The Plagued Parent

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Just Say Yes to Drugs.

It was June and we were there for a diagnostic evaluation. We hoped that getting input from a clinical psychiatrist would help us understand our oldest daughter’s recent behaviors — moodiness, irregular sleep pattern, preference towards isolation and detachment, difficulty maintaining personal relationships with peers, lack of interest in her romantic relationships, lack of motivation and interest in future plans (graduation, college), weight gain and using food as coping tool, among others.

We sat in the waiting room distractedly flipping through magazines and glancing at each other. I nursed my nervous tension by channeling the familiar waiting selves I know from decades of visits to dentist and doctor visits and recall visits that hold little weight. I sat with the the ‘no big deal, nothing to worry about’ mantra in my mind that accompanies teeth cleaning and flu shot appointments. In reality, I knew better. No, I have felt that occassional tug of preordination, that jab at the nerve endings that sits next to you as you wait for the MRI, the X-ray, the biopsy or the chart to be interpreted by a “specialist”.

My hope was that whomever we saw with would say, “No worries. Typical teen angst stuff. It’s all good. Get her a summer job and she’ll be fine.” I examined other patients waiting and wondered about the face of mental illness. Everyone was different except for the fact that all the patients held the white form that, I would later learn, accompanied them into their med-check appointments. It was the same one I held in my hand now. I remember thinking,”Answers are a good thing. One way or another.”

We waited for longer that necessary it seemed, half an hour beyond our appointment time. When the psychiatrist brought us to his office, he explained that while he would offer his diagnosis we would not be seeing him again. No, we’d be seeing the equivalent of a Physician’s Assistant. His role in the office was becoming chiefly administrative. “So let’s start,” he said turning to my daughter. “Any trouble sleeping?”  What followed was a series of similarly innocuous questions which, in reality, I could answer “yes” to.

While filling out the form we held in the waiting area the psychiatrist occasionally glanced at his computer. His Facebook page was open. In between jotting down answers my daughter gave him, he was Facebook-ing. Finally, he decided she had clinical depression. He showed us a photocopy of some medical journal or another that held brain scans. “If we scanned your daughter’s brain, which we can’t because insurance companies won’t pay for this diagnostic, this is what we would see,” he point to a brain scan in the article which showed parts of the brain darker and parts of it lighter than the “normal” brain right next to it.

“I recommend drug therapy,” he said, “in combination with talk therapy.”

My wife asked, “Do you do talk therapy here?” I know she was thinking that perhaps another therapist, a different viewpoint might get at some of the underlying mess that my daughter’s current therapist wasn’t seeing. Fresh eyes on the problem.

“No,” he said. “We just handle drug therapy maintenance.”  My wife also asked about the rates of suicide among teen taking these types of anti-depressants. “I wouldn’t worry,” he said. “Prozac is safe. We’ve been prescribing it for years.” And, with that he stood. We were done. My daughter left with a script to fill and an appointment in roughly a week to see how she was handling the initial dosage. The diagnosis seemed to make sense, it did explain quite a bit. To this day I don’t think we doubt the diagnosis, just the process by which we arrived there. I mean, he was distracted by Facebook! His manner seems perfunctory, and he brushed off my wife’s concerns over use of the medications in teens. Nonetheless, we accepted everything he said and hoped for the best.

Is this really the best approach? Is this the best we can ask for from this system? A number of clinicians have remarked to me well it’s what we have, it is the system that has developed. But is it the best we can hope for?

What if more lay beneath the surface? The rest of our story seems to suggest that there is/was more going on. Something deeper. So how is it that clinicians feel that spending a ridiculously limited period of time with another human being provides them with enough information to render a complete decision about that person’s mental state? And then how do you go from that limited exposure to rendering treatment options that become meaningful and productive in the short and long term?

Next, who knows your child best? The psychiatrist that spends 15 minutes diagnosing? The psychiatrist at the inpatient facility that spends a total of 7 hours over the course of a week “analyzing” her? The hospital staff that oversees group sessions for roughly twice that amount of time? The therapist that has provided treatment for several years but hasn’t really scratched the surface? Or, the parent that has lived with them for 17 years?

