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Re:Is forced treatment for the mentally ill ever humane? by kayodelycaon on Tuesday December 20, 2022 @03:51PM (#34072360)
I don't have any answers here, but I want to provide some context for the drugs in question.

I'm on antipsychotics. They are nasty drugs. Absolutely brutal. The worst of the side-effects for me are the sexual side-effects and motor-control issues. If I get dehydrated or my blood sugar gets low, I can lose the ability to walk.

Within the first hour of taking my meds, I can't stand without losing my balance. I lose both my inner ear and kinesthetic senses. I don't know where my feet or hands are. I can only walk by having my eyes open to see if I'm level and feeling where the pressure is on my feet.

During the day, I have medication that helps this but I still trip on uneven surfaces or drop things.

The sexual side effects, I can't orgasm. Combined with the hypersexuality a manic episode creates, it is unbearable. Fortunately, I'm on yet another drug that makes this less of an issue.

The only reason I can tolerate this is the alternative of going crazy is so terrifying, I'll do anything to prevent that from happening. If anyone wonders why people don't stay on their meds... this is a big reason.

Re:Is forced treatment for the mentally ill ever humane? by asveikau on Tuesday December 20, 2022 @04:05PM (#34072537)
My brother was on antipsychotics for about 20 years. His compliance was poor. He is homeless now and without treatment.

Growing up he would tell me how terrible the medications were. I believed him, and still do to an extent. However he also identified with his illness and thought the drugs were taking away his special powers. That was a symptom. For those reading who have less experience, they sometimes call that anosognosia or lack of awareness.

In the end it's a very existential thing. It's easy to wonder about identity. I had a few people in my life with this sort of illness. I developed a model where medicated, treated, and stable, that is the "normal" them, their identity. However, these people got offended by this, and engaged in behavior I would describe as identifying with symptoms. Acknowledging symptoms, no matter how evident, was tantamount to personal attacks.

I think we all have issues with this in our lives. Self awareness and identity is a difficult problem. It's only when it falls far outside of norms, into extremes, that we call it a disorder. It can be very tricky to draw those lines.

Re:Is forced treatment for the mentally ill ever humane? by kdmccormick on Tuesday December 20, 2022 @04:19PM (#34072741)
Yes, this is a big thing I struggled with when I was off meds. Me without meds felt so much more... "me-like" than me on meds. So when someone referred to medicated me as "normal me", it was extremely hurtful.

What I had to realize is that even if "me without meds" was an existentially truer version of myself, people did not like me without meds, they did not want to be my friend, nor did they want to give me a job. That's what got me on meds, and yes, it felt really shitty at the time.

Years later, I don't feel that way any more. "Me with meds" feels like me, more than ever actually. And, lots of those things I valued about "me without meds" (wit, spontaneity, high energy, creativity) came back over time as I adjusted to being medicated.

Unfortunately, not everyone is able to find a med that allows them to get to that happy point. It took good healthcare, several tries, a support network, and (I assume) luck.

Re:Is forced treatment for the mentally ill ever humane? by kayodelycaon on Tuesday December 20, 2022 @04:22PM (#34072769)
My treatment caused a complete loss of self-identity.

In another time, I would have been a shaman. My entire life, I had a deep spiritual connection with wolves. That's gone. All that's left of it is blank wall and confusion.

This hurt deeply. I can't even begin to describe how it felt to have everything I knew about myself destroyed.

I'm fortunate to have been raised Christian. That hasn't changed and it's been a welcome grounding while I work things out.

Re:Is forced treatment for the mentally ill ever humane? by Biganon on Tuesday December 20, 2022 @04:56PM (#34073235)
You sound extremely brave. Thank you for sharing your story, and merry Christmas in advance
Re:Is forced treatment for the mentally ill ever humane? by asveikau on Tuesday December 20, 2022 @04:56PM (#34073239)
I know a lot of spiritual traditions, especially in the east, talk about loss of self identity as progress. So hard as it was (and it sounds hard!), I hope you are able to have deeper understanding that you might not have had exposure to otherwise.
Re:Is forced treatment for the mentally ill ever humane? by kayodelycaon on Tuesday December 20, 2022 @05:39PM (#34073782)
Not sure.

