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"The real crisis in psychiatry is that there isn’t enough of it"


westcoast
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2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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What an ass

2000 - sertraline for job anxiety low confidence (17 years old) ..which turned the next 16 years into nightmare!

 

On/off sertraline severe withdrawals every time. 2014 - felt better as reduced dose of sertraline no more inner restlessness. Doctor rushed off again. Hit severe withdrawal. Lost the little I had in life. Couldn't get stable again on 12.5mg. Was switched to prozac. Had severe reaction to prozac..came off in November 2015 at 6mg as felt more confused and damaged on it..Even more withdrawal ..rage, depression, dyphoria, near constant suicidal ideation, self harm impulses, doom, concrete block in head, unable to do much of anything with this feeling in head..went back on 6mg of sertraline to see if would alleviate anything. It didn't..reduced from December to June 2016 came off at 2.5mg sertraline as was hospitalised for the severe rage, suicidal impulses, and put on 50mg lofepramine which in 2nd week reduced all symptoms but gave insomnia which still have..psych stopped lofepramine cold turkey..no increased withdrawal symptoms new symptoms from lofepramine except persistant insomnia which has as side effect.

 

Taking Ativan for 8 months for the severe rage self harm impulses 1-3 times a week (mostly 2 times a week) at .5mg. Two months (I'm unsure exactly when the interdose started to happen) ago interdose withdrawal seemed to happen..2 days I think after the Ativan.

 

 

Nightmare that could have been avoided!

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"Another is how stretched services are, or how many patients don’t receive enough support to assist them staying on vital medication, without which relapse is all-too common and all-too ghastly. Others lament the lack of specialised services, at present especially in child psychiatry and addictions."

 

relapse = wdl symptoms from a taper thats as good as a CT ensuring repeat business!...and yes it is a ghastly experience...perhaps summed up with the word 'hell'!!

 

Whats lacking is vital support to get people OFF the so called medication!

 

Any conflicts of interest to disclose Sir Wessely?

Thought for the day: Lets stand up, and let’s speak out , together. G Olsen

We have until the 14th. Feb 2018. 

URGENT REQUEST Please consider submitting  for the petition on Prescribed Drug Dependence and Withdrawal currently awaiting its third consideration at the Scottish Parliament. You don't even have to be from Scotland. By clicking on the link below you can read some of the previous submissions but be warned many of them are quite harrowing.

http://www.parliament.scot/GettingInvolved/Petitions/PE01651   

Please tell them about your problems taking and withdrawing from antidepressants and/or benzos.

Send by email to petitions@parliament.scot and quote PE01651 in the subject heading. Keep to a maximum of 3 sides of A4 and you can't name for legal reasons any doctor you have consulted. Tell them if you wish to remain anonymous. We need the numbers to help convince the committee members we are not isolated cases. You have until mid February. Thank you

Recovering paxil addict

None of the published articles shed light on what ssri's ... actually do or what their hazards might be. Healy 2013. 

This is so true, with anything you get on these drugs, dependance, tapering, withdrawal symptoms, side effects, just silent. And if there is something mentioned then their is a serious disconnect between what is said and reality! 

  "Every time I read of a multi-person shooting, I always presume that person had just started a SSRI or had just stopped."  Dr Mosher. Me too! 

Over two decades later, the number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population. These patients are often advised to continue treatment because their difficulties indicate they need ongoing treatment, just as a person with diabetes needs insulin. Healy 2015

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017

 

 

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conflict of interest.? maybe :)

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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"Richard Kanaan and I have been preoccupied with the distinctions between hysteria, Munchausen's syndrome, and malingering."

 

http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366%2815%2900228-X/fulltext <--free account but I'll paste it to save trouble. It's about a film and a filmmaker, but no. It's about him. Lieberman redux.

 

###

 

It is becoming increasingly hard to avoid talk of psychiatry and mental illness. Politicians outbid each other in their promises to fund treatment, phone-ins discuss it, more and more people are willing to describe their own experiences, and book prizes are won by novels about it. Escaping by a visit to the cinema is risky—films about psychosis, autism, depression, and dementia are all the rage, and often a fast ticket to the Oscars' red carpet. And now mass hysteria joins the list.

 

The Falling premiered at the BFI London Film Festival and now has gone on general release. It is written and directed by Carol Morley, who achieved critical approval with Dreams of a Life, a documentary about Joyce Carol Vincent, who died in her London bedsit in 2003, but whose body was not discovered for 3 years. And now, say the critics, Carol has produced her first piece of fictional film making, on the subject of mass hysteria. Except that she has done no such thing.

 

Yes, the film does make numerous references to other works of cinema, art, and fiction. Few will miss the debt to Peter Weir's Picnic at Hanging Rock (young sexuality, a girls' boarding school, an atmosphere of tension and mystery, even watches that stop for no reason). Add a Pre-Raphaelite setting of green moss-covered ponds in which any moment Ophelia might come floating past, a gnarled oak around which not the Merry Wives of Windsor but disturbed Oxford school girls dance, and, for the occasional comic turn, headmistresses from Ronald Searle's fictional St Trinian's.

