#psychotropic medication

[ex-foster]

[somecunttookmyurl]

Never considered having to get documentation for taking medication into foreign countries while traveling. Thank you for giving me one more thing to add to my travel checklist: is my medication illegal in this country? Lmao.

most medication will be fine (although you might need documentation if you're taking more than a 1 month supply with you, and regardless it should always be in the original packaging with the pharmacy label. always in hand luggage never checked) but if it's a controlled substance in your country it'll almost certainly need documentation elsewhere

[emperornorton47]

[docgold13]

Best antipsychotic medication with fewest “zombie” side effects?

Quetiapine fumarate (Seroquel)

Aripiprazole (Abilify)

Risperidone (Risperdal)

[butchiful]

I didnt even drink anything alcoholic..? But maybe the coke did make weird things 2my brain at like 11pm when I drank it. Whatever

[bipolarblogss]

Not candy

[bicurioustomhardy]

but also...the way they carry out the scarecrow plot at least in the dark knight trilogy (i am extremely unaware of how it's handled in comics and i haven't watched any of the batman animated series episodes that focus on him i think he's like an actual scarecrow there lmfao) is deeply carceral in its thinking: mental illness and instability is specifically used as a ploy to keep criminals from "facing justice" in essence, keeping them out of the prison/criminal justice system and instead kept within the psychiatric incarceration system (basically just arkham asylum in gotham). like it is certainly not downplaying the power of the psychiatric apparatus but of course it's just kind of individualized within jonathan crane himself, who gets a personal sadistic kick out of bringing hardened criminals protected by corrupt external systems of government and turning them into frightened shells of themselves that are denied autonomy (of course) who have no choice but to be brought under arkham's care. but we're supposed to view this and think that the horror is all about them not facing justice and seeing a therapist instead when it's something like much much more evil that is done to like irl ppl with some medications. and of course it completely ignores the intertwining of the prison/psychiatric apparatuses and how uh yeah prison does fuck up your mental health. but uh well that's batman for you.

[girldraki]

i think we're doing a little bit of the classic Hubris right now but fuck you brain-mom we can absolutely try to learn a language and maintain hyperfocus on a video game and flesh out and develop an oc concept and possible fanfiction all at the same time like we're juggling plates Because., (confident smirk) Our strattera has been titrated up. Surely this will not end in us crashing and burnign out for months

[shrinksinsneakers]

(via Rational Polypharmacy and Evidence-Based Off-Label Prescribing: Navigating the Risks of Irrational Treatment)

Today’s post is more of a clinical reflection. I’ve been sharing a lot about research studies lately, but I want to pause and talk about polypharmacy in psychiatry and off-label prescribing. 

[bpdrug-addict]

PILLS

I've been on psychiatric medication since 13 years old. I'm 21 now and I'm not even close to finding meds that help me more than they hurt me. every single medication a doctor has prescribed me has had unbearable side effects. I have BPD and almost every subsect of the major disorders in the DSM and yet ALL the atypical antipyschotics and Anticonvulsants in the world can't help me. I've only tried 1 SSRI and it destroyed my mood for my entire teenage hood. I was empty and angry, vile and unapologetic. My mood stabilizers only help so much. they can only prevent me from crying. my rage still awakens me like the claws of a beast ripping into my flesh every morning. the psychosis has never truely stopped from the meds. The OCD and skin picking has never gotten better from the meds. my appetite may improve on some meds but it doesn't mean I have the money to afford to eat. weed is the only fast acting med besides benzos (and sometimes hydroxyzine/gabapentin/trazodone) that can help with my anxiety or mood swings. Ive only ever been prescribed a benzo at psyche wards or ERs for acute psychosis. Ive been misdiagnosed with bipolar for the past 6 years even though I've been diagnosed with BPD instead twice since I turned 18. The pills for mood and anxiety help my sleep but ruin everything else. I've never been prescribed insomnia meds, only nightmare medication. I've never been to drug or alcohol counseling, only ever been on Naltrexone which doesn't help with cravings all the time and makes me sick for days after drinking (even though they say you can take it while drinking). My doctors are running out of atypical antipyshcotics/mood stabilizers to put me on. they started trying to put me on anticonvulsants instead 2 years ago and I've been on 3 since. They've had the most side effects out of anything else I've taken. I was only on oxcarbazepine for 1 day because I woke up wanting to kill everyone around me. I'm still trying to hold out hope for a life that's easy and meds that help me but my hope is getting slimmer with every pill I cross off my try list. I'm trying to get better but sometimes I wonder if I can.

[ex-foster]

[jbfly46]

Antidepressants and antipsychotics are essentially narcotics that don’t get you high. They only cause brain damage and other negative side effects. Shooting your patient in the head is more ethical and humane than prescribing them these medications.

