Considering that over 40% of U.S. adults have obesity and there are fewer than ten thousand obesity medicine specialists, PCPs are a critical part of the solution as we tackle this epidemic. While PCPs have extremely limited time to delve into the complexities of obesity and provide support between visits, it’s wonderful when they are knowledgeable about evidence-based obesity treatment so that they can at least initiate the conversation and refer their patients to an obesity specialist.

But the collaboration doesn’t stop there. Obesity is not only a chronic disease in its own right; it is also associated with more than 200 other conditions that can affect all body systems. According to data from IQVIA, people ages 40-64 with obesity have 2.4 comorbidities on average. That figure rises to 4.9 for individuals 65 and over (and 7% of people in the latter age group have 10 or more comorbidities). Effective treatment requires taking these comorbidities — and the medications often prescribed for them — into account and communicating with other members of the patient’s care team throughout treatment.

The following are just a few of the subspecialties that obesity touches.

• Cardiology: The impacts of obesity on cardiovascular health — raising the risk of high blood pressure, heart attack and stroke, among other conditions — are among the best known and most thoroughly studied. In fact, the anti-obesity medication, Wegovy, was recently approved specifically to reduce the risk of adverse cardiovascular events in individuals with obesity and established cardiovascular disease.

• Endocrinology: Adipose tissue is an active endocrine organ that produces more than a hundred different hormones, so it’s no surprise that endocrinologists are frequently involved in treating obesity-related conditions — Type 2 diabetes being the most familiar, but also polycystic ovarian syndrome and infertility, among many others.

• Orthopedics: Obesity is a risk factor for the development of soft tissue damage and osteoarthritis in load-bearing joints, particularly the knees, due to both inflammation and mechanical stress. Joint pain then inhibits physical activity, which worsens obesity, creating a vicious circle — while also increasing the risk of complications associated with orthopedic surgery.

• Oncology: Obesity is a risk factor for the development of many types of cancers, including breast, colon, rectal, pancreatic, kidney, esophagus, ovarian, skin, liver, thyroid, gallbladder, brain (meningioma) and endometrial cancer. Researchers believe that excess body fat leads to hormonal and metabolic changes that trigger inflammation and promote tumor growth.

• Gastroenterology: Obesity is associated with many digestive system diseases, including gastroesophageal reflux disease, esophagitis, gallstones, metabolic dysfunction-associated fatty liver disease and cirrhosis, and various related cancers.

• Pulmonology: Individuals with obesity face a higher risk of asthma, obstructive sleep apnea and other respiratory conditions (including, as we observed with COVID-19, potentially worse outcomes from viral infections).

• Psychiatry: Obesity and depression are closely linked, with a bidirectional association, and it’s worth noting that many antidepressants can promote weight gain, so prescribers should be prepared to consider weight-neutral or weight-loss-promoting alternatives for patients with obesity when possible. Other common mental health comorbidities include anxiety and eating disorders.

For many of these obesity-related health complications, losing weight can be the first line of treatment, and the relationship is often dose-dependent, meaning that these conditions worsen as obesity worsens and improve as obesity improves. This correlation may lead us to instinctively reach for GLP-1 medications as the most effective option, since we want to help our patients lose as much of their excess weight as possible and experience the greatest benefit. But especially considering significant cost, coverage and supply constriants, other anti-obesity medications can still bring measurable health benefits and might even be preferable for many individuals. Losing just 5% to 10% of body weight can lead to clinically significant improvements in markers such as blood glucose, cholesterol and blood pressure.

Improving patient health — not just reaching an arbitrary number on the scale — is the ultimate goal. Obesity touches everything, and treating obesity can have a positive, cascading effect on other conditions. If we can help a patient achieve Type 2 diabetes remission, reversal of sleep apnea or improved fertility, we’ll have made a real difference in their life.

The post Obesity Touches Everything appeared first on Medika Life.

Interest has increased so much that one course in nutritional psychology at a major university had over 100 students sign up. Many major universities in the US are offering master’s degree programs in this subject area.

Nutritional psychiatry is a relatively new and developing field that investigates the link between diet and mental health (including schizophrenia and psychotic disorders). Researchers and experts in mental health are starting to investigate how certain foods and eating habits can affect mood, cognition, and general mental health.

