July 27, 2019

"Internalizing my diagnoses as inscriptions of emotional destiny also alleviated my sense of personal blame for the inability to will away my black dogs."

"When the drugs failed to deliver the cure I’d been promised, I didn’t dare reveal my shameful secret: that maybe the issue wasn’t just with chemicals in my brain, but a bad and broken me. Nearly two decades later, I quake with anger at the wholesale failure of mental health care in America — a rigid and restrictive system that leaves even the reasonably privileged, like me, with little to work with, and so many others with nothing. The primacy of the chemical imbalance theory of mental and neurological disorders may be at the root of the problem. It is an oversimplification at best. A new book by the Harvard Medical historian Anne Harrington, 'Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness,' argues that the 'tunnel vision' of modern psychiatry, with its fixation on wiring and fixed diagnoses, cannot adequately address what has yet to be understood about the human psyche."

From "It’s Not Just a Chemical Imbalance/Thinking of my mental illness as preordained missed many of the causes of — and solutions to — my emotional suffering," by Kelli María Korducki (NYT).

46 comments:

Carol said...

Yeah it's all a crock.

But if you take their psych meds long enough your mind chemistry will be unbalanced. Then the only cure is...more drugs...

gilbar said...

WHY is she trying to 'will away' her 'black dogs'?
BLACK DOGS MATTER!!

rhhardin said...

I suppose it's an article for women.

The mood swing problem in its various forms.

Mattman26 said...

I thought the science was settled!

rhhardin said...

There's a gravity imbalance all around. Stuff stuck to the earth.

madAsHell said...

ummmm.....maybe she should find a nice comments section where she can express her mania??

Mattman26 said...

https://www.buzzfeednews.com/article/ryancbrooks/marianne-williamson-antidepressants

Hope that link works. Marianne Williamson, the heartthrob to many around here, talks about treating normal human despair as an illness to be treated with medication.

As to Ms. Williamson generally, she reminds me too much of a Madeline Kahn character for the “hotness “ vibe to come through.

rhhardin said...

The first few pages of Anti-Oedipus are good (Deleuze and Guattari)

"A schizophrenic out for a walk is a better model than a neurotic lying on an analyst's couch." may be googleable

yes, lots of hits.

Hammond X. Gritzkofe said...

"Thinking of my mental illness as preordained...."

So, a Calvinist.

Sydney said...

She's right. It's much easier to prescribe a pill, then another, then another, than it is to help someone do the hard work of self-examination and correction. At least for most mental illness. Schizophrenics are a different matter, though.

pchuck1966 said...

A mentally ill person on the Opinion Pages of the New York Times. Go figure?

Hammond X. Gritzkofe said...

"When the drugs failed to deliver the cure I’d been promised"...
..by the provider who is recompensed
..at rate set by Federal bureaucrats
..which is scarcely enough to make a living from
..partiularly considering all the new records-keeping requirements
..and which therefore encourages, indeed necessitates,
..bare minimum time devoted to thoughtful consideration of the patient
..and more than a modicum of pencil-whipping (aka "filling the squares")
..the end result being
..dashing off a quick Rx and
..on to the next patient
..as quickly as possible.

Fernandinande said...

the cure I’d been promised,

That passive phrasing means she imagined it.

a bad and broken me.

That's most likely the correct answer; personal genetic load and such.

that leaves even the reasonably privileged, like me, with little to work with

How dare they not make me feel better!

cannot adequately address what has yet to be understood about the human psyche.

Lemme guess - the human psyche runs on spiritual magick and the pesky human brain just gets in the way.

William said...

Modern medicine doesn't offer much relief for arthritis or bad backs. Why should they be able to find the handle on mental illness? They're pretty good when it comes to cataract surgery, however. Some of your attitude towards modern medicine is dependent on the ailment with which you're afflicted. I was less cynical about modern medicine after cataract surgery than after the time I threw my back out....I can imitate sanity in many situations, but crazy would seem to be an appropriate response to others. It depends what life throws at you.

Scott Patton said...

Dr Switzer was right, and for only $5.oo

Narr said...

There's a thing inside my brain.

Narr
Still, after all the pills!

Achilles said...

"Nearly two decades later, I quake with anger at the wholesale failure of mental health care in America — a rigid and restrictive system that leaves even the reasonably privileged, like me, with little to work with, and so many others with nothing."


This guy how the vets feel about the VA.