I feel like I'm fundamentally a different person. Like I was dropped into someone else's body. Someone else was here before me and left a bunch of furniture I keep bumping into. :)

But, I know I'm a kinder person than the person before me. Is this spiritual enlightenment? If it is, I might want a refund. :D

Re:Is forced treatment for the mentally ill ever humane? by bell-cot on Tuesday December 20, 2022 @04:35PM (#34072942)
From years of second-hand accounts, my impression is that my friend's niece finds the in-the-moment experience of life off her meds to be somewhat more emotionally rewarding / rich / "genuine" than life on her meds. (On top of the nasty side-effects of the latter.)
Re:Is forced treatment for the mentally ill ever humane? by selectodude on Tuesday December 20, 2022 @04:51PM (#34073164)
I can empathize to a lesser extent. I’m on pretty high doses of antidepressants to keep myself alive. The world feels dead. I’m not sure that I prefer that to me being dead. But I do it for the people who give a shit about me. Am I going to live past 65? Probably not. But for now, it just the way things are.

I’m not psychotic so it’s of course easier to be reasonable about the situation, but it’s never fun to be on drugs like these.

Re:Is forced treatment for the mentally ill ever humane? by AnIdiotOnTheNet on Tuesday December 20, 2022 @08:22PM (#34075484)
I was going to chime in to parent mentioning a similar feeling when I was on an antidepressant. Life felt deadened and hollow, I couldn't really experience much of anything, I was doing things and having absolutely no emotional response to them whatsoever. The first time I cried, which happened extremely easily, while coming off of them I felt joy for the ability to feel something again, even if it was clearly an overreaction. 'Delicious' is the word I used to describe it.
Re:Is forced treatment for the mentally ill ever humane? by kayodelycaon on Tuesday December 20, 2022 @04:57PM (#34073263)
Mania is a hell of a drug. I've done so many amazing things because of it. Life feels dull and slow without it. At the same time, the cost was high.

I chose to live without mania. I want to slow down and work on things I want to do, not be driven to do things, no matter how amazing they turned out.

Re:Is forced treatment for the mentally ill ever humane? by jimkleiber on Tuesday December 20, 2022 @04:16PM (#34072693)
I read this and I start to think about how our identities may just be stories to which we've attached, often shortcuts to summarize characteristics of behaviors. I'm thinking of it more in the romantic "friend" vs "lover" buckets, but I think it plays out a lot in the health space as well.

> For those reading who have less experience, they sometimes call that anosognosia or lack of awareness.

I'm fascinated to learn of this and to read more, thank you.

Re:Is forced treatment for the mentally ill ever humane? by PicassoCTs on Tuesday December 20, 2022 @05:20PM (#34073544)
One of the symptoms can be tremendous creativity. Would you recommend to force treatment upon an artist, because she/he suffers from other side effects?

These mental illnesses are adaptions/optimizations to the rise and fall of violence that was normal human history for the longest time.

A armed paranoid hobo maybe looking like a maladjusted human being to you now, but in stalingrad, sebreniza or bhakmut, he would be very adapted to his surroundings. All those stress triggered changes had their spoke on the wheel of time.

My opinion is that people should be force treated, but only until they reach "sentience" and can decide for themselves, not under any influence.

They also should be able to make sentient "wills", specifying condition under which the state is allowed to step in and help them.

If somebody wants to return to his mental state, nobody should be allowed to stop them. Human lifes value is not there to be useful, aesthetic pleasing or comfortable for society. Its value is only defined by the person living it..

But then again, i view optimists as mentally sick..

Re:Is forced treatment for the mentally ill ever humane? by asveikau on Tuesday December 20, 2022 @05:28PM (#34073637)
> If somebody wants to return to his mental state, nobody should be allowed to stop them

I don't think this works well when clear-cut, unambiguous delusions cause somebody to act on them and harm themselves and others.

I do acknowledge it's very hard to know when that is, and people can disagree.

Re:Is forced treatment for the mentally ill ever humane? by lazide on Tuesday December 20, 2022 @06:41PM (#34074540)
And someone like Kanye which just torpedoed more wealth than many people could ever imagine for his family? I take it they should have no say either?

At least he won’t be stabbing someone in an alley in 10 years - probably.

Re:Is forced treatment for the mentally ill ever humane? by mlyle on Wednesday December 21, 2022 @12:07AM (#34076891)
> just torpedoed more wealth than many people could ever imagine for his family

You know, I believe that Kanye may have significant mental illness, but...

An argument primarily from an economic angle makes me uncomfortable. On paper, I am not maximizing economic value right now-- but I'm pretty sure I'm well adjusted and happy with my (seemingly economically irrational) choices.

Re:Is forced treatment for the mentally ill ever humane? by lazide on Wednesday December 21, 2022 @09:01AM (#34080823)
The family court doesn’t agree btw. He’s on the hook for ‘expected future earnings’, and voluntary actions to decrease them don’t get him out of it.
Re:Is forced treatment for the mentally ill ever humane? by mlyle on Wednesday December 21, 2022 @11:38AM (#34082921)
> I agree, however the family court in California doesn’t agree.