Our experiences have led us to people with similar parenting struggles. Our interactions with others through our social media presence has led me conclude that there needs to be reform in the psychiatric industry, and make no mistake it is an industry. According to the CDC:

  • 11% of Americans age 12 and over take anti-depressants
  • Approximately 6.0% of U.S. adolescents aged 12–19 reported psychotropic drug use in the past month.
  • From 1988–1994 through 2005–2008, the rate of antidepressant use in the United States among all ages increased nearly 400%
  • Twenty-three percent of women aged 40–59 take antidepressants, more than in any other age-sex group.
  • More than 60% of Americans taking antidepressant medication have taken it for 2 years or longer, with 14% having taken the medication for 10 years or more.
  • The use of antidepressants (3.2%) and attention deficit hyperactive disorder (ADHD) drugs (3.2%) was highest, followed by antipsychotics (1.0%); anxiolytics, sedatives, and hypnotics (0.5%); and antimanics (0.2%).

In 2011 the antidepressant Cymbalta had sales in excess of $ 4 billion — that is just one drug. Depression costs employers in the United States roughly $44 billion in lost productivity. In 2003, studies indicated that mental health cost the US over $100 billions dollars. Given the costs associated, I would think that investing more into researching this trend and meaningfully engaging stakeholders — the APA, the patients, the families, the insurance industry — might produce a system that has a “healthier” result for those suffering from mental illnesses such as depression. Tossing medication at the problem cannot be the only solution.

Depression and ADHD are the most common mental health disorders among adolescents. About 4.3% of adolescents aged 12–17 experienced depression in any 2-week period during 2005–2006 (8). Approximately 9.0% of children aged 5–17 had ever been diagnosed with ADHD during 2007–2009 (9). Treatment options other than prescription medication are available for depression, ADHD, and other mental health disorders, including psychosocial treatment and dietary management (10,11).

Data Brief
Number 135, December 2013 (cdc.gov)

Now, I am not suggesting a war on anti-depressants, or mental health professionals. Far from it. What I question is the process by which we diagnose and the conditions under which we medicate. What I question is the efficacy of a system that turns illness, any illness not just depression, into profit.

Scientifically and socially our culture excels at breaking complex things into little parts in an effort to understand them. However, what we don’t excel at is reassembling those parts back into the greater whole and instead the system expends tremendous energy blindly labeling maladies and marketing “cures”. If we were to shift this paradigm of practice and thought to extend beyond a mere “band-aid” approach perhaps we might make progress towards meaningfully addressing these social relationships and their impacts upon individuals.

In collectively choosing not to change we might as well just keep saying “Yes” to drugs.

Updated: March 17, 2016 — 6:45 am

54 Comments

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  1. Everybody has become a chemistry experiment. While going through a divorce I was put on anti-depressants I don’t know if they help or not but I do now you just don’t get to “quit” them without some nasty side effects. Good luck on getting your daughter the help it sounds like she needs.

    1. plaguedparent@gmail.com

      Thank you and I hope you are healing as well. My fear is just what you describe. There seems to be great amounts of planning in the early stages of treatment but nothing dealing with the longterm, big picture step-down.

  2. This reflects my personal experience, except for the Facebook part. I don’t think it’s possible to get decent mental health care even if you DO have the money! It seems all they want to do is write a prescription and follow up in two weeks. I hope your daughter comes out the other side in a much better place.

    1. plaguedparent@gmail.com

      I honestly don’t know how people such as yourself who struggle with this system manage. Why does everyone think they know better than the person who is suffering? And why can’t we give those that suffer the tools to help them communicate their needs to loved ones? Honestly, I would have thought this was the purpose to psychiatry, but I guess that is just wishful thinking.

  3. Great post. I’ve been fobbed off medicine and a number of drugs. It’s a tough one because they can make a difference. That being said I’ve been pushing for talking therapy for 2 years and been turned down…now just being thrown into a mess I’ve realised that the meds aren’t doing what they’re meant to. Sometimes the route of the problem can’t be fixed with a pill. And I wish that this wasn’t always the first option.

    1. plaguedparent@gmail.com

      I hope you finally get the type of treatment you desire. Honestly, it pains me to see that you are being turned down for the type of treatment that might be beneficial. How come the patient’s opinion matters very little? Stay strong and keep running up the hill towards healing. We are here for you…

  4. Okay… every single member of my little family is on psych drugs. Every single one. But let me back up and qualify that. I started 22 years ago, and since that time, I got put on an awful laundry list of different drugs. I spent many years stripping back the crap, and keeping what DID work. My wife was privy to a LOT of this. She was angry and scared because some zombified me, and at least one about killed me.