The gut-brain axis is one of the major topics of study in nutritional psychiatry, and the gut microbiota, which is made up of billions of different bacteria, resides there. Recent studies point to the importance of gut bacteria in affecting mental health and brain function. Having a healthy, diversified gut flora may boost mood and lessen anxiety and depressive symptoms.

Some dietary components have demonstrated the potential to promote mental health. Omega-3 fatty acids, which can be found in fatty fish, walnuts, and flaxseeds, have been linked to a lower incidence of depression and may be used to treat the symptoms of some mental disorders.

B vitamins are crucial for the health of the brain and cognitive function. Whole grains, leafy greens, and dairy products all contain them.
In addition, yogurt and other fermented foods, which include probiotics, might support the maintenance of healthy gut flora and may even enhance mental health.

The Mediterranean diet has been associated with a lower incidence of depression and cognitive decline because it emphasizes a high intake of fruits, vegetables, whole grains, and healthy fats like olive oil. This diet might protect against a number of mental health issues.

Studies have proven that what we eat can affect our mental health and mood. For instance, a diet high in whole foods can improve mental health while a diet high in sugary and processed foods has been linked to an increased risk of sadness and anxiety.

Numerous important variables and developing research have contributed to the shift in psychiatry toward including diet as a crucial component of mental health treatment. What has led to this new perspective on the treatment of mental health disorders?

Over time, nutritional science has made significant strides in understanding how various nutrients affect the body and the brain. Researchers began to learn about the potential effects of nutrition on mental health as they dug deeper into the connection between diet and health.

Globally, the prevalence of mental health illnesses is increasing, which has prompted researchers to look for complementary and alternative treatment modalities. Due to the drawbacks and side effects of conventional psychiatric therapies like pharmaceutical interventions, researchers and clinicians are now looking into alternative approaches, including dietary interventions.

Research on the gut-brain axis has become increasingly important in influencing how nutrition is incorporated into psychiatry. We see that research has shown that there is two-way communication between the gut and the brain, underscoring the gut microbiota’s potential impact on mental health. This research has sparked interest in the relationship between dietary choices, the gut microbiome, and, ultimately, mental health.

Depression and anxiety are two mental health problems that have been linked to chronic inflammation. The Mediterranean diet is one dietary pattern that has been linked to anti-inflammatory effects. There has been an emphasis on researching diets that could assist in reducing inflammation and enhancing mental health outcomes.

In recent years, patient-centered care and a more holistic approach to medicine have become more popular. This shift in thinking acknowledges that a variety of biological, psychological, social, and environmental elements, including nutrition, have an impact on mental health. Thus, psychiatrists are increasingly willing to think about and incorporate nutritional therapies into their therapy strategies.

As the research has evolved, so has the attitude of patients. People are becoming more interested in learning about holistic and lifestyle-based methods of managing their mental health. The new interest in these areas has seen a rise in psychiatrists taking nutrition into account as part of treatment as more people become interested in learning how diet can affect their mental health. But can a prescription be written for a diet? Who would fill it and how would insurance view it?

There has been a substantial paradigm shift in the field of treating mental illness as a result of the increased appreciation of food as “medicine” in psychiatry. Nutritional interventions offer a complementary strategy that can improve general well-being, even if they are not intended to replace conventional therapy. As nutritional psychiatry develops, it has the potential to offer patients a comprehensive and individualized approach to mental health treatment.

One stumbling block to the growth and inclusion of nutritional psychiatry/psychology is the financial factor. If a patient doesn’t have the means to buy these foods, how can they be helped to obtain them?

The post Psychiatry Is Turning to Nutrition in a New Appreciation of Food as “Medicine” appeared first on Medika Life.

In the new wave of medical/psychiatric thinking and training, residents in psychoanalytic training programs panicked. I saw this first-hand as worried young men asked out loud what they were to do now.

Where were they to finish their training if the hospital where they were now training was suddenly shifted to biopsychiatry? How could they switch to a medical model from the one in which they were currently involved? But didn’t they go to medical school with a medical model?

As a result, residents left and tried to re-orient themselves and their careers. And insurance reimbursement came into play. One analyst asked me if health insurance companies would pay for psychoanalysis. I had no idea.

