Tuesday, August 16, 2011

My 2 Cents On the Practice of Handing Out Happy Pills

Happy PillImage by edmittance via Flickr

This post has been syndicated on BlogHer.
Syndicated on BlogHer.com

There are a few things in life that really get me going.  I guess you would call them my pet peeves.  Today I was reminded of one of them as I spent some time on Twitter connecting with my friends.

One of my friends lost her husband not too long ago.  It was a devastating loss for her.  My heart and support went out to her.

While I have never "met" her in person, I can tell from my interactions with her that she is smart, strong and resilient.  She appears to be doing a solid job of dealing with this significant loss and moving on with her life.  I know that she is still grieving, but honestly, I would be more worried if she wasn't.

So when she mentioned today that her primary care doctor thought she wasn't doing very well and offered her antidepressants, I was pissed.  I know that my anger comes from my training in social work--the career that chronic illness has taken away from me.  Even though I can no longer practice being a clinical social worker, all my social work education and experience hasn't become completely lost to me.

Here are the things about this situation that really bother me:

  1. Grieving is a healthy process.  I think that the bigger the loss, the longer the time a person needs to process their grief and loss.
  2. With the exception of psychiatrists, the majority of medical doctors do not have adequate training to diagnose mental health disorders.
  3. If doctors were really trained to diagnose mental health disorders, they would keep a copy of the Diagnostics and Statistical Manual of Mental Disorders (DSM IV) in their offices.  This is a publication of the American Psychiatric Association that lists all the commonly recognized mental disorders and their diagnostic criteria.
  4. If they kept a copy of the DSM IV in their office, they would know that grief is not a mental disorder.  In addition, I believe the DSM cautions against diagnosing someone who is grieving with a mental disorder until at least 6 months have past since the loss.
The problematic thing here is that any medical doctor can prescribe psychotropic medications despite their lack of training in psychiatry.  In addition, as a by-product of how dysfunctional our medical system is, many medical doctors do not refer their patients for a psychiatric assessment if they suspect a mental health problem.  No, they "diagnose" depression and anxiety themselves, write a prescription and send their patients on their way.

That is not to say there isn't a role for the medical doctor in the diagnosis of a mental health disorder.  In fact, medical problems need to be ruled out first before a mental health diagnosis can be given.  But I know from my own experiences that often the mental health card is played when a medical doctor can't figure out what is physically wrong with a patient.

I guess it is easier to call someone depressed or anxious and gives them some "happy pills."

My friend's situation worries me.  I also makes me wonder how often this is happening in doctors' offices across the country.

 I know that there are fewer and fewer mental health professionals, like social workers, hired to be part of medical teams.  I think this is a huge mistake.  I believe being able to accurately diagnose mental health disorders and provide specific and appropriate treatment is as equally important as medical care.  Rather than being housed in separate offices, building or locations, I think medical and mental health services need to be integrate.  

My opinion is that adequate health care needs to include both the body and the mind.

I also think that if someone is going to be given a prescription for antidepressants or anti-anxiety medication, there first needs to be a thorough biopsychosocial assessment completed by a team of medical and mental health professionals.

That's my 2 cents.

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Anonymous said...

I totally agree with you about the practice of handing out "happy pills" to deal with life events and problems. Fortunately, I have a medical doctor who agrees with me and, should she believe I had a mental disorder, would send me to the proper mental health professional. Unfortunately, these drugs are simply too easy to prescribe and it seems that in some circles, they are a status symbol. It's very unfortunate that medicine has gone the way of so much else in our society in that the "easy way" is the preferred route. Until that changes, I'm afraid we'll continue to see doctors hand out these pills like candy.

Sharon Stevens said...

As a patient who has been given antidepressants without being sent to a mental health professional I agree. I am still battling withdraw from a strong antidepressant because my doctor took me off cold turkey!!!! GP's should not be giving out these meds that they know little or nothing about!

Anonymous said...

Selena, I couldn't have said it myself! Too many people taking the wrong drugs for the wrong things! Great post.


FatHeadDog said...

While I agree that medical doctors may be too quick to prescribe antidepressant medication, I don't think relegating situational depression diagnostics (as doctors reference grieving) to psychiatrists is the solution either.

If a man or woman is suffering from symptoms of depression, the worst thing you could do is present obstacles to their treatment.

"Abitbackward" aptly points out that a stigma exists for seeing mental health professionals. Couple that with the added cost of specialists such as psychiatrists and inordinate counseling rates, a grieving person is more likely to go without treatment. That can lead to unresolved depression, which has far-reaching effects.

Thank you for the thought provoking topic, Selena! :)

Kathy said...

Part of the problem is that people (healthy people...not your friend specifically) expect a solution when they spend time and money going to a doctor appointment. And since the problem has to be solved within 15 minutes, doctors are inclined to throw a pill at it.

Because who really wants to hear, "get some exercise and eat good food, mostly plants and spend time with friends"? It takes a while for a lot of us to get to the place that we will actually listen and adhere to that advice.

Our medical system is broke and writing a script is an easy "fix". Ugh.

P.S. Don't get too pissed Selena, remember we're supposed to be living stress-free lives :)

Unknown said...

I'm loving all the comments here. Thanks for sharing them.

As a former social worker who practiced in medical settings, I think I got to dispel a lot of people's fears about talking to a "mental health professional." I was just a helpful person who had the time to listen when someone had a psychosocial problem and needed some help.

As part of a team approach to health care, I was able to provide counseling and advice on-the-spot. There was no extra fee for my services. I was there to help the patient with their problems AND there to help the doctors understand their patients better.

I think it's a shame their are two separate systems: health care and mental health care. I think an integrated approach would help get more people the services they need for mind, body and spirit.