    I don’t know how much I can speak to her experience, but we have worked very hard to be careful in behalf of our children. For our daughter– well, she’s almost 13 and she actually made conscious decisions on a lot of her meds (after deciding for herself that she needed them, sometimes the hard way). No way in hell will I or my wife allow doctors to talk to just us like she’s not able to fully understand. It’s her mind and body- she has a right to make the final say, everything else considered.

    My son has autism– and for that, I am very careful to remind others that NO, we are not medicating the autism, but other accompanying conditions. We *only* considered meds for him after careful discussions with his (self-contained) classroom teacher, and we consult with her still.

    Both my wife and I are on disability, so yes, we can also see that many mental healthcare providers skip right to the pill because of expense. It’s saddening to see this is not just particular to Medicare and Medicaid recipients such as ourselves. The drugs we have right now are broad-spectrum; how will we ever get personalized medicine, much less healthcare practitioners that prescribe them appropriately– if they are skipping appropriate diagnostics because of cost? Personalized meds are said to be more expensive.

    Don’t get me started on DSM-5… it’s like Apple products, almost. “Got a symptom? There’s a pill for that!”

    1. plaguedparent@gmail.com

      You have a complex situation to navigate and I don’t envy you. I like your analogy to Apple. It seems like that is all anyone wants — the quick fix. Too bad the quick fix does not always sustain itself for the long term. Guess that is the nature of life… a constant ebb and flow, flux and change…Thanks for coming back.

  5. I think my family has been fortunate with health professionals, but I definitely see your point. The whole experience you relayed seems so impersonal and thoughtless. And the statistics are scary? Why do we medicate so much? On the other hand, my husband takes meds for ADHD and I take meds for anxiety, and we’re better off on them in a million ways. I just don’t know.

    1. plaguedparent@gmail.com

      Certainly there are legitimate and necessary usages of psychotropic meds. I just wonder if everyone needs them. I am familiar what the rates of prescribing are but I would love to know how many patients walk out with a script that don’t really require it. Also, little discuss seems to be had about the after-medication for some patients. Many are told they will be on meds for their lifetime when it turns out to be other wise. It is, without a doubt, a complicated question.

  6. I have been on antidepressants and/or antipsychotics for 9 years now. I have tried 8 different medications in various combinations and dosages. For a number of years I was managing my own medication. I would tell the doctor which medication and which dose to prescribe. I completely agree with you that the system is broken. Unless it is purely a chemical imbalance, which it rarely is, drugs are not the answer. Studies show that most do best with meds and talk therapy. Finding the right professionals to work with is difficult. I have definitely worked with some duds. There are some wonderful people out there who do listen though and they do their best to help you as much as they can. Even their resources are limited though. Do your research and keep looking. You will find someone who will take you seriously and will discuss things like an equal. Just don’t give up hope.

    1. plaguedparent@gmail.com

      Hope is all we have. Hopefully the right combination will be found; I just hope my daughter is honestly pursuing that on her own. My other big issue is how parents of young-adults (18-25) can be cut out of the process once their children turn 18. Many we’ve come across struggle with this aspect as well. Thank you for your input it is appreciated.

  7. Unfortunately with the advancements in medicine, there comes disadvantages with the advantages. With so many new things in front of us, we just really have to try to keep ourselves properly informed and trust our gut instincts together with what makes sense the most. Best of luck, hope your daughter gets well soon. #twinklytuesday

    1. plaguedparent@gmail.com

      Thanks for you well wishes. We keep hoping for the best as well.

  8. Wow, what a story. I am, myself, stable on antidepressants, but I certainly wouldn’t have wanted to take them by default or based on a single appointment. All the people around me know when to let me know if they’re concerned about a relapse, but it hasn’t happened yet. Are there those of us who “need” antidepressants in the same way that diabetics need insulin? Yes. Does that fix everything or remove responsibility for our choices? Absolutely not. I’ll be thinking of you, both as a mother, and as someone who has well managed clinical depression.

    1. plaguedparent@gmail.com

      Too true. Thank you for your kind thoughts and for taking the time to weigh in.

  9. Sometimes medication is really the best form of help but other times I think the medical profession are a little lazy in their diagnosis and prescriptions… handing out antidepressants is an easy way to solve a problem that could be helped in other ways. Good luck pet — I sincerely hope it’s the right approach for your daughter xx Thanks so much for linking up with #TwinklyTuesday x

    Caro | http://www.thetwinklediaries.co.uk

    1. plaguedparent@gmail.com

      I agree. Only time will tell if the current approach is the best one. Thank you for commenting.

