Psycho-Babble Medication Thread 882093

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

As a board, can we do anything about this?

Posted by Neal on February 23, 2009, at 23:44:16

Anybody aware of this?

from a recent article:

-"Part of the difficulty, Dr. Miles and his colleagues say, is that doctors are, in general, unskilled both in recognizing the symptoms of depression and in treating the illness.

-The findings of a national survey published in June indicated that only 40 percent of Americans in treatment for depression received adequate care.

-Other studies have found that doctors fail to identify depression in their patients 40 to 60 percent of the time."

the second item is just shocking. If it was, say, heart disease, it would be a national scandal, wouldn't it?

 

Re: As a board, can we do anything about this? » Neal

Posted by myco on February 24, 2009, at 10:11:45

In reply to As a board, can we do anything about this?, posted by Neal on February 23, 2009, at 23:44:16

Hey,

This represents the vast majority of my encounters with your standard gp's (family dr's as we call them in canada). They are, in my opinion, poorly educated in issues of the head. Their advice about, and choice to use, specific meds is almost entirely limited to ssri's and within that limited to the information supplied by the pharmaceutical companies.

I remember my pdoc, when I was a univ student, said put away the monograph it's mostly marketing she said. Many gps dont do the specific diagnosis thing, i.e. atypical depression, gad etc...you are either depressed or anxious and in the case of the former I recommend (after type type into the computer) this ssri...the later...exercise, meditation ete (rarely if ever a benzo - an actually anxiolytic) and quite often poor anxiety sufferers have their symptoms increased by the gp's assurance the ssri's are also good for this...bollocks on that.

What can we do? well if you are in the position of communicating/being treating with a competant, open-minded doc (like a pdoc) you can show initiative in your own treatment and issues by researching as much as you can, crossreferencing with people who share the same issues as you, medication searches with supported studies, second opinions from dr's (thereby showing them you are thinking and interested in your treatment)...and I find, the most valuable with gps is to get to a pdoc, at least once, for a proper diagnosis and a letter including that diag and treatments tried and recommended. Canadian pdoc are so few and far between they like the letter idea...move you out into general practice with the ability to communicate back if needed and not waste time with the pdoc (they smile at this). Let the gp deal with the small issues and work with the pdoc if needed. This letter is like gold for a gp...a letter of reference from a specialist proving your issues and treatments that are effective. never again will you (or me rip my hair out) have to argue tooth and nail about diag and right to proper meds for that diag.

I swear ive aged years in the past 3 months over the ignorance of underskilled gp's.

i'm breathing...ugh lol
myco

> Anybody aware of this?
>
> from a recent article:
>
> -"Part of the difficulty, Dr. Miles and his colleagues say, is that doctors are, in general, unskilled both in recognizing the symptoms of depression and in treating the illness.
>
> -The findings of a national survey published in June indicated that only 40 percent of Americans in treatment for depression received adequate care.
>
> -Other studies have found that doctors fail to identify depression in their patients 40 to 60 percent of the time."
>
> the second item is just shocking. If it was, say, heart disease, it would be a national scandal, wouldn't it?

 

Re: As a board, can we do anything about this?

Posted by bleauberry on February 24, 2009, at 18:55:58

In reply to As a board, can we do anything about this?, posted by Neal on February 23, 2009, at 23:44:16

As a board is there anything we can do about this? I doubt it. Write your legislature, try to get an article in your newspaper, stuff like that.

The bigger problem as I see it is not that depression is under recognized, but that it is not thoroughly investigated before pulling out the prescription pad. Basics would be things like a standard blood test, serum B6, B12, folic acid, vitamin D, complete thyroid analysis (not just TSH), a detailed clinical, lab, and historical review for any indication of Lyme or Lyme-like infection, a look in the patient's mouth to see if there are silver fillings (mercury), inquiring about parents, siblings, great grandparents, etc, for psychiatric history, symptoms of Candida or yeast overgrowth. I mean, there are so many biochemical causes of depression, but the above cover the majority of them. Treatment for the symptoms would still be needed, but even better would be the concurrent treatment for the underlying cause to prevent the problem from progressing.

