April 30, 2009A Denunciation Of The Mental Health SystemYesterday, I posted on the fact that 10 percent of people being treated for depression in the US are now being prescribed antipsychotics (Abilify, Seroquel, Risperdal, Zyprexa) and one reader had some thoughts on a Seroquel-related incident. Q is Seroquel (or Susie Q), AZ is AstraZeneca (the drug's maker) and 5oh is the police (as in "Hawaii 5-0"). "There's a certain hospital here in SE Connecticut (not many to chose between, so don't strain yourselves trying to sort it out...) that literally uses a shovel to dispense Q to its in-patients. I thought it rather odd until I saw the AZ clock on the wall and numerous other pharma paraphernalia about the nurse's station. I know how the commenter feels. I've seen the mental health system on a street level on the West Coast for two decades and I've seen so many examples of the above kind of situation that I've at times gone numb to it all. BTW, it's interesting that no one in the media has picked up on that 10 percent Rx rate, which strikes me as a watershed moment in depression treatment. I bet you the media would pay more attention if 10 percent of patients with depression were being given ECT. Posted by Philip Dawdy at April 30, 2009 12:01 AM
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I too had a melt down on Seroquel last summer '08. My depression was bad, but the Seroquel stole my memory. I was taking 800-1200mg per night. I don't drink or take elicit drugs. When all of a sudden I was having fugue states. The first occurred in the middle to the day. I woke up on the lawn of a grade school near my home with my front tooth partially broke out and had lost my glasses (can't see without them). I didn't even have tooth pain. A week or so later I was asleep & during the middle of the night I practically destroyed my downstairs living room, but with no recollection. I quit Seroquel at thtat time and have been ok no further fugue issues. Posted by: Debbie Lawson at April 30, 2009 02:49 AMIt's troubling that no one in the mental health field seems to take seriously the fact that jobs have been declining for years, while homelessness and "severe mental illness" have been on the rise. What is our society doing when it gives someone seroquel and a psych label and record of institutionalization instead of a place to stay and a job? Also, it's odd that in the spate of stories last week about executive suicides, like the Fannie Mae man, no one in the media suggested mental illness as a cause for suicide. Is our society sending the message that if you're broke, suicide is sane behavior, homelessness is not. Us humans, we're all "mentally ill." Posted by: Sally at April 30, 2009 03:28 AMthere is almost no reason, nor evidence, for anyone being at 800 mg. this just tells you that it was not working at 500 or 600, and they had no better idea than to push it higher. same thing happened with prozac. dose was supposed to be 20mg, maybe 40mg. If not, try another strategy. Maybe uh, talk therapy for a change, since it has great evidence for efficacy in depression. These high doses are a sign that poor care is being delivered, or "shoveled." Posted by: MedsVsTherapy at April 30, 2009 05:41 AMPeace be with you I have been watching the houseless population for the last ten years. I saw the signs of increase in what we used to call wingnuttiness in the city 6 miles from mine which was starting to label the houseless as "mentally ill." It was apparent to me that the diagnosing and treatment of MH was directly causing this increase. As soon as the labeling and treatment was expanded county wide my town started to notice an increase. My interest in mental health advocacy started when our health director put in a state mental health funding plan that 80% of Humboldt county's "homeless" suffered mental illness, 90% are addicts, and some unstated amount are co-occurring. Though logic and all available data tells us that this is mathematically implausible, the Mental Health department persists with their delusions. Our county's number one employer is the government, the biggest department in our local county government is our mental health department. Houseless, foster youth, and inmates are their bread and butter commodity. And a couple of "off their meds" houseless on the streets are good PR events for their increased funding efforts. love eternal love eternal Or, MedsVsTherapy, Or perhaps you could LISTEN to your client's/patient's laundry list of symptoms as you peruse the results and use BOTH sets of information in making an informed treatment decision. There's a thought. I am in the process of having my thyroid hormone dosage upped because my thyroid's been flagging again. This explains my recent depression, fatigue, incredible