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Re:The Challenge of Going Off Psychiatric Drugs by com2kid on Monday April 01, 2019 @02:06PM (#19546231)
I generally am supportive of people seeking psychiatric treatment, but wow, this woman's case seems, in retrospect, rather mismanaged.

It is like her doctors tried to medicate away an epiphany. Realizing that "the glittering balls and designer clothing has no real underlying substance" and being depressed that one's life is limited to such things, is not a cause for medication.

It sounds like she was struggling to be happy in a situation in which she was never going to find happiness.

Finding purpose, the thing she said was missing so early on, seems to ultimately be what helped her. Her reason to get up every day is that she can now help others, instead of live just for herself.

Some people look inward, they want to be the best dressed at the party, have a good career, and overall be successful in life. If that brings them happiness, then good for them! They have found what makes their life fulfilling. But different people need other forms of fulfillment, be it an artist completing their latest work, or someone who wants to have a daily positive impact on the world around them.

Medication cannot make people happy. (Well at least not the legal drugs, and the illegal ones won't work long term!) They can only create the possibility for happiness for those who need some extra help.

But, doctors need to do a better job of discovering if that extra help is just needed, or if the road their patient is going down is not going to lead to happiness no matter what is written on the prescription pad.

Re:The Challenge of Going Off Psychiatric Drugs by JamesBarney on Monday April 01, 2019 @03:50PM (#19547427)
> Medication cannot make people happy. (Well at least not the legal drugs, and the illegal ones won't work long term!) They can only create the possibility for happiness for those who need some extra help.

There are phase 3 randomized controlled trials that prove differently.

Re:The Challenge of Going Off Psychiatric Drugs by captainredbeard on Monday April 01, 2019 @08:25PM (#19549805)
Let’s not forget that 8% of SSRI users end up having an SSRI-induced [hypo]manic episode. It’s a hidden epidemic.

Additionally, there are few longitudinal studies that show antidepressants as being effective and reasonably side effect free.

Worse, neuroleptics leave the majority of long term users with lifelong tics, tremors, rigidity, and other Parkinson’s style symptoms.

But yeah, there’s a study showing they make people happy with a slightly better efficacy than placebo.

Playing with fire has its risks. Listen to the burned ones, it’s more complicated than a whitepaper.

Re:The Challenge of Going Off Psychiatric Drugs by sjg007 on Tuesday April 02, 2019 @12:17AM (#19551067)
That 8% are likely bipolar.
Re:The Challenge of Going Off Psychiatric Drugs by mastox on Tuesday April 02, 2019 @12:31AM (#19551115)
Source? My understanding is the 8% would also include people with just family history.
Re:The Challenge of Going Off Psychiatric Drugs by captainredbeard on Wednesday April 03, 2019 @11:46AM (#19564325)
They arbitrarily removed SSRI-caused (i.e. NOT latent bipolar) as a subtype in DSM-V. The only reasoning behind this that I could find was a decision by a "round-table" of experts. Most other changes in related categories were substantiated by much more.
Re:The Challenge of Going Off Psychiatric Drugs by sjg007 on Tuesday April 02, 2019 @01:40AM (#19551360)
Here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922360/

The issue with SSRIs for people who are bipolar is that it can trigger a manic episode.

Re:The Challenge of Going Off Psychiatric Drugs by captainredbeard on Wednesday April 03, 2019 @11:45AM (#19564310)
That's an awfully convenient explanation. Many people never develop symptoms, so exposing folks with latent bipolar disorder is still a near criminal offense.
Re:The Challenge of Going Off Psychiatric Drugs by KerryJones on Monday April 01, 2019 @03:53PM (#19547474)
And they are?

Your statement is completely anecdotal and carries no weight without the references.

Re:The Challenge of Going Off Psychiatric Drugs by DanBC on Monday April 01, 2019 @05:52PM (#19548692)
> Your statement is completely anecdotal and carries no weight without the references.

I don't see you asking other people to reference the stuff they're coming out with.

