revisiting the psychiatric drug debates we've had here....

excerpt from article re:

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Harm Reduction Guide to Coming Off Psychiatric Medications.... is all about informed choice that allows one to take the risks that make most sense given one’s situation. 

Will Hall, the primary author of the guide, is a former psychiatric patient and is passionate about informed choice when it comes to psychiatric medications. Hall, no anti-drug ideologue, begins by pointing out that in U.S. society there are confusing messages about drugs, and this results in a great deal of fear:

Drugs become demons or angels. We need to stay on them at all costs, or get off them at all costs. We look only at the risks, or we’re too frightened to look at the risks at all. There is no compromise: it’s black and white, all or nothing. It’s easy to fall into absolutist thinking when it comes to psychiatric drugs. Pro-drug advocates focus on the risks of extreme emotional states, while anti-drug advocates focus on the risks of taking drugs. But it is the belief of this guide, and the philosophy of our pro-choice work at the Freedom Center and the Icarus Project, that either-or thinking around drugs is a big part of the problem.

Hall’s serious emotional suffering included “multiple suicide attempts, hearing persecutory voices, extreme mistrust, bizarre experiences, hiding alone in my apartment, unable to take care of myself.” The psychotherapy that he received hadn’t worked, and no one provided him with any other options besides medication. Hall writes, “I was under pressure to see my problems as ‘biologi­cally based’ and ‘needing’ medication, instead of looking at medication as one option among many.”

After spending a great deal of time in hospitals, residential facilities, and homeless shelters (where he lived for nearly a year), Hall began to believe that so-called “expert authorities” had failed him and started his own investigating, “I started judging my options more carefully.” That process led Hall to co-found, along with Oryx Cohen, the Freedom Center, a support community in Western Massachusetts that brings together people asking similar questions. From all of this came the Harm Reduction Guide to Coming Off Psychiatric Medications.

For Hall, “This is a guide I wish I had when I was taking psychiatric drugs. Prozac helped me for a while, then made me manic and suicidal. I was sick for days after coming off Zoloft, with counselors telling me I was faking it. Nurses who drew blood samples for my lithium levels never explained it was to check for drug toxicity, and I was told the Navane and other antipsychotics I took to calm my wild mental states were necessary because of faulty brain chemistry.” Hall used many different psychiatric drugs over several years but, he tells us, “the medical professionals who prescribed them never made me feel empowered or informed. They didn’t explain how the drugs work, honestly discuss the risks involved, offer alternatives, or help me withdraw when I wanted to stop taking them.” Hall wrote this guide because, “Information I needed was missing, incomplete, or inaccurate.”

“Making harm reduction decisions,” says Hall, “means looking honestly at all sides of the equation: how drugs might help a life that feels out of control, how risky those same drugs might be, and the role of options and alternatives. Any decisions involve a process of experimentation and learning, including learning from your own mistakes and changing your goals along the way.”

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Full article: A Sane Approach to Psychiatric Drugs by BRUCE E. LEVINE

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No, this has not been an issue for me personally, but many of my friends have suffered irreparable harm (sometimes fatal) both from such medications and withdrawal effects..[Forrest]

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As someone who has been on medications for some time, although not as deeply or as long as some Friends who have commented here, I am still waiting for a clear leading on the matter of psychiatric drugs and their proper use.  I offer these queries rather than advices....

At what point does a person's behavior prevent them from safely interacting with others and them self?  Should this be a general standard or specific to the individual and their context?

What is a Friend's obligation to another Friend to address changes in behavior?  What is a Meeting's obligation to a Friend whose behavior changes or becomes threatening?

Should there be a general standard of good treatment that requires complementary therapeutics (e.g. talk therapy with any course of psychiatric medicine?)

Should a Meeting offer Clearance and holding the Friend up in the Light as a complement to any medical support?

Should an Overseer or Care Committee be available to support a Friend in their daily living with their challenges?

Should a Friend under psychiatric care assent to making a Care Committee or Clearance Committee a party to their plan of treatment and their advocate with institutions or physicians?

Your leadings?

I humbly feel that dealing with health issues, it is wise for the individual to have choices of their own. Otherwise it will come across as dictatorship. No one would want someone else to choose their doctor for them. No one would like it if someone called their doctor or made choices for the person. I feel it would be best to leave that issue to the individual, their own doctor/health provider, and to God.

I was involuntarily placed in Danville's Mental Institution, and I would not wish for anyone to go there involuntary. It was nightmarish. I was in a room without a window and only artificial light. Involuntary—without thy choice or say in the matter.

In 1991, I was hospitalised at VA Baptist Hospital on Krise 6, the sixth floor of that unit. I was placed on one medicine then another and another. Lithium Bicarbonate made me so very sickly!! I was shackled to the bed, injected with Haldol, then put into a small carpeted room without a window or door knob! Outside the locked door, someone sat watching me constantly.

My suggestion would be leave out the dictation and just encourage the individual. Offer to help them in other ways. Offer to listen to them. Offer love, and prayer. Encourage them with the Light of the Word of God! This is my only plea. Also, the Golden Rule: "As ye would that men should do to you, do ye even so to them likewise." Just a few of my thoughts to thee about meetings and medical health care. . .

Someone deleted a reply here, presumably the person who posted it. (I would not have done so.)

While lacking any personal knowledge of the circumstances... I agree with that person that when a Meeting committee, without a person's specific invitation, intervenes in their affairs in such a manner -- it has gone far beyond any just claim to understand whatever-it-is we mean by 'mental illness' or how such phenomena should best be addressed.