  10. Wow he certainly doesn’t sound like he really cared! As someone who has had mental health issues (depression) what your daughter needs is obviously a doctor who actually listens and gives a monkey’s about he out come. I had three different anti depressants until one was found that worked (prozac certainly didn’t for me), and your doctor should have been talking through these options.

    1. plaguedparent@gmail.com

      No the medical establishment is really disconnected in some regard. I am sure some out there are far more compassionate than what we experienced. Perhaps the day will come when more options will reveal themselves. Thanks for sharing.

  11. Well… this is quite a shocking story! I for one would not have accepted this as doctors are only human and many of them are not as good as they make out. I think that drugs should be a last resort and often time, effort, guidance and community are the best steps toward combating a situation such as this. All the best 🙂

    1. plaguedparent@gmail.com

      Yes it is a complicated mess. Thank you for sharing.

  12. I agree that sometimes as a nation we like to throw drugs at a problem before trying gentler more natural methods. Did your daughter try natural herbs/accupuncture? And how is she doing now?

    1. plaguedparent@gmail.com

      As far as we know she is still taking medication. If we are to the point when we are no longer estranged then perhaps we can explore options. Thanks for reading.

  13. Wow I am so sorry your family is having to face this. However, you are right medicine definitely isn’t what it use to be. In any case, you should definitely research your issue yourself. And get a second opinion. In addition, seeking out alternative medicine.

    1. plaguedparent@gmail.com

      Thank you. You suggestions are good ones that, hopefully, down the road we can explore.

  14. Wow, a doctor was “Facebooking” while meeting with a patient? That is atrocious. I hope that you find a solution to the problem your daughter is experiencing soon. There is nothing worse than seeing your child hurting and feeling like you can’t do anything to help. All the best to you and your family.

    1. plaguedparent@gmail.com

      It really was astounding, but nonetheless true. Thank you for your well wishes and for taking the time to read and comment.

  15. Thanks for sharing this. It can be hard to share something so private but you don’t realize how many people you may have helped by opening up. So I commend you and wish you well.

    1. plaguedparent@gmail.com

      You are right it is hard, but that is exactly why we started our blog! Thank you for reading!

  16. This is such an important subject, and I think all too often it gets pushed under the rug. Whether people are embarrassed or just don’t know what to say about it. I am glad that you sought help and asked all the right questions. Its hard to know what to do!

    1. plaguedparent@gmail.com

      I really is a complex issue mired in misinformation and at times too much information.Thanks again for taking the time to read our work.

  17. I was 16 when I was diagnosed with depression following a really bad car crash I was in where 2 of my friends died. I’m now 28. I (thankfully) wasn’t put on anti-depressants right away. Instead told to see a counsellor, which helped a little. My final end of school grades came out so bad that I needed help getting into Uni. All through Uni I had sleeping problems. Towards the end of university I found myself on the edge of a cliff, thinking I should jump off. I scared the shit out of myself that day, saw a doctor and got on anti-depressants (I was 22 at this time). Though I’d been seeing a counsellor on and off I never really felt “cured”. Though I have only been on the pills for that short time (maybe a few months). What has finally helped me has been Yoga, accompanied by breathing exercises and meditation when my life is stressful. I honestly cannot be grateful enough to Yoga. My mother just passed away very young and it has only been doing yoga and meditation for an hour a day that’s got me through it. It’s the best alternative to pills I can think of!

    1. plaguedparent@gmail.com

      I am sorry for your losses and your struggles. I am so very glad that you found a “prescription” that works for you. It really is amazing how meditation and yoga can have an effect. Guess Buddha was on to something… I wish you the best, and thanks for taking the time to comment.

  18. I also agree to drugs, when they can help the body, mind, and person. There’s absolutely nothing wrong with it. It was eye opening especially to me as a young twenty-something when I worked in the psych unit one summer (I was a Ward Clerk aka secretary for the nurses).

    1. plaguedparent@gmail.com

      It is complex issue to say the least.

  19. The statistics are startling and very sad! I can’t believe that doctor was facebooking while you were in for the evaluation. I hope your daughter is able to get the kind of help she needs and that will be beneficial to her.

    1. plaguedparent@gmail.com

      Sad but true. Hopefully you are right and we will see some progress sooner rather than later.

  20. This was a good read. Like a few other commenters, I too, try to stay away from medicine as much as possible. Even if I have a headache, I will try to sleep it off or whatever I can to avoid taking meds. I would prefer to deal with the root cause of the problem, not mask the symptoms of the problem with medicine. I have watched a number of really good documentaries on Netflix about how profitable prescription drug companies are and the economics behind diagnosing patients with illnesses. It’s very interesting stuff!

