Can’t We All Just Get Along?
In the spirit of Mental Health Awareness Month and a lively discussion with a colleague this fine spring morning, I want to talk about a movement that leaves me flummoxed as both a patient and provider. The anti-psychiatry movement. I have to be honest. I do not understand it. We cry out for understanding, we beg for acceptance, we boycott Mercedes-Benz for stigmatizing car commercials over the use of the word crazy and then there is a population who thumbs their nose at all this work, telling us our treatment is wrong. Our doctors are wrong, our medications are killing us and that we should be smarter than we are for seeking help. They actually tell us and anyone else who will listen that we were never sick to begin with and that if we just stopped our medication we would get better.
Now, I don’t know about you, but this makes me sick. I have stopped my medications before in fits of non-compliance. The results are disastrous rather than miraculous, and that is because like millions of others, I have a bona-fide disease that requires medical treatment. Thus my confusion regarding this movement. Why the backlash?
The Anti-Psychiatry advocates believe psychiatry harms more individuals than helps. They cite the medications used and procedures such as electro-convulsive therapy (ECT) as examples. As a medical professional, I would like to look at this from a common sense stance. When one pulls back the curtain on medicine, it is an imperfect science. We will find errors and harm in all areas of it. Patients have died in all disciplines, be it medicine or surgery. Oncology or Obstetrics. Cardiology or Neurology. Pediatrics or Geriatrics. Psychiatry is not the lone wolf in medicine causing harm.
When a person signs consent for chemotherapy, the list of side effects is long, complicated and confusing. The side effects go far beyond hair loss, nausea, vomiting and fatigue. They can include heart failure, increased infection risk due to immunosuppression, kidney failure, and other organ dysfunction. Yet there is no movement to stop oncology. Cancer treatments are held in the highest regard and we do everything we can to stop cancer in it’s tracks.
Another example in medicine is the care provided in the intensive care units across the country. When a loved one is critically ill and hanging on to life by a mere thread, we do not hesitate to ask physicians to do every thing possible to save that person’s life. That would include multiple machines to perhaps mimic the work of the lungs, the kidneys and in some instances the heart. We can provide nutrition, provide hydration, provide medications to ensure adequate blood pressure, provide sedation to ensure our loved one is less aware or sometimes completely unaware. These patients often need to be restrained for their safety. In my nearly twenty years of nursing, ten as a nurse practitioner I have never had a critically ill patient live and declare themselves a “survivor of medicine” and be ungrateful to the very care that pulled them through.
The anti-psychiatry movement often cites the pharmaceutical industry as nothing more than a business in cahoots with psychiatrists to keep patients ill and generate profits. I did a search of most prescribed medications by both sales and prescription in America for the period July 2013-June 2014. I pulled data that any layperson could easily gather, doing a quick web search and getting the data from WebMD; a common site that laypeople use for medical information. (http://www.webmd.com/news/20140805/top-10-drugs). I learned that for the time period stated, the top five medications prescribed in our country are used to treat thyroid disease, cholesterol, acid reflux and are inhalers for lung disease. The top ten is rounded out by medications to treat the heart, diabetes, fibromyalgia (chronic pain of unknown cause) and ONE for attention deficit disorder. ONE psychiatric medication in the top ten prescribed. By sales, the top five medications in our country are an anti-psychotic, an anti-inflammatory used to treat Crohn’s/psoriasis, an acid reflux reducer, a cholesterol-lowering agent and a second anti-inflammatory agent for the treatment of psoriasis. The top ten in sales is rounded out by medications for lung, diabetes, cancer, hepatitis and inflammatory conditions. Again, by sales, we are only looking at ONE psychiatric medication. I do recognize this is a billion dollar industry, however the other specialties in medicine are accounting for far more dollars than psychiatry.
These simple illustrations fail to even begin to scratch the surface of the good psychiatry has done for individuals with mental illness. As a patient, I cannot fathom turning my back on providers who worked so hard to bring me back from the brink of my own mind. As a provider, I know realistically medicine is an imperfect science, we fail people on occasion despite our best efforts in all specialties. We can only improve our system if we work together and support psychiatry to constantly strive for perfection in the same fashion we cheerlead other disciplines.
Ann Roselle is an Acute Care Nurse Practitioner at the Heart and Vascular Center at Yale-New Haven Hospital in New Haven, CT. She has been practicing nursing since 1998 and a nurse practitioner since 2006. She was diagnosed with postpartum onset bipolar disorder in 2013 and has been a vocal advocate for mental illness since, either blogging or volunteering for various organizations. She lives in Bethany, CT with her husband and three boys. In her spare time she can be found blogging at www.bipolarandme.virb.com or playing in mud puddles.