Chemical Restraints

</font><blockquote><div id="quote"><font class="small">Quote:</font>
sunrise said:
Meds help some people, but not others, and some people somewhat, etc.

</div></font></blockquote><font class="post">

That is so true. Although meds have helped me, my friend had a terrible experience with them. She was prescribed Adderall and went into a psychosis after several weeks on it. Her doctor actually wanted to add an anti-psychotic instead of stopping the Adderall! In her case, an anti-psychotic would have been a complete disaster because her psychosis was caused by a drug, not by a mental illness. Luckily, her parents did not allow that and she went back to her normal self after discontinuing the Adderall. So yes, everyone is different. Doctors are different. Some docs are great and others doctors are idiots.

Anti psychotics were used to sedate people so they weren't management problems well BEFORE the days of managed care.

I think that it is important to resist the

'if your meds work for you then you have a legitimate disorder'
vs
'if your meds don't work for you then you are a whiny whinge with nothing really wrong with you' line.

genuine cases of depression can result from upsetting events (such as not being accepted into a particular colledge).
parents can be genuinely distressed and upset that they can't manage their childs behaviour better - and they can be attempting to seek help the best way they know how (and the doctor suggests that 'it isn't your fault - just give him some ritalin).

> Our experiences are trivialized because psych drugs are overused.

I don't think anybody is trying to trivialize your experience. I think we should be wary of trivilizing the experience of those who manage off meds or of those who think that meds are what they need (including the pill poppers).

I mean... Their attitude isn't so very surprising given the marketing - is it?

The medicalization of distress...

And the drug companies get richer...

</font><blockquote><div id="quote"><font class="small">Quote:</font>
alexandra_k said:
Anti psychotics were used to sedate people so they weren't management problems well BEFORE the days of managed care.

</div></font></blockquote><font class="post">
Good point. I do think managed care makes the situation worse though.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
alexandra_k said:
I think that it is important to resist the

'if your meds work for you then you have a legitimate disorder'
vs
'if your meds don't work for you then you are a whiny whinge with nothing really wrong with you' line.

</div></font></blockquote><font class="post">
Oh I never meant to suggest that at all. There are plenty of people with geniune mental illnesses whose meds don't work for them. I'm concerned that these people's experiences are being discounted by the people who've had good experiences w/meds. That was the point of my post.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
alexandra_k said:
parents can be genuinely distressed and upset that they can't manage their childs behaviour better - and they can be attempting to seek help the best way they know how (and the doctor suggests that 'it isn't your fault - just give him some ritalin).

</div></font></blockquote><font class="post">
That's a sad reflection of our society. Unfortunately people sometimes like to use biology because they don't want to admit that they might have made some mistakes. Doctors need to be more responsible about prescribing meds instead of taking kickbacks from pharmaceutical companies. People who have mental disorders should be offered a variety of treatment options including but not limited to medications.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
alexandra_k said:
I don't think anybody is trying to trivialize your experience.

</div></font></blockquote><font class="post">
True, that's not the intent but that's the inevitable result of overdiagnosing mental disorders. Not just my experiences, but the experiences of every person who has ever struggled with a mental illness. I mean, we've gotten to the point where textbooks are describing clinical depression as the "common cold" of mental disorders and I find that VERY disturbing. The people who suffer from true clinical depression are really being screwed over by this. That's why we need to fight against overmedicating. The truly clinically depressed are being ignored and stigmatized and told to "just get over it" because depression is supposedly just like the "common cold".

</font><blockquote><div id="quote"><font class="small">Quote:</font>
alexandra_k said:
I think we should be wary of trivilizing the experience of those who manage off meds or of those who think that meds are what they need (including the pill poppers).

I mean... Their attitude isn't so very surprising given the marketing - is it?

The medicalization of distress...

And the drug companies get richer...

</div></font></blockquote><font class="post">
Yeah the drug companies are pretty f-ed up.

