Over Medication in Mental Health Care

In a blog on Psychology Today Mel Schwartz discussed a young woman he had recently treated. She came into his office having symptoms of anxiety but had no previous therapy and was  prescribed four different medications. His question was the same as mine when first reading this story, what kind of doctor would do this? With the help of therapy the girl was able to get off her medication and control the anxiety.

Schwartz pointed out a very important fact when describing the reasons this girl was medicated so heavily; prescription drugs are handed out like candy these days! It is more time effective to simply write a  prescription to treat a disorder than to spend hours counseling a person. Also, there is big money apparently for doctors who work with pharmaceutical companies to get their brand of a medication out there.

Another point made by Schwartz is that this woman’s illness was handled in such a nonchalant manner because symptoms like hers have become so common place. Depression and anxiety have replaced the common cold in our culture and many doctors tend to treat these disorders much like a doctor in the E.R. would treat a cold. Give them some aspirin, tell them to drink a lot of water, and get some rest. Nothing out of the ordinary, not worth wasting time examining  the patient or doing blood tests.

The levels of depression and anxiety in our culture are staggering. Never before have there been so many clients diagnosed with emotional and mental distresses like these. However, there is money to be made of off people’s suffering (this is a capitalist society after all) and by asking the obvious question -why have these diseases risen to the levels they have in our society?- inevitably pharmaceutical companies and doctors would miss out on money to be made. Therefore, by ignoring the root of the problem, and simply accepting the fact that the epidemic level of these disorders is just a bump in the road of our changing culture no one is helped. The real problem is just swept further under the rug and covered with expensive medications like a Band Aid.

Depression and anxiety like so many other things in our society have become McDonaldized. We have engineered ways to get patients in and out of the office with as little time spent interacting as possible. Medication has taken the place of doctors and has put an even bigger gap in between patients and their health care providers. It’s because of this mechanized process that we see individuals slipping through the cracks and not getting the care they need.

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Overmedicating children with ADHD

This subject has always been of interest to me for more reasons than one.  Although this CNN article, “Ritalin debate: Are We Over Medicating” is several years old, I still find it to be extremely relevant and a valid argument today.

There is currently no objective diagnostic tool for the disorder, so the diagnosis often comes down to a judgment call. Last year the American Academy of Pediatrics published guidelines recommending that children suspected of ADHD have at least 2 to 3 visits with a physician, and that the physician solicit additional information from parents and teachers.

But Winkler says, in reality, too often it’s the teacher who’s making the diagnosis.

“In some situations, even parents were told if they didn’t place their child on a psychotropic drug, their child wouldn’t be able to attend school. And I just found this horrendous,” she said.

I’m a firm believer that things such as counseling and behavior modification should be used before we resort to medication. I hate the idea of children being prescribed such medications prior to exhausting other resources. One of the things that irritates me the most is that it is more often than not male children who are being diagnosed with ADD and ADHD. What ever happened to letting boys be boys? Sure, there are some instances where they need to be reigned in and taught how to behave, but a little rambunctiousness never really hurt anyone. Teachers need to realize that not every student can fit into their perfect little angelic mode of behavior. Just because a student is a little more hyper than another or can not fully focus does not mean he or she should be medicated at the first sign of this behavior. Parents need to take an active approach and work with their children to teach them acceptable and unacceptable behavior. I have a 10 year old cousin who was prescribed Ritalin a little over two years ago. He does not need the medication, his parents need to take a more active approach at parenting.  His mom is so flighty she has decided that she will only give him the medication during the school week. He doesn’t get it on the weekends or during school breaks. My opinion is this: either take the kid off the medication completely, or give it to him as prescribed. Don’t pick and choose when he should or shouldn’t have it.
Prior to moving here last summer, I was an assistant manager for Walgreen’s. Having this job meant I also had to be a licenesed pharmacy assistant. I learned a ton at the job. It amazed me to see just how many children are taking medication for ADHD and other behavioral issues. I really wanted to ask the parents if they knew what they were doing to their kids, or whether they had even tried other alternatives before choosing to medicate them. Due to things such as advertisements in print and in the media, many patients are now asking for drugs by name and attempting to self diagnose themselves and their children. It seems inapprorpriate to me for a patient to ask their doctor to be prescribed a certain medication just because they’ve seen it on TV and think it will cure their problems. And by no means is this any different than it is for parents and their children. Contrary to their belief, parents don’t always know best! This is when the physicians need to step up and educate the parents on the side effects medication can give their children. What ever happened to a little unconditional love and attention as an effective parenting tool?