Confessions of a Serial Insomniac

I am scared of psychiatrists.  In fact, my lovely GP excepted, I am generally scared of medical doctors full-stop.  I think that quite a few are incompetent, overpaid megalomaniacs who become disillusioned with the personnel necessarily involved in their chosen career all too quickly, and whose over-the-top professional cynicism grossly deters patients from seeing them to the point where it could be dangerous.

But I am not anti-psychiatry.  In fact, I find some of the claims and terminology bandied about by the anti-psychiatry lobby to be, by turns, hilarious and personally insulting.

Psychiatry is Just a Pseudo-Science!

But of course it’s a pseudo-science.  All science, to an extent at least, is pseudo in that parts of it will have tenets that are based on ‘mere’ theory as opposed to proven, demonstrable results, and psychiatry is no different.  I believe some parts of it can be proven – more on this later – but on the parts that cannot be, or have not yet been, the discipline is no different from any other hard science out there.

Furthermore, psychiatrists themselves will be the first to admit that their particular brand of medicine is not perfect, at least in part because neuroscience is still so poorly understood.

Indeed, would you dismiss the discipline of neuroscience itself merely because it’s investigative and highly speculative?  What about astronomy, cosmology?  Marine biology?  Even human biology to some extent – let’s say stem cell technology.  Clearly a promising field of medicinal investigation, but still very much at a preliminary stage.  Quantum physics has not yet produced a unified and complete theory of everything – do we dismiss it with such ease?

Point: psychiatry is like every science – it seeks to investigate issues through testing and examination with a view to obtaining results that back up or discredit existing theories.  It is dealing with the mind, which is housed in the brain – a poorly understood organ, even now – and, moreover, it is dealing with the unpredictability that is people.  These things, quite probably, make it imperfect, but that does not make its contribution to medicine and to patients invalid and contrived.

It’s a Big Pharma Conspiracy!

On this one, I believe there is a difference between the USA and the UK.  Certainly so-called ‘Big Pharma’ markets its drugs to the NHS, which is then co-funded by prescription charges (where applicable) and those paying national insurance, but individual patients here do not pay in the more traditional sense.

Currently prescriptions are free of charge to everyone in Northern Ireland, though I don’t believe that this applies to the rest of the UK.  Even where prescription charges do apply, they’re something like £7, which – relative to the overall price of the drugs, anyway – is fuck all really.  The point I’m making here is that this means that, for the most part, the NHS has to fund psychiatric (and other) prescriptions.

Anyone who’s followed my story of my battle with the fucking Trust will know that the NHS is completely obsessed with finances and cost-saving, to the point where it frankly endangers the lives of many.  To that end, in my experience, they simply will not prescribe you expensive drugs unless they feel strongly that they are necessary.

As an anecdotal aside, with no disrespect meant to anyone, I personally believe that most British and Irish NHS doctors/buyers are far too cynical to fall for ‘Big Pharma’ bullshit in the first place, unless they see a clear link between Drug A and Improvement.

Point: the ‘Big Pharma’ conspiracy may or may not have weight in some parts of the world, but I think it’s applicability is very limited in this jurisdiction.

Psychiatric Medication is a Form of Social Control…!

I got lambasted on Facebook the other day for making a remark criticising censorship but defending medication.  Apparently all psychiatric medication does is act as a tool of censorship.  ”Take the meds like a good little girl – either that or stop banging on about censorship,” the woman ranted hysterically, as if Facebook had newly developed into a dystopian A Clockwork Orange-like world of indoctrination by medicine.

Riiiiiight. I have been taking some form of psychiatric medication since I was 14 – that’s nearly 13 years, and nearly half my life.  I do remember what things were like before it, however – both the good and the bad.  My experience has been that what medication has done for me personally, the stuff that works anyway, is to help me become more like the person I was before mental illness (which apparently isn’t real – that one in a minute!) struck me with the force that it did as a teenager.  It brings me back to some semblance of what I used to perceive as ‘normality’.

