MED fear

I think humans were designed as negative feed back loops. When someone is doing great on meds you probably are not going to hear about it. They are just sailing along living their lives and don't feel a need to come on these forums.

As soon as someone has a bad reaction or a med quits working then every one is going to hear about it. It is human nature. If nothing is broken why draw attention to it. All is as it should be. When something is wrong we draw all kinds of attention to it because something needs to be fixed.

So we end up with a skewed view of things.

I think I got lost on page one with the paintballing thing.

I think this is so true. I think there tends to be an overall lack of trust toward psychiatrists and psych meds in general because of what we hear about SE's. We never hear about the success stories. The truth is that most pdocs want what is best for their patients, and are not slaves to big pharma as many people in the general public might believe. But there are only so many options out there and a lot of people who need help, so its difficult. A pdoc who is well versed in combinations of meds that may work well together and off lable uses can be the most valuable out there.

My pdoc did a study on how quickly AD's take effect and he believes many people DO feel the effects right away - positive and negative. So if it is workibg, many times its not a placebo effect, it is really working. SSRIs take a little longer, so you do have to give it at least a month, and they'll argue you should even give it two months. Three months is pushing it, according to my pdoc at least. And if by then youre feeling more side effects than benefit, then you should switch. But, its important to admit that the reality is there is no psych med out there that is 100% without side effects. Many go away with time, but for some don't, you just have to be patient. In my case, my pdoc agreed that Lexapro made me much more depressed, as do most SSRIs at the higher dosage. But that is not uncommon for certain people. Wellbutrin made me so tired I could barely stand or speak. MAOIs are miracle drugs for me in one regard, but the weight gain was too much and dietary restrictions were too risky. And Lamictal made me stupid. He won't even touch Effexor for me, he thinks it will make me more depressed and avoids it also because if the SE profile and withdrawals. It took a few years but we finally found a combo that did it for me...prozac and a stimulant. Without the stimulant add on its not great, but with it its great. You just have to be open to the possibility that there is something out there that can help you if you have the right guidance.

"I think this is so true. I think there tends to be an overall lack of trust toward psychiatrists and psych meds in general because of what we hear about SE's. We never hear about the success stories."

We hear the success stories all the time! You have the whole marketing arm doling out success stories on the news and media and drs offices. The overall lack of trust is not as simplistic as SE. People want to have faith in their doctors. It has taken years build distrust.

If you go in for chemo you expect to be scared. Not just for the disease. For the treatment too. The professionals give you ALL the information they can before hand so you are prepared. The same is true with an operation. "So you know what to expect". And you can refuse the treatment too without criticism. If the dr wants the patient to try it for 3 months why don't they tell them? If they say call me if you feel discomfort what exactly do you expect them to do? The ads tell you it is going to be a "glorious" day once you take this magic pill and the dr says almost nothing other than make an appointment.

Why is there so much distrust of patients to make intelligent decisions?

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Its more the fear some people put to med newbies they are scared and ask advice . To be unsensitive to these frighted people by trashing the very med they just started is cruel to say the least. Seasoned med user,s know the in and out of start up but newbies don't . But if the thing they ask sounds dangerous ocourse let the no. but for someone to ask about headache or constipation feeling tired or sickness. They don't need to be told to get down A-E straight away you may be in serious trouble, We have all had bad reactions, but not all the same on the same med. DOCTORS soon get fed up with people that wont do a med trail but ask for help, some times a med don't suit and we react , but reacting because you have been told its going to happen you by someone on a forum, will get you no help from the doc.

I don't fear medication. When I really needed a new med I took all kinds of stupid risks and I didn't care about possible dangerous side effects. I was so desperate and my problem was trying not to get my hopes up. I always thought my new med would be the one making a difference. Those who say meds work if you believe in them, LIE. They work if they work, they don't work if they don't, no matter how much you have hoped!!! So many times I was disappointed, still next med and I had the same naive hope.... Not afraid of side effects and believing in the med. It should have worked, right? Most meds did not work. Despite the "right" attitude.

