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Psychiatrists are the devil and eat babies
Feral
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I feel like you're using the term "psychology" in a much looser sense than the (other) APA would like. Are you trying to talk about the difference between psychotherapy and psychopharmacology? Because those are both a part of psychiatry. Psychotherapy is quite likely to be something prescribed or recommended by a psychiatrist, but very few psychiatrists have the time to do it themselves.
Saying that a psychiatrist should also be a psychologist is like saying that a radiologist should also hold a doctorate in electromagnetic physics.
im saying the complete absence of psychotherapy in the treatment of psychological disorders is like modern day bloodletting.
This is one of the stupidest things I've read all week.
First off, non-psychiatric physicians (GPs, PCPs, pediatricians) are more likely than psychiatrists to prescribe psych meds without referring the patient to a therapist. Calling out psychiatrists is barking up the wrong tree. And, yeah, I can find the citation for this, I just don't have it off-hand.
Second, this is as much the patient's fault as the doctor's. It's easy to go to a doctor for 15 minutes and get a prescription for pills; it's a lot harder to carve out an hour a week to deal with your inner demons. You can't drag a patient to a therapist kicking and screaming, all you can do is give them a phone number and hope for the best.
Third... bloodletting? Really? Really?
every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
the "no true scotch man" fallacy.
the "no true scotch man" fallacy.
Feral on
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Most people agree that combating psychological disorders is best accomplished with both medication and therapy, but just like you wouldn't go to a mechanic to fix your car and then teach you how to drive, you wouldn't go to a psychiatrist for both.
1) get diagnosed with depression
2) get medicated
3) medication doesn't work
4) ditch it in favor of therapy
5) get better
6) decry psychiatry as bullshit.
This is, of course, completely sidestepping the point that different treatments will work differently on different people. Sometimes pills don't work on you. That doesn't mean they never work for anyone. I hypothesize that this issue comes from people not understanding that mental illnesses don't have particular causes like bacteria-related diseases do. Many things can trigger depression (to continue using my example), and so you can only treat peoples' symptoms, which will naturally respond differently in different situations.
There really should be more talk between the doctors and psycyatrists/councilers if medication is discussed, even if it's just a phonecall or a letter.
Now THERE'S a form of treatment that's misunderstood and demonized.
As a recovering Scientologist I don't have anything really substantial to add. The only person I know to have been on psych meds is one of my cousins who I see about once a year. He's a nice guy, and I wouldn't have known he was taking antidepressants if I hadn't been told. They seemed to be working for him, and I really don't see the problem.
Maybe drugs are being prescribed too often, but the statistics (if you can call them that) that I grew up with were so wildly skewed and biased that there's no way I can trust them.
And I've contributed nothing to this discussion. Oh well.
Anyone want to beta read a paranormal mystery novella? Here's your chance.
stream
I don't have ADHD, I was just an annoying kid, and my second grade teacher refused to speak to my mother again until I was on Ritalin.
I have no issues with psychiatry as a whole however.
Yeah, I keep hearing that. However, everyone seems to assume that it's axiomatic and never seem to actually bother citing that from an unbiased source.
Ah, but here's the hang-up:
In popular culture, people hate Scientology (for me, it's just another bizarro religion, like Christianity or Voodoo, but I'm a strict non-believing heathen).
On the other hand, they hate psychiatrists. Just another thing for people to reconcile.
I've only had exposure to a few psychiatrists in my life (I'm horrible about not seeing any doctor for a problem until I'm lying down, bleeding on my kitchen floor or something equally stupid), but I'd never considered that they're less likely to offer medication. It seems to be true, at least in my experience.
Most people who say that are, in my experience, just uncomfortable with the idea of psychiatric medicine in general. People don't like to think of their minds as being something that can get sick and need medicine.
Something about it being in your head doesn't necessarily make it any less real. Most medicines were invented for a reason, but I do think that some things are overdiagnosed/prescribed. Back when I was growing up (I'm 24) it was ADHD and ADD, now its that Autism falls across a whole spectrum (instead of just being ascribed to neurosis) and is the new 'favorite' mental illness. Especially in combination with vaccinations.
The real irony is that Ritalin is a stimulant, and so if the child doesn't have ADHD it can actually make them even worse; in some cases it's like giving the hyper kid more caffiene.
That said, I'm a major proponent of psychopharmacology, psychotherapy, really most medicine. Several members of my family use psych drugs regularly and espouse how great they are. We've come a long way from the early days, when we could only treat the symptoms.
That's not my issue. I had a period of depression and considered taking antidepressants, but therapy just happened to work just fine for me. Also, my little brother actually does have ADHD and is on Concerta, and it has improved his scholastic performance considerably.
After a quick googling, it is difficult to find an unbiased study regarding ADHD being overdiagnosed. I could be completely wrong, but what I have seen and heard from personal experience is a lot of teachers who don't want to deal with hyper kids that don't have any cognitive impairment (can focus just fine) attempt to get their students on ADHD medication.
I've never met a kid zombified by medication. Sometimes it's taken awhile to get it right, which can be an interesting process.