Re:The Challenge of Going Off Psychiatric Drugs by KerryJones on Wednesday April 03, 2019 @06:24PM (#19567748)
Irrelevant?

I'm not trying to be the "reference" police, I glanced at the first page or so of comments and this is what stood out to me as being against the multitudes of information/research that I've read.

It seems poor form to reject someone else's point by saying "studies say otherwise!" and not provide the studies.

Re:The Challenge of Going Off Psychiatric Drugs by JamesBarney on Monday April 01, 2019 @05:04PM (#19548211)
Here is one trial there are 100's of others on the same website. https://clinicaltrials.gov/ct2/show/results/NCT01441440

P.S. My statement wasn't an anecdote.(I think you're using that word incorrectly)

Re:The Challenge of Going Off Psychiatric Drugs by com2kid on Monday April 01, 2019 @05:29PM (#19548486)
The outcome measures for that study are all related to decrease of depressive symptoms, they are not measuring increase in happiness.

(Also no one is taking effexor to get high!)

An SNRI isn't going to make people feel happy or joyous. It may lift the fog of depression and allow one to feel happiness, but it doesn't create it on its own.

Joy in a pill, without long term side effects, doesn't yet exist.

Re:The Challenge of Going Off Psychiatric Drugs by YjSe2GMQ on Tuesday April 02, 2019 @12:50AM (#19551191)
> It may lift the fog of depression and allow one to feel happiness.

Well if removing pain isn't happiness. It was for me. At least I don't think any more of how killing yourself is only a problem because of the people that will stay alive and suffer because of your suicide.

Re:The Challenge of Going Off Psychiatric Drugs by KerryJones on Wednesday April 03, 2019 @06:20PM (#19567729)
Anecdotal: "(of an account) not necessarily true or reliable, because based on personal accounts rather than facts or research"

My comment was "without references...", ie. facts or research, it would make it anecdotal.

As others commented, "lack of depressive symptoms" is very different from happiness. That's what "numbness" is.

Re:The Challenge of Going Off Psychiatric Drugs by JamesBarney on Thursday April 04, 2019 @02:39AM (#19569825)
There are many ways to measure happiness. But I can't imagine any that aren't affected by a remission of depression.
Re:The Challenge of Going Off Psychiatric Drugs by nerdponx on Monday April 01, 2019 @02:22PM (#19546427)
Psychiatry should not be front-line treatment for most people. End of story.
Re:The Challenge of Going Off Psychiatric Drugs by beenBoutIT on Monday April 01, 2019 @03:14PM (#19547024)
It should be a last resort for people who have been thoroughly screened by MDs and neurologists. According to sleep experts at Stanford at least 25% of people with ADHD/ADD are narcoleptics who've been misdiagnosed. That's a shitload of people who are currently living suboptimal lives because they went to a psychiatrist prior to being evaluated by a neurologist.
Re:The Challenge of Going Off Psychiatric Drugs by penagwin on Monday April 01, 2019 @04:05PM (#19547614)
Might not be the best example, as narcolepsy is usually treated with stimulants and antidepressants, so adding say ritalin may still improve symptoms regardless of if it's actual ADD/ADHD or narcolepsy
Re:The Challenge of Going Off Psychiatric Drugs by beenBoutIT on Monday April 01, 2019 @05:00PM (#19548178)
In this case psychiatry covers up the symptoms with stimulants (that further degrade sleep) while neurology can effectively fix the bad sleep. Psychiatry provides a poorly fitting bandage while neurology has something on par with a cure. There's no better example that I'm aware of.
Re:The Challenge of Going Off Psychiatric Drugs by Gibbon1 on Monday April 01, 2019 @05:39PM (#19548575)
A good example is everyone I know with hypothyroidism, five out of five were put on a variety of psychiatric drugs for years before being properly diagnosed.

Frankly I think MD's shouldn't be allowed to prescribe psychiatric drugs period.

