Wednesday, January 17, 2007

Psyched Out

Observations from within E2/E3, the acute Psychiatric Unit

We could all use a litle more common sense. We had this
one patient who shuffled around listlessly, his eyes half
shut, appearance dishelved, and hair unkempt. We asked him
daily why he appeared so somnolent and presented with so
much lethargy, as if it were too big a mystery to figure
out. This guy was juiced up on near-maximal doses of
Depakote, Haldol, Zyprexa, Lithium, Ativan, and Ambien,
each one, when taken individually at the therapeutic dose,
could likely do that to either you or me.

Our patients are disgruntled. We place them on mood
stabilizers and antipsychotics. We ask them daily why they
are feeling so irritable and vexed to be here, as if there
would be nothing incongruent with appearing content and
happy to be held against your will inside a locked acute
psychiatry unit. How do you react when you see someone
smiling in their mugshot? Does that not strike you as being
inconsistent?

Can a cocktail of the most clinically effective
antidepressants possibly ameliorate a depression caused
by the sores of troubled relaionships, exhausted financial
recources, and a life mired deeply in substance abuse? Do
pills really have the power to reforge troubled bonds,
replenish a lifetime of frivolous spending, and exhume a
life buried by drugs and alcohol?

So why do we continue to keep pushing meds? I am starting
to wonder whether all those free catered lunches have a part
to play in all of this? Are the pharm companines having it
their way unjustly?


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