Over-Prescribed: Mental Health & Drug Dependency
An experience with mental illness and prescription culture.
Preface: I feel the need to state that this is an extremely abbreviated account. This article could be expanded indefinitely; I hope only to make a generalized point, a point that I feel to be of vital importance as we seek to understand, treat, and better ourselves.
They greet you with a soft-spoken welcome, a searching smile, and a submissive handshake. You walk into a dank-smelling room that’s made up to emit some sort of pseudo-homey energies. The assessment begins as soon as contact is made; they allow you to choose which seat you’d like to sit in, and watch you decide as if it were some sort of significant indicator of who/what they’re working with.
They’ll begin the session with an open-ended introductory question that prompts you to begin speaking about yourself. If you lack direction, or begin fumbling over your own thoughts, they’ll begin offering more defined questions to help steer you towards the subject of your troubles. The topics you offer first will be telling, and will not be forgotten.
Should you find speaking about—or accessing—your thoughts difficult, the health care professional will probably implement a personal-confession of their own as a tactic to make you feel safe. If they expose a vulnerability, especially one that you can both relate to and empathize with, it will help you to feel safe and willing to expose a vulnerability of your own.
They’ll neither agree nor disagree with you. They won’t give personal answers to opinion based questions, they won’t affirm or condemn; they’ll continue answering your questions with questions, until you expose your own opinion of the question you asked of them. Completing these thought-circuits will tell them about your thinking process, your experiences, your opinions, your fears, your emotions, your insecurities, your traits and tendencies, your desire to affirm your own beliefs, etc.
The Diagnostic and Statistical Manual of Mental Disorders (DSM): the psychologist’s and psychiatrist’s bible.
They won’t wield the DSM immediately, you probably won’t even see it in view. But, you’ll see it in their eyes. As they watch you and speak with you, they are reading from it, flipping through its pages behind their eyes, categorizing traits and behaviors, inputing your responses to search for matches and criterion as they relate to mental conditions and illnesses.
Categorize. Define.
Take ten people off of the street and still them down with a psychiatrist: ten out of ten people will be diagnosed with a mental illness.
The DSM is not a list of illnesses, it’s is an ever-growing collection — amassed over many decades — of synonyms for the human mind state. We are all in there, we are all on multiple spectrums at varying degrees of severity. But it’s the spectrum itself that indicates well-being or illness, not the spectrum’s title. As with anything, there is a healthy range of operation, and an unhealthy range — but being on a/the spectrum itself is not bad, it’s inevitable.
There will, invariably, be a spectrum in which it is determined that your mind exists at an unhealthy level and you will be diagnosed with a personality disorder or other mental illness as titled and defined by the DSM.
Rather than first exploring the root cause of this “illness,” disorder, or imbalance—the psychiatrist is going to prescribe to you a regimen of prescription medications. They’ll tell you they want to follow up with you at specified intervals to, “See how the treatment is working.”
When you come back and tell them that you don’t feel much different, and—in fact—the meds have been making you quite sick and that you don’t know how you feel about taking pills, they’ll tell you to allow the treatment more time. “It takes time for the body to assimilate to the new medication, and it takes even longer for the medication to begin to work effectively—”
“—but, if after [certain amount of time] you find that these medicines still aren’t working for you, we can work together to find a prescription that’s a better fit.”
Once you’re able to report to them that many of your symptoms have subsided, except for the occasional “flare-up,” they’ll all but declare you healed. They’ll write you a script for some more [psychoactive drug name] to be taken supplementally to quell the “flare ups” and they’ll encourage you to remain diligent and consistent with the ingestion of your daily meds. But, now that you’ve established an effective treatment plan, they’ll tell you that, “We won’t need to meet as often, but feel free to call to schedule appointment at any time if anything changes.”
Numb. Tranquilize. Mask: “Heal.”
Unfortunately, it now seems that even psychotherapy is becoming more and more controlled by the psychiatric process of prescribing.
Anyone can leave a psychiatrist’s or physician’s office with a prescription, that’s to be expected. But, I’ve commonly left initial appointments with psychologists, working in tandem with a nurse practitioner (NP) or psychiatrist, with a follow-up appointment to receive my recommended meds from the acting-prescriber.
It seems no matter which avenue you pursue—psychiatry, psychotherapy, or both—the pivotal component of your western-medicine mental health program will come in pill form.
The mental health industry’s apathy is subsidized by big pharm. It’s in big money’s best interest to keep you sick, to diagnose, and to give people the understanding that they need their pills—typically in perpetuity [see: recurring revenue].
Professionals are taught and trained to quickly and efficiently pick a title from their diagnostic bible and to prescribe to it the recommended regimen of medications.
Treat the symptom, not the cause.
“There is a huge financial incentive for psychiatrists to prescribe instead of doing psychotherapy,” he says. “You can make two, three, four times as much money being a prescriber than a therapist. The vicious cycle here is that as psychiatrists limit their practices primarily to prescribing, they lose their therapy skills by attrition and do even less therapy.” (“Inappropriate Prescribing,” Brendan L. Smith, American Psychological Association)
After only precursory meet-and-greet sessions, I’ve walked away with prescriptions for narcotics, anti-psychotics, anti-depressants (typically SSRIs), and benzos (tranquilizers). Many of these drugs made me very sick, especially the SSRIs which require a long period of assimilation and must be taken each day, usually for a number of months before they become effective.
