16 November 2006

Can psychiatric drugs be good?

For many who identify with the anti-psychiatry movement or view, opposition to psychiatric drugs is frequently a key belief. Though I identify with this myself to a degree, I also feel drugs themselves are not the problem.

To illustrate this, some instances from my personal experience. I feel the need to obtain a degree of anonymity, and for that reason I'm not going into too many details.

I can point to two specific instances where I suffered from being given psychiatric medicine. Whilst medicine of any description is not an exact science, and things do not always work out the way predicted, these had clear causes. One was the result of insufficient record keeping, monitoring and lack of continuity of "care", the other from a coverup on the part of drugs companies regarding the side effects of their products. Both caused significant physical and psychological symptoms which I'm still not entirely free of.

Did this make me anti-medication? Yes and no. I think psychiatric medicine is over used, I would never use it again and I maintain that, particularly given the fact that my problems were largely the result of trauma, it should not have been used as the first attempt at treating me. I also, of course, believe that producing/designing drugs for profit is hugely dangerous, and it goes without saying that they should only be used with the consent of the person taking them. However, I do have another experience that makes my view not-so-black-and-white.

As a result of such incidents, I began to learn about the drugs. I went beyond the patient information and devoured whole websites of medical jargon. Sometimes it took me hours, having to look up virtually every word. I also read people's personal experiences, looking for patterns.

I finally got a stable psychiatrist and a combination of drugs that seemed to help. I think also the fact that my external situation was improving helped dramatically. However, there were still side effects from the mood stabiliser I was on. I was exhausted most of the time, and had problems functioning after a full day's work. In addition there was the weight gain and very high risk of diabetes – and given my family history I didn't want to increase the chances. Then there was the sheer inconvenience and expense, particularly the fact that it left me tied to medical professionals and institutions of some description and I felt that even the best of these would deprive me of the self sufficiency I craved.

So I went back to my research. I worked out how the combination of different medications and to monitor my own symptoms and the patterns they occured in (which isn't nearly as simple as it sounds). I began to get an idea of what other factors infulenced my mood and how they did that (diet, sunlight, exercise).

The first thing I did was begin to adjust my medication. I read an article which suggested that my medication could be taken at specific points in the mood cycle (which worked out at about once a fortnight) rather than twice daily, and found other people who had successfully been doing this. At this point I was away from family and doctors (I somehow managed to persuade my GP to give me a years supply of drugs, god only knows how that happened), so I decided to try this. It took me a while to get right, but it worked fantastically, and kept me going up to a point, around three years ago, where I was ready and able to wean myself off them completely.

I don't think the positive effects were just limited to the fact that I had the type and dosage of medicine right, however. I believe I gained substantially from the control I had over it, the fact that I was using it with my moods rather than just a blanket coverage, and that I chose how, when and what I took. But the system we have at the moment promotes the opposite. At worst it involves force and violence, in my case it was threats and emotional bullying, but even in the better cases it involves paternalism, a clear divide between patient and doctor, one who knows and one who doesn't.

Now, I'm not suggesting everyone could do what I did. I was in a pretty unique position in terms of my medication. I had the access to information and the ability to interpret it, a lot of people for various reasons do not. But it is possible to gain advice without relinquishing control, to implement a social solution not a heirarchical one, and that may involve the use of medication.