Monday, August 3, 2015

psychopharmaceutical witchdoctors

Saw this opinion piece in my newsfeed this morning, about depression in teens, and how more of them should be medicated.  He's trying to make the case against concerns that antidepressants might actually be harmful.

In sticking with the theme of my "textrovert"post, I want to highlight that I responded to the article like this:

Joshua Abell Antidepressants are only marginally more effective than placebos, and in many cases can initially aggravate depression, increasing risk of suicide. Maybe we should be trying to come up with more serious solutions, rather than pushing dubious pharmaceuticals as if they're some sort of panacea.
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In person, I could never do that.  When I see Dr. Lim in a few days, I won't be able to do that.  The author is a professor of­ clinical psychiatry, and while that's naturally intimidating, I'm fairly well-versed in this stuff myself.  I'm confident in my ability to debate the point, turning to Google if I need citations or anything.  I am confident that I am on equal footing intellectually, and possibly even then some.

As long as I can have a little extra time to organize my thoughts, and utilize any and all available data.  In person, I can't do this, although anxiety is really the number one barrier.  The mere fact that I might need to fall back on some brief research is enough to shut down my ability to even have the discussion.  The fact that I have to respond immediately, even as my neurochemistry goes haywire in the awkwardness of the moment.  I can only deal with this, in text.

Still, how can I possibly say that I'm on equal footing with a professor of psychiatry?  Me, a mentally ill impoverished high-school drop-out?  Seriously?

Yeah.  We're not talking about real doctors, here.  I mean, sure, they do have real medical knowledge, and could certainly run circles around me in a discussion of general physiology, but psychiatry itself is, in a sense, a complete sham.  They don't know why one person gets depression and another doesn't.  They don't know why some people recover, and some people are miserable their entire lives.  They don't even know with any serious scientific certainty why some people hallucinate, never mind all the more nuanced psychiatric problems they encounter.

"The best science we have, which is on problems like color vision and amnesia, long term memory, and language processing. We know the most, about what intuitively matters the least."

They don't know why the meds they push on everyone that comes into their office don't always work, and they're usually in denial about just how often those meds don't work.  Just keep trying, more meds, higher dosages, different combinations.  Stay optimistic, while their patients muddle through a myriad of side-effects that can often make their problems worse.  When some of their patients eventually kinda sorta recover, is it because of the meds, or in spite of them?  When some of their patients hang themselves, is it in spite of these dubious pharmaceuticals, or because of them?

I don't even need to look up the statistics, or take guesses as to why that happens sometimes.  I know how they've made me feel.  I know that if I act on it, these clowns would just think they should have prescribed a higher dosage.  Take some responsibility for it though?  Hell no, that's just crazy talk.

They're practically witchdoctors, in how primitive and spotty their knowledge of the human mind actually is.  Not them personally, but medical science overall.  We still have such a ways to go, as far as really understanding the mechanics of human thought and emotion.  Psychiatrists are relegated to pointing to their occasional successes, statistics showing that intervention is, overall, better than leaving people to drink themselves to death, or whatever else.  Their methods are still akin to shooting buckshot in the dark.  Like shamans giving people herbal remedies that sometimes do the trick, while they really had no idea why, nor a complete grasp of side-effects, long term risks, or really, what the hell they were actually doing.

It's all too easy to manipulate statistics to give the impression that psychiatry works, but there are comparable statistics indicating that it actually doesn't, and some of that hinges on how you even define efficacy.  It isn't even remotely cut and dry.

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