Mary Beth said...

cott Patton said...

Dr Switzer was right, and for only $5.oo

7/27/19, 11:25 AM


Thank you. Now I have words to live by.

h said...

My limited experience leads me to the conclusion that "medical science" is not science: A patient tells the doctor, "I'm feeling depressed." The doctor says, "My diagnosis is that you are suffering from depression. To confirm that diagnosis we will put you a drug regimen known to help treat depression." If the drugs work, the doctor (and patient) conclude, "The diagnosis was correct, and the doctor cured the disease." Here's where the unscientific part comes in. If the drugs don't work, that is never accepted as proof that the diagnosis of depression was wrong. It only means that the initial drug regimen was the wrong one -- we need to try different dosage, or different drugs until the diagnosis is confirmed.

Fernandinande said...

Nearly two decades later, I quake with anger...

There are anti-quaker pills for that.

...at the wholesale failure of mental health care in America

Go back to Africa!

wild chicken said...

+1 for cataract surgery, also knee replacement.

American medicine been very good to me.

Leland said...

I can accept that chemical imbalance isn't the only issue. But all of society shouldn't be forced to renounce who they are for another.

Roughcoat said...

I strongly disagree with some of the statements here. Neuro-biological rewiring, via medication, worked miracles for me. Combined with ACT, it virtually eliminated my OCD and the accompanying depression. In fact my problems in this regard WERE attributable to a chemical imbalance, and once the chemistry was brought into balance (via medication and applied Acceptance-Commitment Therapy) the problems vanished.

Fernandinande said...
This comment has been removed by the author.
Fernandinande said...

My limited experience leads me to the conclusion that "medical science" is not science:

Psychology, at least, has always had an intimate relationship with mumbo-jumbo.

There was a big website about this until they published the book:

Evolutionary Psychology and the Classification of Mental Disorders

"It argues that, from an evolutionary perspective, some of the disorders recognized in standard manuals like DSM-IV may turn out not to be disorders at all. The people who have these conditions do not have problems; they just cause problems."

IOW, they have personalities which are unpleasant to other people and perhaps also to themselves, the mental version of being funny looking without having a disease.

Years ago a psychiatrist wrote a paper about how there are only 4 or 5 actual mental illnesses (schizo, manic-dep, dementia, autism and major depression, IIRC) and that one can learn to diagnose and treat them all, to the slight extent that any of them are treatable, in an afternoon.

wildswan said...

There are different chemical balances - and they mean that some people will become addicted to marijuana or opioids or even anti-depressants the first time they try them and go on to addiction, often to hard drugs. It's terrible to see.

And people coming off drugs ought to be warned - you have to train like an athlete to join society after addiction.

Ingachuck'stoothlessARM said...

will we see a rise in Dem drug usage ?

some "19th Nervous Breakdown" action? Does O-Care cover TDS?

tim in vermont said...

Jordon Peterson made the point that lobsters get depressed after being defeated in battle with a dominant lobster, per research, and the dominant lobster gets a charge out of hassling the ‘betas.’ He also says that studies have shown that if you give a depressed beta lobster Prozac, he will cheer up and head right back into battle with the dominant guy.

Maybe depression is adaptive. Maybe the brain evolved such that if you were not a dominant creature, you would avoid picking fights that you were destined to lose, and so live to breed another day.

Liberals make fun of this because they don’t honestly, deep down, rooted in their psyche, believe in evolution. They just. say they do.

DavidUW said...

Bring back the diagnosis of "melancholia" and leave it at that.

stever said...

I don't think the overall good vs bad nets a positive, especially with young people.

tim in vermont said...

“she reminds me too much of a Madeline Kahn character for the “hotness “ vibe to come through.”

Madeline Kahn has always seemed like a hottie to me!

tim in vermont said...

I have a black dog too. Commonly known as a Labrador, but more accurately described as a Canadian crumbhound.

traditionalguy said...

Different diagnostic words for different folks. Christians once called this The Spirit of Heaviness that called for a deliverance.

Narr said...

Self-medication is a human right.

Narr
Sorry, Human Right!

madAsHell said...

studies have shown that if you give a depressed beta lobster Prozac, he will cheer up and head right back into battle with the dominant guy.

Ya' know. This just doesn't pass the sniff test!! Who in the hell would feed Prozac to lobsters, and then interpret the results through an anthropomorphic lens??

tim in vermont said...