I have not become some vapid, compliant, brain-dead bitch because I have taken it – far from it.  In fact, the opposite is true – in general, I am fiercely anti-authoritarian, I am extremely intelligent and because of psychiatric medication I was able to get through school and get myself two degrees.  Anyone who has read this blog should surely to be able to attest to the fact that I am not at all under the influence of some sort of evil tool of social control.  If you think that I am then sorry, but I’m not the delusional one here.  Kindly fuck off.

If you think that I am simply an anomaly, please go and speak to the hundreds of other mental health bloggers, Twitterers and Facebook users out there who take psychiatric medication and are not some degraded servants of the big, bad state.

To be fair, I recognise that particularly strong medication such as Haloperidol can turn individuals into drivelling nobodies devoid of any personality and moral agency, and I agree that use of such drugs is appalling – in general.  If someone is in imminent danger of being violent, though, I can see the need for such tranquilisers.  I think it’s horrific, but I think that it can be – on occasion – a necessity.

I can’t speak for other parts of the world, and in fact I can’t speak from experience either as I’ve never been a psychiatric inpatient, but I really believe that in the vast majority of cases, the hideous days where One Flew Over the Cuckoo’s Nest was a daily grim reality are gone from UK medicine.  People are only forcibly drugged to such grotesque extents when there is a clear and imminent need for it.

Point:  psychiatric medications are only used for ‘control’ purposes when there is some sort of utilitarian reason, such as a need to protect a number of people from violence.  Otherwise it’s merely there to treat illnesses, and is offered to people, not forced upon them.

…No, wait!  It’s Not Social Control, It’s Just Placebo.  That’s What I Meant.

So what if it is?  It isn’t, but so what if it was?  A placebo effect is still an effect.

Anyway, I beg to differ; I quite simply would not be alive but for Fluoxetine and Quetiapine.  But why listen to me – I’m just the indoctrinated fuckwit who is compliant with the evil medics and who erroneously just thinks she’s experiencing a beneficial modification in brain chemistry.

Since I am no longer taking Fluoxetine, I’ll concentrate on Quetiapine here:

Study One
Study Two
Study Three

You might also be interested in taking a gander through Neuroskeptic’s neuroscientific archives.

For the sake of brevity (insofar as I am capable thereof), that’s all I’m going to include here for now, but feel free to ask me for further studies should you wish to do so.

*ponders*

Augh, screw it.  Here’s one I liked on Fluoxetine (specifically on how it works) after all.  Now I’m done.

A friend of mine recommended I read a book called The Chemical Cure dealing with the supposed myths of the benefits of psychiatric medication.  I intend to do so, but one criticism I have of the book before even having picked it up is the inference that medicine purports to be a ‘cure’.  It isn’t a cure.  Medication is nothing more than managerial, so the terminology is, I feel, misleading.

In a case like mine, where it can be reasonably argued whether correctly or otherwise that a mental illness is induced psycho-socially, medication can make things less bad, but if the disorder(s) can be cured (and I am not convinced of that), then it is only through proper, individualised psychotherapy.  Just because medication is not a cure, though, does not mean that it is necessarily unhelpful.

In a case where one can reasonably argue that the illness is more organic in nature – and I know supporters of anti-psychiatry dismiss that as a possibility, but indulge me for a minute – medication specifically doesn’t claim to be able to cure; it is prescribed for the management of the disorder in question.  Maybe people can be ‘cured’ of things like schizophrenia, and maybe they can’t.  For now, though, the most provably effective management of such an illness is medication, in conjunction with therapy that helps the sufferer manage specific symptoms when entering or when in ‘an episode’.

Point: medication is imperfect, but for many it is very helpful.

But the Side Effects!  They’re so Insidious and Evil, and You Weren’t Given All the Facts About Them!

I find this an incredibly insulting argument.  Of course I know about the fucking side effects.  I know they suck arse.  I don’t like them and I don’t want them.  I did, however, know about them.

Just because I am mental does not make me incapable of reading, asking questions or weighing up the pros and cons when making a major decision.  I know that both Quetiapine and Venlafaxine, my current medications, are some of the most horrible tablets side-effects wise that are out there.  Nevertheless, I made the decision, based on all the information, to act on my consultant’s advice and take these drugs, because on balance I hoped and believed that their positive indicated effects would outweigh their negative side effects.

