Shortcomings of Pill Psychiatrists

Those of you who have seen my postings will assume that I am anti-pill treatment. That is not exactly true. There was a long article in today's New York Times Magazine by a psychiatrist who treated his patients by diagnosing their emotional problem and determining the appropriate medication. For anxiety, for instance, he asked 11 set questions  Based on the replies he selected the appropriate treatment. Nowhere in this article does he consider a physical or nutritional cause for the patients condition. Had I gone to a psychiatrist and described my symptoms of anxiety and panic attacks, he would have come with just the right pill for me.

Only it would not have been the right  pill. I had an adrenal problem. It was a clever physician, who took the time to talk to me (as opposed to this psychiatrist who spent 15 or 20 minutes with each patient) who thought he found my problem and had me tested. The test was positive and I was treated for adrenal fatigue - successfully. Had I gone the psychiatry route I would be on drugs of one sort or another, for who knows how long. And who knows what toll the medication would have taken on my body - and I would still have the problem.

Although psychiatrists are also physicians, like all specialists they suffer from tunnel vision. Parents who have children suspected of having ADD or ADHD would do well to investigate a  physical or nutritional cause first. If none can be found then I would think of going to a psychiatrist specializing in children. The drugs for ADD and ADHD can be quite nasty and should only be used when all else fails.

[benjimom]

I agree with you and I also think physicians in general, not just psychiatrists are too quick to reach for the prescription pad for any type of symptoms.  Some people genuinly need medications.   The psychiatrist I took my son to is very conservative in his approach.  So far, no medications, it kinda shocks me, but in a way relieves me too b/c it will give us more time to observe him and figure out what is wrong, etc.  

I'm glad you found out about your adrenal insuffiency.  

There is a book I read, should I medicate my child and it talks a lot about this sort of thing, maybe the meds do help, but really don't chnage the underlying cause.  It just sedates a child or like Ritalin, it would make any of us do better.  If we took Ritalin, we could all focus and really get things done.  

Yes, specialists do tend to be tunnel visioned. I remember working with a cardiologist who would say I'm just the heart doctor, he did not want to hear any other problems unless they specifically pertained to the heart.  We aren't just hearts walking around or brains, but a WHOLE being.

[madelefant]

I'm amazed at how in the medical profession the left hand never knows what the right hand is doing.  I don't find it unusual there are so many medical legal suits. I'm surprised there aren't more.  

[specialmom]

Well, depression and anxiety are clinical conditions to be treated.  For example, if you have a thyroid issue such as hypothyroidism, you will often see a person present with depression.  The two often go hand in hand.  However, that does not mean that the depression should not be treated.  Based on seeing a psychiatrist which is a specialist for mental health issues, it is assumed that one has had a general medical work up at some point with a primary care physician.  Depression and other mental health disorders are chemically related.  It is proven science that the best treatment for someone who is clinically depressed is talk therapy with medication.  

Medication has helped a tremendous amount of people and I feel happy to live in an era that medications are available to help adults and children.  There are many things available to us and seeing a specialist in mental health is one of them.  When you do, you will be treated for your clinical presentation of a psychiatric disorder.

For children, a prudent parent would try other options first as a good parent does not relish medicating their kid.  Oh, there are those out there that would rather do that then the hard work of parenting a child through a crisis, but I'm optimistic that this is still a small percentage.  

My hope is that all are given whatever it is that they need to feel healthy and live their life to their full capacity.  

  

[allmymarbles]

We all have a medical philosophy. For me I want to know the cause of the symptoms and avoid the quick fix. I am wary of medical fads, and these are as prevalent in the medical profession as they are elsewhere. I never take any medication unless it is absolutely necessary. (I once made a nasty mistake in that regard.) I use alternative therapies whenever possible. I advocate medical treatment rather than surgery, when feasible. I stay away from doctors who love the knife. Obstetricians and unnecessary C-sections come to mind. I keep in mind that not all doctors are intelligent and that some are downright unethical.

Having said that, I have the good fortune to know some very fine doctors. The one I rely on the most does not take insurance and I am happy to pay him from my pocket.

[specialmom]

allmymarbles, I think your medical approach is fine and works well for you.  You found this out from your general practitioner?  Well, specialists are usually seen after you've worked with your general practitioner to rule out any underlying medical condition.  At least that is the way it is suppose to work.

I am glad that you uncovered the cause of your issue and were able to treat it successfully.  

The above who mentioned lawsuits must know that frivolous lawsuits are what have driven malpractice insurance sky high and is a leading contributor to the outlandish cost of health care in the US.  Malpractice is clearly defined under law and in nothing that Allmymarbles said would a psychiatrist be doing the wrong thing in treating her.  If one goes to a psychiatrists office presenting with symptoms of a psychiatric disorder, they treat.  Typically that is what most people do need in terms of mental health.   Quite often it is depression that is underlying other health concerns and in treating depression, the patient gets better overall.  I am speaking more from the aspect of adults that are being seen for a psychiatric issue.    All of this is just my opinion, of course.

Anyhoo, you do bring up a good point that ultimately we have some responsibility to educate ourselves about our medical needs and adequately convey them to the physician treating us.  Sounds like you did a good job of that Allymymarbles and I'm glad you are better from the condition.

[allmymarbles]

The doctor "I rely on the most" did not indoctrinate me into his way of thinking. I chose him because I agreed with his approach. My own attitudes evolved from personal experience,  professional, familial and social, in the medical community. Certainly many in that community have ideas much less conservative than mine. This is where our own perceptions and goals come into play.

[benjimom]

unfortunately with psychiatry there is limited hard data with diagnoses and children are even more difficult to diagnose.  

[allmymarbles]

Which is why we should be ultra cautious in dealing with the very young. Which is why we should refrain from drugging them, except in blatantly extreme cases.

[specialmom]

Yes, it is agreed that we should be extra careful with our children.  They are our most precious gifts to take care of.  

There is limited scientific study in children mainly because of the above statement as well.  The ability to study things in children is hampered by the liabilities.  Most parents do not want their child to be the "test" child and studies are very difficult to conduct.  

I don't think children should be medicated unless there is a clear diagnosis and all other things have been tried.  Medication is rarely an easy answer anyway.  Most children or adults that need medication for the nervous system (as psychiatric orders and add/adhd are) need all sorts of other intervention as well to have a good chance for success.  I'd go the route of trying the other things first and going to medication last.  Just my opinion.

[allmymarbles]

Thank you all for your replies. It is gratifying that I am not alone in my thinking. Our children are vulnerable, and it is we, the parents, who must ultimately take responsibility for their care. Therefore we should not be shy about questioning a doctor's diagnosis and treatment. Having an MD does not make him infallible. And, remember, we know our children more intimately than anyone else, and we care more than anyone else.

[benjimom]

Yes, and we shoudl not think of medications as the "magic bullet". I mean they help people such as in depression, but there is more that they need to do than just take a pill.  In Adhd, it might help, but it's not the only thing you should do.