Psychiatry transitioned from one of multiple weekly one-hour (or 50-minute) therapy sessions over years (what did Woody Allen say?) to one of consultation, diagnosis, prescription, and referral to a psychotherapist. No longer would psychiatrists be involved in psychotherapy. The prescription pad was their instrument of change.

A man with whom I am well-acquainted suffers from chronic, often debilitating panic attacks resulting from severe childhood trauma in a highly dysfunctional household. The mother beat the father with a frying pan, but he never touched her because he was raised to respect and never strike women. She attempted to set the house on fire, and the children suffered lifelong anxiety.

Referred to a new psychiatrist, the man, at the end of their first appointment, asked naively, “When do we schedule our therapy sessions?”

Without missing a beat, the nonplussed young woman psychiatrist responded, “I’m a psychiatrist. I’ve refilled all your prescriptions.” Nothing more was offered, and he received the name and number of a psychologist. What was the patient to think?

Where is psychiatry headed in the future as science marches on and attempts to find the biological basis of all behavior and abnormality? The questions have been asked by psychiatrists like Dr. Thomas Szasz, who wrote “The Myth of Mental Illness,” Dr. Allen Frances, who wrote “Saving Normal,” and Dr. David Viscott, who had a successful radio show.

In some of his statements about psychiatry, Dr. Francis is quite bold. “Psychiatry is certainly not alone in its overreaching — we are just a special case of the bloat and waste that characterize all of US medicine. Commercial interests have hijacked the medical enterprise, putting profit before patients and creating a feeding frenzy of overdiagnosis, over testing, and over treatment. We spend twice as much on healthcare as other countries and have only mediocre outcomes to show for it. Some of our citizens are harmed by too much medical care, others by shameful neglect. Medicine and psychiatry both stand greatly in need of taming, pruning, reformulation, and redirection.”

A few decades ago, Dr. Szasz wrote similarly about the behavior that psychiatry called mental illness and misused the terms in their nosology to create a special mystique. Neuroses and anal-retentive still hang in there today.

Where do we stand currently regarding our understanding and treatment of mental illness? Providers often use medications off-label, and these cause damage. Do we even know what mental illness is, or are we so highly dependent on the DSM-5 that we cannot see normal in its varied iterations? I applaud Dr. Martin Seligman for his emphasis on the positive aspects of human behavior, not psychopathology.

In addition, the DSM is behavioral in its diagnoses. There are no medical indications in it, nor is any medical testing recommended. Behavioral features and differential diagnoses are offered, but no medical illnesses that I can find in it. Why would only medications be prescribed? I’m sure objections can be raised here.

And the same book used to diagnose, the DSM, is revised periodically to include more mental illnesses. An excellent example was provided in Dr. Frances’ book, where a psychiatrist wanted to include “psychosis risk syndrome.” What would that have done to how many patients?

The questions are serious and must be constantly asked because people’s lives depend on what is provided to them by medical professionals. Once given a diagnosis, you might as well put a large, somewhat invisible letter on the person’s head, as in The Scarlet Letter. The stigma is long-lasting.

Arrogance has no place in medicine because it can cause more harm than the most dangerous poisons — it poisons the mind to reason and innovative thinking.

The post Psychiatry Has an Identity Crisis, and It’s a Problem for Patients appeared first on Medika Life.

Look in the back of the book, and you’ll find those for future consideration, many of them cultural in nature. This point indicates that the prior diagnoses in the earlier editions of the manual could too heavily load on American culture.

An interesting, unacceptable previously diagnosed in the “to be considered” category was nightmare deaths of Laotian men. How did they diagnose it? Perhaps some form of psychosis? In the Philippines, it is known as bangungut. And it has also been categorized as Oriental nightmare death syndrome. Is it a psychiatric disorder or a cultural belief?

The team that worked on the latest iteration of the DSM indicated that “more than 200 subject matter experts” worked on the book, including ethnocultural and racial concepts.

Questions arise regarding the reason these cultural and racial elements were missing in prior editions and whether they stigmatized patients in the past. The number of experts does not strengthen the book’s content, just as the number of subjects in a protocol doesn’t necessarily increase its validity. It’s illusory. Numbers alone are not magical.

Are there many as-yet-undiagnosed mental illnesses waiting to be discovered and treated, or is there too fervent an eagerness to find the obscure and plump-up, already burgeoning manual? One has to wonder at the expense of sounding skeptical of both motives and medicine.