This has, indeed, been the case.

Point: don’t insult our intelligences, please.  We have mental health problems, not IQs of -7,293.  Even in the unlikely event that our psychiatrists or GPs don’t tell us about the nasty side effects, we can very easily find them out for ourselves, then weigh up whether or not we feel the bad outweighs the good.

Mental ‘Illnesses’ Aren’t Even Real!  Stop Pathologising Our Humanity!

I actually find this one hilarious, because it is so far removed from most people’s experiences of mental ill health that it’s absurd.

• Person dies.  Person left behind is depressed.  That’s humanity.  Fair enough.
• Person gets raped, person develops depression.  That’s humanity.  Fair enough.

In both of the aforesaid, it’s certainly arguable that no mental illness is present.  Nevertheless, it doesn’t mean that psychiatric intervention is a necessarily evil thing.  It doesn’t mean it’s a good thing either.  It’s an individual matter.

Now then…

• Person gets raped.  Person dissociates (a human coping mechanism, arguably).  Person is fine for years.  Then person develops severe anxiety, depression, yadda yadda.  Person starts self-harming as way to cope and tries to kill his/herself.  Person becomes volatile to be around and enters fugue states randomly.  Person may hallucinate and/or experience delusions.
• Person has no known issues of trauma.  One day when person is 25 (s)he starts seeing/hearing talking settees on his/her route to work, and eventually befriends them.  Person starts to believe that (s)he is God’s personification on Earth and talks to Jesus, who can be heard (but not seen) by person but not by person’s friend.

Whether trauma is or isn’t present, how such extreme examples can just be seen as ‘just’ humanity is frankly beyond my comprehension and – at the risk of sounding arrogant, I have a high IQ and can see most viewpoints on most things, regardless of whether or not I agree with them.  Arguably there is a sliding scale between a ‘normal’ reaction to something and an ‘extreme’ one – but therein lies a notable point: if a reaction is extreme enough to cause significant and enduring psychological distress, then it is evidently extreme enough to warrant treatment.

Humanity is a very individual concept, and what is ‘normal’ for one person is obviously not necessarily so for another.  Additionally, we all suffer mentally to some extent or another at times in our lives, and would be inhuman if we did not.  Nevertheless, where our ‘humanity’ is exmplified by extreme behaviour and mental agony, help is clearly needed for us.  Psychiatry can, through the process of conceptualising symptoms and possibly prescribing medication, been one avenue amongst several to offer that help.

Point: mental illnesses are real, regardless of whether they are psychosocial, biological or something else entirely.  It almost doesn’t matter whether or not that specific is agreed upon – what is surely undeniable is that mental suffering exists, and in extreme cases thereof, psychiatrists can be of assistance.

Other Points to Note

• In the afore-referenced Facebook discussion, someone said that they wanted me to make an informed choice regarding medication (as clearly I am incapable of same on my own).  Assuming I had suddenly managed to become informed after so obviously having no conception of anything to do with the medication prior to the person’s incredibly insightful comment, they told me that they would not judge me for my decision. However, the use of scare quotes and derogatory terminology, as often seen being used by many people who hold these beliefs, spoke very much to the contrary.  It is clear to me that whether consciously or, more likely in fairness, unconsciously, those of us that are not anti-psychiatry are constantly being judged and looked down upon by many of those who are.
• I believe in the effectiveness of psychotherapy, but just like the psychiatric medication so derided by the anti-psychiatry lobby, it is a highly individual concept.  CBT, DBT, life-coaching, NLP – this, to me, is all complete and utter wank.  To some it may be life-saving.  Psychodynamic therapy was helping me (the only reason it did not continue to do so was because it was cut short, not because it was per se shit), and I believe also that analysis could do so.  For others it may drive them to suicide.  No talking therapy may work for some people.  Ditto lifestyle changes, ditto herbal remedies, ditto whatever.  The point is that treatment for mental illness/pathologised humanity/distress/whatever you want to call it is by its very nature highly individualised, and there is no one size fits all.  For some, psychiatry has no place.  For others, it does.  Denying, stigmatising or shaming those people who choose to utilise psychiatry has exactly the same effect on society as anti-psychiatry supporters claim psychiatry itself does – that of censorship, a removal of choice, a degrading of an individual’s personal agency.