I think what you describe is completely orthogonal to what we were discussing-- whether seemingly acting in one's economic interest can be a measure on one's mental well being and used to judge whether someone is using their autonomy appropriately.

If we use outside economic tests, we become pretty fascist and authoritarian really-quick-like.

Re:Is forced treatment for the mentally ill ever humane? by asveikau on Wednesday December 21, 2022 @12:52PM (#34083983)
Being able to support yourself is actually a point that psychiatrists can use.

Eg. A lot of people can have symptoms of a psychotic disorder but they are still "productive" and functioning.

On the other hand a lot of people with bipolar disorder go through "manic spending sprees" which leaves them in huge debt. Or, people start to be unable to hold a job or keep up with studies. They might quit their job impulsively persuing a delusion, or make unwise investments while manic. This can be a proxy for how they are doing with the illness.

Someone with this type of issue who is very wealthy kind of makes that kind of argument fall apart. Kanye can blow a lot of money and still survive. A more normal person with bipolar disorder would hit rock bottom from a financial standpoint much sooner.

Re:Is forced treatment for the mentally ill ever humane? by mlyle on Wednesday December 21, 2022 @01:13PM (#34084252)
> Being able to support yourself is actually a point that psychiatrists can use.

Yes, and Kanye may have various financial and business problems, but by any sane metric is able to support himself.

> Kanye can blow a lot of money and still survive.

Yes, which makes the behavior less obviously irrational.

This is why diagnostic criteria have phrases like "cause marked impairment in social or occupational functioning" --- and meeting diagnostic criteria alone is not generally sufficient for involuntary commitment. There, we reach the legal system, and definitions that generally include a pretty strict definition of danger-to-self-or-others-or-gravely-disabled, which wouldn't include this kind of thing.

Re:Is forced treatment for the mentally ill ever humane? by lazide on Wednesday December 21, 2022 @04:31PM (#34086660)
If he was poor, he’d be crazy. Since he’s rich (still provably?) he’s just eccentric.

I agree, though it’s not clear if you’re talking 5150 or conservatorship.

IMO, a pretty clear argument could be made (if someone had standing and wanted to do so) for conservatorship, at least of the estate, and possibly for him individually, in Kanye’s case.

I don’t see anything even hinting at a justification for 5150 WIC, even without considering the de-facto loosening of when it’s applied, which is I’m guessing what you’re referring to.

Hell, even if you’re lunging at someone with knife while talking about killing your self, it seems like most jurisdictions won’t do it. (Especially SF). If particularly public safety minded at the moment, they might take away your knife if they don’t shoot you first.

Budget reasons.

As to where it would go, god knows.

Re:Is forced treatment for the mentally ill ever humane? by mlyle on Wednesday December 21, 2022 @05:01PM (#34086951)
> If he was poor, he’d be crazy.

Plenty of poor people say messed up things, alienate people around them, and screw up their employment. They generally don't end up with involuntary mental treatment. Even if the root cause is because of mania or something.

> I don’t see anything even hinting at a justification for 5150 WIC, even without considering the de-facto loosening of when it’s applied, which is I’m guessing what you’re referring to.

Well, the whole context we're talking about things in is in the context of involuntary treatment.

Re:Is forced treatment for the mentally ill ever humane? by lazide on Wednesday December 21, 2022 @05:20PM (#34087166)
It’s not unlikely that 75 years ago someone doing what he has has been doing would get involuntarily committed.

Budget has a big part to play in this.

Re:Is forced treatment for the mentally ill ever humane? by mlyle on Wednesday December 21, 2022 @05:54PM (#34087464)
We're galloping to further and further away topics from the original discussion... if he were poor, and it was 75 years ago, it would be not unlikely.

I disagree with this assertion, too, BTW, but it's so far from what I set out to discuss that I'm not too interested in responding further.

Re:Is forced treatment for the mentally ill ever humane? by lazide on Wednesday December 21, 2022 @04:25PM (#34086603)
Don’t be so sure he can support himself now, let alone if he continues doing what he is doing.

It’s quite common for folks in entertainment and sports for people to accrue large ‘fixed’ expenses (property, debt, child support, etc), on a variable future income.

He’s earned a lot of money, but he’s also spent a lot of money, and he nuked his major source of income and wealth not that long ago.

The divorce clearly is setting up even more cashflow issues. That kind of thing has ruined many normal/objectively mentally stable men.