Over the past few decades, psychiatry has undergone a seismic change from analytic practice to biological concerns and research. In the DSM, the specialization tends more toward psychology than biological medicine. We know thousands of healthcare personnel use the tome without medical degrees.

I recall working in psychiatry research where we saw psychiatry residents who were disillusioned because they thought they would learn how to practice psychotherapy, not look at blood draws or medication side effects. The department began to select only those interested in biological psychiatry, and any who found this unacceptable had to find substitute residency programs. To my mind, it seemed there should be a melding of the DSM and the then-current Physicians’ Desk Reference, now known as the Prescribers Digital Reference.

Perusing the DSM will quickly reveal no biological diagnostic indicators for a psychiatric diagnosis other than behavioral symptoms. There are no required blood tests, no serologic tests, and no imaging (even for Alzheimer’s). So, is this medicine in the true sense or psychology?

One point that also contributes to the existence of this manual is that insurance companies wished to have something on which to rely for reimbursement. And reimbursement may play a role in giving patients diagnoses other than the evident one. In family therapy, the mother may be the IP (identified patient). Should she be placed in that role, or is the diagnosis being skewed for the insurance?

There were two categories of physicians in a psychiatric hospital where I once worked: medical doctors and psychiatrists. All psychiatrists are medical doctors, so why the dichotomy? I never did get an answer because I don’t believe anyone knew how it came to be.

And when medical doctors in the hospital noted a sharp uptick in diabetes in patients on the units, there was little to no discussion with psychiatrists about psychotropics playing a role in its incidence. It did have a role they later discovered. Some patients on specific drugs gained an inordinate amount of weight without an intake of additional calories.

One voice calling out against what he indicates is the “medicalization” of normal life is the eminent psychiatrist, Dr. Allen Frances, once the chairman of the committee to establish the DSM in its overall position of power of diagnosis. His concern regarding the current issues resulted in writing “Saving Normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life.”

The book was a shot over the bow of those promoting the DSM as the ultimate text for diagnosis. But this isn’t the only area where Dr. Frances has expressed his concern because he believes that the diagnosis of ADHD in kids is far too common.

We’ve seen the prior wave of diagnosis of children with bipolar disorder begun by Dr. Joseph Biederman, a well-known child psychiatrist. “Dr. Biederman’s work helped to fuel a fortyfold increase from 1994 to 2003 in the diagnosis of pediatric bipolar disorder and a rapid rise in the use of powerful, risky and expensive antipsychotic medicines in children.” Would most of us question, without a medical degree, the use of powerful drugs that act on a child’s developing brain?

I wonder what Dr. Frances thinks about the latest diagnosis of Prolonged Grief Disorder (PGD) added to the current edition known as DSM5-TR. The new addition is described as “the bereaved individual may experience intense longings for the deceased or preoccupation with thoughts of the deceased, or in children and adolescents, with the circumstances around the death. These grief reactions occur most of the day, nearly every day for at least a month. The individual experiences clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

The concern among some healthcare professionals is that this new inclusion will be the tipping point for pharmaceutical interventions in a process that should be permitted its normal action. One research project for grieving consisted of a specific 16-week protocol with an antidepressant. The researchers believe that the new PGD disorder applies to about 4% of the population, but the pandemic may have increased the numbers.

While mental health professionals may wish to see PGD as treatable with medications for depression and anxiety and psychotherapy, there is agreement that little is known about the biology of grief. The missing pieces in the puzzle would seem to present a major impediment to effective care of those engaged in prolonged grieving. Where research exists, it has found a formidable negative connection with the immune system.

Additional protocols noted the increased mortality of spouses after the death of their spouse and the relationship between depression and cardiovascular disease. Undoubtedly, grief includes degrees of depression which can be long-term in nature. It affects an individual’s ability to function normally and may not wane sufficiently without intervention, but which persons need the intervention and for how long still requires investigation. Most will see grief gradually lessen over a six-month period without intervention, but others may take one to four years. The question is one of serious impairment in daily life.

Besides adding a new diagnostic category, there needs to be a proviso about combining medication with psychotherapy, not simply medication alone. The reverse is also true; psychotherapy without medication where it may be indicated.

The post The Time Is Now to Closely Question Psychiatry’s “Bible” — the DSM appeared first on Medika Life.