    1. plaguedparent@gmail.com

      Netflix has some great stuff doesn’t it? Unfortunately $$$$ poisons the issues. If the business end can meet up with the medical ethics end of the problem perhaps some progress could be made and outcomes regarding treatment might improve.

  21. Though antidepressant medication is one profitable business for pharma companies it is also one hard one to deal with because you’re treating the brain and no idea how each person will reactive either during or when they want to stop taking the product. There definitely needs to be a better system in the industry, wishing your daughter only the best.

    1. plaguedparent@gmail.com

      Yes, this is the tricky part of the puzzle. Perhaps as study and awareness increase we can form a better understanding of what patients need and how best to provide that to them.

  22. Hi!
    This is my official welcome to my blog comment! =) I unoffically welcomed you on Twitter. I forgot how many of the same bloggers we know–Gary, Suzi, and of course Lysa.
    So glad. I’ve felt for a long time that you and I were part of the same community. I feel like Lysa is the glue! Thank you again! I’m really flattered.
    Janice

    1. plaguedparent@gmail.com

      Thank you Janice for the official welcome and for saying hi! We love being in the same community as you and so many fabulous talents!

  23. This is what passes for mental health help in the U.S. It’s terrible. Write a script and that’s it. Period.

    1. plaguedparent@gmail.com

      Thank you for writing in Carol. We’ve industrialized everything in our culture even the medical system. A very sad state indeed.

  24. FACEBOOKING??? I mean…the visit was already so impersonal. That is a detail that takes it into the realm of potential malpractice. I am one of your stats. I have been on (every type of) anti-depressant for over a decade. I have a psychiatrist that has been my doctor since 1996. Even with that consistency and care we have trouble with dosage and diagnosis. I understand the urge to get an answer/label/script. But it is JUST that. A script. A life and a mind and the parent relationship can never follow a script.

    1. plaguedparent@gmail.com

      Anna, I could not agree more. I won’t ruin your comment with a wordy reply so all I’ll say is, Thanks. And, I am glad you get it.

  25. My son meets with a psychiatrist next month for medication evaluation because he was just diagnosed with depression and adhd combined. This piece highlights all the worries I, too, have been facing with deciding whether to medicate or not.

    1. plaguedparent@gmail.com

      To be clear, I am certainly not anti-medication. My hope with the piece would be for anyone in our position to actively engage (or aggravate) clinicians so that all your apprehensions are addressed throughout the process. I would also hope that your son finds the support he needs from the medical establishment and that you are heard compassionately when you speak. Thanks and best of luck.

  26. So interesting. I think there has become a worrying trend to jumping too quickly into prescribing anti-depressants to people. I do think that for some people they really are necessary – for some people that is the only way to get them to a level of functioning that will enable them to engage with other treatments that can address the underlying issues. But it should not just be the automatic go to, and I don’t think it should be something that stands alone as though it is a treatment itself, when actually it just masks the issues. I think they are far too often used for cases that don’t warrant going straight to medication, and the effect of that is that now so many people EXPECT to get the drugs. They assume that is what they need and should have, and feel they have not been treated properly without them, which is a shame. For teens it is particularly concerning. As you say, some anti depressants have dangerous side effects for young people. Again, I think some young people are so ill that they do need the medication, but it should not be given lightly or without careful thought, or if there are good and effective alternatives still to be tried.

    1. plaguedparent@gmail.com

      The corporate humm in the background that suggests there is a solution for everything and that solution is a pill or a product. We seem to have the cultural expectation that every little thing can be “cured” that way. Perhaps to some degree doctors feel the same when faced with a patient for whom they can arrive at no other treatment options that satisfy their “customers” so they whip out the script pad. You can’t really blame them. I agree many certainly benefit from the drugs. There’s no denying that. But not everyone needs them. Thanks S.M. for weighing in, your voice is appreciated.

  27. A brilliant post ! No wonder I had to scroll way down ..look at all these comments . So need to share this , I am sooooo thinking the same as you . Only 2 days ago we were discussing that issue , way too many children already are under medication . What is wrong with society ?!

    1. plaguedparent@gmail.com

      What is wrong with society? Indeed a critical question to which, I for one, have no answer. Guess all we can do is say something when we se something that doesn’t quite compute. Thanks for adding to the thread Klaudia.

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