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Originally Posted by Cracking Slowly
Sometimes & Costello I think you have made some very good points in your posts. However, I don't know Newtus personally. I only know her online. She lives in a very small town about an hour or so away from me. I know the area very well. The choices we have here in our area for mental health care aren't that great. I know this from my own personal experiences with myself and two family members. I agree that a person must work very hard and desire to recover. I've been there and done that myself. Although I am not "well" I manage to function in my life. For that I am very blessed. I don't think Newtus "doesn't" want recovery nor do I think she wants to "cheat the system". I think the reason she feels like giving up is because she feels that the mental health system she has available in her area isn't listening to her. I think because of where she lives she doesn't have the option to seek better pdocs, and therapy. And from Newtus posts she has said that she has zero family support. She lives with an older alcoholic father who has his own problems. He can't help her get better if he can't help himself. And her mother isn't around to help her either. I think Newtus is crying out for that nurse to understand that the injectable medication that they are forcing her to take is not giving her a "good quality of life". If the medicine isn't working and only making things worse for her then they should not continue to force something into her body that isn't working. In my opinion I think this is what pushes her to want to drink the alcohol and to want to discontinue her medication. I don't think Newtus wants to just "not comply". It sounds to me like she has some very serious issues with the medication and they continue to up the medicine and force her to take it by injection. What better way to shut her up by over injecting her with a horrible medication that is taking away the "quality of her life". She is still hearing voices even on the medicine. She still has the same flipping problems on that medication as she does off of it. So why force her to continue that injection if it's making things worse for her? I think Newtus would jump at a chance to see a "good" pdoc and a "good" therapist if they would listen to her. In my experience with the mental health care in our area they just want to fill you full of medicine, shut you up, and send you on your way. I have experienced this myself with my own daughter! Just because a person has a mental illness does not mean that they should not be listened to. They should not be treated rudely or told they have no chance at going to school because they "aren't stable". Maybe they should listen to Newtus and get to the root of the problem to understand why she behaved the way she did. I of course wasn't there so I have no clue how she behaved with her nurse. But I think she behaved this way out of anger and frustration. When someone continues not to listen to you and they force you to be injected with a medication that ruins your "quality of life" you get angry! You flip out because you are so freaking tired of going down that same damn road and getting the same terrible results. I think Newtus wants to recover she wants to have a better life. I don't think she should just shut up and do what they tell her if it's not working. I think they should open up their ears and really listen to her. I think she had every right to stand up for herself! And look how they reacted....they raised her horrible injectable medication once again!
Did the nurse do this because she was pissed off at how Newtus reacted towards her? I believe she did! I believe they want to focus on her reaction instead of her words. They see her behave as an "unstable" person. If they have all the education like you mentioned in your post then shouldn't they be smart enough to figure out that her "unstable" behaviour is due to being forced to take the injection? Shouldn't they get to the root of the problem instead of continuing to force the injection on her? I don't think Newtus wants to respond "unstable" to the nurse. I think she is crying out loudly to be heard and all they want to do is tranquilize her! I think it's wrong and I am sad for Newtus that she is forced to go through this. And have "no quality of life".
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Thanks for this---I'm generally aware of her life situation---it is incredibly difficult and I would struggle given the same situation. What I was trying to explain was the point of view of her doctor and society. It is not necessarily a view I agree with but unfortunately it is the reality. The reality is it does not matter that these meds do nothing for her or make a marginal difference at best---the doctors have essentially one form of treatment for psychosis---all the treatments that work inhibit the D2 receptor and then they inhibit various other receptors as well. The only other mechanism is clozapine which is also a minor D2 antagonist. So if I were an MD and I got a new patient who was both psychotic and potentially suicidal---I have to fix her because she might hurt herself and as a doctor I would be legally bound. I know that Newtus has tried nearly every medicine out there----at least all of the atypicals so why not try a typical like haldol. Perhaps she's not recovering because of non-compliance? Well then it needs to be an injectable. The problem is what do you do when people don't respond to treatment? Personally I think they should be allowed to discontinue treatment but I doubt any pdoc would allow that---if I were an MD I would have zero incentive to leave any patient unmedicated because it would put me at risk legally. Switching meds is OK but a med must be used or it looks like I'm not doing my job. Pdocs are for meds---that's all they do. Its not that I really think she is consciously trying to cheat the system but that disability is a deal with the devil. In order to accept it you must make concessions it does not come without strings, one of those strings is seeing a doctor---as I said above a pdoc implies meds, that's all they know how to do.
Newtus I'm not trying to tell you that you're wrong with the way you're thinking. I totally agree you shouldn't be on the meds if you don't want to be. I would also wish to choose no meds in the same situation. But if disability were the only way I could live then I would play by the rules and attempt treatment. Whether it worked or not because I would see the limits of the doctors and nurses and choose to respect them for doing what they have to do. I would understand that they hoped to help me but that it might not be possible. I guess I feel that you are fighting the wrong battle. The nurse is there to inject you---that is her only job---she's probably not even aware of the specifics of your treatment----she is not the one to argue with because the only thing that will come of that is anger---the situation is not in her control. The doctor has more freedom to alter your treatment but because of legal ramifications he is unlikely to do so until you are well. The only way to get a doctor to change your dose is to become well or feign wellness. If you become well (truly or through lies) you may no longer qualify for disability. Its a catch 22. Here's the thing, the system itself sucks...the only way to really change things is to change the system. You need to think about changing laws and policies not the nurse she is trapped in the system. The reason I'm promoting recovery is that it's an alternate much easier approach vs. changing laws---if you get better you won't need disability. I'm not saying that you don't want to---I know that you've tried before. Try again or if you prefer to fight then fight the system----fight the laws that make things impossible for the mentally ill. Fight where it will make a difference, arguing with either your doctor or nurse isn't going to get you anywhere---they are trapped because they must do the jobs they are paid to do---nurses inject--doctors prescribe. Decide what you want to do and then do it. Its a lot easier to be on the drugs for a couple of years and then taper off than to change 200 years of public policy. But if that doesn't suit you then fight, but fight smart. Fight people who can actually make changes not those forced to play their own role by society. Write letters, make calls start a lobbying group...whatever it takes. But really leave your treatment team out of it they may be a**holes but they are as stuck as you are regarding your care, when you come to them it is implicit that you are asking for help. Do you really expect them to risk their jobs for you because that is exactly what you are asking them to do...