Some excellent, large data sets were either being put to purposes which they weren’t well suited or authors were drawing conclusions that really weren’t the results of analyzing the data.

Why can’t they just report their results accurately and transparently and not be afraid of doing so?

Journals are a big part of the problem. They seduce researchers with temptations that they cannot resist.

A while ago the JAMA family of papers spent millions of dollars revamping their publishing platform. The publisher announced that editors were going to make decisions about papers based on altmetrics — how much traffic similar papers have attracted to the journal website, and how much time readers spent there, and therefore how much the journal could charge for advertising.

That means that some papers that are solid science and have important messages for mental health care will be given lower priority. The papers are not in hot, trending topic areas and would not attract broader audiences.

Despite being obviously weak in their methods or data, other papers will be accepted because they are trendy in their conclusions. Some papers will be rejected because they persuasively present inconvenient findings.

In the case of this issue of JAMA Psychiatry, an obvious decision was made by the editors to emphasize racial and ethnic health disparities in a special section Psychiatry and COVID.

A call went out for papers. I doubt that some of the authors even had that intention of examining health disparities or racism in mind when they gathered their data and made plans to analyze it.

I am picking one article to dissect because I have a great deal of respect for one of the authors. I’ve followed his work closely for decades because he does very good work. I think he knew what he and his co-authors were doing in putting a message on their results that weren’t there. He was having harmless fun and not trying to corrupt science.

Naively or on purpose, Greg Simon allowed his co-authors to say silly things in the section discussing implications, where such speculations seem natural.

Maybe I am giving too much credit to Greg but what I liked was that this paper was so transparent in how he manipulated the reviewers and the readers. Right away, he revealed what he was up to in an incredibly transparent abstract. Like a magician spoiling the trick by explaining what he was doing, he was communicating to the smart, attentive members of the audience and allowing them to feel smart. Too bad that most people do not read carefully.

The article could be paywalled by now, but you can access the abstract here and see the context of the statements that I am going to pick out.

The authors state as their research question:

*Could implementation of suicide prediction models reinforce and worsen racial/ethnic disparities in care?”

Translation: How white people’s science hurts black and indigenous people and perpetuates systemic racism.

The huge retrospective study consists of administrative data of 13,980,570 visits by 1,433,543 patients. The data came from seven health systems providing integrated physical and mental health services.

The authors used sophisticated statistics to construct a model predicting which patients would die by suicide within 90 days of when observation of a particular patient started.

The authors conclude

These suicide prediction models may provide fewer benefits and more potential harms to American Indian/Alaskan Native or Black patients…Improving predictive performance in disadvantaged populations should be prioritized to improve, rather than exacerbate, health disparities.

Unraveling this conclusion

In epidemiological/mental health services studies, it is not how big your data set is that matters, but how many events you are available for particular groups.

From the clearly written and transparent abstract, you can tell right off that the data set is not very good to be used to predict black and Native American suicides because there were so few Blacks and Native Americans in the sample.

Hiding in plain sight in the abstract, the authors openly admitted that they only had n=65 black who died by suicide within 90 days of when tracking starred. They only had n= 21 Native Americans who died by suicide within 90 days of when tracking starred.

These are horribly small numbers, even useless, to be used in making generalizable scientific statements. But the situation is even worse. The sample was split between building and validating the model. In the validating sample, there were only 30 black patients and 15 Native Americans.

The authors claim that their predictive model worked well for whites. That would be expected without even seeing the predictive model, because it was built to a predominately white sample.

But who should care about this predictive model?

Recall this was an administrative data set constructed from information collected for other purposes. The diagnosis and service utilization data in the final predictive equation are so crude that the model would not be clinically useful in real-world settings. Maybe it delights epidemiologists for looking so good in terms of statistical significance, but clinicians should ignore it. I am sure that they will.

Every suicide is a tragedy, but because it is such an infrequent event, a base rate “won’t die by suicide” is likely to be more accurate than a predictive model based on group data. Aficionados will recognize that is a classic Paul Meehl observation.

Here comes the pablum.

Pablum is boring tasting baby food. Authors put pablum in papers because they need a filler.