But yeah, some doctors don't even ask or see it when it is right in front of them. They might just say you aren't sleeping well or you aren't exercising enough or get some rest or something. All worthy comments of course, but meaningless in the face of major depression.

I know I can, so maybe other people too, look apparently ok even when deep in the dumps. I mean, there might be a cover-up thing or an embarrassment thing or a fear thing or whatever that keeps us from being open and honest with the doctor. So maybe it isn't completely their fault. They can only know what we share with them.

 

Re: As a board, can we do anything about this?

Posted by JadeKelly on February 24, 2009, at 20:07:54

In reply to Re: As a board, can we do anything about this?, posted by bleauberry on February 24, 2009, at 18:55:58

But if they investigated, it would take longer than the alotted 15 minutes. In addition, if anything were to be found they wouldn't collect $100 per 15 minutes to write that script.

In my case, and in my opinion, we (as patients) have to advocate for ourselves or its unlikely we will recieve proper care. Just like other field I geuss, some PDocs are tops (mine), and others should be in jail (my old one).

The problem with this is were not fixing cars here, when people are really sick, depressesed, hurting, thats the worst possible time to have to come up with well thought out treatment plans and which Doc is best, etc.

It stinks. Glad people can come here.

~Jade

 

Re: As a board, can we do anything about this?

Posted by Neal on February 24, 2009, at 23:39:38

In reply to As a board, can we do anything about this?, posted by Neal on February 23, 2009, at 23:44:16

-"The findings of a national survey published in June indicated that only 40 percent of Americans in treatment for depression received adequate care."

I was'nt trying to rag on doctors. The article this cut came from was about docs who get depression and don't recognize in themselves! It's just the low state of knowledge in this country; people want to sweep it under the rug. Little by little things are changing, but there's so much suffering that could be turned around.

And to answer my own question; this board is part of the answer. If some of us get a little ponderous in our answers, it's because we're aware that were talking to more than one person. And that our posts will be on the web for years after the date of posting.

The irony is that this is the one disease that puts a lot of the responsibility for treatment on the patient themselves, but its symptoms makes it 5 times as hard for the patient to deal with.

______________________________

 

Re: As a board, can we do anything about this? » Neal

Posted by myco on February 25, 2009, at 0:29:05

In reply to Re: As a board, can we do anything about this?, posted by Neal on February 24, 2009, at 23:39:38

> I was'nt trying to rag on doctors.


I was in a way. In my experience improper diagnosis and understanding of our conditions go hands in hand with gp's 'low state of knowledge' and/or, as I think Jade was getting at, lack of time spent in really taking a closer in depth look at the patient. This is one way to percieve what you had written.

And I agree that a large part of the respsonsibility for treatment is on the patient...my friend, personally, I wouldnt have it any other way.

myco


 

Re: As a board, can we do anything about this?

Posted by Neal on February 25, 2009, at 0:56:06

In reply to Re: As a board, can we do anything about this? » Neal, posted by myco on February 25, 2009, at 0:29:05

> > I was'nt trying to rag on doctors.
>
>
> I was in a way. , myco

that's fine. I just realized that the perception of my post was different from the intention.

I know a few docs lurk here; not my intention to give them a hard-time. I can get on a rant about the topic, but not this go-around.

~neal

 

Re: As a board, can we do anything about this? » Neal

Posted by myco on February 25, 2009, at 9:59:54

In reply to Re: As a board, can we do anything about this?, posted by Neal on February 25, 2009, at 0:56:06

lol it's mostly just a vent, all is well on this end finally :-)



> that's fine. I just realized that the perception of my post was different from the intention.
>
> I know a few docs lurk here; not my intention to give them a hard-time. I can get on a rant about the topic, but not this go-around.
>
> ~neal

 

Re: As a board, can we do anything about this? » bleauberry

Posted by desolationrower on February 27, 2009, at 2:07:29

In reply to Re: As a board, can we do anything about this?, posted by bleauberry on February 24, 2009, at 18:55:58

I think that would be a large waste of time. Some things should be checked anyway, because most everyone is D deficient if they don't work out of doors and thats bad for lots of things. but the thorough medical testing shouldn't happen until one has had a few trials of an AD, unless there are other symptoms indicating something specific is required. Most people aren't treatment resistant, and will respond to the first drug they try. Spending thousands of dollars testing and the time woudl reduce helpful treatment, and create even more expense.

d-0/r

 

Re: As a board, can we do anything about this?