There has long been this divide between 'you don't have a biological disorder and it is all your fault' vs 'it isn't your fault at all, it is genetic and / or neurological'. Part of this is the nature vs nurture debate, to be sure, but I also think that the divide has somehow found a life of its own. The majority of people will acknowledge that 'nature vs nurture' simply isn't an interesting dispute, the million dollar question is figuring out how nature and nurture interact and influence each other such to produce the phenomenon that is of interest. Unfortunately, this received wisdom hasn't made it through to the 'you don't have a biological disorder it is all your fault' vs 'it isn't your fault at all, it is genetic and / or neurological' debates.

There was a lot of stuff done in... The 60's, I think. One 'social' explanation of autism was the 'refridgerator parent' hypothesis. The idea is that some parents are cold and distant and that causes certain infants to develop autism. Now, I haven't read those theorists myself, but I do know that a common interpretation / misinterpretation of those theorists was 'you parents are the cause of your infants problems - the cause of your infants problems is simple - bad parenting!' If I thought I had to choose between blaming myself for my bad parenting and blaming my infants biology and giving them medication then the latter line surely looks tempting!

Fortunately, social explanations are typically much more sensitive now. Unfortunately, this seems slow to filter through.

> Unfortunately people sometimes like to use biology because they don't want to admit that they might have made some mistakes.

I think it might be about fear. People think they have to choose between 'not biological therefore my fault' and 'biological therefore not my fault'. But of course people can be partly responsible for their biological disorder (e.g., eating badly - diabetes, smoking - cancer) and people can be not responsible for things that aren't biological (e.g., abuse).

> I mean, we've gotten to the point where textbooks are describing clinical depression as the "common cold" of mental disorders and I find that VERY disturbing. The people who suffer from true clinical depression are really being screwed over by this.

I think by 'common cold' they mean 'very prevalent' rather than 'just get over it in 7-10 days there is nothing we can do and it isn't very bad anyway'.

> The truly clinically depressed are being ignored and stigmatized and told to "just get over it" because depression is supposedly just like the "common cold".

I think I hear you. But then... I guess I worry about the thought that people can 'just get over' various things that aren't biological (like abuse), too.

When I was a CENA, once a year the state would come in and evaluate the facility. During that month (more if there were problems) the facility was REQUIRED to attempt to wean residents off of chemical restraints and attempt to go without physical restraints. Among these were drugs like ativan, xanax etc.

First, I’ve never been beaten so much in my entire life. It was not comfortable for the residents either. People that were “normally” mellow and even tempered became combative toward the staff and other residents.

Second, the “first” line of attack is physical restrains. Safety belts in wheel chairs are considered physical restraints. We had more falls in that month than in the rest of the year combined.

Let me just say, that I personally would much rather be chemically restrained rather than physically restrained. I understand that these rules are in place for the health and safety of the residents, but if I had to go into a nursing home tomorrow, I would NOT be a happy camper if they took my medication from me because that’s the way it is once a year. These people have pdocs, who is the state to come in and say that these meds are not required?

At the time I was doing the job, I did not fully realize how important these medications were. I’m not advocating turning people into zombies, but there needs to be more common sense involved in these blanket decisions. I do not consider mood stabilizers or anxiety medications as “flat line” medications. I can now fully understand what it must have been like for them. All of these strangers running around watching everything that you’re doing and you’re anxiety meds are taken from you… It makes my stomach turn; and someday that might be me. Hmm, maybe I’ll add that to my living will, I wonder if it’s legal.

> During that month (more if there were problems) the facility was REQUIRED to attempt to wean residents off of chemical restraints and attempt to go without physical restraints. Among these were drugs like ativan, xanax etc. First, I’ve never been beaten so much in my entire life. It was not comfortable for the residents either.

Yeah. When you have been on those kinds of drugs for a while then you suffer through a 'withdrawal syndrome' upon the cessation of the drug. People often describe this as a magnification of their original symptoms (so worse anxiety / agitation / irritability / rage than they have ever experienced before).