Readers expect certain things to be said about a trending topic, even if things were not among the findings of the paper. Alert reviewers play gatekeeper and keep pablum out of the discussion section if they are not actual findings. In this paper, the authors make the unsubstantiated claim:

Relative benefits and harms of suicide prevention interventions vary by race/ethnicity. Additional attention from a mental health care professional may increase access to beneficial services and likely presents limited harm but could cause stigmatization or discrimination and damage patient-practitioner therapeutic alliances, particularly for patients from marginalized communities already less likely to trust or engage with traditional mental health care.

This may be true or not in other findings that were not cited. Why are the authors bringing this up near the end of a paper that was doomed from the start not to advance our understanding of suicides by ethnic and minority persons?

Of course, a journalist from MedPage Today fell for the trick and gave the authors some extra publicity. One of the authors of the study is quoted in the MedPage Today article:

“We must not ignore unintended consequences of suicide prediction models,” she said via email. “Identifying patients at high risk of suicide could initiate a cascade of more intrusive interventions, including involuntary psychiatric hospitalization and ‘wellness checks’ that put a patient in contact with law enforcement. We have to recognize, due to structural racism, that the risk of these harms is greater for BIPOC [Black, Indigenous, and people of color] populations.”

A touch of moral panic attracts more readers to MedPage Today and the JAMA Psychiatry article, keeping MedPage Today, JAMA Psychiatry, and the authors’ institution happy.

But science suffers from the confirmation of a hypothesis that was not tested, especially when the paper is cited for this conclusion that did not arise in the data.

What important message about racism and health disparities is missing in this paper?

Unwarranted talk about systemic racism distracts from looking for real, modifiable racial disparities.

Mental health services researchers like these authors require large data sets, which come from settings that are organized enough to provide them. This particular study relied on integrated care settings in which patients could easily access both primary medical and mental health treatment. These settings depend on an alignment of incentives, insurance benefits that make integrated care possible.

There were not many black or Native American suicides for which data were available in the settings. That is a serious health disparity. Such patients don’t get to such settings.

Black or Native Americans don’t have the right insurance or live in close proximity to such quality care. It is a long way from most Native American reservations to the doorsteps of a well-resourced integrative care setting. Those who reside on a reservation mostly won’t have the proper insurance nor the transportation to get there.

That was strongly suggested by taking a peek at what data the authors collected or even where they collected it. Nothing fancy had to be done, but then again, they probably would not get their paper in the prestigious JAMA Psychiatry,

You might think from this article that there is harm and even danger for Native Americans to be treated in one of the settings that were studied.

I have a close native American relative by marriage whose 90+ years old (It has to be a guess because birth certificates of many Native Americans are not preserved from back then.) grandmother was a reservation orphan from another tribe who was sent to a Navajo reservation because that nation was able to keep polio victims in the 50s. I wish she could get all the treatment of post-polio syndrome that she deserves in the reservation. She wants to keep working for the US National Parks Service, as she has for decades, and accessible integrated care would help.

Algorithms that poorly predict individual suicides of any race or ethnic background be damned. If we care about social disparities in health, we must concentrate on getting more blacks and Native Americans into treatment in integrated care settings.

The post Suicidology Is Corrupted by Researchers Who Say Things That Aren’t in Their Data appeared first on Medika Life.

It’s a tip of the hat to faith healers, shamans, and witch doctors. It is also a shameful marketing ploy by medically trained professionals that should know better and it is a seriously dangerous red flashing light for the profession and its credibility.

Drugs have become our fallback for almost everything. Practitioners in general are massively guilty of doling them out as a panacea for socially compromised adults. Adults that possess no life skills or coping mechanisms are simply drugged into oblivion. You don’t need to worry about handling life if you’re too stoned to notice it. Forget therapy or actually trying to provide the necessary life skills. Too time-consuming and really, why cure when you create a lifetime of dependence? 

Medicine is slipping, quitely, intentionally and unnoticed, into a new sideline.

It is becoming the traveling quack show we so despise, prescribing drugs to treat conditions that mostly don’t exist, conditions some practitioners are unqualified to recognize, let alone prescribe for, and unfortunately, when it comes to those who are trained, the fallback (and sometimes go-to)treatment is the ever lucrative cocktail of mind-altering concoctions we now have at our disposal.

