My Psychiatrist doesn't know pharmacology

[ennuied]

To preface, I began taking amitriptyline for chronic stomach pain (IBS) and my depression. My psychiatrist suggested that I begin Mirtazapine instead, citing its efficacy in appetite stimulation and general mood. I added that since they are chemically similar in regards to the mechanism of action and chemical structure (Ami. has three rings and is called tri-cyclic while Mir. has four and is called tetra-cyclic), it would likely be an easy transition. She responded with a defiant "No." and balked at the notion of a mentally ill person attempting to understand pharmacology (at least in a functional way). She then looked it up and walked it back after reticently admitting I was right. I should add too that I'm not an egoist--If I'm wrong I enjoy the opportunity to learn something new, I have no problem with that. It wasn't about me being right, my problem is that she confidently told me a lie with not an ounce of hesitation. I should've taken heed of the massive red flag she showcased after laughing at my college course load (I only take two classes at a local community college after leaving a decent private college due to a suicide attempt I got scarily close to fulfilling), although that could've been in jest--I don't know anymore. She runs a fairly large sub clinic and tried to refer me to a quack homeopathic doctor (whose practice relies on the teachings of the former personal doctor of the Clintons, so pretty grifty), for my stomach pain; it's not entirely unlikely that she's essentially a charlatan--finding terminally broken people and selling them a cure they'll have to rely on for the rest of their lives and in turn, her.

It seems like a pedantic point, and it sort of is, but how the hell does someone become a well-regarded psychiatric doctor without understanding the drugs she's giving to people? She would like me to start Adderall as well, which I can understand from a mental energy standpoint, but does it seem necessary to give a person with Major Depressive Disorder what is basically meth? Very few of these doctors care about treating or addressing the underlying causes or problems with the disease, so it seems like they merely want to get you into a position where you can work a 9-5 job without literally killing yourself so that you can come again next Tuesday to keep paying them. Maybe it's part of a larger issue with the American healthcare system; it's all about managing sickness, not facilitating good health. They'll pump you with just enough drugs to get you through the work week, but don't give a shit about anything else. It's sick really. They're selling me fucking meth and pseudoscience, and I'm the sick person?

 

[GentleJerk]

Well said, and I agree wholeheartedly. I literally just posted a comment in another thread that mirrors some of your sentiments almost exactly.

I want them to have some damn accountability when they wantonly ruin lives, through heavy-handed drugging with dangerous and poorly understood chemicals.

I want them to climb down off their pedestal and acknowledge that reducing someone to a foot-shuffling zombie with a goldfish memory, hypertension, and no libido doesn't count as true healing and healthcare.

I want them to admit that almost nowhere else in medicine is there such folly, and arbitrary definitions of conditions, causes and treatments. The entire profession is frequently unethical, rooted in pseudo science, and is as far from medicine as it gets, and more akin to a blindfolded lobotomy lucky-dip.

I want psychiatric drugs to be a last resort, not a first choice, and for them to pursue as many alternative treatments as possible, and at least investigate other possible causes for things like symptoms of mental illness, before forcing people onto the perilous path of being 'medicated' for the rest of their lives at the drop of a hat... Especially children.

If someone is making drugs to treat illnesses, then that is one thing, but if they are making millions and profiting by cornering a market then that is inherently corrupt, and it would be naive to think that the main goal here is to cure the sick.

There might be the odd saint in the profession but they are still operating within the confines of a fundamentally flawed pseudo science. It's true they really haven't got the foggiest when it comes to the tools of their own trade, but know enough to secure the whole industry, sustain their careers and the illusion of prestige. Mankind, if it survives the current dystopia it has created for itself, will look back at many of these achievements as the lowest of the low.

They've known for many years now that mental illnesses are frequently related to physical health including the gut and microbiota. Here's a link to an Australian woman who was able to cure her long term severe mental illnesses with a microbiota transplant (heads up it's a bit gross) with her psychiatrist admitting that it looks like all psychs might be out of a profession one day if this gets more funding and study. https://whathavewedung.com/about/ But I've been holding my breath for years waiting for any sort of real progress in these matters beyond treating deadly antibiotic resistant c.diff.

