Although Bupropion (Wellbutrin, also known as Zyban when used to treat smoking addiction) allowed me to become functional and clear my head again
during a time when I was completely depressed to the point of total inactivity and dysfunction, and curbed by appetite which, as a side effect of my
depression, had made me gain a dangerous amount of weight... I do strongly agree that both the diagnosis of depression (as well as other mental health
conditions) and the prescribing of psychoactive drugs are far too easily and unrigorously given.
They give these substances out like candy now. (They do the same thing with synthetic opioid painkillers, incidentally, which can be highly
addicting.) Anyone who feels down is often called depressed and given pills, sometimes whether they meet the clinical criteria or not, and regardless
of severity. Even if every physician referred a patient with symptoms to a clinical psychiatrist and had them properly assessed (I mean true DSM
assessment and analysis) it would still be arguable as to whether it should happen as much as it would. But they don't. Doctors will often simply
conclude - irrespective of their own background or knowledge in psychology or psychiatric medicine - that someone has condition X and should receive
prescription Y. It's irresponsible in the extreme in my opinion. They tried to do it to me, and I insisted on seeing an experienced psychiatric
clinician at the very least, and some serious time spent on analyzing my issues before just squeezing me into a box and giving me some pills.
Now, that doesn't mean that these substances don't have therapeutic benefit to people. As I said, Bupropion helped me a great deal at a time in my
life when I really needed it. And there have been subsequent times when it becomes necessary again. Nor does it mean that mental health care is not
important or something we don't need more of in my opinion. The lack of
good, scientifically rigorous, comprehensive mental health care, as
opposed to pop culture and casual mental health care, is the problem in my view.
Take my use of Bupropion. It's just one tool in a broader array of approaches to dealing with some issues I have, though. It isn't a perennial magic
bullet. And it is most assuredly not for everyone. Certainly not as many people as I know it or something like it is being prescribed for, in my
opinion. Especially since - and this is just one example for one drug - it can have side effects like elevated blood pressure. They tried to give it
to me once when I was overweight and had hypertension. I had to actually point out to them that side effect, and only then did they say, "Oh wow,
you're right, you can't take this until your blood pressure is under control!" Now imagine that attitude being applied to a child or adolescent, whose
hormonal and neurotransmitter balances are still developing, along with their cognitive and emotional functions. There are few long term studies on
the effects of these substances, and some which strongly implicate them - as Heff points out clearly - in increased instances of violence, aggression,
psychosis, and even, paradoxically, suicide. We need more and better mental health care in this country, but in my view it is essential that it be
scientific, comprehensive, and tempered with caution. The mind is an extremely amorphous, difficult to predict and control part of our overall
wellbeing.
There seems to be a casual, lackadaisical attitude on the part of medical doctors that stems from a perplexing, almost paradoxical combination of on
one hand not taking mental health and medication thereof seriously, and on the other hand aggressively pursuing the pharmacology route, while
believing that everything approved by the FDA in succession must be an ever more safe and effective product. I have to strongly suspect that the
lobbying mentioned herein has a powerful influence at some point in the process of determining exactly which drugs become first line treatments, and
which drugs doctors are most likely to prescribe.
It's like everything else. Why are histamine and leukotrine inhibitors the first line drugs for asthma and allergies when alternatives exist? Why are
alcohol and tobacco legal and viewed favorably by society and the law (apart from driving while drinking of course,) while medicinal cannabis, despite
being legal in many states, is demonized? Everything - and the perception of everything - is driven by policy, which in turn is driven by lobbyists.
The policy needs to change to one that emphasizes science and caution (and in my personal experience at least, fewer quick fixes; a return to longer
term therapy rather than the bandaid approach) rather than immediacy and psycho-pharmacology.
Peace.
edit on 12/26/2012 by AceWombat04 because: Typo, elaboration
edit on 12/26/2012 by AceWombat04 because: Ditto