Posted by JadeKelly on February 27, 2009, at 19:59:53

In reply to Re: As a board, can we do anything about this? » bleauberry, posted by desolationrower on February 27, 2009, at 2:07:29

Most people aren't treatment resistant, and will respond to the first drug they try. >
> d-0/r


You really believe this?

~Jade

 

Re: As a board, can we do anything about this? » desolationrower

Posted by garnet71 on February 27, 2009, at 22:41:13

In reply to Re: As a board, can we do anything about this? » bleauberry, posted by desolationrower on February 27, 2009, at 2:07:29

d/r, Concerning the tests, I respectfully disagree with you here. I'm not sure what you meant by 'tests', but I think everyone should, at the very least, get an expanded blood panel before starting on psych meds. There are just too many medical conditions that cause similar symptoms, which I'm sure you know. My insurance company had no problem paying thousands per year on meds that I ended up throwing in the garbage. The loss in productivity is a huge cost to society, not to mention the other peripheal social costs; for example, being a single mom and not being able to adequately take care of your child....funnels down to the school system, etc. Then there are the ER visits for all those with severe anxiety. Of course, no one could actually quantify the costs to facilitate an accurate cost/benefit analysis. But really-$1000 in tests vs. $300 in meds per month (for some), that may not be needed?

For children/teens, I also think its potentially dangerous to casually start them on antidepressents, especially.

 

Re: As a board, can we do anything about this?

Posted by desolationrower on February 28, 2009, at 3:16:28

In reply to Re: As a board, can we do anything about this? » desolationrower, posted by garnet71 on February 27, 2009, at 22:41:13

well its like trying an aspirin for a headache before a triptan or looking for a brain tumor. more agressive treatment for those who don't imrpove, as well as right away for those with severe problems.

-d/r

 

Re: As a board, can we do anything about this? » Neal

Posted by detroitpistons on February 28, 2009, at 13:07:22

In reply to As a board, can we do anything about this?, posted by Neal on February 23, 2009, at 23:44:16

Personally, I try to tell people I know who are seeking mental health treatment to get an appointment with a psychiatrist as soon as possible. I tell them that GP's are not adequately trained in psychiatry.

On the bright side, I think GP's have started to realize over the past 10 years or so, that they have no idea what they're doing. For example, they are starting to learn that you can't just prescribe antidepressants without first ruling out a bipolar disorder.

Also, some GP's are a lot better than others. I think it comes down to intellectual curiosity. If they want to be informed about something, they have all the resources they need. Some care to educate themselves and others don't.

> Anybody aware of this?
>
> from a recent article:
>
> -"Part of the difficulty, Dr. Miles and his colleagues say, is that doctors are, in general, unskilled both in recognizing the symptoms of depression and in treating the illness.
>
> -The findings of a national survey published in June indicated that only 40 percent of Americans in treatment for depression received adequate care.
>
> -Other studies have found that doctors fail to identify depression in their patients 40 to 60 percent of the time."
>
> the second item is just shocking. If it was, say, heart disease, it would be a national scandal, wouldn't it?

 

Re: As a board, can we do anything about this? » detroitpistons

Posted by Neal on March 1, 2009, at 21:16:24

In reply to Re: As a board, can we do anything about this? » Neal, posted by detroitpistons on February 28, 2009, at 13:07:22

_____________________________


I agree Detroit. There's plenty on the positive side, and I don't go there enough. There's been a revolution in mental health care in the lifetimes of many of us. Meds and understanding docs and Pdocs have made life enjoyable again for most all of us. Is the glass half-full or half-empty? It's half full in my estimation.

__________________________


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