Posted by baseball55 on July 30, 2016, at 19:24:56
In reply to Re: Fact Checking Some Anti-Psychiatry Claims » Hello321, posted by Tabitha on July 29, 2016, at 13:58:26
My GP and pdoc exchange records on physical issues - meds, tests, etc. Just not on therapy sessions. They can also exchange records on diagnosis, etc, as long as I give each permission.
I agree that psychiatry has a long way to go, but, as I told my husband when he began complaining about psychiatry, it's not like pdocs go trolling the streets for patients. The days of state hospitals that Szasz wrote about are long gone. People seek out treatment because they are miserable and want to be better. This whole board exists because people are looking for meds that work and looking for pdocs to prescribe them
I would be more critical of psychiatry as compared to other medical specialties if I didn't read so much about other medical specialties. Oncologists routinely prescribe (super expensive) drugs they barely understand and that don't work while impairing the quality of the last few months of life for terminal cancer patients. Orthopedic surgeons do arthoscopic knee surgery at the drop of a hat, though studies show that outcomes are no better for patients who have it than for patients who don't. For years, gastroenterologists gave valium to people with ulcers (assumed to be caused by stress) and operated when the ulcer bled, when foreign studies showed conclusively that ulcers were caused by h-pylori and could be treated with antibiotics. General surgeons in the US continue to cut people open for appendicitis even though Europeans successfully use antibiotics.
The worst are neurologists whose only function seems to be to deliver bad news about conditions that can't be treated - MS, ALS, Parkinson's, dementia, etc - and in many cases are diagnosed only through symptoms. Drugs are prescribed that don't work and the underlying mechanism of the disease is not understood. GPs know nothing about the causes or treatments of fybromyalgia, CFS, IBS, which are diagnosed on symptoms alone. As is chronic back pain, migraines, autism and on and on. The pathology and causes of most auto-immune disorders are not understood and treatments given (extremely expensive) rarely work.
As for the hope that neuroscience will eventually prevail, I continue to believe that most mental illness is bio-psycho-social in origin. I doubt very much that social anxiety and many anxiety disorders will ever be completely treatable by drugs, since they involve so many psycho-socail factors like low self-esteem, problematic upbringings, experience with traumatic experiences that cause chronic stress, etc. Mild or moderate depression- based on my experience with many, many therapy groups, is significantly affected by psycho-social components. Even severe depression, as I have had, derives content and themes from life experiences. How people react to it - do they become suicidal for example - has everything to do with psycho-social experiences that affect how strong a grip on life people have.
In fact, studies are finding that even schizophrenia, usually thought of as primarily a neurological disorder, is helped immeasurably by psycho-social interventions that teach sufferers insight into their delusions and ways to control or ignore them.
One real problem with psychiatry today is that pdocs have jettisoned therapy in favor of drugs, which are often ineffective or have intolerable side effects, especially weight gain. I have a pdoc who does therapy, pressure patients to add behavioral therapy and works closely with other therapists as well as with other physicians.
Maybe he is unusual. Probably he is. But I think the failure to understand what psychotherapies work is the biggest failing today of psychiatry, given how thin the medication arsenal available and how little is known about the brain and mental illness. I also have strong doubts that mental illness will ever be fully understood through neuroscience.
> I don't consider myself as pro-psychiatry. I think psychiatry is one of the weaker branches of medicine at this point. Barely out of the Freudian origins, completely cordoned off from other medical specialties (my GP and pdoc can't even exchange records.) Relying on subjective evaluations of symptoms and response to treatments. Diagnoses that change with changing social morals.
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> I hope psychiatry will eventually disappear, replaced by treatments that come from neuroscience research. May not happen in my lifetime though.
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poster:baseball55
thread:1090941
URL: http://www.dr-bob.org/babble/20160713/msgs/1091011.html