Unless he’s been carefully squirreling away something, or setting up trusts carefully to protect his ass - not something that seems characteristic for him - it’s possible he’s defacto negative cashflow and bankrupt right now, and just doesn’t know it. Or maybe he does, and that’s feeding the mania.

Re:Is forced treatment for the mentally ill ever humane? by lazide on Wednesday December 21, 2022 @04:20PM (#34086559)
I’m quite confident that a great many men would consider family court fascist and authoritarian hah.

Not disagreeing with you. Noting that such a system does exist, is currently active, alive, and ‘doing well’, and applicable when someone’s decisions impact the economic well-being of others in a certain situation.

Re:Is forced treatment for the mentally ill ever humane? by bell-cot on Tuesday December 20, 2022 @04:13PM (#34072663)
+100 (if I could).

And similar for being sane enough to be so intent upon staying that way.

Re:Is forced treatment for the mentally ill ever humane? by citizenpaul on Tuesday December 20, 2022 @05:26PM (#34073608)
I've often been confused by reports like the OP that the person refuses meds then proceeds to descend into some sort of pure madness. How can that madness be better than the meds? Why do you think they prefer the madness? You seem to resist it do you know any reason why?

I've known three people one directly and two indirectly that were lunatic level if they were off meds and all refused meds consistantly.

1. Was a guy I worked in the same dept during an early job. His thing was to start telling people that government agents were in the elevator to control your mind or something and ending out emails about it and corning people to warn them. Funny thing was it was a government job so there were government agents in the elevator pretty much anytime someone was in the elevator. He resisted because he didn't like the meds.

2. My friends brother in his 30's would not take his meds and his parents had to sneak them in his food. If he missed enough doses he would eventually go raving mad into the woods and eventually be found passed out somewhere by emergency responders usually naked and injured. He resisted because he didn't like the meds.

3. My brother in laws brother was paralyzed and brain damaged from a car wreck. Yet when off meds he would run off in his wheelchair into dangerous traffic or be found passed out(and injured) from exhaustion of crawling because he went somewhere a wheelchair couldn't go and just crawled for miles. Again he didn't like the drugs.

Re:Is forced treatment for the mentally ill ever humane? by themanmaran on Tuesday December 20, 2022 @05:32PM (#34073686)
For all of these, I assume it's a lack of awareness of the manic state. By it's definition, the individual is going to be less cognizant/aware of their surroundings. Likely they don't have the best memory of these lapses either.

I doubt in each of these cases people are making the rational choice to ditch the meds in favor of a state of "pure madness". Instead they probably get fed up with side effects, and decide that "this time won't be as bad", or "I'll just stop taking them for a day".

Re:Is forced treatment for the mentally ill ever humane? by dsego on Tuesday December 20, 2022 @05:58PM (#34074029)
You can get intramuscular depot injections monthly nowadays.
Re:Is forced treatment for the mentally ill ever humane? by kayodelycaon on Tuesday December 20, 2022 @06:43PM (#34074566)
For some people, the medication does more than just wreck their body, it takes away their identity or removes all of the color from their world.

I had to learn to be a different person. (Discussed in another comment.)

This is an extreme example, but imagine smashing into an artist’s home, breaking their tools, and telling them they’ll be working in a warehouse for the rest of their life.

Maybe they’ll be happier working in a warehouse, but they don’t know that. Change is hard.

It’s not as simple as they didn’t like the drugs.

I’m fortunate to have kept my creativity. If I had lost that, I’d prefer being crazy, even knowing it would end badly.

Re:Is forced treatment for the mentally ill ever humane? by petesergeant on Wednesday December 21, 2022 @12:23PM (#34083524)
> How can that madness be better than the meds? Why do you think they prefer the madness?

Lots of people voluntarily take substances that make them think much less clearly but also make them feel good: it's just a matter of scale

Re:Is forced treatment for the mentally ill ever humane? by thehappypm on Tuesday December 20, 2022 @10:48PM (#34076414)
I have a super bad phobia of doctors and needles. Like, I literally pass out during a physical exam or a dental appointment in an uncontrolled panic spiral

50 mg of Zoloft later I am 100% panic attack free. But even 50mg of Zoloft (which is essentially the lowest dose of a very safe drug, and I am a large male) has side effects I dislike, and accidentally missing a dose makes me feel absolutely awful.

I can hardly imagine what serious drugs do to you and the implications of them.

Re:Is forced treatment for the mentally ill ever humane? by profstasiak on Wednesday December 21, 2022 @02:16PM (#34085070)
do u mind sharing drug and dosage? Sounds really extreme. I am working as a healthcare provider but never knew sideffects can be that harsh. I guess clopazine right?