October 10, 2007

This Is Just a Joke, Really, No, Really, It's Not Real, We're Much More Rigorous Than This, I Said It's A Joke, Okay? Let It Go!

(From Bliss at ComicsPage)

bliss 

 

Sigh.  Rispalin.   Go ahead and deny it.


It's certainly easy to  make fun of it, but as a slightly different point: why do psychiatrists-- educated, intelligent, dare I say on the intellectual side of the field-- do this in the first place?

Pharmacologically, it really doesn't make sense.  Ritalin is a dopamine/norepinephrine and sometimes serotonin reuptake inhibitor, as well as some degree of catecholamine releaser.  Risperdal and Thorazine are tight D2 blockers.  So while antipsychotics won't negate the stimulatory effects of amphetamines (different dopamine receptors, etc) the amphetamines do compete with antipsychotics for their sites, thus reducing their effect.  (NB: less relevant in quickly dissociating antipsychotics (clozaril, seroquel).)

I think the reason it is done is language, i.e. the child psychiatrist can say to a parent: "I'm giving this drug for attention and concentration, and this other drug for impulsivity/aggression."  Even if, pharmacologically, this can't possibly work, nor does it even make any structural sense to separate the two classes of "symptoms."

But "working" isn't the goal.  Psychiatrists in this regard are asked to do something impossible: counteract a gigantic social/economic/cultural matrix of pathology with two to three medications of dubious efficacy, given to only one of the players in the matrix, i.e. the kid. 

The reason they are called upon to do this herculean task is that society lacks the language and the power/commitment to handle these social ills in any other meaningful way, so it repackages them as psychiatric illnesses.  In this sense, pediatric bipolar is underdiagnosed, not overdiagnosed. 

So the goal isn't better treatment for the "patients"-- listen up everyone, I'm letting you in on the Trilateral Commission's big secret-- it's keeping the doctors believing the problem is medical, not social.

As long as doctors believe the problem is theirs, it will be.






Comments

and thanks to Walter F w... (Below threshold)

October 10, 2007 2:07 PM | Posted by Alone: | Reply

and thanks to Walter F who sent the comic to me. Anyone who thinks something is interesting, by all means forward it to me. I can only find so much stuff, even with three monitors.

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The doc in that comic needs... (Below threshold)

October 10, 2007 4:27 PM | Posted by phill: | Reply

The doc in that comic needs to read Fear and Loathing. Then he'd know.

Alone's response: I read Fear And Trembling, does that count? And I even tied it in to Lost.

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It might be a joke for some... (Below threshold)

October 11, 2007 1:11 AM | Posted by Whatever: | Reply

It might be a joke for some, but for most of us... this is reality.

While I enjoy reading your posts (mostly because they are written in such a way, that even an uneducated person like me can understand) I am also terrified of the enormous power that psychiatrists hold these days.

For the majority of them, it is undeservedly so.

Alone's response: and so the thesis of the blog. Check out posts on the death penalty.

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mental illness is a myth?</... (Below threshold)

October 11, 2007 6:49 PM | Posted by Tom: | Reply

mental illness is a myth?

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True definition of disea... (Below threshold)

October 12, 2007 8:17 PM | Posted by Joseph j7uy5: | Reply

True definition of disease: whatever doctors decide they want to meddle with.

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"But "working" isn't the go... (Below threshold)

October 16, 2010 8:58 PM | Posted by Steve Wynn's Macau Paradise: | Reply

"But "working" isn't the goal. Psychiatrists in this regard are asked to do something impossible: counteract a gigantic social/economic/cultural matrix of pathology with two to three medications of dubious efficacy, given to only one of the players in the matrix, i.e. the kid.

The reason they are called upon to do this herculean task is that society lacks the language and the power/commitment to handle these social ills in any other meaningful way, so it repackages them as psychiatric illnesses. In this sense, pediatric bipolar is underdiagnosed, not overdiagnosed.

So the goal isn't better treatment for the "patients"-- listen up everyone, I'm letting you in on the Trilateral Commission's big secret-- it's keeping the doctors believing the problem is medical, not social."

Yes, I seem to be getting what you are saying, but I wonder will society ever have the power/commitment to handle these "social ills" in a meaningful way?

As well, I'm not sure that this current system of "keeping the doctors believing the problem is medical, not social" is sustainable as the existence of your blog suggests; self-deception in those with a moral conscience can exist only so long before 1) cancer develops and you die from self-hatred or 2) one is moved to speak and act truthfully. I'm not sure if my generation (creatively termed 'millenial') is morally strong enough to a) recognize what is happening and/or b) speak up. So, in conclusion, yes, I am saying that it is up to you and your colleagues to set this shit straight or forever hold your war. May the force be with you.

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