Problems of Living
The title of the MSN piece says it all:
Docs: Antipsychotics often prescribed for ‘problems of living’
Doctors who are in the trenches get “stuck” with cases all the time that are really very difficult. Many patients have it bad and they need help. We feel obligated to do something. That doesn’t excuse those docs who prescribe antipsychotic meds without a clear indication. It also doesn’t give the associate professor of pharmacology at Georgetown University the right to scream that it is a “total outrage” either. Yes, doctors need to not give pills for every situation. I get that and agree. I remember doing a parody in our first Placebo Journal ten years ago about “Shitty Life Syndrome”. There really is no fix for it. It seems to me that “problems of living” is eerily similar. The dilemma, however, is what to do for these poor souls? They don’t go to their church or synagogue anymore. They won’t go to counseling (or can’t afford it). They are depressed, drinking, unemployed and want answers. And you have seven minutes to fix them. Go.
Had a patient years ago seeing me for a follow-up for depression, who allowed that she had been doing overall better; but the week before, she had a really bad day, so she took and extra pill.
After explaining her incorrect pharmacology, we looked at the far more serious implication: rather than recognizing an improved and stabilized mood as the context for normal living, her approach to a bad day was to take a pill.
This profession has abetted, and has been victimized by this societal trend which trivializes the actual cases that need intervention. I think there is a fix for the ‘worried well’ and we who attempt to placate them, but sadly, requires a massive zombie outbreak to realign people’s priorities.
Oooh, can you post the parody of SLS? we could really use that for our diagnostic categories for our team. Thanks! Love the gazette!
will work on it
“When there’s no vision,
the people get out of control,
but whoever obeys instruction is happy.” Proverbs 29:18 CEB
When times are tough, when people are hurting, when people are dealing with so much on their plate, they need something beyond themselves to hold on to. Meds can help some, counseling can help some, but even beyond that…
When one builds one’s house on a firm foundation, when the winds blow and torrents come, the house stands firm. But when one build’s one’s house on sand, the winds and torrents come and the house is utterly destroyed. (My paraphrase of Matthew 7:24-27)
I give patients Philippians 4:6,7, and 1 Peter 5:7, assuming they have a Christian background. If another religion, or no religion, I offer them as much as I can with meds and advice, suggest counseling and places to go where they might be able to get it, and let them know I’m praying for them. Meds help, but sometimes people need much more. It is difficult.
If a doctor tried preaching to me, I would NEVER go to him again. One place to expect reality is in a doctor’s office!