Conclusion

Despite the tone of the forgoing, I am actually not anti-anti-psychiatry – not conceptually, at least.  What I am anti is anti-choice.  Most people will claim to not be anti-choice, but I have to say that I think that some ardent supporters of the anti-psychiatry movement, through their belittling terminologies and vehement contempt of medication, are effectively putting themselves in the role of a ubiquitous, societal decision-maker.  I think that that is wrong.

On a related note, I also find the proselytism of some members of this lobby to be grossly offensive, because it again strikes me as being an attempt to remove choice, and assumes that I do not have the mental capacity to have reasoned the relevant issues in my own mind.

Anti-psychiatry has got some things right.  Some historical methods of psychiatric treatment were vile beyond description, and defied even the most rudimentary understandings of human rights.  To a lesser extent, hardcore medications such as Haloperidol do the same when they are used as chemical restraints – though, as argued above, I firmly believe that this is only done in the most extreme of circumstances, at least in this country.

And therein lies a point – just because things might be ‘OK’ in the UK, it doesn’t mean they are elsewhere.  We must therefore demonise psychiatry, right, so that those nations where disgustingly outdated and demeaning practices are ongoing know that what they’re doing is evil?  Er…no.  We must show that it doesn’t have to be like that, and that regulation, rather than prohibition, is an absolute must (as it should be in any medical or caring profession).

Medication is not a ‘chemical cure’, and although I have provided a critique of that above, let’s be honest here – for a long time that was exactly how it was treated.  By some GPs, it frankly still is.  That, to me, is exactly why psychiatry is a necessity: GPs do not and cannot have the refined, if flawed, understanding that specialists do, and are thus more likely to simply throw drugs at you.  A psychiatrist may feel that your case may be better dealt with by therapy, or different drugs, or a combination of both.  But drugs are not a cure, whatever the case, and perhaps anti-psychiatry can be credited for originally making that point (though I’m not sure).  Nowadays, however, as noted above, no one feels that medication is a cure.

Do psychiatrists exist to serve the will of ‘Big Pharma’?  As I stated above, perhaps to a certain extent they do in some jurisdictions, and if indeed that is the case, then I am grateful to the anti-psychiatry lobby for raising awareness on the issue.  As I stated, though, I am not sure how applicable this argument is to the nationalised healthcare we normally see here in the UK.  Additionally, even if psychiatrists are plying patients with medication because ‘Big Pharma’ says so – well, it doesn’t necessarily mean that those drugs are shit.  They may be over-marketed, but that in itself does not mean that they are of no value. They are only of no value if they are of no value, not because their manufacturers are cunts.

Finally, yes – sometimes mental distress and, indeed, our very humanity is over-pathologised.  We all experience worries, anxieties, low periods and traumas, and mostly it’s just life.  Existence is not all fun and games, nor should it be.  Bad things happen, bad feelings result.  That’s life.

But it’s not all just life, is it?  The demarcation line is blurred, to be sure, but there’s normal human suffering and then there’s severe and enduring mental distress, of the like unimaginable unless you have personally experienced it.

And this is the whole point; the only point that ultimately matters in this whole debate.  No one is asking for permanent happiness; life is about mere tolerance or, at best, accepting contentment.  When we are at our lowest, our worst in whatever form that may be, and when that’s beyond a normal life experience or is chronic in nature, in order to achieve some contented state of being – or, frankly, to even come remotely close to it - it is only natural and right that we seek help.  For some, that help may be something as simple as a modification in diet, or a daily walk.  For others, it may include meditation or a talking therapy.  For some, it may be psychiatry, whether alone or in conjunction with other treatment(s).

It is not evil to look to a psychiatrist for help in easing mental agony.  For some of us, it is a simple necessity.

Please try and leave dogma and damnation at the door on this issue and remember that we are all different – and that it is crucial to our most fundamental human rights that we are allowed to remain so, in whatever field of play that may be.

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