Re:The Challenge of Going Off Psychiatric Drugs by nerdponx on Monday April 01, 2019 @06:05PM (#19548796)
How about my friend, whose "bipolar" disappeared when they got a positive test result for celiac and stopped eating gluten? Or myself for that matter, whose problems with sleep, gait, muscle weakness, mood instability, and difficulty paying attention all more or less evaporated when I went gluten free after my own celiac diagnosis?

These weren't quack diagnoses either. We both saw traditional gastroenterologists, in different states, several years apart, both of us seeking treatment for different things. My diagnosis was confirmed with blood and endoscopy, as well as a follow-up DNA test to make sure I had the right mutation that makes it possible for celiac to arise.

Re:The Challenge of Going Off Psychiatric Drugs by sixo on Monday April 01, 2019 @02:53PM (#19546776)
I think a decent cutoff for when to defer to medication is when the problem becomes self-sustaining. E.g. you get anxiety about your anxiety, or your mania leads to disastrous actions that can't be emotionally handled in a normal state, or your depression causes you to fail at goals in a way that contributes to your depression.

At those points the cycle is the problem and needs to be broken.

Re:The Challenge of Going Off Psychiatric Drugs by com2kid on Monday April 01, 2019 @02:44PM (#19546667)
For most people, psychiatry is overkill, sure sure.

But heck, look at the diagnostic criteria for Bi-Polar,

> The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

That line about "marked impairment in occupational functioning" is a common theme in the DSM. (Hypomania has a lower threshhold, but still involves risk to self) If someone is able to live their life, hold down a job, isn't a risk to themselves / others, then they should be directed to a psychologist or therapist.

Bloody hell, the DSM says this, again and again and again.

In the must be met criteria for ADHD:

> There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

Major depressive disorder, again, with this requirement:

> Cause significant distress or severely impact social, occupational or other important life areas

The diagnostic criteria is pretty on point.

But even so, misdiagnosis is possible. If someone comes in and says that they hate their job and their spouse is abusive, the correct solution is a lawyer / career training (probably in that order?), not a pill!

If someone comes in and says "my life has no meaning", maybe it isn't anhedonia, maybe the activities in their life legitimately aren't of interest to them!

We all feel social pressure to fit in with the culture we grow up with. The great thing about America is, if we don't fit in with that culture, plenty of other culture's abound! But first people have to realize that they can leave the culture they are familiar with if it isn't bringing them happiness.

We all know that one engineer who decided to be become a brick layer, and who is now super happy! Heck one of my friends and old co-workers went from being a preacher to coder!

We all need to realize that laying bricks is just as fulfilling and meaningful as writing code[1] and not being judgmental about people's choice to leave one career behind and go into another.

My masseuse used to be in the corporate world.

One of the best Chocolatiers[2] alive used to work at Microsoft.

Parents, if you kids aren't happy living the upper class lifestyle that you dreamed of when you were working your way up the ladder, then support them doing something else! Tell them that they don't have to live up to your dreams, or fit into the societal image of perfection created by the culture one is surrounded by.

[1] Possibly more so, the bricks are going to outlive 99.9% of code that is ever written, and will likely be appreciated by far more people.

[2] I've traveled to quite a few countries and found her equal, but none that surpass. http://bruggechocolates.com/

Re:The Challenge of Going Off Psychiatric Drugs by GuB-42 on Monday April 01, 2019 @03:23PM (#19547133)
The article mentions talking about wanting to die, cutting oneself with razor blades, drinking through the night and doing cocaine. And that's before treatment, so it is not at fault. That's not something to take lightly, especially combined together.

Also, that story somehow reminds me of someone I know who really is bipolar, she looked somewhat normal until she went completely bonkers, burning down most of her stuff at home, etc... It is serious. She now takes mood stabilizers (lithium) and lives a healthy life. So don't dismiss psychiatry.

