Tag Archives: ethics and mental illness

A Long Post/Rant: What’s the Question? What’s the Answer?

I feel stuck.

Right now, in 2014, I am on disability.  In terms of disclosure I want to make it clear that my disability is based on having PTSD and……horror of horrors, bipolar disorder.  (Eventually they will add the mystery illness and degenerative disk disease, but that’s more paperwork than I can handle right now.)

I put it that way – “horror of horrors” – because I am really reluctant to disclose this.  The reason is because there is still a great deal of stigma attached to mental illness – and if a therapist has been diagnosed with it, it’s pretty much the end of his/her career.

Since I haven’t worked since I lost my last job in 2010, I think it’s probably a bit silly to think it’s going to matter if anyone – or everyone – knows about my struggle with a mood disorder.  After all, I have already disclosed about my experience as a domestic violence survivor, from where the PTSD came.

The bipolar disorder diagnosis is another matter, and I will get to that farther along in this entry.  Suffice to say. I am nearly 100% sure that was brought on by the use of antidepressants.

Side note: Even the DSM (Diagnostic and Statistical Manual. the book from which all psychiatric diagnoses are made) acknowledges that “antidepressant-induced hypomania or mania will now qualify a patient for a diagnosis of bipolar disorder” (“DSM-V Won’t Solve the Overdiagnosis of Bipolar Disorder – But Clinicians Can”, Psychiatric Times, 5/9/2013).

See anything wrong with that?  I do

The drug companies cause the disorder and then treat it as a disease.  And I can tell you from experience, even if you could convince a doctor it was antidepressant-induced, the usual treatment is still adding more medications like mood stabilizers or anticonvulsants.

Or perhaps by adding one of the newer antipsychotic drugs – they are being advertised all over TV and the internet for “when your antidepressant doesn’t work, add this.”

Back to the main idea…

I want to write about some things regarding the mental health system, criticisms mostly, and I feel it only fair that I disclose I now have experience on ‘both sides of the desk’.

Not that this makes my experiences any more valid than anyone else’s, but tell you what – I am really sick of people who have only had the experience of being a client/patient rant and rave against psychology as a legitimate field, because they have no idea what they’re talking about.

Oh! I bet you expected me to say something completely different, didn’t you?  Something like how sick I am of mental health professionals inflicting harm on patients?

I am sick of that, yes.  It’s the main reason I have lost jobs on a number of different occasions.  I have advocated on behalf of patients against hospitals who have not treated them properly, or haven’t treated them at all, or have treated them when they didn’t even need treatment.

I have convinced psychiatrists to release people who did not have a severe mental illness, and were being held against their will, because some admissions person lied about their assessment.

It happens.  Especially in the case of teenagers being committed because their parents couldn’t handle their behavior.  Or in the case of elderly people whose relatives wanted their money.

Another side note: I still have a lot of respect for some psychiatrists I have worked with, who backed me up and released someone against the screaming of the hospital administrators.  Hint: They’re all in practice in Memphis or Mississippi, in case anyone believes the only ethical professionals are in northern states.

I have gone to bat many times for patients – and have gotten fired.

Even worse, in some cases the patient’s family or the patient him/herself filed a grievance against me (!) because they didn’t think I had gone far enough – in other words, I had failed to obtain a discharge and so, because the patient or family didn’t have the guts to blame the hospital administrators and their lawyers, they turned on me.

Minor digression ahead…

I have had parents of patients demand that I lose my job because I had the nerve to suggest the parents might be part of the problem, that I couldn’t just “fix their kid” and hand the child/teenager back to them, all perfect and well-behaved.

Change?  Why should the parents have to change?  After all, they had “tried everything”…everything except consistency, that is.  In other words, they ground their kid “for a month!” then back down when they can’t take the whining, surliness, or other tactics kids use to get their way, usually only after a few days.

All the kid learns then is that they can outwait their parents.  Kids can whine seemingly until the end of time, and they know their parents have a limited amount of patience to ignore it.

In one job I had, I used to have a supply of earplugs I would give to parents, and instruct them to use them with their favorite music…so they wouldn’t engage in useless arguments and debates with their teenagers.

Because, as anyone with a teenager knows, it’s like arguing with a particularly obnoxious attorney. They’ll talk circles around you until you give in – just so they’ll shut up.

I have given parents behavioral charts and chore charts so they can let the child/teenager know what is expected of them (don’t just say, “clean your room,” because your definition of “clean” and theirs will probably be very different – be clear about what you want).  Complete with a point system and meaningful rewards for the child/teenager – not meaningful to the parents, and not “you get an iPhone for cleaning the bathroom on Saturday”.

To that, add consequences to the chart, if they don’t do things.  Not, “pull Jimmy off the sports team at school”, because that is what we call a “pro-social activity” and not something up for debate or loss.  More like, “Jimmy can’t go to the movies that week” or something like that.

If the parents do not see the difference between a pro-social activity like sports/choir/science club and a privilege like going to the movies, I know I have a lot of parent education to do.