The new forums will be named Coin Return (based on the most recent vote)! You can check on the status and timeline of the transition to the new forums here.
The Guiding Principles and New Rules document is now in effect.
In response to 'Dear Diary' - On Anxiety
Darthus
Registered User regular
Registered User regular
This post is regarding Gabe's discussion on the front page about him coming to the decision of taking anxiety medication. I know Gabe doesn't really read the forum, this isn't for him. But I'd like to discuss the process he went through and what everyone thinks of the situation. Since he decided to make it a public topic, I think it's ok to discuss it publicly. I didn't see another thread on this, but I often have a hard time finding stuff in this forum. I think there should be a forum specifically made to respond to the news post of the day, but I digress.
First, some framework; I'm a first year graduate student in Psychology, going for a doctorate. So while I'm no expert, I have some knowledge about this topic, and I definitely have some opinions. The overall point of this post is to express my opinion that psychiatric medication is too often considered a first and only line of defense against psychological disorders and therapy is neglected. As part of this, I think that in general, your general practitioner prescribing psychiatric meds (as it sounds like Gabe has) is a bad idea, especially for a long term condition. I'll discuss why in a bit.
1) Gabe's comment that someone said he took 4 medications for allergies, so it made sense for him to take medication for Anxiety. I understand the argument here, it's for him to convince himself he has a medical condition that requires medicinal treatment as maintenance, like allergies. A few things here. You have no control over your allergies. Your outlook, your behavior, your thoughts have no effect on whether or not you are allergic.
This is not the case with something like Anxiety. He can make behavioral and cognitive changes which will affect his anxiety, so medication is not the only option. Even if you want to take the analogy explicitly, there are other options for his allergy suffering friend. He can learn what he's allergic to and avoid it. He can modify his health, diet, etc in order to reduce the severity of his allergies. That's just to illustrate that medication is not the only way of dealing with his condition.
2) He describes himself as "Chain Worrying" and over-worrying about everyday things. This sounds to me like GAD (Generalized Anxiety Disorder), which involves just that: you worry about things people might worry about, just a bit too much. So this is a defined psychological disorder, which has treatments both of a pharmacological variety and psychotherapeutical variety.
3) He mentions thinking he worries too much and that might have a problem, then thinking, "No, I'm just worrying too much." and dismissing it. Well yeah, his worrying too much IS the problem. Even worrying that he's worrying too much is part of the issue. A psychological disorder is defined as something that is out of the ordinary and causes clinical levels of distress. He definitely matches this description from what I can tell.
His concern that it's a brain disease or not treatable is in my mind another danger of him viewing his anxiety as entirely a physiological condition. Nearly every psychological disorder has a biological base, as in you're predisposed to it, but also significant environmental and cognitive/behavioral components. That's to say, he might be genetically predisposed to anxiety, but his behavior, thoughts and what he's been through also contributes. It's a general tendency to think, "If it's not biological, I should just be able to stop, or I'm not trying hard enough." Nothing could be further from the truth. That's why therapy exists.
4) He also says that he had resigned himself to live with it (very sad), but had recently decided to get rid of the weight and find another way of living. Well, it's been shown that treating mood disorders with psychiatric meds alone has a much higher chance of relapse, and that the meds become less and less effective. If there is a component that is not biological (which is almost always the case), then ignoring it will only cause the condition to persist and not only will he be on meds for the rest of his life in order to feel more "normal", but after getting better at first, it will come back and he'll likely have to up his dose.
Ok, so given all that, here's my opinion. It sounds to me like he had already decided this was a medical condition and so went to see his doctor. That's pretty normal, people trust their doctor. However, when a doctor prescribes you psychiatric meds, I am of the opinion that that's much less effective than seeing a psychiatrist. A doctor is mostly trained in the physiology. He knows that this drug works for this, it shouldn't be taken with this, etc etc. He isn't as trained in what other treatments might help for something like Anxiety, nor is he as likely to monitor the progress of the drugs, tweak the dosage if needed, try a different drug etc. That's what a psychiatrist is for.
So you often get people prescribed meds by their GP (general practitioner) in order to treat symptoms and then leaving it be. And if things get worse, all they can do is up the dosage or switch meds. If you see a Psychiatrist, not only will they often require you to come back pretty often to monitor the progress, they have a lot more knowledge about the condition, and would refer you to psychologist if therapy might help (which it often would for anxiety).
In summary, after all that blathering, it's my opinion that Gabe would do much better to have seen a psychiatrist for his medication. Also, it would have made even more sense to see a Psychologist first, someone who has been exclusively trained in the diagnosis and treatment of mental disorders, who could assess the severity and type of disorder and refer him to a psychiatrist for meds if needed, while trying behavioral and cognitive treatment first to see if that helps. This makes even more sense for Gabe, since it sounds like taking meds is anxiety provoking for him in the first place.