[thoughtsoftrash]

Word of the day

Pharmageddon

[transmutationisms]

serious question but do you personally believe there is a way to approach psychiatry in a way that uplifts and upholds patient autonomy and wellness or is the entire trade essentially fucked haha. Btw this is an ask coming from a 3rd year med student—with a background of severe mental illness—who is considering a residency in psychiatry after receiving life-saving care in high school pertaining to said conditions. (I have peers who have been involuntarily hospitalized and treated horribly in psych wards, with approaches i patently disagree with, but was lucky not to experience. I don’t like modern american medicine’s approach to mental illness; “throw pills” at it to “make it go away” ie. a problem of overprescribing, inadequate and non-holistic approach to mental health, and i feel a lot of that can be attributed to the capitalistic framework. I also def agree with you that so much of what can be considered normal human responses to traumatic events/normal human suffering can be unnecessarily pathologized—a great example being the whole “chemical imbalances in the brain is the ONLY reason why im like this” argument that ive unfortunately fallen hard for when i was younger and am still currently dismantling within myself…and like dont even get me started on this field’s history of demonizing POC, women, LGBT, etc). Like i deeply love my psych rotations so far, and i utterly feel in my gut that this is the manner in which i would like to help people—a lot of whom are just like me—but im wondering if there is a way to reconcile these aspects in a way that one can feel morally okay participating within such an imperfect system, in ur opinion… ngghhhhhh i just want to be a good doctor to my patients…

(ps i love all ur writing and analysis on succession!! big fan mwah <333)

i don't mean to sound unduly pissy at you, specifically, but i do have to say: every single time i've talked about antipsych or broader criticism of medicine on this website, i immediately get a wave of responses like this, from doctors/nurses/psychs/students of the above, asking me to, like, reassure them that they're not doing something immoral or un-communist or whatever by having or pursuing these jobs. and it's honestly frustrating. why is it that these conversations get re-framed around this particular line of inquiry and medical ego-soothing? why is it that when i say "the medical encounter is not structured to protect patient autonomy or well-being," so many people hear something more along the lines of "doctors are mean and i wish they were nicer"? why is it that it's impossible to discuss the philosophical and structural violence of academic and clinical medicine without it becoming a referendum on the individual morality of doctors?

i'm choosing to read you in good faith because i think it's possible to re-re-frame this line of questioning to demonstrate to you the sorts of critiques and inquiries i find more interesting and more conducive to patient autonomy and liberation. so, let me pick apart a few lines of this ask.

"is the entire trade essentially fucked?"

if you're thinking of trying to 'reform' the project of medical psychology within existing infrastructures and institutions, then yeah, it's fucked. if you're still assuming that affective distress can only be 'treated' within this medical apparatus (despite, again, no psychiatric dx satisfying any pathologist's understanding of a 'disease' ie an aberration from 'normal' physiological functioning) then you're not challenging the things that actually make psychiatry violent. you're simply fantasising about making the violence nicer.

"I don’t like modern american medicine’s approach to mental illness; “throw pills” at it to “make it go away” ie. a problem of overprescribing, inadequate and non-holistic approach to mental health, and i feel a lot of that can be attributed to the capitalistic framework."

i hate when i talk about psychotropic drugs being marketed to patients using lies like the chemical imbalance myth, and then pushed on patients—including through outright force—by psychiatrists, and the discussion gets re-framed as one about 'overprescribing'. my problem is not with people taking drugs. i am, in fact, so pro-drugs that i think even the ones administered in a clinical setting sometimes have value. my issue is with, again, the provision of misleading or outright false information, the use of force and coercion to put patients on such drugs in order to force social conformity and employability, and the general model of medicine and medical psychology that assumes patients ought to be passive recipients of medical enlightenment rather than active participants in their own treatment who are given the agency to decide when and how to engage with any form of curative or meliorative intervention.

'holistic' medicine and psychiatry do not solve this problem! they are not a paradigm shift because they continue to locate expertise and epistemological authority with the credentialed physician, and to position patients as too sick, stupid, or helpless to do anything but receive and comply with the medical interventions. there are certainly psychotropic drugs that are demonstrably more harmful than others (antipsychotics, for example), and some that are demonstrably prescribed to patients who do not benefit from them and are even harmed by them. conversely, there are certainly forms of intervention besides pharmaceuticals that people may find helpful. but my general critique here is aimed less at haggling over specific methods of intervention, and more at the ideological and philosophical tenets of medicine that cause any interventions to be imposed by force or coercion on patients, then framed as being 'for their own good'. were suffering people given the information and autonomy to actually choose whether and how to engage in any kind of intervention, some might still choose drugs! my position here is not one of moralising drugs, but making the act of taking them one that is freely chosen and available as an option without relying on physician determination of a patient's interests over their own assessment of their needs and wants.

"so much of what can be considered normal human responses to traumatic events/normal human suffering can be unnecessarily pathologized"

true, but don't misunderstand me as saying that drugs or any other form of intervention should be forcibly withheld from those who do want them and are made fully aware of what risks and harms seeking them could entail. again, this would still be an authoritarian model; my critique is aimed at increasing patient autonomy, not at creating equally authoritarian and empowered doctors who just have slightly different treatment philosophies.

