Bus stop lady

[Dancing David]

So if people are ony allowed to agree with you, how does that aid discussion?

My point being, I think it is very difficult for medical professionals to accept that people with mental illness may have valid objections for not wanting their meds.

Not the non-medical case managers!

If someone is too paranoid to leave the house, then are doctors likely to take their concern about weight gain on meds seriously, or are they likely to be of the opinion that enabling someone to get out and about should be more important to their life than weight gain? My experience is that doctors are more likely to try and persuade patients that their complaints are trivial in the context of their illness instead of working to find a viable alternative.

It really depends, the choice is ultimately the clients. The doctor was one agenda, it is not their role to support more than medical intervention and recommend alternatives.

When it comes to psychosis, there may not be a viable alternative.

I take lisionopril/hctz , setraline and simvastatin. Many people choose not to because of the side effects. The sertraline has side effects, many people would not make my choice.

My mother consistently has her doctor lower the dose of of lisinopril/hctz, despite the fact that it makes her lungs hold fluid and creates more strain on her heart. there are no alternatives for my mom, the doctor does it because she would rather my mom be compliant on a daily basis then not.

Now I must ask what exactly you mean by 'viable alternatives' in what context?

 

[Dancing David]

We aren't discussing at all if it's possibly practical in a limited sense and for only a few patients.

It appears to me you're trying to say we shouldn't even consider the idea at all, because of those who have "valid objections." So, again, it appears the response is "don't even bother to try or consider it; if it won't work for everyone, it won't work for anyone."

It is an alternative, the have even tried predirectives signed by the individual themselves. So far the court in Illinois will not uphold them.

The sort of thing that states "I being of... do state clearly that I would rather be hospitalized against my will... to further my well being"

 

[mediocrity511]

We aren't discussing at all if it's possibly practical in a limited sense and for only a few patients.

It appears to me you're trying to say we shouldn't even consider the idea at all, because of those who have "valid objections." So, again, it appears the response is "don't even bother to try or consider it; if it won't work for everyone, it won't work for anyone."

No, my point is that coercive powers should always be used as a last resort. My point is also that medical professionals are always likely to judge that the benefits of treatment outweigh the side effects, otherwise they would stop or change the treatment. So anyone who wants to change medication is already disagreeing with their care providers. A system would need to be set up with a neutral party weighing up both sets of opinions and assessing wether the patient truly is making an informed and reasonable judgement on refusing medication.

 

[slingblade]

David, I see. It just seems sad.

 

[slingblade]

No, my point is that coercive powers should always be used as a last resort. My point is also that medical professionals are always likely to judge that the benefits of treatment outweigh the side effects, otherwise they would stop or change the treatment. So anyone who wants to change medication is already disagreeing with their care providers. A system would need to be set up with a neutral party weighing up both sets of opinions and assessing wether the patient truly is making an informed and reasonable judgement on refusing medication.

I think that's more like what I was suggesting, thanks for that.

 

[mediocrity511]

Not the non-medical case managers!



It really depends, the choice is ultimately the clients. The doctor was one agenda, it is not their role to support more than medical intervention and recommend alternatives.

When it comes to psychosis, there may not be a viable alternative.

I take lisionopril/hctz , setraline and simvastatin. Many people choose not to because of the side effects. The sertraline has side effects, many people would not make my choice.

My mother consistently has her doctor lower the dose of of lisinopril/hctz, despite the fact that it makes her lungs hold fluid and creates more strain on her heart. there are no alternatives for my mom, the doctor does it because she would rather my mom be compliant on a daily basis then not.

Now I must ask what exactly you mean by 'viable alternatives' in what context?

Viable alternatives may mean different psych meds, there are very many different antipsychotics, antidepressants and the like. It may also be that there are ways of working with the existing meds, for example I've been allowed to take all my meds at night to avoid the sedation affecting me too much and I've also tried slow release versions of some things as well. It may also mean trying talking therapies. It can also mean working with someone to carefully come off meds, with continuous monitoring, instead of refusing and then someone going cold turkey and ending up with terrible withdrawl symptoms. Don't know if you're in the UK, but over here we have WRAP (wellness recovery action plans), which allow people to make decisions when well about what they would like to happen when they get ill. They're quite good, as it's about MH professionals working with patients, instead of coercing them or just removing all care if they fail to comply.

 

[Dancing David]

David, I see. It just seems sad.

It is great idea however, but a person can not consent to involuntary hospitalization in the future. It delves into the very high bar of competency. It is sad but most of the people I knew chose to take their meds after a few go arounds.

 

[Dancing David]

Um, I don't know about doctors refusing care due to compliance, but I worked out reach mental health, that was expected.

 

[Jarlaxle]

Someone can not be cogent in some aspects of their life yet have sensible reasons for not wanting to take meds. If someone says "I can't take my pills because otherwise my socks are going to come to life and strangle me" then maybe there could be an argument to coerce someone into taking their meds. But a lot of the problems I've had with meds and known other's have are more along the lines of not wanting them because they make people feel tired, make them fat, make them not feel like themselves, flatten out the good bits of their mood as well as the bad.

My brother was on Ritalin for a while in high school. He was a different person...no creativity, no emotion, pretty much no personality. He was half a step above catatonic on 15% the normal dose.

If I am ever in a situation where I need to be medicated to function, I hope someone would be kind enough to shoot me.

 

[marplots]

If I am ever in a situation where I need to be medicated to function, I hope someone would be kind enough to shoot me.