memory loss (which I, yep, forgot to mention to my doc), difficulty in tracking conversations to the point where it felt almost as if I was dissociating and general bitchiness when confronted with the need to make the effort to deal with members of my species. I was so spaced out I didn't recognize what was creeping up on me. Of course, thirty years of "It's all in your head" brainwashing doesn't help. Thank goodness I'm no longer seeing a psychiatrist. Those dunderheads, each and every one of them, loaded me up with psych meds instead of making a simple medical diagnosis. Do these folks sleep through med school or what? And yes, most of us could benefit from some therapy. At this point the focus of mine is my recovery from the mental health system. I'll let you know if we ever get to my family of origin. Sherry Posted by: Sherry at April 30, 2009 08:46 AMI wonder what the chief of psychiatry was thinking at the elite hospital when he ramped my daughter up on 800mg of Seroquel in 2006? maybe he didn't know what he was doing.(there's the answer) Posted by: Stephany at April 30, 2009 09:26 AMDon't get me started on what passes for therapy in the in-patient setting. I remember a nurse asking a patient who just lost his probate commitment hearing how he felt. He answered (paraphrasing) "what kinda stupid ass question is that? How do you think I feel being forced to answer questions from fucking retards all day long???" His meds were increased later that day. He didn't much much more to say afterwards. I tried so hard not to laugh out loud at his comment, but I wept like a baby later when I had I seen what had happened to him and read what was written in his chart. Posted by: Paul at April 30, 2009 09:36 AMI am a registered nurse and have worked 29yrs as a nurse. I even work in a psych hosp. I trust my psych doc completely. The Seroquel 800mg @ hs was what I thought I needed at the time. I've found out since then I don't do well with antipsychotics. My thyroid had been checked freq. & on thyroid med. for several years now. Problem was I had intractable Bipolar depression for so long I had been on multiple antidepressants & anti-psychotics. Nothing helped. I did ECT & on my 2cd tx it affected my heart and I could no longer have any tx's until after a 6 month wait. My pdoc told me to stop the Seroquel when I told him about the severe memory loss, but I was scared to death. Psychotic & suicidal. I just had no hope and I thought the Seroquel would make me normal. Even though I've been psychotic many time I won't take Antipsychotics again They are dangerous for me. Posted by: dmlawson57 at April 30, 2009 09:44 AMSherry, A good endo can be so very hard to find. Many people have sensitive thyroids and tolerate a very narrow range of replacement. Therapy or some good friends and spending time together? It's amazing what just listening and not judging can do. Paul Posted by: Paul at April 30, 2009 09:49 AMTad, You hit the nail on the head. Mental health and drug and alcohol addiction "treatment" are huge industries. If we did away with these and provided housing and work, food and water, we'd be a lot better off as a society. The conflicts between mental health and drug "courts" and for profit "treatment" centers are also a big deal. Posted by: Sally at April 30, 2009 11:57 AMPaul, The first time I saw this PA was after 30 years of "treament" by mental "health" docs. I went to see her for a sinus infection. On my way out the door I asked "Oh, by the way, what were the results of the blood tests they did six months ago?" She looked them up and, lo and behold, noticed I have hypothyroidism, something I'd suspected since my late twenties. No one had called to inform me of this little factoid. I hate being near doctors or their offices now, but she's dragged me back twice, using my need for scrip refills as leverage. Both times she's made me take the blood test that was used to deny me treatment for what is now acknowledged as 30 years of hypothyroidism. I've hated every moment of this. And having to haul my sorry ass to the office twice each time--once for the hated blood draw and once for the (almost equally) hated stilted little visit has not been fun. This time she took a look at my test results and said "You're in the normal range at 2.4 TSH, but I like to see people more around 1.5. Since you're not having any problems..." At that point I told her of the problems I'd been having and she immediately raised my dosage. Turns out my thyroid is lagging and the old symptoms have started creeping up on me. I hear so many tales of docs ignoring thyroid patients who feel horrible with clear symptoms but who are "in the normal range" that I hadn't bothered to mention anything. By now I mistrust doctors so much I never