Tuesday, June 9, 2009

A Friend's Diagnosis

One of the difficulties of knowing so much about depression is knowing how poor the treatment is for so many. When a friend was recently diagnosed, we had the following dialogue.

"My psychiatrist said it's a low-grade depression," she said, "and he recommended Lexapro."

"Did he ask you anything about your lifestyle," I asked.

"Not really. He had me fill out a questionnaire, but he didn't ask about my marriage, my kids, the fact I work at night, the stress with my mom."

"Did he ask you how you deal with stress in general?" I asked.

"No."

"Did he ask you whether you exercise or ask about your diet?"

"No."

"Did he tell you it might take 14 days for the Lexapro to kick in, that is if it works?" I asked.

"Yes. All we seemed to talk about was medication."

"Did he explain the importance of keeping a mood chart?"

"No."

Well, I could go on and on, but suffice it to say that until discussions with psychiatrists focus more on lifestyle rather than medication, I don't have much hope that the treatment will ever improve."

Any thoughts?

12 comments:

Gianna said...

my only thoughts are filled with curses...

I'll keep them to myself.

I will keep you and your friend in mind...I hope you shared your thoughts with her...you are a dear friend and she is lucky to have you.

love to you.

Wellness Writer said...

Dear Gianna,
I feel the same way. Yes, I did share my thoughts with her. And, surely she knows what I've gone through.

But, sometimes at the beginning, I've found that people truly want to follow their doctor's advice, even if it's not really advice at all.

So, I couldn't convince her about the importance of a mood chart, exercise, or diet.

She's so stressed out that I just said, "If you're ever interested in talking about adjunctive or alternative treatments, I'm here," and I left it at that.

It makes me terribly sad (and angry). But, I guess she's going to have to figure this out for herself. She seems to hope that medication will solve all her problems.

Susan

Gianna said...

Susan,
that is all we can do and that is all we should do...we can't force our answers on others and for some weird reason some of us seem to simply HAVE to find things out the hard way...

there were people who told me I shouldn't take the drugs early on...one boyfriend tried one of my thorazine pills (that's how long ago I got diagnosed!!) and he freaked...he was yelling at me...what they hell are you taking that s*&t for?? He knew..he was a good guy and he knew...but I too went my own way...and we have to respect that everyone does need to feel they are doing what is right for them and ultimately we don't know how any of this works...

even though I often regret the last 20 years of my life in my more lucid and optimistic moments I see that it has also created me with my strong voice for change...and now I help people I've never met even if I often can't help my friends...

weird how that goes, huh?

seed planting...I see everything as seed planting, but I also deeply respect people's right to choose...and if I didn't I'd be a major hypocrite...

you've done what you can...have peace in that. you friend knows you love her and that is better than anything...no need to control her choices to let her know how you love her and that you are there for her.

Mariposa said...

I'll say it -- D@MN!

Those questions were basic questions I feel anyone who feels for the patient would us. Okay, forget feeling for the patient, make it wanting to help the patient!

I can go on asking, how could anyone focus on a discussion of certain medication without asking other factors which might be affected or affecting it?

Now I am sitting at my desk looking back and gosh, I'm so thankful I got sensitive people helping me then and now.

Maybe that friend of yours can ask the doctor something like, by the way...I am having issues with...and I am currently doing therse...etc, etc, and add, just thought those info might help you with my medication. Pfft!

Holding your friend in my prayers now...and for all patients who need better care.

Wellness Writer said...

Dear Gianna,
Again, I agree. When I hear stories like this, I always try to ask questions rather than tell anyone what to do.

And, as I've said before, I believe the psychiatric profession is "in crisis" and they've lost their way. If they had been interested in spending their days dispensing medication, they should have gone to pharmacy school.

Instead, most of them do spend their days dispensing medication without even asking the basic questions.

Alas...

Susan

Wellness Writer said...

Dear Mariposa,
You're "damn" right! I totally agree. I truly believe it's a huge disservice to think that any medication can help someone who has "issues" that are affecting every aspect of their lives.

But, in the United States, insurance pays more for medication than for therapy. And I personally feel that the treatment is influenced more by insurance and pharmaceutical companies than it is by therapists and psychiatrists.

Susan

James the Greatest said...

if your friend is a computer-user or one of the intellectual and curious types, recommend some of your favourite websites to her too. some people won't listen to what others have to say as nearly as they'll read it.

I mean, don't flood her inbox. but just something along the line of: "I was cleaning up my bookmarks and I stumbled across a few about depression. feel free to take a look at them. personally, I found them really useful."

now mention plans you have later, or something else more on the light side (assuming she's sensitive to the conversation, as many people are).

but that's just my advice. I would hate for your friend to be uneducated about herself and her condition because she has an incompetent psychiatrist.

Paula Joy said...

It saddens me that those questions were not asked, but it doesn't surprise me in the least!

One good thing that came out of me being medicated right away was that it gave me the steadyness and strength I needed in order to be able to see where I was and why I was there. It was good on the short-term, just to get myself regulated and balanced, to deal with the real issues.

Your friend may take the same route. She may need to find the comfort of meds for a while until she can grasp reality and deal with the issues.

You are a good friend, Susan.

Wellness Writer said...

Dear James,
Given that I have written this blog for more than two years, she could actually read what I have to say. I've spent a long time discussing all these issues. And, of course, there are other blogs and sites as well.

My feeling is that people deal with things in their own way and in their own time. As far as I can tell, at this point in her treatment, she's looking to her doctor as the "be-all end-all source of information, and that's her choice.

I'm sure that if she's interested in seeking out other information she'll let me know. But thanks for the suggestions.

Susan

Wellness Writer said...

Dear Paula,
I agree with you about medication. It can lift a person's mood enough so that they can deal with the issues that are causing their depression, particularly if it's situational.

And, if they need medication long-term, that's another issue.

But, as I've written many times before--and I know you agree--at best, medication is only one part of a larger wellness program.

Susan
P.S. And thank you. I believe I am a good friend, as well.

sallyo said...

The ignorance of some, especially those who should know better, is truly amazing and incredibly appalling! I hope your friend finds someone who can give her the help she really needs.

Wellness Writer said...

Dear Sallyo,
It sure is appalling, isn't it? And I would be more surprised if it wasn't so common. Thanks for your comment on this topic.

Susan