That's the kind of statement that will get you medicated for sure.

 

[kerikiwi]

If I am ever in a situation where I need to be medicated to function, I hope someone would be kind enough to shoot me.

This really makes no sense.

If various body parts are not functioning, and medication allows them to function, that is a good thing.
If 'you' are not functioning, and medication allows you to function, how can that not be a good thing?

 

[slingblade]

This really makes no sense.

If various body parts are not functioning, and medication allows them to function, that is a good thing.
If 'you' are not functioning, and medication allows you to function, how can that not be a good thing?

Agree with this.

It's like we're fine with taking medicine to help the body, but the brain is somehow off limits.

Wha?

 

[Pup]

It seems everyone has snipped out the most important part of jarlaxle's post, that puts the final sentence in its proper context: "My brother was on Ritalin for a while in high school. He was a different person...no creativity, no emotion, pretty much no personality. He was half a step above catatonic on 15% the normal dose."

Obviously, there was something unacceptable about the way jarlaxle's brother was "functioning" without medication, or he wouldn't have been told to take Ritalin. He may have "functioned" in a more socially acceptable way when taking it, from an objective viewpoint--there's no way of knowing with the little information given, since we don't know what he was like before--but it subjectively wasn't what he or jarlaxle wanted.

Society would generally be sympathetic to a person who said they would rather die than live helplessly bedridden, hooked up to feeding and breathing tubes, even though those tubes were making the body "function." There are living wills for just that situation. I think more people would be appalled if society's response was, too bad, if you need to live hooked up to tubes, we'll ignore your wishes, and even if you're able to complain, we'll drug you so you won't want to.

It's like we're okay with people who don't want to live in a broken-down body and provide living wills for that circumstance, but if they have a broken-down brain, too bad, their wishes--even when competent--don't count.

Now, I know everyone will get in a quibble about "kind enough to shoot me," and take it literally, saying we don't kill people on life support, we just take away that support until they die.

My response is 1) in a casually written post, it's clearly just a common expression, not meant to be taken literally, and has a meaning closer to "I wouldn't want to live like that," and 2) I think it should be legal to sign something like a living will when you're competent, saying that you don't want to be forced to take psychiatric medicine, and therefore want to be subject merely to legal penalties for your behavior rather than having it modified with medication. As a practical matter, it would cover all circumstances, including of course what's called suicide by cop.

Not sure whether I'd sign a living will like that myself, but I think anyone should have the right to make that contract with society, as part of basic rights over their own body and brain.

 

[Dancing David]

My brother was on Ritalin for a while in high school. He was a different person...no creativity, no emotion, pretty much no personality. He was half a step above catatonic on 15% the normal dose.

If I am ever in a situation where I need to be medicated to function, I hope someone would be kind enough to shoot me.

Different people respond differently, due to having highly elevated emotions, compulsions and obsessions, I felt a great deal of affective flattening from zoloft. At first I was really concerned that I had the classic frozen feelings syndrome as often complained of. However now that it is many years later I see that I now have normal feelings.

In your brothers case it sounds like he did have ADD but my have benefited from a different medication. Maybe even a different class of medication.

 

[tuoni]

Agree with this.

It's like we're fine with taking medicine to help the body, but the brain is somehow off limits.

Wha?

Well for me, some of the stuff I was prescribed when I was a teen made me almost catatonic - sure, it evened out the cycles I have had to learn to live with as I've got older, but it evened everything out. I ended up in a situation where I was watching my life happening on a screen in front of me. And as a result of some of the medications they put me on when I was a teen, I am still suffering... I kinda missed out on the "emotional development" which is supposed to happen, because I was on medication which flattened them all out.

I really don't know where I stand on this; I am certain that if I hadn't been put on that stuff I wouldn't be here today... at the same time, because I was, even now I'm not taking any of it I am still suffering its effects.

 

[slingblade]

That's rather odd, though I don't doubt anyone's experiences. My own son was placed on Ritalin for a while as a teen, and he didn't flatten. His emotions were still there, but he was finally able to exert some control over himself with the meds. He used to tell me he didn't read for pleasure because by the time he got to the bottom of the page, he'd forgotten what he'd read.

While taking the Ritalin, he developed an enjoyment of Lovecraft's works ; the kids in his class found him more friendly and he developed good friendships he still has some 20 years later; and his grades shot up.

His medication was court-ordered. He'd become something of a firebug at 13, setting little fires, but one got away from him and burnt part of the rear wall of a body shop. The behavior problems were much reduced on the meds, and the fire-setting stopped.

He stayed on them for the two years the court ordered. If he's had any long-lasting negative effects, he never mentioned them to me.

 

[tuoni]

I wasn't on Ritalin, I was on Haloperidol.

 

[Lamuella]

If I am ever in a situation where I need to be medicated to function, I hope someone would be kind enough to shoot me.

I need to be medicated to keep my blood pressure at a healthy level. Should I be shot?

 

[slingblade]

I wasn't on Ritalin, I was on Haloperidol.

I see. I referenced Ritalin b/c of an earlier post that did so, and my son's experience. I am not familiar with the medication you took. Sorry if I lumped you into a category in which you didn't belong; it was not intended.

 

[tuoni]

I see. I referenced Ritalin b/c of an earlier post that did so, and my son's experience. I am not familiar with the medication you took. Sorry if I lumped you into a category in which you didn't belong; it was not intended.

No worries