People, "mentally ill" or otherwise, simply don't always make good choices. They don't necessarily choose well on their own behalf -- But when they happen to choose badly, that is simply how life works -- While even a "good" choice, made on another's behalf & against their wishes, does harm to them and to any friendship with them.

We have a right to make mistakes and suffer from them. We do not have a right to make someone else's mistakes.

I have friends who I believe have made, who continue to make very self-destructive treatment-choices. There simply isn't a good way to "deal with" this situation, except to remain friends, to pray that any mistakes including my own will be mitigated, that the eventual outcome will be according to God's good will. As Timothy says here.

It looks like people are collectively hampered by a bad selection of metaphors, in trying to make sense of the wide range of conditions that can lead to someone being 'diagosed' and/or 'medicated'.

A helpful analogy: "Being on a skateboard" is not the same concept as "falling down" -- despite the fact that for me, they are equivalent conditions.

Back in the day, I knew a great many people who took 'pattern-enhancing' chemicals, almost entirely with beneficial, at worst neutral, outcomes. One friend, recently released from a State hospital, ran into old friends who gave her a dose of 'mescaline' (given the state of the black market at the time, probably 'substandard, weak LSD'). This led to her immediate, direct return to the 'hospital'.

There are at least three dimensions to be considered:

1) To what degree is a person in a state of 'overdrive': somewhat overwhelmed, emotionally-volatile, perceiving outside the range of 'normal psychological functioning'? This could arise from chemical toxins, internal metabolic disruptions, fasting or meditation... and depending on other factors, be a condition to be sought-after or desperately fled.

2) What's the emotional tone? -- 'stoned' aka 'astounded', calm, or 'freaked out'?

3) To what degree is a person "in touch"? This is crucial; and it can vary all over the scale despite where they are on those other two dimensions.

A friend who abruptly 'went off his meds' (These things are addictive!) was trying to play chess with me while insisting that "P-K4 means 'Let's go to Mischa's house!' " Was perfectly competent to drive himself to the hospital, although I went along for company and to make sure he got there. Did not impress the staff as 'needing hospitalization' (although most of his friends were pretty sure!) until he decided he needed to 'tap' one of them to make himself clear.

I have been "talked down from" an extremely bad LSD trip... which did not mean that the floor stopped wriggling before the stuff physiologically wore off. (I'd taken some alone, took some more because "This isn't working", then got desperately lonesome and wandered off into one of those nights when the police were teargassing everything in sight, found refuge in the lobby of the Berkeley Inn, where the guy at the desk was a moonlighting ex-medic.) The LSD neither facilitated nor prevented him in helping me deceive myself (enough to bear with the anxiety & discomfort for the duration.) What it did add, I believe, was awareness that I was, in fact, defending my emotional stability by self-deception.

I was able to look back on this later, say "Hmmmm!!!" and recognize what I'd been doing & how. Another person I talked to later about their own experience -- was evidently still clinging to ideas he'd needed at the time, years before -- went on thinking he needed to continually stave off what he felt to be imminent terror.

I firmly believe that there are "normal" people who have never taken a funny pill, or had an odd experience in their lives -- whose mental functioning and belief systems are as resolutely "out-of-touch" as anyone they'd consider "nuts". That at some level people are struggling with very similar issues, whether they 'self-medicate,' have 'medication' imposed upon them, or simply muddle on...

All I can say is I am so grateful for the drugs I finally decided to take.  I have been wandering in a dark depressive cloud for years...afraid of mental health drugs as I saw myself as a "weak" person to give into them.....but my life slowly spiraled out of control to the point I had unbelieveable panic and anxiety attacks that were mind numbingly crippling.  I hated each day.....now....I have found the joy of life again.  I am able to practice deep breathing exercises to control the panic and anxiety that was so amazingly incapacitating. 

They were a God-send.....they saved my life.



Ray White said:

All I can say is I am so grateful for the drugs I finally decided to take.  I have been wandering in a dark depressive cloud for years...afraid of mental health drugs as I saw myself as a "weak" person to give into them.....but my life slowly spiraled out of control to the point I had unbelieveable panic and anxiety attacks that were mind numbingly crippling.  I hated each day.....now....I have found the joy of life again.  I am able to practice deep breathing exercises to control the panic and anxiety that was so amazingly incapacitating. 

They were a God-send.....they saved my life.

That happens too.

Please allow me to add my own experiences to this thread.  My own use of psychoactive drugs, mostly legal, has been varied. Currently, I am finding buproprion useful in dealing with depression; however, others I have found to be negative in varying degrees. I suspect the larger lesson on drugs for mental health improvement comes from students I taught over a 30-year career.

The public really doesn't have a clue about the amount of mental health problems confronted in the classroom. These are kids who desperately need help but ours is a culture that offers few resources with often tragic results. My observation was that kids who received professional help often benefitted and this was often due to a medication. Sometimes the change was practically magical. Very immediate and drastic. Sometimes this would last and sometimes the positive would wear off and that situation had to be dealt with. There was also a not insignificant number of these young people on which nothing seemed to help whatever demons their illness was throwing at them. And, of course, many many received little help at all. 

People in the helping professions mostly want to help and possess varying degrees of expertise and ability. But they exist in a societal substrate of Big Pharma and Vulture Capitalism that are powerful forces making it an uphill battle. The awareness and willingness to wage that uphill battle are a major reason I so value my participation in the Quaker community.

I've personally been extremely fortunate to have received help from VA as a PTSD veteran. This has changed my life and I intend to do what I can to engender similar opportunities for others. Sharing with others, whether in a group or a blog, can be a powerful thing. May you all go with God.

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