“Ya' know. This just doesn't pass the sniff test!! Who in the hell would feed Prozac to lobsters, and then interpret the results through an anthropomorphic lens??”

Read his book, “Twelve Rules” and you can find references to the actual studies.

Or you could do a simple search of scholar.google.com

https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=fluoxetine+lobster&btnG=

Roughcoat said...

Border collies are the smartest of dogs -- scary smart, actually. I have two, and they continually amaze me with their cognitive abilities. The downside to this is that they they need something to do, their minds need to be engaged, they need to work. If they aren't engaged they can develop emotional problems which frequently manifest as OCD. The treatment for Border Collie OCD -- apart from giving them jobs which will draw upon their cognitive abilities -- is prozac. And guess what: the prozac works.

jrapdx said...

FWIW the ancient Greeks described depression much like current-day diagnostic terms. However they lacked the concept of "mental illness", rather considered such disturbances like any other illness a condition of the physical body.

IOW separating "mental illness" from other illnesses only obscures a clear view of a person's plight. What's true of all illness is that "causes" are always multi-factorial, and treatment is rarely simple. The necessity of considering the "whole person" may be burdensome in our era of excessive cost-consciousness, but indeed it's even more costly to oversimplify approaches to alleviating a patient's condition.

In today's world chronic, incurable illness occupies 80-90% of practitioner attention. Autoimmune, cancer, metabolic, cardiovascular, neurological, psychiatric conditions (among others) are usual focuses. Commonly effects on emotional, cognitive, social and occupational functioning are profound but mostly ignored.

For psychiatric disorders medications should only be used when there's a damn good reason to use them. Medicines are just tools. While they can be lifesavers, prescribing requires careful judgement and awareness of substantial risks of side-effects.

Furthermore, medications by themselves will very rarely cure the condition, almost always other work needs to be done. For example, where patient skills are deficient, improvement through practice is necessary. When such an array of approaches is used, most patients gradually benefit, typically over a course of several years.

Roughcoat said...
This comment has been removed by the author.
Roughcoat said...

For me, Prozac was a lifesaver -- I literally thank God for it. It pulled me up out of the hellish abyss of OCD/depression and gave my life back to me.

Note: "talk" therapy by itself was completely and utterly ineffective. It only became ouseful when done in combination with Prozac.

Lesson: you cannot talk your way out of a chemical imbalance.

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Jamie said...

Roughcoat and jrapdx, thank you for the perspective!

A family member was diagnosed with depression and panic disorder this year. His own father, who loves him very much, nevertheless was insistent at first that his "problems" were purely situational; if he hadn't exposed himself to the trigger of his panic attacks, they never would have happened. In vain did his mother say that avoiding a common life experience (that trigger) hardly counted as making the problem *better.* Thanks to his mom, this young man is now seeing both a therapist and a psychiatrist, is taking medication that has enabled him to face each day without wondering how long he can bear his own terror and pain, and is moving forward with his life.

No good was going to come of treating his issues as if they were "only in his mind." The only way he AND his dad came to terms with the need for drugs was by accepting that the way he feels had a somatic cause. (He does and always did acknowledge that the talk therapy was also going to be a necessary party of his treatment - but it would have been insufficient alone.) And society in general now treats (or in learning to treat) people with depression as *ill* rather than *weak,* which is a huge improvement. Neither of these things could have come about without the admittedly flawed and incomplete modern understanding of what we call "mental illness."

madAsHell said...

And guess what: the prozac works.

I'm sure it is very effective. I also find the physiology of a dog much closer to humans than a lobster.

tim in vermont said...

“I also find the physiology of a dog much closer to humans than a lobster.”

Evolution never happened.

gilbar said...

DavidUW97 said...
Bring back the diagnosis of "melancholia" and leave it at that.


the trouble with melancholy, is that you need someone to solace you, and to be your companion,
otherwise, you might end up dying muddy drunk, in the road

AND! if you DO find a companion, they might end up in love with your mining claim
and then things just get complicated

PluralThumb said...

5 cents for a Coka Cola. Those were the days. Pepsi did not put pepsin in their Pepsi. The keebler elves did not put hat there either. Memories.

Almost 10 years on meds and I concur with the first post. Jerry Springer doesn't even have to attempt a final thought. For you Jerry.

Don't get me started on TV.
Where are my manners,
please don't get me started on television.