Let's play the devil's advocate here... I've known people who have lost their marbles once they stopped taking their meds. Are we rally saying that their grip on sanity was a placebo effect? Or are we saying that we're just treating the symptom? If it's just the symptom, who cares, as long as the drugs help people?
For context, I'm not on any psychiatric drugs, have never been on any, and think they're largely being abused by American society. But the extreme cases suggest to me that they have a use.
Let's play the devil's advocate here... I've known people who have lost their marbles once they stopped taking their meds. Are we rally saying that their grip on sanity was a placebo effect?
Well, the withdrawal effects for quite a few of these drugs includes various acute psychiatric symptoms, include suicide and homicide.
I lost one of my bests friends a number of years ago to this.
I'm not saying that I think it is the case, but a possible other hypothesis might be that they stopped taking their drugs because they began to lose their marbles again.
This and similar comments in this thread is a plausible guess, but it's fascinating how so many of the computer programmers here are domain experts that have thought of things that all the psychiatrists in the world haven't thought of yet. All psychiatrists have six years of basic scientific education before starting their specialization. They're not the unwashed idiots that people here seem to think.
I'm a big "weird crime" geek and pretty much every single one of them, if you dig deep enough (and quick enough--I've seen news articles "cleaned up" after-the-fact to remove references about medications. Doesn't need to be a conspiracy when we have HIPAA), you find that the perpetrator had either been prescribed new meds/upped dosage in the past week or discontinued suddenly. Also, it's a little bit like a miscarriage--if you talk about it even a little, the private stories come out of the woodwork. Some tragedies, some "holy cow, am I glad I figured out what made me want to buy a gun." What kills me is not knowing how many suicides could have been avoided. And that the word isn't out yet, how many more will we see?
I am seriously a little terrified about a mass shortage of these medications (SSRIs and antipsychotics aren't the only medications that can cause akathisia, delusion, homicidal/suicidal ideation...we've got Larium, ADHD meds, I even just read about a weight loss drug with suicidal ideation as a side effect...banned in Europe but A-OK in the US). How irresponsible if pharmaceutical companies just cut these drugs out without giving their patients a method of safely withdrawing from them... Dig around for withdrawal-induced crimes (especially at the local level; more data there), and you'll see that it's actually murderous. The least they can do is research which genotypes are most susceptible to dangerous side effects (for example, is it possible that people with the MTHFR gene mutation or other characteristics are hit with serious withdrawal symptoms?) to share with prescribing doctors.
> If it's just the symptom, who cares, as long as the drugs help people?
Because for many, these symptoms are not adequately addressed through more conservative means. There are numerous ways to attack an unusual disposition that do not involve medication -- exercising, weight loss, meditation, psychotherapy, cognitive behavioral therapy, rectifying family issues, finding a job. Many of these options are not adequately pursued. I have never seen a psychiatrist refer a patient to see a psychologist or a cognitive behavioral therapist, and they have no incentive to really.
On the other hand, where I live (a non-US country with public healthcare), you don't get in contact with a psychiatrist directly; you get referred to one from a therapist. The therapist decides which kind of treatment of your symptoms is best, where one of their options is to pass you off to a psychiatrist (who the therapist thinks of as "the guy who will mostly think of this in terms of prescribing medications.") Even when the therapist thinks medication is a good treatment regimen, they usually suggest combining it various forms of talk-therapy (in other words, to keep seeing them, as well as seeing the psychiatrist.) Those are some much more neatly-aligned incentives, I think.
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I have to say, though, as a separate issue: neuroaffective medications of all kinds (whether for chemical imbalances, or hormonal imbalances, or pain-management, etc.) are basically like crutches.
Your problem might not be "just" a chemical imbalance, just like your problem might not be "just" pain. But even if the cause is external, and the "true solution" is external, the symptoms the external problem is causing in you might be too debilitating for you to pursue the external solution on your own, while you're still afflicted. That's when you need a crutch.
If you break your leg, walking on it enough to get it to heal is usually far too painful to do all on your own. So, you get crutches. Now you can get some support to lessen the pain, while still walking on it to help it heal. If you lost your job while you were in the hospital for the leg-break, the crutch can let you go back to work before you otherwise would, which can give you the motivation to keep pushing yourself to heal, rather than just sitting around. Once your leg has healed, you don't need the crutch.
If you're clinically depressed, going out and doing things you'd otherwise enjoy is hard. SSRIs and the like are a crutch that let you feel less pessimistic about your situation, so you can pursue real sources of happiness (getting a better job, finding a relationship, etc.) Once you've done those things, you might not need the crutch.
Sometimes, though, we need crutches for life. Once you're old enough to need a cane or a walker, you're never going to not need a cane or a walker. Some people are born with conditions that put them in a wheelchair for their entire lives. If your problem is inherent to your physiology, there's no external problem to solve--so you'll always need the crutch.
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Here's the odd thing about neurotransmitter imbalances, though. I asked a psychiatrist friend of mine about whether, generally, his patients have obvious problems in their lives that could be possible causes of their symptoms, or whether they more often say things like "everything's great so I don't see why I'm so--". He said it was overwhelmingly the latter.
My pure guess to explain this data, is that something happened to our brain chemistry that paralleled the rise of near-/farsightedness as a genetic trait. After the rise of agriculture, sharp near/far vision stopped being something we had natural selection pressuring us to keep--and, unlike traits like height, it's hard to tell how well your partner can see, so it wasn't sexually selected, either. So the likelihood of your vision staying perfectly "in tune" with the reference point became pretty much random chance, with near-/far-sighted people mating with other near-/far-sighted people with no concern for the consequences.
So, just as our eyes have to be tuned to a certain reference point to work optimally, so do our neurotransmitter levels. And just like people don't much care if their partner can see well, people don't much care if their partner has strange moods sometimes (--in fact, some might prefer partners with a certain demeanor.) So we've let genetic drift and random crossovers take the place of selective pressure in determining our brain chemistry. A lot more people are born needing figurative wheelchairs than find themselves needing figurative crutches.
But a wheelchair is a bad metaphor, here, isn't it? A wheelchair is for someone who can't walk at all without it. Whereas, being slightly off your reference point, and using something to bring you back in line? Why, that's a lot more like wearing glasses!
For context, I'm not on any psychiatric drugs, have never been on any, and think they're largely being abused by American society. But the extreme cases suggest to me that they have a use.