Utah out of the anti-depressant cellar?

[rongo]

It looks like psychotropic/anti-depressant prescriptions are running amok all over the place. Including a sharp increase in the elderly with no history of mental illness.

https://www.nytimes.com/2017/02/13/health/psychiatric-drugs-prescriptions.html?_r=0

Looks to me like a lazy substitute for teaching/helping with coping skills.*

*Yes, of course there are legitimate cases that require drug therapy. But I think everyone agrees that these things are over-prescribed, and that non-drug options aren't tried nearly enough first.

[Calm]

I agree that they are overprescribed and this is in part a result of doctors' laziness.  I think it is more a result of doctors' jumping to the conclusion too soon because of being too confident in their ability to figure out what is wrong rather than choosing to seriously listen to the patient and doublecheck their conclusions before settling on treatment.  I had a doctor listen to me talk for at least 20 minutes about my desire to have another child, but be prepared for possible postpartum end the consultation by telling me to tell my husband I didn't want any more children (I never even hinted my husband was pressuring me) and giving me a script for an AD that was not only unnecessary, but dangerous since I was trying to get pregnant at the time.  If I had misunderstood him, it could have caused problems for the child.  Thankfully I didn't and I tore it up on my way out...and changed doctors.  I also had numerous antidepressant scripts written for me when I would tell doctors I was quite happy overall, just exhausted.  (These were not Utah doctors except in one case).

None of them suggested therapy.

Otoh, my daughter's current doctors are pushing therapy with her anxiety and depression and have been since she was diagnosed at 12 with diabetes.  The first psychiatrist was horrible, ignored significant issues to treat only the anxiety and made things much worse.  The current one is extremely cautious and trying her best to get it right.  Therapists so far have been so-so to great.

However after all that, I have to say patient laziness is contributing to the problem as much as well.  No one in my family wanted to take the time to explore the ramifications of taking ADs or the likelihood of getting hit with the progressive disorder we are all saddled with.  No one asked me for advice in early internet days when it would have been hard to find good info even though they had seen the results of poor treatment in the past.  My dad couldn't even spend one day to see a specialist I had recommended to ensure he was still getting the right meds when I saw on a visit he was getting poor quality sleep and his evenings were hell.  He had gone once to a specialist and that was enough, his gp could handle dispensing the drug recommended then.  Which is why ten years after the specialist he was on a dose 8 times too high and in agony...but still refused to talk about it with me.

 I know a lot of people like this, they don't want to be proactive in their health care and see those who are as hypochondriacs.  They ignore medical issues until they can no longer endure it, go to the doctor for the magic pill and then again ignore it if given minimal relief.

Edited February 13, 2017 by Calm

[RevTestament]

20 minutes ago, rongo said:

It looks like psychotropic/anti-depressant prescriptions are running amok all over the place. Including a sharp increase in the elderly with no history of mental illness.

https://www.nytimes.com/2017/02/13/health/psychiatric-drugs-prescriptions.html?_r=0

Looks to me like a lazy substitute for teaching/helping with coping skills.*

*Yes, of course there are legitimate cases that require drug therapy. But I think everyone agrees that these things are over-prescribed, and that non-drug options aren't tried nearly enough first.

Just 2 weeks ago my ward had a discussion on mental health. Some people sounded a little worried/desperate about depression, anxiety, etc. I tried to point out that our brains are very complex and require optimal health to work properly. Optimal health depends on a healthy diet. Even if we eat a healthy diet some people are going to have mental health issues, but if we do not eat a healthy diet, we can expect more mental health issues. Our stores are full of prepared foods - almost all of which have substantial amounts of salt, sugar and preservatives. Islanders who come to Utah often/usually complain that the food makes them sick. I believe many elderly are no longer preparing their own food, and often more likely to eat a TV dinner or other prepared food. I am not attributing all mental health issues to diet, but there are just a plethora of mental health issues which seem to be on the rise - I believe autism is much more prevalent than even 50 years ago. Air pollutants, pesticides, food chemicals/additives, may all be contributing factors. High stress jobs can cause some people to have unnatural cortisol levels, and wear out their adrenal system, which can lead to anxiety disorders. The body is so complex, that I don't think we can hope to understand even 20% of the chemical results of the many different things we subject them to in our society. But yeah, psychotropics are usually just a patch to try to help a symptom rather than showing an effort to try to understand what the cause is, and perhaps addressing it. I personally feel psychiatry has become a shell of what it once was - I am glad I am not a psychiatrist. 