So where did I go wrong since it was obviously MY fault somehow....

I have not heard that many success stories in the media. There are certainly tons of ads by big pharma. I don't give them any credence. They do have a huge influence on people.
Lately it seems Andrew Solomon is the media poster boy for depression. I am part way through his book Noon Day Demon and from what I can tell he had this great life and then in his thirties had a major depressive episode, went on meds and therapy and has been fine ever since. I am like big deal, that is nothing like what most of us go through. He is extremely educated on the issue.

The last story I heard before that was promising studies on ketamine for depression but that was a couple of years ago. The main stream media doesn't talk about that much.

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Question: if you had a gods-eye view of a sample of people with depression symptoms but you knew exactly what the cause was. Sometimes it is depression and sometimes it is something else. Would the pdoc ask questions that would identify the need for a different specialist and they should be tested for yadda yadda? Or would they walk out the door with an rx?

The distrust I have is that there are a lot of things you can rule out but pdocs aren't trained to even suspect another problem. I don't mean they should be able to diagnose cancer. I mean if your friend's symptoms are depressive and similar to something else that can be ruled out wouldn't you want your friend or family member to be referred? In engineering that's exactly how you work it if you don't know the root cause. You rule out what you can then go from there. Just about every other specialty can rule out one or more things. Meds often cause the same symptoms as depression. Once you start them it is much more difficult to determine what the reason for depression is. That's why I hate to see moody teenagers put on AD's.

I appreciate that you guys feel grateful for finding something that works for you. I have trouble when I or somebody else has to work so hard to convince you that it isn't the best way for them. I've noticed people, including myself, practically writing dissertations to explain themselves. What's even harder to understand is I and others have used meds as a tool. Somebody even suggested I am in denial. On an individual basis you seem to understand but only after that dissertation.

Steve Jobs recognized that alternative medicine didn't work for him in the end. That if he had gone the western route he would probably still be alive. But people didn't bang him up either. (Well, I doubt you could ) Many people make those kinds of choices for lots of different reasons. They understand there is a risk. Why isn't it possible to respect their decision at face value instead of explaining it away as fear or denial or noncompliance or ignorance or whatever?

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A lot of people give those ads credence and they don't know when a blog post or news article is basically a pr piece. Then they share it and off it goes.

Ketamine is still being studied. I have heard about study with LSD too but you don't hear anything about that. But that's kind of the point isn't it? Nobody owns the patent for either one. I'm not being negative... That's just how marketing works. It's a market economy. There are a lot of things they could be studying but aren't studying because there is no ROI.

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I meant you hear less success stories from patients in this type of forum. It tends to be human nature that we are more likely to complain when something isnt workng, but say nothing when things are working (and thats true for anything, not just medication). And since the bulk of positive info you hear is marketing for pharma companies, finding unbiased information on both sides can be a struggle. As a "newbie" to meds, that can be pretty intimidating.

I think you have to self advocate and educate yourself no matter the health condition. Many people don't.

I don't think I have ever disparaged anyone for not wanting to take meds or for going for "alternerant" methods.

The last four times I have had to interface with a mental health facility I had to do a two hour intake with a psychologist, had to meet with a nurse, had to get blood work done, and had to have a GP before I could see a pdoc.

It is certainly true though that if you go straight to a pdoc chances are you will walk out 15 minutes later with an rx.

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I think the biggest factor in a psychiatrist's decision to prescribe AD's to a patient is the fact that the patient is seeing them in the first place. Even though many do, I don't think a general practitioner should ever diagnose depression or prescribe psychiatric medication. So I'm looking at this from the perspective of a patient who has interest in trying antidepressant therapy and has taken the initiative to see a psychiatrist. Otherwise, why even go to one? I know this is going to vary with everyone's personal experience, but depression/ anxiety due to an underlying medical condition are usually accompanied by physical symptoms (like with hypothyroidism or iron deficiency for instance). When they're not, then the GP will recommend psychiatric treatment.