"dont even get me started on this field’s history of demonizing POC, women, LGBT, etc"

ok, framing this as "demonisation" tells me that you're not understanding that, again, this is a systemic and structural critique. it is certainly true that a great many doctors currently are, and have historically have been, outright racist, trans/misogynist, ableist, and so on. framing this as a problem of a well-intentioned discipline being corrupted by some assholes is getting it backwards. medicine attracts prejudiced people, not to mention strengthens and promotes these prejudices in its entire training and practice infrastructures, because of its underlying philosophical orientation toward enforcing 'normality' as defined by 18th-century statistics and 19th-century human sciences that explicitly place white, cis, able-bodied european men as the normal ideal that everyone else is inferior to or failing to live up to. doctors who really nicely tell you that you're too fat are still using bmi charts that come from the statistical anthropometry of adolphe quételet and the flawed actuarial calculations of metlife insurance. doctors who really nicely deny you access to transition surgery are still operating under a paradigm that gives the practitioner authority over expressions and embodiments of gender. the issue isn't 'demonisation', it's that medicine and psychiatry explicitly attempt to render judgments about who and what is 'normal' and therefore socially 'healthy', and enforce those standards on patients. this is not a promotion of patient well-being, but of social conformity.

"i deeply love my psych rotations so far, and i utterly feel in my gut that this is the manner in which i would like to help people"

let me ask you a few questions. you say that you like your psych rotations... but how do your patients feel about them? is their autonomy protected? are they in treatment by free choice, and free to leave any time they wish? are they treated as human beings with full self-determination? if you witnessed a situation in which a patient was coerced or forced into a certain treatment, or in which you were not sure whether they were consenting with full knowledge or freedom, would you feel empowered to intervene? or would doing so threaten your career by exposing you to anger and retaliation from your higher-ups? what higher-ups will you be exposed to as a resident, and then as a practicing physician? could you practice in a way that committed fully, 100%, to patient autonomy if you were working at someone else's practice, or in a hospital or clinic? could you, according to current medical guidelines, even if you had your own practice?

when you say "this is the manner in which i would like to help people", what do you mean by "this"? can you define your philosophy of treatment, and the relationship and power dynamic you want to have with any future patients? is it one in which you hold authority over them and see yourself as determining what's in their 'best interests', even over their own expressed wishes? have you connected with patient advocates, psych survivors (other than your friends), and radical psychiatrists and anti-psychiatrists who may espouse heterodox treatment philosophies that you could consider? do you think such philosophies are sufficient for protecting patient autonomy and well-being, or are they still models that position the physician's judgment and authority over that of the patient?

"im wondering if there is a way to reconcile these aspects in a way that one can feel morally okay participating within such an imperfect system"

and here is the crux of the problem with this entire ask. you are wondering how to sleep at night, if you are participating in a career you find morally distasteful. where, though, do your patients enter into that equation? do you worry about how they sleep at night, after having interacted with a system of social violence that may very well have traumatised them under the guise of providing help? why does your own guilty conscience worry you more than violations of your patients' bodies, minds, and basic self-determination?

i can't tell you whether your career path is morally acceptable to you. i don't think this type of guilt or self-flagellation is fruitful and i don't think it helps protect patients. i don't, frankly, have a handy roadmap sitting around for creating a new system of medicine and health care that rests on patient autonomy. affective distress is real, and is not something we should have to bear alone or with the risk of having violence inflicted upon us. what you need to ask yourself is: how does the medical model and establishment serve people experiencing such distress? how does it perpetuate violence against them? and how do you see yourself countering, or perpetuating, such violence as someone operating within this discipline? what would it mean to be a 'good' actor within a violent system, if you do indeed believe that such a thing is ontologically possible?

[maculategiraffe]

so y'all know that with the help of psychotropic medication and marie kondo I have healed a lot of damage and destructive thinking around cleaning / tidying. to the point that now I actively enjoy tidying and organizing. but I'm still figuring stuff out obviously

well I'm out of town again this weekend and staying in the same place as my sister and steve and the baby and my parents. but my parents didn't arrive until like 24 hours after the rest of us. and the afternoon right before my parents were to arrive my sister took the baby for a car nap ride and I was like "while the hurricane is napping I will tidy up!" and put away all his toys from all over the floor in nicely organized bins and did the dishes and cleaned the kitchen and organized the countertops and emptied the cooler bag of snacks and refrigerated the refrigerated stuff and wiped out the bag and hung it upside down to dry. again, I actually enjoy this now. so it wasn't like I was doing it with the express purpose of avoiding my mom's censure but I did think "oh and won't it be nice when my parents get here and everything is all nice and they don't have to worry about stepping on a lego"

and then when they got here I unpacked all the cooler bags they had brought and organized everything nicely in the fridge and put the cold packs in the freezer. because again. I enjoy it. but also I know my mom finds traveling stressful and I did think it was a nice thing to do for her and might ease her stress

and my mom immediately started complaining about other stuff that we hadn't done. and didn't seem to notice anything I HAD done or say anything nice

and weirdly this is also a healing thing for me? because my whole life I felt like my mom's moods and criticism were kind of my fault because I was so bad at this stuff. and now that I'm not so bad at it I'm like okay so this lady is just fucking MOODY