branching_twigs [none/use name]

I’m unsure how to reply to your comment. I don’t think I’ve experienced someone being so hateful towards me before. I’m sorry that I hurt you.

See my comment above for some elaboration, but I am not arguing that people should have their access to medication removed. And I don’t believe that the cure to mental health issues is self-help. We can discuss it further, but only if you would find it meaningful.

While I am (maybe a bit too) hyperbolic in my comment, I would never argue that we can eliminate mental illness, not even in a utopic world.

I also want to point out that I in no way whatsoever support deprescription in the sense of either force-tapering, removing access to medication or obstructing the path to recieve medical help.

When I have encountered ideas of deprescription previously, it has been connected to initiatives such as:

• Informed consent about what the side effects may be, and the difficulties that some people experience when stopping SSRIs.
• Better guidelines about how to stop or taper off SSRIs, along with regulation for companies to produce dosages small enough to taper off in a safe way.
• A call for professionals to stop viewing medication as the “final stop” of treatment, but as another tool in the toolbox, where different options should be explored as well.

All of which are aimed at helping people who don’t find their medication helpful and are either unable to stop without the proper help or have been told that they shouldn’t stop by their doctors.

It sure is. I just wish we could lessen the burden on people, so they wouldn’t have to go through all that in the first place.

Regarding ADHD specifically I think we (in most of the western world at least) live in societies that demand a lot from the individual regarding planning, structure, bureaucratic work and timeliness - all things that are difficult for most people with ADHD. So yes, that would be taking away their ability to function as members of society.

In this sense, ADHD medication is still not a cure, but a tradeoff that allow us to keep having the same expectation of peoples ability to comply with the above values, regardless of who they are. As the expectations become more demanding, so does the need for ADHD medication.

My original point was not that it is good to take away medication and leave people to themselves, but that (in the case of ADHD) embracing neurodiversity and the demands we put on each other as a society could lessen the need for medication, thereby making less medication = good. Of course this is very much an oversimplification of what would be needed.

For me, the biggest problem is that there appears to be very little awareness in politics about this tradeoff. Keeping the same kind of societal demands and also wanting less medication is impossible and harmful.

Just that one being ‘better’ in a best-of-all-worlds scenario doesn’t mean that we should disregard the other on an individual level, since circumstances might differ.

Of course its not as definitve as i made it out to be, that was just for the sake of making a point, as this is about mental health and not transportation (I also prefer my bike).

I generally agree, and the comparison was mostly to get the point across that medicatiin is not ‘bad’. But one could argue that there is a similar competition regarding the ideas of what constitutes a cure/treatment/wellbeing etc. The psychiatric and medical industry is very intent on furthering the use of psychiatric medication as the safe, correct and responsible way to deal with mental health issues, while downplaying the feasibility of other options.

I know many people who have had similar experiences. I think doctors should help people understand what it means to go on these types of medications in the first place - that it is not a cure but more of a trial-and-error experiment, which might help but can also result in severe side effects, and that other options are available.

Given that it is the US, and RFK specifically who is responsible, it’ll probably cause a lot of unnecessary suffering for the people who need it the most. But I believe the idea itself is actually neither wrong nor bad.

Long argument incoming:

There is no conclusive evidence supporting the idea, that any mental health issue is caused by a chemical imbalance in the brain. At the same time, there is plenty of research pointing to the contrary. The reasoning has basically been, that since introducing X chemical to the brain helps it must mean that lack of X is the problem - with no further evidence to support it. Two major arguments against this reasoning are as follows:

• There is evidence that medication increasing the uptake of serotonin lessen the symptoms of depression, but there is also evidence that medication decreasing the uptake of serotonin lessen the symptoms of depression. We can only conclude that some drugs work sometimes for some people, but not why they work.
• When going off antidepressant, antipsychotic or anti anxiety medication people experience withdrawal symptoms. These can range from mild to severe. This is why you need to slowly taper off. The reason we experience withdrawal symptoms is because the brain needs time to regulate itself back to normal - what we call homeostasis. When the withdrawal symptoms disappear it means that the brain has regulated its own uptake of X to fit with the previous levels. The fact that people who are depressed and use antidepressants are capable of homeostasis in regard to the specific chemical targeted by the drugs means that we are unable to account for what we really mean by a chemical imbalance, since imbalance implies a brain incapable of this.

By accepting the chemical imbalance hypothesis and using that reasoning when prescribing medication, we end up overprescribing medication while neglecting to investigate treatment that could actually be more helpful. This is a problem, since medication is both expensive and has many severe side-effects that people just have to live with if the only perceived alternative is to keep being depressed, psychotic, etc.

In the end it boils down to something akin to the cars vs. public transport debate. Public transport is undeniably better, but it requires the political commitment to invest in the necessary infrastructure. As long as this infrastructure is non-existent, and we live in a world of paved roads, owning a car can be a life saver.

The same can be said about psychiatric medication. It only becomes the necessary, or go-to, treatment because we are unwilling to address the bigger causes of our suffering - and by bigger I mean something much more drastic than just public transport infrastructure.

All of this to say, that the idea of deprescription can be helpful if we in turn focus on changing society and the way we live, both together and as individuals. However, merely limiting the access to psychiatric medication without changing anything else will only lead to suffering.