The Problem with Handing Out Happy Pills
There are a few things in life that really get me going. I guess you would call them my pet peeves. Today I was reminded of one of them as I spent some time on Twitter connecting with my friends.
One of my friends lost her husband not too long ago. It was a devastating loss for her. My heart and support went out to her.
While I have never "met" her in person, I can tell from my interactions with her that she is smart, strong and resilient. She appears to be doing a solid job of dealing with this significant loss and moving on with her life. I know that she is still grieving, but honestly, I would be more worried if she wasn't.
So when she mentioned today that her primary care doctor thought she wasn't doing very well and offered her antidepressants, I was pissed. I know that my anger comes from my training in social work--the career that chronic illness has taken away from me. Even though I can no longer practice being a clinical social worker, all my social work education and experience hasn't become completely lost to me.
Here are the things about this situation that really bother me:
- Grieving is a healthy process. I think that the bigger the loss, the longer the time a person needs to process their grief and loss.
- With the exception of psychiatrists, the majority of medical doctors do not have adequate training to diagnose mental health disorders.
- If doctors were really trained to diagnose mental health disorders, they would keep a copy of the Diagnostics and Statistical Manual of Mental Disorders (DSM IV) in their offices. This is a publication of the American Psychiatric Association that lists all the commonly recognized mental disorders and their diagnostic criteria.
- If they kept a copy of the DSM IV in their office, they would know that grief is not a mental disorder. In addition, I believe the DSM cautions against diagnosing someone who is grieving with a mental disorder until at least 6 months have past since the loss.
The problematic thing here is that any medical doctor can prescribe psychotropic medications despite their lack of training in psychiatry. In addition, as a by-product of how dysfunctional our medical system is, many medical doctors do not refer their patients for a psychiatric assessment if they suspect a mental health problem. No, they "diagnose" depression and anxiety themselves, write a prescription and send their patients on their way.
That is not to say there isn't a role for medical doctors in the diagnosis of a mental health disorder. In fact, medical problems need to be ruled out first before a mental health diagnosis can be given. But I know from my own experiences that often the mental health card is played when a medical doctor can't figure out what is physically wrong with a patient.
I guess it is easier to call someone depressed or anxious and give them some "happy pills."
My friend's situation worries me. I also makes me wonder how often this is happening in doctors' offices across the country.
I know that there are fewer and fewer mental health professionals, like social workers, hired to be part of medical teams. I think this is a huge mistake. I believe being able to accurately diagnose mental health disorders and provide specific and appropriate treatment is as equally important as medical care. Rather than being housed in separate offices, building or locations, I think medical and mental health services need to be integrate.
My opinion is that adequate health care needs to include both the body and the mind.
I also think that if someone is going to be given a prescription for antidepressants or anti-anxiety medication, there first needs to be a thorough biopsychosocial assessment completed by a team of medical and mental health professionals.
That's my 2 cents.
sick chick, patient blogger & health advocate
Oh My Aches and Pains!