tell them anything unless I have to. I went on to tell her how I felt about coming in and she stunned me by offering to make a home visit! I was so touched I began to cry. Then, as she listened intently (often with a totally stunned expression on her face) I went on to tell her of the chain of almost unbelieveable malpractice by several doctors and a mental health worker (who actually was fired as a result) that had nearly killed me about ten years ago. I had told her in a previous visit that I didn't trust doctors but she didn't know why. As I left she said she might be able to help me clear my records of the outright lies the docs had put there to cover their arses. So I am lucky. I have found a physician's assistant who is so superior to any doctor I've ever found that they hardly seem to work in the same occupational grouping. Sometimes I think of all the money wasted incarcerating me twelve times in various nuthouses and multiply that by how many others with undiagnosed thyroid problems. I'm sure we could be spending our money on something better. Sherry, I really identify with you. I spent quite a while in therapy trying to deal with my inpatient experiences. It's mind boggling really that people who are hurting are treated like total crap. It makes no sense to me. Obviously those memories are still very painful. The year I moved away and began the long process of attempting to put the pieces of my life back together, I needed to see a regular physician but had no health insurance at that time. So, I had to go to a health care clinic for the indigent. I walked in with my head down fully expecting to be treated like crap. Instead, I met a physician (all the physicians at that clinic were volunteers) who treated me with such tenderness. I was stunned. I had forgotten what it was like to be treated like a human being, someone of value. This physician had worked as a family practice physician for many years and surprisingly had not become jaded. She reached out to me, and I can't help but wonder what a difference it would have made to have encountered such kindness when I was inpatient and needed it so desperately. As I was leaving the clinic that day she asked when I had last eaten. I mumbled a reply. She turned and unzipped her purse and took my hand and put two twenty dollar bills in my hand. I shook my head no and said I can't accept this. She said, "I want you to. I just ask that you spend it on food. And I want you to promise me that you will let me know how you're doing." My eyes flooded with tears. This was not a mental health care clinic, but in less that twenty minutes she did more for my wounded spirit than any psych hospitalization, any antidepressant medication, any med check. Posted by: Lisa at April 30, 2009 07:21 PMLisa, Are you familiar with Mary Ellen Copeland's work? She does a lot of peer-to-peer work, teaches people how to make an advanced directive plan for their mental health "care" to avoid the many abuses the system perpetrates in its quest to maintain the cultural status quo. Her mother spent many years in the snake pit of the Waterbury, VT state hospital being "treated" for manic depression. Mary Ellen describes the place very eloquently, then ponders aloud just why anyone would think putting her mother in such an environment would ever be helpful? And hey, what would have happened had they spent that money sending her on a nice cruise to Bermuda? Good questions. Have a great, psychiatric-free day. Sherry, I had not encountered Mary Ellen Copeland's work. Thanks for the tip. I just watched a couple of her youtube videos. A breath of fresh air. Posted by: Lisa at May 1, 2009 08:35 PMfound great endo in phone book who returned my page immed. and saw me next day. Knew the scoop, asked the right stuff, ordered sonagram of thyroid and bone density scan. Result, years of unneeded lith (14-) not only caused (treated, mind you) total disappearance of thyroid (suspect a tiny little pea will show up on eventual cat scan of throat, and hypothy caused a totally destroyed neck of rt. femur bone. Risk of breakage very high. Fun fun fun. endo not only compassionate but actually took a thorough history and was compassionate....thought I would faint dead away from this response Posted by: sorrowful at May 4, 2009 06:51 PMsorrowful, I just had a very healing time with my physician's assistant last week. She listened intently to my story of near death from medical mismanagement and malpractice and subsequent pejorative diagnoses. And believed me. Said she might be able to help me expunge my record of falsehoods. I'm so glad to hear your news. It's a shock to finally get the hypo treated but you'll really feel like a new person. Post a comment
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