I would go so far as to say that 90% of the patients showing up cap in hand at your door aren’t suffering from any condition your medication could possibly treat, let alone cure. Forget management, if that’s where you’re going. That isn’t an out either. Someone who hasn’t been given the tools or strategies to cope with life doesn’t require medication, they need the school of life and real help to develop mechanisms many of us are already fortunate enough to possess. Medicating these patients is CRIMINAL. It is WRONG. It is UNETHICAL.

I would suggest to our modern-day mental health professionals and doctors alike, that unless you are really gullible or simply follow the flock, that you are aware of the failings in your treatment of these individuals. It’s an easy out, isn’t it? We’ve conditioned the patients to expect the pill. The miracle in the bottle, the panacea that will solve all of life’s problems.

Your patient doesn’t want any other form of help. They simply want the easy route and they’ll sit in front of you and bitch till you get out that pad and start writing. Part of you justifies it with a simplistic thought to ease your conscience. If you don’t prescribe, they’ll simply get it somewhere else. So you cave in. It’s quicker, it’s easier and at least, you think to yourself as you start writing, you can keep an eye on them.

WRONG. STOP. What you are doing is unethical. Is it in the patient’s best interest? Are you properly qualified to make that judgment? Do you understand that you are fundamentally changing the course of the person’s life sitting in front of you. Do you REALLY? Those quick, few lines on that script are potentially going to create a life of addiction and dependency. Was that why you joined the medical profession. For some doctors and many psychiatrists, it clearly seems to be.

Your flashing lights, new age mumbo jumbo, and cutting edge designer drugs are simply complex rituals you’ve designed to cover your snake oil shows. The best interests of the patient ceased being at issue years ago and the danger now, as even universities get involved in the medical mystery tour routine, is that people will start to perceive this as being real medicine. It isn’t and every effort must be made to ensure it never becomes that.

 It is a marketing farce, quackery, and pseudoscience wrapped up in what you assume to be a professional presentation to fool the public We see you. We see the lives you are destroying and you better believe we aren’t going to let it go.

It’s time to clean up your sad acts. Revert back to your core principles and HELP the patient, stop helping yourselves. Why Treat when you can Cure? By all means, assist your patients, but do so ethically. Treat them humanely and help them to address the shortcomings in their lives by providing them with lasting skills to cope with their existences. None of this involves any need to get your local pharmacist involved.

You’ll find the rewards from this difficult and lengthy process to be far more rewarding than all the time you currently spend arranging your mirrors and putting on the makeup. 

Where are your facts?

Oh, they’re coming. Don’t fret. This is simply a warning shot, fired across the bows, to encourage those with sense to pause, stop, and re-assess their current practices. Most will ignore it, but it may hopefully reach a few professionals. Medika will be publishing a few in-depth articles in the coming weeks on the disgraceful practices that are now becoming almost routine within the mental health community. Medication will feature strongly, as will the tendency to misdiagnose.

To push patients into neatly labeled boxes, each representing a different condition. Boxes that simplify everyone’s life. The patient considers his medication justified, even if the diagnosis of late-onset autism seems a little iffy. The care provider has only to continue handing out the medication and monitoring the patient. A lengthy and sometimes lifelong relationship that benefits no one, other than the practitioner.

Good doctors, ethical doctors, of whom there are many, whose sole purpose is to ensure the health of their patients, are also compromised as trust in the profession is eroded. Patients no longer view the profession with the dewy-eyed trust enjoyed by doctors fifty years ago. No one is more to blame for this than the quacks and charlatans from within the ranks of medicine itself.

That these quacks were, and are still able, in some instances, to pursue their chosen professions, speaks volumes to the lack of proper, swift, and merciless sanction from governing bodies. Lenient approaches from regulatory bodies within certain states encourage the problem and any potential solutions to eradicating this rot from the medical profession have to be undertaken with the full engagement of these bodies.

It must be eradicated. Medicine cannot afford further dilution of the trust it enjoys from the public. The consequences will be devastating, impacting vaccination rates, terminal care, and the inevitable escalating costs of trying to save those who have ventured away from traditional medicine to seek salvation in the hands of the natural healers and fraudsters that permeate the internet.

If we continue to dispense so easily, to medicate without sound reason, then we are in effect digging our own graves. You cannot magic away the problems of two generations of poorly parented adults with a pill. You see doctor, your patients aren’t ill, they are just ill-prepared.

The post Drugs are Rapidly Becoming Healthcare’s Greatest Burden appeared first on Medika Life.