On medication debates and strange circumstances

If you talk to a psychiatrist about medication and tell him that it just isnt working out the odds are he will tell you that you havent waited long enough.  “You may have to try another medication, but if you are persistent and keep trying we will find what works for you.”

If you talk to a person against medication and tell him that it is working out the odds will be that he will tell you that you just havent waited long enough.  “Maybe it is helping and maybe you are not having a lot of side effects now, but if you are persistent and keep on trying dont worry the bad side effects are coming.”

Consider the following strange hypothetical circumstance:

A person is diagnosed with bipolar disorder.  They are taking medication which seems  to be stable and things seem to be going well.  Something goes wrong.  The person seems to be developing signs of akathesia.  They go to their doctor and the response they get is not helpful at all.  So they decide to make their own medical decisions.  They stop the offending meds.  For 4-6 weeks they feel wonderful.  The “buzzing” in their brain is gone.  They are involved with a therapist and a support group.  They are trying as hard as they can to remain in recovery.  The relationship with the psychiatrist is in their eyes irretreviably broken.  Because of the nature of their health insurance they have however no other options for a psychiatrist they can go to.  They read more about all the harm medications do and decide no more meds.  About 3 weeks ago they started having problems with depression.  It has been the most severe attack they have ever had.  Suicidal thoughts are basically continous and the person is know terrified.  They dont know what to do.  Their impulse is to try to “bootstrap it”, but they admit freely they cant live much longer like this.  Every day is an agony.  And it is getting worse.  They are trying to focus on other things and stay positive as much as possible. They remain in contact with many friends who are very supportive and also very worried.  They want no meds.  They can cite chapter and verse of different things they have read supporting this.  Yet they know other people whose depression is being managed effectively with meds and part of them wonders “perhaps a different med might be the answer…”  Fear is rising.  Anxiety is out of control.  They are considering going into a hospital, but know that means being medicated and are afraid the next psychiatrist might not be any better than the last one.  They simply dont know what to do and feel like they are running out of time to make a decision.  In their eyes the situation is getting very dangerous (and I agree with that).  WHAT DO THEY DO?

The biggest problem with this situation is that it is not hypothetical.  It describes someone I know fairly well.  Some details have been changed to camaflouge their identity but the thrust of the description is true.

I really wonder about the people who claim to have all the answers (the “you havent waited long enough crowd”) and I wonder if they have begun to realize the kinds of consequences their actions have for others.  Many people are medicated for conditions that dont need it.  Mild and even moderate depression doesnt respond that well to medication for example.  On the other hand people with severe conditions may depend on it for their lives.  I have talked with literally thousands of people who have told me that and who resent heartily the idea of someone trying to say they are politically incorrect.

The real point of medication debates is not just who wins, but the costs paid by those who have to vote.