Nothing so benign as a stimulant— Ritalin and Adderall are classified as pro-psychotic.
I think it is difficult to test for because there are varying metrics and biases involved. As someone who needs ADHD medication in order to function in an academic environment (Strattera) I am personally aware of the benefits and pitfalls of medication (for me, Ritalin was a colossal failure). When I was diagnosed, my doctor was unwilling to make the diagnosis and directed me to a psychologist who submitted me to several tests and interviews with both myself and my immediate family. This was when I was 18 years old. Since that time, I can easily understand the concern people have when they talk about over-diagnosis, and the medical community has probably failed in properly presenting their case to the public, and there is a lot of misinformation about. Is a family doctor prescribing Ritalin more or less capable of determining ADHD than a trained psychologist/psychiatrist? Is the child's hyperactivity actually due to a mental disorder, or is it just because they are six years old? Is the child impulsive and brash because of a mental disorder, or is it because there is a lack of any effective parenting?
There are too many variables and too many people of varying expertise arguing pro and con for ADHD that it is extremely difficult to have any actual academic research into the topic. All that we truly know is that it exists and that in some cases stimulant medication can substantially help.
I can say, a schizophrenic I know cannot function without his drugs, but I'm proud to say he's been holding down a job for months now and he doesn't get therapy anymore.
I have mostly good things to say about psychiatrists and psychologists.
I don't have ADD. Nobody has ever thought I did. But I like the medicine and like to use it during cramtime at school, so I told my doctor in vague terms "I had trouble paying attention" and wham, bam, walked away with a prescription.
I can get whatever I want, it's just a matter of being responsible enough to acquire what you know will actually help you. A fairly extensive knowledge of drug effects and manifestations helps a lot, too.
Just remember, you know, pro-psychotic.
What precisely does that mean?
Addiction? Nope. Bipolar? Nope. Schizophrenia? Nope. DID/MPD? Nope. PTSD? Nope. Anxiety? Nope. Depression? Well that one goes away on it's own.
I find it hard to believe that, sans drugs, most psychiatrists prove efficacy in a double blind experiment.
Yes, it is possible to bilk doctors out of drugs. This is nothing new. The fact that you can do it does not necessarily mean the system is broken as much as you are.
Drug users have been using this scam long before Adderal became the de facto scapegoat.
Even if all these drugs do is relieve symptoms that's a good thing in and of itself.
Right. I've nothing against the drugs; I think they work wonders.
My problem is that I don't think psychiatrists offer anything other than hope and prescriptions, and that their therapy isn't effective.
That is to say, I doubt the state of mental health would be much impacted if you removed all psychiatrists and just let people print prescriptions from WebMD or Wikipedia. [/hyperbole]
Antipsychotics (in general) act as dopamine inhibitors. They don't really know why, but that seems to be effective in treating psychosis.
Now, amphetamine and amphetamine-derivative ADHD medications (this is Adderall, Ritalin and variants) work by increasing dopamine production in the brain. I'm sure you can connect the dots yourself.
Most psychiatrists here don't offer much therapy....as feral said they are too busy.
I am not on any anti-psychotics. I occassionally use one of the more powerful varieties as a sedative I acquire from my friend, but otherwise I am on Zoloft, Vyvanse, and Xanax. I don't actually use the Xanax much, it's just nice to have around.
And in response to Sentry, I believe the ease with which drugs can be acquired speaks volumes about the flaws in the current system.
You would be wrong about that. Cognitive behavioral therapy in particular has empirically demonstrated efficacy for a large number of disorders, particularly depression and sleep disorders.
Additionally, self-medicating for mental illness is most likely to end you up with a substance abuse problem on top of whatever you already had. Psychiatry may be guesswork, but it is complicated and dangerous guesswork. There's a reason these people have to go through so much school.
well, then you have to apply it to the entire spectrum of drug acquisition. It's not fair to single out psychotropics when I could just as easily get muscle relaxants or heavy duty pain killers.
And yes, the volume of benzodiazepines, muscle relaxants, painkillers, and other mind-altering drugs is far too high. The vast majority of people taking benzos have no idea what they're getting themselves into.
I think you misunderstand me. Pro-psychotics can cause psychosis in a healthy person. If you happen to have a predisposition towards psychotic behavior it is much, much riskier.
We all have some kind of story about someone who sped for too long and started acting a bit crazy— that's because they were taking pro-psychotics. For a shrink, this is a "no duh" situation.
Are there any risks for someone who is not depressed to take Celexa or other SSRIs for a short term (2 weeks)?
I didn't know this about stimulant medication (the increasing of dopamine vs. the decreasing of dopamine due to anti-psychotics). It makes those stories about the really crazy people on Ritalin much more understandable.
I think a tried and true method of ADHD diagnosis would be the following: Doctor gives kid a quad shot espresso and sees if it calms him down or makes him hyper. If he calms down, we go from there.
Frankly, I think my years of recreational drug use have helped me make better decisions about my medication.
No real risk, but they won't be particularly effective. You will still experience moderately unpleasant withdrawal.
Let's listen to this guy, it sounds like he knows a lot about mental illness.