Kirsty Alley is right. Psychiatric medications cause aggression and suicide…
I probably would have added a ‘some’ in front of psychiatric medications and a ‘can’ in front of ‘cause’. And I draw the line at blaming all shooting homicides in the US on psychiatric medications, but it is true that some psychiatric medications cause psychiatric side effects. For a harrowing account of how psychiatric care can go horribly wrong one need only read Rebekah Beddoe’s memoir Dying For A Cure.
Psychiatric care done right is complex and unfortunately not always easy to access.
Regardless of the specific type of treatment someone with a mental illness receives, I believe there are four things crucial to recovery:
Clear communication between patient and care giver
Patient trust in their care giver
Continuity of care
An acceptance that successful treatment looks different for different patients.
Psychiatric medications are a contentious issue. They are often viewed with suspicion and are shrouded in stigma. I believe it is simplistic to describe them as ‘good’ or ‘bad’. As with most medications, in addition to their purported benefits, they carry risks. As with most medications the benefits have to be weighed against the risks when prescribing them. The challenge with psychiatric medications is that often the only way to know whether or not a medication will work in any given individual, or whether it will produce undesirable side effects, is to try it.
Because of this inherent unpredictability, I feel strongly that once medication is required it should be a psychiatrist and not a GP doing the prescribing. There is a reason psychiatry is a medical specialty. If I needed open heart surgery I would get a referral for a cardiothoracic surgeon. I would not expect my GP to do the surgery.
I trust my psychiatrist with my life. His approach suits my personality. This doesn’t make him the best psychiatrist for everyone. But he knows me. He knows what I look and sound like when I’m well, and when not. We have continuity of care. He knows me well enough to pick up unusual medication side effects, sometimes before I do. A couple of years ago I changed to a newer generation anti-psychotic medication. I developed Parkinsonian side effects. My face lost expression. My psychiatrist recognised this before either I or my husband did.
At times we are both working in the dark. Six years ago I started on a new anti-depressant. When I asked him how some of his other patients had gone on it, he said: ‘You are my first patient to go on it.’ For me, this medication worked brilliantly with no side effects, and yet if you read the package insert for this anti-depressant, it lists suicidal thoughts or behaviour and aggressive behaviour as potential side effects.
There have been times my psychiatrist has discharged me after months in hospital on a new medication regime, and his parting words have been: ‘Fingers crossed.’ For someone with a medical and scientific background this is highly disconcerting. But that is where the element of trust comes into it.
And perhaps most reassuringly, when he has been stumped at different times in the last eleven years, he has recommended a second opinion with another psychiatrist.
I would not be functional or possibly even alive without my medication. But it has never been a case of just taking the medication, lying back and waiting for it to fix me. Medication gets me part of the way well and keeps me part of the way well. I still have to get enough sleep, exercise, eat well a lot of the time, drink minimally, steer clear of emotionally draining or dysfunctional relationships, and follow up with regular psychiatry and psychology appointments to give my medication the best chance to work.
There is no doubt that many cases of mental illness, for example mild anxiety or mild depression, particularly if they are situational, can be managed and sometimes completely resolved without medication. Psychological therapies such as Cognitive Behavioural Therapy and a healthy lifestyle may be all that are required.
But if medication is necessary to help manage a mental illness, one of the least helpful things family or friends of the patient can do is to suggest just pulling themselves together and having a cup of chamomile tea instead of taking prescribed medication.
Perhaps rather than arguing for or against medication, the best way forward when supporting anyone with a mental illness, is to offer unconditional love and support, and respect that there are different paths to wellness.
(Written For QLD Mental Health Week 2017)
Other pieces and events from Qld Mental Health Week 2017: