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Shortcomings of Pill Psychiatrists
Those of you who have seen my postings, particularly on ADD and ADHD, will assume 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 he asked 11 set questions. The answers focused led him to his diagnosis. Nowhere in this article does he consider a physical or nutritional cause for the patient's condition. Had I gone to a psychiatrist and described my symptoms of anxiety and panic attacks, he would have come up with just the right pill for me.
Only it wouldn't 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 still would have had the problem.
I am not against psychiatry. But a psychiatrist is also a physician, and he should not forget that.
Only it wouldn't 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 still would have had the problem.
I am not against psychiatry. But a psychiatrist is also a physician, and he should not forget that.
I'm so glad you got a proper diagnosis, that is so important.
If I may, for a minute, just play devil's advocate. When a person goes to a p-doc, TYPICALLY they are referred by their PCP, who is the one responsible for ruling out any medical problem that couldbe responsible for the symptoms. It kind of goes without saying that once a person gets to a p-doc, any physiological problem has already been ruled out. If a person decides to go to a p-doc BEFORE that happens, or if a PCP recommends that before a proper medical work-up...then the process is backwards, and certainly something medical may be missed.
I know that every time I went to a new p-doc, a thorough medical history was collected by the physician, including asking what kind of a medical work-up was done (including labs, diagnostic studies, etc) before I was referred to him/her. In all fairness to the p-docs...their primary responsibility is to treat the "mind" AFTER any and all other MD's have done their part physically to rule out a medical cause. If anyone would be dropping the ball, it would be the PCP, who jumped the gun to refer patients before an all inclusive work-up was done.
Like I said though...I find it pretty standard that the p-doc collects all of that info at time of intake...of course they are interested in that, they need that info...and maybe I'm naive, but if a person was sent to them without ANY medical work-up and they knew that...I would find it hard to believe that they wouldn't at least rule out the most common "copy cat" disorders (meaning common medical maladies that mimic a mental disorder) before treating and diagnosing a mental illness. They would actually open themselves up to a lot of liability issues if they did that.
Just my two and half cents. LOL
If I may, for a minute, just play devil's advocate. When a person goes to a p-doc, TYPICALLY they are referred by their PCP, who is the one responsible for ruling out any medical problem that couldbe responsible for the symptoms. It kind of goes without saying that once a person gets to a p-doc, any physiological problem has already been ruled out. If a person decides to go to a p-doc BEFORE that happens, or if a PCP recommends that before a proper medical work-up...then the process is backwards, and certainly something medical may be missed.
I know that every time I went to a new p-doc, a thorough medical history was collected by the physician, including asking what kind of a medical work-up was done (including labs, diagnostic studies, etc) before I was referred to him/her. In all fairness to the p-docs...their primary responsibility is to treat the "mind" AFTER any and all other MD's have done their part physically to rule out a medical cause. If anyone would be dropping the ball, it would be the PCP, who jumped the gun to refer patients before an all inclusive work-up was done.
Like I said though...I find it pretty standard that the p-doc collects all of that info at time of intake...of course they are interested in that, they need that info...and maybe I'm naive, but if a person was sent to them without ANY medical work-up and they knew that...I would find it hard to believe that they wouldn't at least rule out the most common "copy cat" disorders (meaning common medical maladies that mimic a mental disorder) before treating and diagnosing a mental illness. They would actually open themselves up to a lot of liability issues if they did that.
Just my two and half cents. LOL
That group sounds impressive, but I am so sure they are worth the money. They perform every test they can think of, useless and otherwise, then sit back and read the results. My doctor takes a different approach - he speaks to his patients - and he listens to them and observes them. The first session is at least an hour. Once he understands who and what he is dealing with, he arranges for specific tests. He has the heart and brain of a diagnostician. Interestingly he has never done a test on me that has come back negative. He just used the test to confirm what he was thinking. As for blood tests and that sort of routine thing I have the HMO quack do them, and then I give the results to my REAL doctor. My doctor does not take insurance. I pay him out of my own pocket, and he is worth every cent.
P.S. The first lengthy visit costs about $400, and the cost of the tests themselves are affordable (since he only tests what he thinks is necessary). Followup visits are $200. He is physician out of Yale who practices both traditional and alternative medicine.
P.S. The first lengthy visit costs about $400, and the cost of the tests themselves are affordable (since he only tests what he thinks is necessary). Followup visits are $200. He is physician out of Yale who practices both traditional and alternative medicine.
They were 24-hour saliva and urine tests. The main symptom was extreme fatigue. At times I had difficulty walking across a room. The fatigue, though always present to some degree, came in waves. I suffered panic attacks. The problem was traced to an inhaled steroid I used for asthma (actually I found the culprit myself). I stopped using the steroid, was given natural products to support my adrenal glands. On a short-term basis I took a very small dose of Xanax when I felt a panic attack impending.
There are a group of psychiatrists who feel exactly the same way. They call themselves functional physicians, deciding that, hey, they're doctors. They do rigorous exams and tests, particularly hormones, blood sugar, and other ailments that can cause mental symptoms. Only when they rule out all physiological causes do they turn to the meds for mental disorders. Problem is, they're few in number, don't work with insurance, and their tests are extremely expensive. The couple around me charge just to see if they'll treat you, and the first visit can run $1000 and the tests up to another $10,000. Personally can't afford that. If you're rich, you can find these innovators; if you're not, you will always run into the checklist people. Regular docs aren't much better -- they typically don't check for exotic illnesses and many illnesses are very hard to define, much less diagnose, by the run of the mill doc. The notion we know all these things and can find them is untrue. We know virtually nothing, but we are collecting a lot of information quickly. We are the guinea pigs; those who follow will benefit from our suffering. That's at least something to ease the difficulty. It is always how technological change and knowledge progress.
May i ask you something plez, what tests did the doc do to discover you were suffering from Adrenal fatigue and what were the syptoms? Was it a simple routine blood test that lead to this diagnosis or where there other factors and tests involved? Plus how was it treated? did you have medication to strengthen your adrenal gland?
I am extremely interested to know so please respond as soon as ur able. Thank-you
Julie
I am extremely interested to know so please respond as soon as ur able. Thank-you
Julie
I will also add to ILADVOCATE's words that we always tell people we are not doctors and to have tests done to make sure it is of the mind first. We have told numerous people that theraphy alone might be the best option. If someone comes on asking what medication they should be on, we tell them to ask their doctor. It is not like we are telling people to go out and get medication at the drop of a hat. Some people might need it. Others might not. But it is not up to us decide. If they are on medication we can give our opinions on the medication. But that's as far as it goes. We do try and get people to do other things as well. Exercises we think might help them. So what worked for you, and good luck to you, may not be the answer to everyone elses problems. At the end of the day that comes down to them and their doctor.
Yes that's understandable and that's why physical criteria should be ruled out before any psychiatric diagnosis is made. Before I was diagnosed with a psychiatric disability, I received a wide variety of tests including bloodtests and an MRI. These were to test for many criteria. However the difficulty being that once those criteria are ruled out there are no exact clinical tests for any psychiatric disability. However, through research into the brain and new treatment modalities (you can read through my posts, I am in a clinical study) they are further understanding exactly how to treat psychiatric disabilities. Anyone who has any concerns about any physical disability or illness potentially being the cause of what they have can discuss it with their doctor but those potential causes are not unknown and they do test for them and do further tests if there are any specific concerns.
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