It's just a shame that the general populace thinks the psychological profession is for "whackos" and so instead go their general practitioner with their psychological issues when ironically that person is someone who's woefully undertrained to handle those issues.
Discuss.
First, some framework; I'm a first year graduate student in Psychology, going for a doctorate. So while I'm no expert, I have some knowledge about this topic, and I definitely have some opinions. The overall point of this post is to express my opinion that psychiatric medication is too often considered a first and only line of defense against psychological disorders and therapy is neglected. As part of this, I think that in general, your general practitioner prescribing psychiatric meds (as it sounds like Gabe has) is a bad idea, especially for a long term condition. I'll discuss why in a bit.
1) Gabe's comment that someone said he took 4 medications for allergies, so it made sense for him to take medication for Anxiety. I understand the argument here, it's for him to convince himself he has a medical condition that requires medicinal treatment as maintenance, like allergies. A few things here. You have no control over your allergies. Your outlook, your behavior, your thoughts have no effect on whether or not you are allergic.
This is not the case with something like Anxiety. He can make behavioral and cognitive changes which will affect his anxiety, so medication is not the only option. Even if you want to take the analogy explicitly, there are other options for his allergy suffering friend. He can learn what he's allergic to and avoid it. He can modify his health, diet, etc in order to reduce the severity of his allergies. That's just to illustrate that medication is not the only way of dealing with his condition.
2) He describes himself as "Chain Worrying" and over-worrying about everyday things. This sounds to me like GAD (Generalized Anxiety Disorder), which involves just that: you worry about things people might worry about, just a bit too much. So this is a defined psychological disorder, which has treatments both of a pharmacological variety and psychotherapeutical variety.
3) He mentions thinking he worries too much and that might have a problem, then thinking, "No, I'm just worrying too much." and dismissing it. Well yeah, his worrying too much IS the problem. Even worrying that he's worrying too much is part of the issue. A psychological disorder is defined as something that is out of the ordinary and causes clinical levels of distress. He definitely matches this description from what I can tell.
His concern that it's a brain disease or not treatable is in my mind another danger of him viewing his anxiety as entirely a physiological condition. Nearly every psychological disorder has a biological base, as in you're predisposed to it, but also significant environmental and cognitive/behavioral components. That's to say, he might be genetically predisposed to anxiety, but his behavior, thoughts and what he's been through also contributes. It's a general tendency to think, "If it's not biological, I should just be able to stop, or I'm not trying hard enough." Nothing could be further from the truth. That's why therapy exists.
4) He also says that he had resigned himself to live with it (very sad), but had recently decided to get rid of the weight and find another way of living. Well, it's been shown that treating mood disorders with psychiatric meds alone has a much higher chance of relapse, and that the meds become less and less effective. If there is a component that is not biological (which is almost always the case), then ignoring it will only cause the condition to persist and not only will he be on meds for the rest of his life in order to feel more "normal", but after getting better at first, it will come back and he'll likely have to up his dose.
Ok, so given all that, here's my opinion. It sounds to me like he had already decided this was a medical condition and so went to see his doctor. That's pretty normal, people trust their doctor. However, when a doctor prescribes you psychiatric meds, I am of the opinion that that's much less effective than seeing a psychiatrist. A doctor is mostly trained in the physiology. He knows that this drug works for this, it shouldn't be taken with this, etc etc. He isn't as trained in what other treatments might help for something like Anxiety, nor is he as likely to monitor the progress of the drugs, tweak the dosage if needed, try a different drug etc. That's what a psychiatrist is for.
So you often get people prescribed meds by their GP (general practitioner) in order to treat symptoms and then leaving it be. And if things get worse, all they can do is up the dosage or switch meds. If you see a Psychiatrist, not only will they often require you to come back pretty often to monitor the progress, they have a lot more knowledge about the condition, and would refer you to psychologist if therapy might help (which it often would for anxiety).
In summary, after all that blathering, it's my opinion that Gabe would do much better to have seen a psychiatrist for his medication. Also, it would have made even more sense to see a Psychologist first, someone who has been exclusively trained in the diagnosis and treatment of mental disorders, who could assess the severity and type of disorder and refer him to a psychiatrist for meds if needed, while trying behavioral and cognitive treatment first to see if that helps. This makes even more sense for Gabe, since it sounds like taking meds is anxiety provoking for him in the first place.
It's just a shame that the general populace thinks the psychological profession is for "whackos" and so instead go their general practitioner with their psychological issues when ironically that person is someone who's woefully undertrained to handle those issues.
Discuss.
Darthus on
0
This discussion has been closed.
Posts
Comic title: The French Word For Future
(2001/07/18)
Damn, we're way behind schedule.