[Guest]

7 hours ago, rongo said:

It looks like psychotropic/anti-depressant prescriptions are running amok all over the place. Including a sharp increase in the elderly with no history of mental illness.

https://www.nytimes.com/2017/02/13/health/psychiatric-drugs-prescriptions.html?_r=0

Looks to me like a lazy substitute for teaching/helping with coping skills.*

*Yes, of course there are legitimate cases that require drug therapy. But I think everyone agrees that these things are over-prescribed, and that non-drug options aren't tried nearly enough first.

It never should have been nothing, as Utah is barely, or maybe not...so telling of this was an effort to makes charges that people in the Church was in a state of depression. 

[bsjkki]

7 hours ago, Calm said:

I agree that they are overprescribed and this is in part a result of doctors' laziness.  I think it is more a result of doctors' jumping to the conclusion too soon because of being too confident in their ability to figure out what is wrong rather than choosing to seriously listen to the patient and doublecheck their conclusions before settling on treatment.  I had a doctor listen to me talk for at least 20 minutes about my desire to have another child, but be prepared for possible postpartum end the consultation by telling me to tell my husband I didn't want any more children (I never even hinted my husband was pressuring me) and giving me a script for an AD that was not only unnecessary, but dangerous since I was trying to get pregnant at the time.  If I had misunderstood him, it could have caused problems for the child.  Thankfully I didn't and I tore it up on my way out...and changed doctors.  I also had numerous antidepressant scripts written for me when I would tell doctors I was quite happy overall, just exhausted.  (These were not Utah doctors except in one case).

None of them suggested therapy.

Otoh, my daughter's current doctors are pushing therapy with her anxiety and depression and have been since she was diagnosed at 12 with diabetes.  The first psychiatrist was horrible, ignored significant issues to treat only the anxiety and made things much worse.  The current one is extremely cautious and trying her best to get it right.  Therapists so far have been so-so to great.

However after all that, I have to say patient laziness is contributing to the problem as much as well.  No one in my family wanted to take the time to explore the ramifications of taking ADs or the likelihood of getting hit with the progressive disorder we are all saddled with.  No one asked me for advice in early internet days when it would have been hard to find good info even though they had seen the results of poor treatment in the past.  My dad couldn't even spend one day to see a specialist I had recommended to ensure he was still getting the right meds when I saw on a visit he was getting poor quality sleep and his evenings were hell.  He had gone once to a specialist and that was enough, his gp could handle dispensing the drug recommended then.  Which is why ten years after the specialist he was on a dose 8 times too high and in agony...but still refused to talk about it with me.

 I know a lot of people like this, they don't want to be proactive in their health care and see those who are as hypochondriacs.  They ignore medical issues until they can no longer endure it, go to the doctor for the magic pill and then again ignore it if given minimal relief.

I have found it very difficult to find a good therapist for my T1 daughter. She quit therapy and lost trust in her doctor (not the endo) Most do not understand T1 enough to understand the mental and physical challenges T1's endure...especially the girls. They wanted to put her on meds and she refused. One of the best things I've seen is her dropping the birth control pill. She started on it to help regulate her blood sugars. I've seen an amazing change in her ability to handle stress since dropping it. I think birth control pills cause way more depression than people think.

http://www.spectator.co.uk/2016/10/the-pill-makes-some-women-depressed-why-isnt-this-more-of-a-scandal/

Edited February 14, 2017 by bsjkki
Added link

[Calm]

Birth control pills almost caused my marriage to end as soon as it started.  Thankfully I had decided I had to just endure and get past the shock to give my new husband a fair chance.  Three months later we figured out the pill might be causing some issues and dropped it and surprising, I came out of the cloud.  The first time I had known a drug to slam me down...course I hadn't taken much more than an occasional antihistamine for an allergy attack before.  Not even aspirin for headaches.  