Re:The Challenge of Going Off Psychiatric Drugs by mastox on Monday April 01, 2019 @06:37PM (#19549061)
I don't consider being on lithium a win. My Dad was on lithium for bipolar for 40 years, trashed his kidney's to the point of renal failure, and committed suicide...
Re:The Challenge of Going Off Psychiatric Drugs by SketchySeaBeast on Monday April 01, 2019 @02:49PM (#19546726)
The definitions can be more easily met when you consider "Cause significant distress" or "reduce the quality of, social, school, or work functioning" - that's much larger, and people can be visibly firing on all cylinders, but if they report reduced quality or distress, then it meets those criteria.
Re:The Challenge of Going Off Psychiatric Drugs by com2kid on Monday April 01, 2019 @03:02PM (#19546874)
But as the article made clear, the drugs were reducing her performance at school!

This is one area where I think the ADHD community has pulled ahead, good doctors will, when someone starts a new treatment, do weekly check-ins[1] with how one's quality of life is going across multiple metrics. Mood, self image, social life, and work/school performance.

The fact this isn't done for all forms of psychiatric treatment is shocking and sad.

From a non-medical perspective, Cognitive Behavioral Therapy is good in that it tries to help people find fulfillment, or at least come to peace with themself.

[1] Proper ADHD treatment is supposed to be provided by a psychiatrist and psychologist working in tandem and communicating with each other. Unfortunately the % of times this is actually done is most certainly way under 1%. Not even going to get into the insurance issues around this...

Re:The Challenge of Going Off Psychiatric Drugs by SketchySeaBeast on Monday April 01, 2019 @04:14PM (#19547693)
> But as the article made clear, the drugs were reducing her performance at school!

She was by no means stable before the medication. In fact - Bipolar, if the hypomanic/manic states hit at the right time, could be a huge help with school. I'm not saying it's in any way right, I'm saying there are broad criteria for getting on medication, and there's no DSM criteria for when she should be coming off.

Re:The Challenge of Going Off Psychiatric Drugs by stronglikedan on Monday April 01, 2019 @03:01PM (#19546867)
> Medication cannot make people happy.

But it can allow one to find happiness. Depression is a chemical imbalance, and not everyone can overcome it on their own - especially if left untreated for extended lengths of time. The medicine helps people get back into balance, so they can start to work on their happiness again, whatever that may be.

Re:The Challenge of Going Off Psychiatric Drugs by Gibbon1 on Monday April 01, 2019 @05:40PM (#19548596)
> Depression is a chemical imbalance

That is literally drug company marketing propaganda.

Re:The Challenge of Going Off Psychiatric Drugs by pbhjpbhj on Monday April 01, 2019 @06:10PM (#19548840)
So, human bodies are perfectly self-regulating in brain chemistry?
Re:The Challenge of Going Off Psychiatric Drugs by chaseha on Monday April 01, 2019 @08:15PM (#19549752)
The article speaks to how this phrase is a shortcut that doesn't get to the fact that mental health issues like depression can have a range of factors behind them including genetics and environmental factors
Re:The Challenge of Going Off Psychiatric Drugs by Gibbon1 on Monday April 01, 2019 @07:58PM (#19549640)
Define 'brain chemistry'
Re:The Challenge of Going Off Psychiatric Drugs by com2kid on Monday April 01, 2019 @03:03PM (#19546891)
Literally the next sentence I wrote:

> They can only create the possibility for happiness for those who need some extra help.

Re:The Challenge of Going Off Psychiatric Drugs by stronglikedan on Monday April 01, 2019 @03:14PM (#19547021)
Literally what I expounded upon.
Re:The Challenge of Going Off Psychiatric Drugs by com2kid on Monday April 01, 2019 @03:48PM (#19547407)
True, apologizes for the rudeness on my part.
Re:The Challenge of Going Off Psychiatric Drugs by bongo662 on Monday April 01, 2019 @03:22PM (#19547112)
Literally
Re:The Challenge of Going Off Psychiatric Drugs by mastox on Monday April 01, 2019 @06:39PM (#19549083)
Which is fine as long as its sold as a tool not a cure.
Re:The Challenge of Going Off Psychiatric Drugs by plutonorm on Tuesday April 02, 2019 @01:34AM (#19551338)