It’s no secret that the cost of depression in America runs into the billions, but does it matter if a person’s depression is clinical or situational? I think it does. Doctors continue to medicate people and label them depressives when in fact the person is depressed because of a specific situation: divorce, job loss, death in the family, and yes, the holidays, for many, spurs depression. That sort of depression is situational and often what a person needs more than antidepressants or psych meds is talk therapy, social support, grief therapy…people have different mental health issues when they face certain crises and crossroads in their lives. Why does the mental health system treat all depression the same by throwing medication at people’s feelings?
After twenty-five years of working in the medical community, I’ve witnessed a huge shift away from wellness. Diagnoses such as anxiety, depression, and bipolar are liberally tossed about, and what most people will never know unless someone tells them, is that insurance companies pay better reimbursements for a bipolar diagnosis than they will for perhaps a diagnosis of anxiety. Could this be why so many more people are all of a sudden diagnosed bipolar?
I tend to believe that the shift in the way doctors practice coincided with when insurance companies began to stick their noses into the practice of medicine. I’ve worked on numerous units in hospitals: ER, telemetry, med-surg, endoscopy, to name a few, but for approximately the last thirteen years, I’ve worked in psych, and I’ve paid attention to the trends. I use the word trends because as soon as a certain medication becomes available I noticed how three-fourths of the people on the unit are prescribed that medication. Furthermore, once doctors gleaned an understanding of the games insurance companies play, they began to tailor their practice to accommodate ways to get reimbursed. In the last five years or more, I’ve noticed that practically everyone who comes to the hospital for psych admissions are diagnosed bipolar, and “treatment” consists of medication. Lots and lots of medication. One psychiatrist put it bluntly, “If people don’t want medication, why do they come to us?”
In order to recover from any disease, including depression, anxiety, alcoholism or drug addiction, we have to do something and not just take something.
How do we heal a chemical problem by taking more chemicals? How can we relieve situational depression with a pill? We can’t. I don’t want to get into a debate about clinical depression because I know many who ARE helped by medications. When it comes to addiction: MAT can be life-saving, but most people who go the MAT route and who are successful are also people who are engaged in trying to live healthier lives. They are open to dealing with their emotional baggage, they’re open to righting their wrongs; they continue to grow because they’re willing to work on recovery and work on themselves. In my experience, the people who only use Medication-Assisted Treatment (MAT) and do nothing else to address the emotional or mental side of their addiction, well, it’s been my experience that these people tend to relapse.
The medical community has a lack of understanding when it comes to alcoholism and addiction. They don’t understand, or maybe they don’t want to hear that addiction/alcoholism is a three-fold disease and the effect it has on a person is multifaceted: spiritual malady, physical cravings, and the mental obsession. When you understand the threefold nature of the disease, how can they expect a person to recover when they only address the physical component of the disease by doling out pills?
I know many doctors in recovery, and most all agreed that they knew nothing about the disease of addiction until it happened to them. I included stories in Raising the Bottom from doctors who were shocked at how little they knew about addiction/alcoholism until they found themselves in rehab. Too many people lose their lives or live half-lived lives because they continue to look toward their doctors for guidance, and most doctors don’t have the desire to tell their patients they don’t know how to help them but perhaps they will find someone who can.
I’ve met so many people in recovery who fessed-up and said that once they got sober they were able to admit that they had conned their doctors into giving them anxiety medication and even agreed to take numerous psychiatric medications because they said they’d rather have filled a prescription than admit they had a substance abuse problem.
When we’re in addiction our mental state is abnormal, but recovery brings about a new clarity to our lives where we can then discern if mental health treatment is necessary. No doctor should diagnose a person with a mental health ailment while that person is under the influence of drugs or alcohol—but they do. They do it all of the time, and it’s shameful. I watch doctors prescribe toxic drug regimens for people who come to the hospital and admit they’ve been on a three-day meth or coke binge—some of these people haven’t had a meal in days, nor have they slept. Those voices they hear—who wouldn’t hear voices or perhaps see things that aren’t there when the body is drug-addled and in a state of stress without food or sleep? Too many doctors label these patients as psychotic and treat them with the same medications that they treat people who are schizophrenic.
I don’t think the drug epidemic can take much more of doctors misdiagnosing and mistreating people. And, what about the children on the backside? What chance do they have of getting their parents back when the medical community is complicit in the drama of addiction? What chance do these kids have of avoiding the horrors of foster care because their parents can’t function, yet, a team of doctors does nothing to bring about the hope of recovery and instead medicates people to such an extent that they are little more than walking shells of their former selves.
Everyone has to make the choice for themselves. Either we stay mired in depression, psychiatric meds, and dysfunction, or we break free and try to rebuild our lives in recovery. I encourage people to question their doctors instead of blindly going along with everything their doctors say. Most doctors are not that interested in what happens to a person’s life once they step out of the hospital or their offices. They could care less if your life gets worse or better. All they know is that once they have you on medications, you will continue to come back, and now they have a loyal customer.
Inpatient psychiatric admissions are all about the medications. Even insurance companies are complicit. They don’t want to allow people to stay in the hospital for more than a few days, but if the doctor is “tweaking” medications, then they are more apt to grant additional days.
People should be outraged, but they’re not. In fact, some are outraged when they hear the truth and get angry because they’ve come to believe that any criticism of the system or their meds is unsympathetic. I might even agree with them if I didn’t work in healthcare and realized how prescription centric healthcare has become. I might agree if I wasn’t also the child of an alcoholic whose mother got caught up in the system and wasted twenty-five years of her life listening to doctors and taking their prescribed poison. My mother only got her life back when she found a doctor in recovery who debunked what the other doctors had said and diagnosed my mother as an alcoholic. That bipolar diagnosis–totally false. This happened back in the ’60s and ’70s and not one thing has changed—in fact, it’s gotten worse. The shift toward increased medications is disturbing. And what’s even more disturbing is I don’t see people getting well. I see them come back repeatedly—their lives continue to unravel and the only solution for too many doctors is to add more pills while saying things like, “I don’t know. I’ll put them on X and we’ll see what happens.” It’s like playing darts with your life. How can anyone find this acceptable?
The best patient advocate is you. We have to be honest about what’s going on in our lives and if we know we have a substance abuse problem, find the courage to take baby steps toward the solution—recovery. The agony of addiction is real. The length of time a person spends in addiction can be lessened if people would stop looking toward their doctors and start looking toward recovery. There are numerous resources and people who have been there done that and many are willing to talk, share, and explain how they were able to extract themselves from the vicious cycle of allowing their doctors to medicate instead of educate.
Lisa is the author of the multi-award winning book, Raising the Bottom: Mindful Choices in a Drinking Culture. After short stints where she trained polo horses, worked as a flight attendant, hairdresser, and bartender, she revamped her life and settled in as a registered nurse. For the past twenty-nine years has worked with hundreds of women to overcome alcoholism, live better lives and become better parents. She was prompted to write Raising the Bottom when she realized after twenty plus years of working in hospitals, that doctors and traditional healthcare offer few solutions to women with addiction issues. You can start reading for free on Amazon. Follow her on Twitter @LBoucherAuthor and Instagram