This is not necessarily an indication that western-medicine professionals are being negligent in their practice—in fact, many of them are diligent and dutiful. They are simply doing what they’ve been educated and trained to do: medicate.
There’s also a tendency for the patient to simply accept a psychological assessment and prescription-based treatment plan; thereby enabling the system. Not only do patients regularly, and blindly, accept diagnosis—they commonly accept the diagnosis as being absolute and beyond their power of control.
The diagnosis is often adopted both as a personal identity and a scapegoat:
“I can’t help it, I’m [title of mental illness].”
“I need my pills, I can’t function without them. I have [personality disorder].”
After all, isn’t identifying the problem and immediately receiving the cure an easy and convenient route?—especially if it the ailment can be understood as being beyond one’s realm of responsibility and/or control? Why do the work to understand the cause, and take responsibility for one’s unique conditions and challenges, when the symptoms can simply be muted and one’s deficiencies can be effectively blamed on a clinical diagnosis?
Adoption. Addiction.
“A pill to make you numb, a pill to make you dumb
A pill to make you anybody else
But all the drugs in this world
Won’t save her from herself.”
(“Coma White,” Marilyn Manson.)
You’ll leave their office with your prescription order, feeling a little foggy and dissociated as you attempt to digest the implications of what you’ve just been told.
You’ll shuffle out to your car and stop by the pharmacy on your way home. You’ll be a little more self-conscious than usual as the pharmacist hands you your medicine. You’ll say you’re familiar with the pills and do not need to receive a consultation from the pharmacist in an effort to spare yourself the added embarrassment.
The stigma of being diagnosed with a personality disorder often caries more influence that the disorder itself, and only further exacerbates the perceived need of your new pills.
Escape. Avoidance. Refuge.
When a patient with a broken leg comes to the hospital, the medical professionals don’t administer morphine and then wait until the patient confirms that the pain has subsided to pronounce the patient as being healed.
They inspect and image the leg, they identify the break, and proceed as needed to heal the cause of the pain: the break itself.
But we cannot see anxiety, depression, dissociation, delusion, trauma, stress, withdrawal…
…we cannot image mental illness. We cannot explain clearly why it exists, when it came into existence, or how to definitively treat the condition.
“I don’t see any bone sticking out, and you’re not bleeding — you look all right to me.”
Because we cannot “see” that anything’s wrong, because we don’t understand “what” is wrong or “why” it is wrong, we shy away from it. It becomes vague and nebulous—it exposes our collective lack of knowledge about the human brain and our experiences. Rather than work to understand our conditions, we work quickly to mute their symptoms.
“Prescribing drugs at the onset of a mental health problem perpetuates a medical model of mental health that may lead many sufferers to believe their recovery is now out of their hands and in the hands of medical experts.” (Graham C.L. Davey Ph.D., Psychology Today.)
I was lucky enough to make it out of my “clinical trials” intact. I had some run-ins with heavy drugs, I experienced withdrawals as a I took myself off of benzos, I developed a horrible and—at times—debilitating sleep disorder, I suffered depression as a result of being diagnosed, I spent years looking for competent professionals and doing independent research —
—in desperation, I’ve dumped numerous pill bottles into the toilet and instantly jammed down on the flush-lever, watching with fear, anxiety, and relief as they dissolved and went swirling out of my grasp—
—but, as I gradually gained knowledge, experience, and confidence, I also gradually began to heal, understand, and learn to live with my own unique conditions.
Eventually, I was fortunate enough to establish a relationship with a psychologist/therapist who I very much respected, worked well with, and who proved to be both trustworthy and of great benefit to me. Because I was willing to work, to put in my own effort, and remain accountable for myself—she was willing to work with me, to continue to make slow progress organically, without the use of pills.
“Patients also must be willing to invest the time and energy in therapy if they want treatment that isn’t centered on drugs, Carlat says. “From the standpoint of consumers and patients, it’s very attractive on different levels to take a pill to solve your problems,” he says. “But we haven’t gotten to a point where a pill alone can resolve most people’s depression or anxiety.” (“Inappropriate Prescribing,” Brendan L. Smith, American Psychological Association)
Despite my general disillusionment with our medical system, I remain an unwavering proponent of proactively pursuing mental health.
Mental health is not taboo or frivolous, it is not fringe, it is not for, “The Crazies.” It’s one of the great human unifiers; we all carry the weight of consciousness, and with that consciousness comes difficulty, struggle, and confusion.
There should be open dialogue about people’s minds, their state of life, their mortalities, their conditions — it should not only be accepted, but expected, that people will have deficiencies and imbalances. That doesn’t mean you’re sick, it means you’re a human.
We must be willing to look objectively at our own vulnerabilities. Taking a pill and accepting a diagnosis offers instant gratification — but working to gain a wholesome knowledge of one’s own self, the individual mind, and the unique conditions of one’s personality is exponentially more beneficial.
This is demanding, arduous work; it requires determination and apathy has no place. The pursuit of mental health is a life-long endeavor, just as is the pursuit of physical health—but the benefits are profound and life-altering.
Don’t blindly accept the pills, don’t take the professional’s word as gospel. Keep searching—find the professional that’s willing to investigate, ask questions, and work as hard as you are to improve your quality of life.