One can't assess what it would *typically* be like for a person off a drug when they are going through a withdrawal syndrome. It would be like telling the opiate addict in a 10 day detox that the flu symptoms they are experiencing would be a *normal* state for them in the absence of their opiates. The point is that the withdrawal syndrome passes - but it does take time.

alexandra k,

Until I was on these medications, I did not realize the physical extent of the misery. Recently I saw a new Dr. that did not understand that I was on Effexor, and Rx'd me a different med. It was awful.

My main problem with the current system is again who in the hell is the state to come in and make these demands without being familiar with a resident and their history. What happens if I'm a resident one day? They're going to make me go through hell for a month to "see" if I "really" need meds that I've been taking for years?

Oh, and I just remembered this. My grandmother suffered from sundowners. She HATED being hospitalized because of it. She had to be an impatient for a minimum of 8 weeks when she was dx with cancer. We went over her symptoms with her oncologist, and he Rx her Halidol. All's well the first week.

The second week, I get a call in the middle of the night, she was in other patience rooms confused. I go in to calm her down 2am and ask about her meds. Halidol is a chemical restraint they were hesitant to give it to her. I told them "tonight you get confused, tomorrow she's going to be combative, and two days from now she's going to be ripping IV's out of other patients."

Weeks 2 and 3 go by. Week 4 I come in and she's ripped the line out that they've been using to give her chemo in. Now this is a heavy duty line, not a stint, that got infected and had to be removed, this was a heavy duty line. Because of the cancer and blood thinners etc, they were having a hard time getting the bleeding to stop. Again, 3 days without the Halidol.

This time I talked to the head nurse, she's a danger to herself and others without the meds. I told her if they keep withholding the meds, she's going to be in someone else's room soon and rip their IV's etc out, she'd done it the last time she'd been hospitalized. We (the family) had to sign a release and demand that she get the Halidol each and every night.

Did I kill the thread?

I think this is a good thread and has me thinking that we all need to be cognizant of the drugs we take and constantly re-evaluate.

I take Prozac, Adderall, Neurontin and Seroquel. All of them are low doses. The Seroquel has helped me immensly with paranoia, especially while I'm in therapy.

I am decreasing my Prozac and want to stop this one because I don't think it is helping me. My P-doc infuriated me when she said okay decrease 20mg every 2-3 weeks but most likely you'll see you actually do need it.

Ha! I'm more determined than ever to do without it. The first 2 weeks was hard but I'm okay now and went from 60 to 40mg. I'm waiting a bit longer and then will do another 20mg.

I've been on Prozac most of my life off and on and until Neurontin and Seroquel, have not felt functional. I think Prozac makes me worse...time will tell.

I certainly didn't like p-doc's response to me.

I think it's a good thread too. I think AAAA's examples illustrate the importance of finding a balance between the Tom Cruise mentality and the pill-popping mentality. The pill poppers really make life harder for people who actually need medications. Thanks to the pill poppers, people who actually need meds are stigamatized or have their meds taken away.

Maybe it'll be easier if you decrease your Prozac more gradually, perhaps by 5mg increments so your brain will have more time to adjust. I'm secretly decreasing my Paxil. I haven't told my pdoc because I'm worried he'll react the same way as your doc. I was on 20mg and then I cut 1/8 of my pill down to 17.5mg per day for several weeks. Right now I'm on 15mg. I'm going to wait a little longer and then go down to 12.5mg or 10mg.

I think this is also a good thread.

My objections were to the title and the patronizing sound of the first few lines of the post. In my opinion, their use only served to perpetuate the images of people treated for a mental illness with medications, and other means as "drooling idiots" (my term). I am neither, thank you , although I have had said treatments.

I agree that people need to find balance in their own life. Each person has their own issues, just take a look at the number of different forums on this board alone. Consequently, each person's journey will be different and what works for some may not work for others.

All I ask is that we treat each other with respect.