Like most cutting edge breakthrough science that should be readily attainable for us, of course it will likely take 20+ years of 'further funding and study needed'. Once again the constraints of the global financial institutions are slowing down the progress of humanity.

Social redesign NOW, this shit's gotta go. I want a global Resource Based Economy for the children of the future. Science and technology for the benefit of all, abundance not scarcity, freedom from debt and servitude.

 

[ennuied]

Well said, and I agree wholeheartedly. I literally just posted a comment in another thread that mirrors some of your sentiments almost exactly.


There might be the odd saint in the profession but they are still operating within the confines of a fundamentally flawed pseudo science. It's true they really haven't got the foggiest when it comes to the tools of their own trade, but know enough to secure the whole industry, sustain their careers and the illusion of prestige. Mankind, if it survives the current dystopia it has created for itself, will look back at many of these achievements as the lowest of the low.

They've known for many years now that mental illnesses are frequently related to physical health including the gut and microbiota. Here's a link to an Australian woman who was able to cure her long term severe mental illnesses with a microbiota transplant (heads up it's a bit gross) with her psychiatrist admitting that it looks like all psychs might be out of a profession one day if this gets more funding and study. https://whathavewedung.com/about/ But I've been holding my breath for years waiting for any sort of real progress in these matters beyond treating deadly antibiotic resistant c.diff.

Like most cutting edge breakthrough science that should be readily attainable for us, of course it will likely take 20+ years of 'further funding and study needed'. Once again the constraints of the global financial institutions are slowing down the progress of humanity.

Social redesign NOW, this shit's gotta go. I want a global Resource Based Economy for the children of the future. Science and technology for the benefit of all, abundance not scarcity, freedom from debt and servitude.

Thank you so much for your wonderfully cogent and thorough response! I had never heard of microbiota transplants before and it's fascinating. My IBS and MDD are likely co-morbid, so this research is an incredible revelation.

I empathize with a lot of what you've said but I'm at the point of fatalism here. There are so many bulwarks in front of finding reliable alternatives (non-pseudoscientific) for treatment that I, like many others, am realistically probably going to be on these meds for the rest of my life. It's a horrible industry that profits off the misery of people deemed essentially untreatable and coerces them into staying for "their own benefit".

The link for the Venus Project film was really interesting as well, I skimmed Jacque Fresco's Wikipedia and saw that he gave a lauded speech to the Miami branch of the Occupy Movement--hell yeah! I'll have to check that out too. Love most things idealistic and altruistic.

But thank you again for your reply, I've got a nice chunk of reading I'm excited to start now

 

[Smart No More]

I'm so with you OP. The system is entirely broken and rife with double standards and paid ignorance to corruption. If a company makes it and manipulates their way to market it's medication regardless of its similarity to the drugs they warn their kids off. I'm increasingly finding myself calling out the emporer has no clothes though it mostly falls on deaf ears.

 

[Sherri]

Sorry you have this doctor, I had around 15 to get to one that actually was able to make me function again. if you feel that doctor is not helping, maybe get a second opinion From another?

 

[Samsal112]

I think that most psych doctors do not understand pharmacology. At least she was willing to admit she was wrong; a lot of doctors will not do that. All these doctors only know what the pamphlet and sales representative tells them. Yes, I generalized and said "All" and I will stand by that statement. My doctor ruined my life and often I would tell him things I looked up and he would admit that he never knew that about the drug. I should have ran then, but I trusted the professional.

 

[Smart No More]

I think that most psych doctors do not understand pharmacology. At least she was willing to admit she was wrong; a lot of doctors will not do that. All these doctors only know what the pamphlet and sales representative tells them. Yes, I generalized and said "All" and I will stand by that statement. My doctor ruined my life and often I would tell him things I looked up and he would admit that he never knew that about the drug. I should have ran then, but I trusted the professional.

