bad that I could barely eat anything. I lost over 10 lbs in a month (and I’m pretty damn thin). So I go to the doctor for help. I should have been tipped off by the fact that his examining room was plastered w/ posters about stress & depression….. but what did I know. Anyhow, he asks if there is anything new &/or stressful going on w/ me. I say, “No, just this horrible cramping every time I eat.” So he prescribes Paxil & says to come back in a month (or was it 2?). So I go & take the Paxil (even though I thought he was nuts & didn’t want to, but the spouse pushes so….). And I come back to see him. He asks how it’s working. I tell him that everything is exactly the same w/ regards to intestines & eating, but I have the added bonus of a complete removal of libido. So he prescribes an anti-anxiety drug (the name of which I forget). Again I think he’s out of his gourd, but the spouse wants me to try so I do. I come back 6 or 8 weeks later & he asks how I’m doing. Exactly the same, says I, wrt intestinal cramping when I eat. And every time I take one of those pills I suffer tingling in my extremities & loss of equilibrium. So he says we must up the dose of the anti-anxiety drug. That’s when I stopped listening to him, stopped seeing him & found a GI specialist to help me out.
I’m much better now. And guess what? I’m not taking anti-depressants or anti-anxiety drugs for my digestive/intestinal problem. Weird huh?
Buspar. The anti-anxiety drug was called buspar.
I have a problem with anyone but a psychiatrist or neurologist handing out scripts for psychotropic drugs. I guess there’s a resistance to referring out, but I don’t see why, considering the trouble it can cause. Just read Jakes post.
I am (only) a medical social worker, but my pet theory is that antidepressants are great in the short term. They can bring a patient into a place where they can start the real work — changing behavior and thought patterns (cognative-behavioralist? You bet!). Long-term use of such drugs is appropriate for a diagnosed chemical imbalance, of course.
One of the obvious reasons that physicians are pushing drugs and more drugs is that insurance companies and government programs would much rather pay for a monthly prescription than a weekly, or more frequent, therapy session.
Also, the office can code a PCP visit to monitor antidepressants as “medical,” which gets you paid a lot faster than anything under “mental health.” Many insurance companies have entirely separate divisions for mental health; many insurance companies don’t cover it at all.
So, unfortunately, often the reason people only get the cheap, limited help of pills is that the alternative is NO help.
Ananna’s experience is one I’ve seen a few times. A diagnosis of schizophrenia makes her/him eligible for more services than mere depression. You do the math.
As for the “pre-emptive strikes” against postpartum, I guess the OB’s involved are just afraid of getting sued in case another Yates walks into the office.