Children are another subject altogether. I'm really talking about adults here, by the way. Kids don't have the same control over their medical treatment. So while Im not against meds for kids per se, I definitely can see a lot more room for error in that respect.

Thats a really good argument to not allow direct to consumer advertising. The whole point of that kind of marketing is to get patients to go and ask for it by name. I have a hard time believing most patients go to the gp and then are referred. I could see that happening in other countries but here, with the marketing?

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I think it is true though that psychiatrist have ended primarily in the role of doing 15 minute med checks and all they do is deal with meds. They get 250 an hour so....

I have been lucky that the private insurance I had, Kaiser in CA, and now community mental health in Michigan have been very thorough before letting me see a psychiatrist.

I also agree with you that by the time you reach out to a psychiatrist you are in really bad shape and have probably self diagnosed.

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You had a good experience with kaiser for MH? I loved the well care treatment... That is their strength after all but I was not happy with the MH treatment at all. If I worked for a company offering their insurance I would probably get my own (and I can do that now ) I was being considered for a job with them recently and I was trying to figure out how I would handle that actually.

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I feel meds have a place in treatment, but a lot of pdocs are over prescribing. At one time, I was on 5 different meds at one time. I was like a zombie walking around, this is just wrong.A lot of pdocs are nothing but drug pushers! It wasn't until I cut back on my meds and started CBT, that I started feeling better.
Why did it take my pdoc 20 yrs. to figure out CBT would be helpful?

Kaiser in Northern California. Most of my experience was with the chemical dependency side which had its own pdocs. The last pdoc I had with them on the mental health side was lousy. Overall I was very satisfied with kaiser. I have heard that kaiser on the east coast is lousy. I think a lot depends on the location. If I was offered a job at a Nor Cal facility I would take it.

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Well it's day 2 on Pristiq and I definitely feel a difference. 1. I am not feeling depressed at all. 2.) I am not having anxiety. Both good things so far. I do feel kind of high. I get tired but then a surge of energy will come kind of like taking Ritalin LA without the euphoria, I've had some nausea and other GI issues. I see the doc tomorrow, well see what the doc says about what I've experienced so far and if she would like me to take the Wellbutrin or wait for a few weeks to see how this drug works out.

I have been feeling kind of wired once in awhile on Fetzima too. An SSNRI it's the norepinephrine

I think you should stick it out. I do now think it is different than Effexor.

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Yes I agree with you on that, Michanne. I think its wrong to market medications this way. It's bizarre how these ads can both encourage the promise and frighten people at the same time.

Consumer advertisement is banned here, the ban against advertising OTC meds was lifted though. But what does it matter when your doc had a visit from a drug seller and really wants you to try this new cool drug on you? The med that finally helped me she didn't want to give me at first because no drug company had pushed it so she figured it wasn't worthwhile. If docs can be that dumb, advertising towards them must end also!

Jimi... Ouch! That is scary as heck! I don't know if it is still legal in AU (is that where u r?) but if it is US and AU are the only countries that allow it. A T in a hospital ( not mine) told me the docs she worked with were so grateful to the reps because they are able to help the "needy". The problem is those phd's couldn't see that those patients are going to struggling to pay for them down the road. But also, were they right drugs or were they just on hand?

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EU. Sorry wrong "u". LOL.

It used to be illegal in the states for the direct marketing to consumers and should be again. They did crack down some on the drug reps. No more gifts and luncheons and donuts for the staff and extravagant dinner presentations for the doc and whole staff. This is recent.

My brother in law worked as a drug rep for Pfizer for many years. Food and charm were his biggest ally and getting in with the staff. He always had top sales in his division and won trips and awards.

A lot of docs would refuse to see him or any other drug reps. Now they can only see them for "educational" reasons, no gifts.

If you want Viagra pens I have hundreds of them, chantix too.

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I was wondering about the norepinephrine. I was curious if I even needed an SNRI because the SSRI (Celexa) worked fine for my mood. I am wondering what the norepinephrine will do for me and if I really need it. I'll have to do some research on norepinephrine.