[The Nehor]

I am grateful for my medication. Drugs are nature's hugs.

[Calm]

Love hate relationship here.  Love them at night as I drift off to sleep.  Hate them in the morning when I wake up and can't move for the pain that lasts until the morning dose hits simply because my body is too used to having the drug around.

[The Nehor]

11 minutes ago, Calm said:

Love hate relationship here.  Love them at night as I drift off to sleep.  Hate them in the morning when I wake up and can't move for the pain that lasts until the morning dose hits simply because my body is too used to having the drug around.

Mine are milder and just give me energy and pep. Sorry, that is rough.  

[Calm]

4 hours ago, The Nehor said:

Mine are milder and just give me energy and pep. Sorry, that is rough.  

It works, that is all that really matters.  My daughter's isn't, I wish mine worked a bit better so I could be putting more energy into fixing her better meals and coaxing her out on walks in the hills.

[Duncan]

it's funny my dr. asked me how my testosterone level was, since I'm over 32 and apparently it goes down. Anyways I had no clue, it's not like I have testosterone meter reader that I check everyday, anyways he wanted to put me on meds if it was low but I had to take a blood test first. So I did and it came back as having above average testosterone, which is interesting as my dad had me when he was 46 and my sister at 48 so I think i'm good for that junk

[rongo]

Funny story, Duncan:

Four years ago, I decided to have a full endocrine exam while we had gold-plated insurance (I have a family history of thyroid disease). When the doctor was preparing to go over the results, he looked concerned and was silent as he read the results. "Anything wrong?" I asked. "Other than you should be dead?" he responded (he had my full attention). Then, relief and amusement came over his face. "Your testosterone is way too high." Lowering my voice, I said, "Yeah, I get that a lot . . ."  He said that the lab had down that I was a female, and that by rights I should be dead with my T levels. As a male in my late 30s, though . . . I was exactly average.

[Rain]

15 hours ago, Calm said:

I agree that they are overprescribed and this is in part a result of doctors' laziness.  I think it is more a result of doctors' jumping to the conclusion too soon because of being too confident in their ability to figure out what is wrong rather than choosing to seriously listen to the patient and doublecheck their conclusions before settling on treatment.  I had a doctor listen to me talk for at least 20 minutes about my desire to have another child, but be prepared for possible postpartum end the consultation by telling me to tell my husband I didn't want any more children (I never even hinted my husband was pressuring me) and giving me a script for an AD that was not only unnecessary, but dangerous since I was trying to get pregnant at the time.  If I had misunderstood him, it could have caused problems for the child.  Thankfully I didn't and I tore it up on my way out...and changed doctors.  I also had numerous antidepressant scripts written for me when I would tell doctors I was quite happy overall, just exhausted.  (These were not Utah doctors except in one case).

The night after or second night after my third child some alarm kept going off near my room. I was having a hard time sleeping anyway, but if I did manage to go to sleep that alarm would wake me again.  I could barely make it out of bed on my own with my c-section. I worried that if there was a fire or something that the medical staff wouldn't be able to get us all out and maybe I needed to go rescue my son from the NICU - where that was I didn't know.  I thought of calling to see if there was a fire for sure,  but if there was I didn't want to disturb and slow down evacuation by them answering my call.

The next morning I asked my Dr to release me because I was so exhausted.  He was quite concerned and wanted to put me on anti-depresents. It took some time though to get him to understand that I wasn't depressed, just exhausted. I was glad I was with it enough to tell him no I didn't need the meds.

I did need meds after my daughter. I not only had suicidal thoughts, but thoughts of hurting her as well.  When I finally realized what was happening I prayed to find out what I needed. The answer very clearly was that I needed to be on meds for 6 months along with do some other things.  

So I know what it is like to need them, but also know from this and other experiences what it is like to have a Dr rush to give them when I shouldn't have them.  

Edited February 14, 2017 by Rain