 

But there is little that is fictional about the plot. When Ian McEwan wrote Enduring Love he concluded the novel with an appendix containing an apparently genuine but actually skilfully written pastiche of a scientific paper on “De Clérambault's Syndrome”, in which he was aided by psychiatrist and neuroscientist Ray Dolan. But the writer and director of The Fallen needs no such artifice, because her script is a remarkably accurate adaption of an authentic paper, published in 1973 in the newly formed Psychological Medicine, describing an epidemic of fainting in a north London girls' school.

 

I played some part in this myself, because 10 years ago Carol Morley came to see me to talk about mass hysteria. We discussed my own theories of mass hysteria—the subject of my medical school dissertation and my first “proper” paper. She spent a couple of days in my office rummaging through my collection of accounts about episodes of mass hysteria; I had stopped my previous practice of letting journalists borrow my files since an investigative journalist took home a large box of original documents about the early years of ME, and lost them. It was then that Carol found the account of events at a north London girls' school, written by psychiatrist Silvio Benaim and the distinguished general practitioner John Horder.

 

Reading the paper for the first time in over a decade I am struck by the amount of detail that the authors provide. The current ethical test for publishing confidential information remains whether any of the protagonists can recognise themselves; if so, then publication can only be with consent. One suspects that everyone involved in the 1973 paper would recognise themselves within a few lines, and any attempt to successfully disguise them would have made the subsequent paper useless from any academic perspective, which may account for the disappearance of the case report from contemporary psychiatric literature.

 

I soon forgot about the encounter. But Carol didn't, and spent the next 10 years developing what would be The Falling. In a lengthy and impressive essay on mass hysteria and her film in the Observer, she remembers our meeting—describing me as having “wispy hair standing on end” (which might be true now but I hope wasn't then) to convey the impression of the mad professor. I forgive her.

 

And so 10 years later we met again at the gala opening of The Falling. The screenplay has stayed close to what we know about mass hysteria in general, and the 1973 description in particular—starting with the death of a classmate (Abigail in the film, echoes of the Salem witch trials?) after a teenage pregnancy and the increasingly disturbed behaviour of Lydia (Louise in the paper), whose mother (played by an almost mute Maxine Peake) would have furnished enough material for several films. In both paper and film, Lydia embarks on incestuous relationships. Equally faithful both to the original and to subsequent work on mass hysteria, in the film the epidemic spreads along social friendship groups, excluding the one Indian member of the class (in the paper it is not just the “coloured” girl who is unaffected, but also the Jewish and Greek members of the class).

 

Richard Kanaan and I have been preoccupied with the distinctions between hysteria, Munchausen's syndrome, and malingering. For many years it has been argued that in hysteria the person has no conscious knowledge that their symptoms are not explicable by organic illness, in Munchausen's they do know they are faking but their motives for so doing remain unconscious, and finally in malingering both behaviour and motivation is conscious. Carol Morley has one member of the “in crowd” accusing Lydia of faking it—the paper quotes at length a “confession” made by the Lydia character in which she admits to conscious simulation. Kanaan and I argue that it is rarely so simple, and often we make this judgement on our own hidden biases, being more likely to assume hysteria in those we like or feel sympathy for, keeping concepts of deliberate deception for either rather obvious cases (prisoners on death row, soldiers trying to avoid highly dangerous missions) or those we feel less sympathy and affinity with. The Falling maintains these ambiguities; we feel irritated by Lydia's behaviour, and secretly applaud when the headmistress calmly ends one hysterical seizure by pricking Lydia with her brooch, but at the same time empathising with her hideously dysfunctional background, and her feelings when her best but prettier and more sexually successful friend Abigail (a wonderful debut by Florence Pugh) gets pregnant, and then dies in circumstances not shared with the audience (the original source notes that this was the result of a post-partum cerebral haemorrhage). One does not need much knowledge of psychiatry to accept that Abigail's illicit sexual experimentation which led directly to her death (neither of which can be acknowledged, let alone discussed) would have a dramatic effect on her coterie of friends. Carol Morley also expertly lays a few false trails (a few hints at a hidden organic causation, and some flirtation with an occult explanation), but the former should always be considered in any episode of mass hysteria, and the latter was part of the preoccupations of the teenagers in the original episode. In the end, the film leaves no room for ambiguity that the phenomena described must reflect powerful psychological and social forces, but considerable ambiguity as to why these events unfolded as they did.

 

It is more than 40 years since the events described in The Falling took place. But the phenomena so beautifully captured in the film remain with us. The rise of social media meant that perhaps millions followed recent events at Leroy High School in New York State, which has many similarities with The Falling. I doubt it will take another 40 years before another film director becomes as fascinated with that story as Carol Morley did when she first opened my copy of Psychological Medicine 10 years ago in my office.

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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