My experience with doing research and presenting it to medical professionals is that you get stigmatised. I was told in an appointment with a new person that my history says I "go on google a lot". Poor grammar for one thing but more importantly a real dumbing down of my efforts to pick up the slack of my doctors. Doing research is far from "going on google". It's infuriating as there's a whole game you have to learn to play to get sufficient medical care in a lot of places. Some countries do it much better. Poland/polish doctors for example, are much better and will play detective if there is no obvious reason for your ailments. My docs are very defensive if you question anything and will go out of their way to negate any questions or suggestions you make, putting your actual health care further to one side. I've considered changing but it's a dice roll on what you get next.

 

[ennuied]

My experience with doing research and presenting it to medical professionals is that you get stigmatised. I was told in an appointment with a new person that my history says I "go on google a lot". Poor grammar for one thing but more importantly a real dumbing down of my efforts to pick up the slack of my doctors. Doing research is far from "going on google". It's infuriating as there's a whole game you have to learn to play to get sufficient medical care in a lot of places. Some countries do it much better. Poland/polish doctors for example, are much better and will play detective if there is no obvious reason for your ailments. My docs are very defensive if you question anything and will go out of their way to negate any questions or suggestions you make, putting your actual health care further to one side. I've considered changing but it's a dice roll on what you get next.

That's such an absurd thing to put on one's medical record, I'm so sorry you've been treated that way. It's interesting, though, that they would consider someone who "googles/read" to be problematic. It's distinct from hypochondria or malingering, we're not searching for an excuse to keep feeling this way, we're merely utilizing the unprecedented level of information we have access to--literally just self-education (even Abe Lincoln was an autodidact!). I suppose it makes it harder for them to medicate you without pushback; it's radically easier to convince someone of a drug's/therapeutic method's supposed efficacy if they have no other information to draw from.

 

[Smart No More]

That's such an absurd thing to put on one's medical record, I'm so sorry you've been treated that way. It's interesting, though, that they would consider someone who "googles/read" to be problematic. It's distinct from hypochondria or malingering, we're not searching for an excuse to keep feeling this way, we're merely utilizing the unprecedented level of information we have access to--literally just self-education (even Abe Lincoln was an autodidact!). I suppose it makes it harder for them to medicate you without pushback; it's radically easier to convince someone of a drug's/therapeutic method's supposed efficacy if they have no other information to draw from.

Thanks for your kind words.

I do get it to some extent but it doesn't justify things. Many people go online and get triggered into thinking they have the first thing they read about that slightly fits their symptoms. They kind of subconsciously fit their ailments into what they're reading and can fool theirselves into thinking they have something they don't. It's a common issue from what I gather but it's also something that existed before the internet. I can imagine how frustrating that is. That said it doesn't warrant the assumption that everyone is like that and they should judge and treat each person on individual merit. It's insulting as much as frustrating to be shut down for trying to solve a problem they don't want to do the legwork on or don't have an answer for. I initially thought they'd appreciate and welcome some input. Old school doctors would have. I hadn't visited a doctor properly since I was a child so I went in expecting the same thing/service I experienced back then and faced a very rude awakening.

 

[Samsal112]

My experience with doing research and presenting it to medical professionals is that you get stigmatised. I was told in an appointment with a new person that my history says I "go on google a lot". Poor grammar for one thing but more importantly a real dumbing down of my efforts to pick up the slack of my doctors. Doing research is far from "going on google". It's infuriating as there's a whole game you have to learn to play to get sufficient medical care in a lot of places. Some countries do it much better. Poland/polish doctors for example, are much better and will play detective if there is no obvious reason for your ailments. My docs are very defensive if you question anything and will go out of their way to negate any questions or suggestions you make, putting your actual health care further to one side. I've considered changing but it's a dice roll on what you get next.

Absolutely, it is a dice roll. I have chosen to never see one again, but I understand that not everyone has this luxury. I have had doctors get angry with me about using the internet, but honestly, the internet has helped me more than any medical, mental, or dental doctor.