Monday, August 6, 2012

It Matters Who Prescribes Your Medicine

I realize that I have never talked about what to do if you think you need treatment for a possible mental illness. There is really not enough information out there on how to find the help so I will be creating a few posts on the subject.

So today my first piece of advice on this topic is one I am adamant about:


While I love all you primary care physicians and I know you care about your patients, in my experience this has never worked out well. It has always led to larger problems.

You would not let your primary care physician treat you for cancer, heart disease, scoliosis, or anything that requires detailed knowledge of a condition. Mental illness is not different. First of all, you really need to be diagnosed by a psychiatrist to know if you have an actual mental illness. A primary care physician does not have the detailed knowledge of all different types of mental illness to diagnose you. Misdiagnosing you and giving you the wrong medication can be extremely dangerous, such as sending someone into a medication induced manic episode because they were misdiagnosed as depressed when they were really bipolar. "Studies show that 74% of people seeking help for depression will first go to their primary care physician. Of these cases, as many as 50% are misdiagnosed. Even of the cases that are correctly diagnosed, 80% are given too little medication for too short a time." Also, many primary care physicians do not know how to correctly take someone off a medication for mental illness which is dangerous as well.

Photo by Jeff Norris

Lastly, these medications are very tricky to handle and have many physical and psychological side effects. Your primary care physician needs to know the basics about many different medications in order to do their job. They do not have the time to know the detailed facts about specific medications for mental illness and the less common side effects they cause which are not listed in the drug information packet.

So, if you are in crisis and feel you need help right away, get admitted to a psychiatric ward. If not, then ask you primary care physician to refer you to a psychiatrist for prescriptions and a psychologist (or other licensed mental health therapy professional) for therapy. If you are on medication which you are worried about, do not just stop taking it. These medications need to be tapered down under a psychiatrists supervision.

There is an exception to my rule of never letting a primary care doctor prescribe for you, and that is if your insurance does not cover a psychiatrist and you can not afford one on your own. This happens to far too many people. My husband and I have accrued quite a bit of dept paying out of pocket for psychiatrists, psychologists, and other mental health treatments. For us, debt was better than death, but I am not recommending everyone make that decision. No matter what, get treatment though.  Fight for the best medical care you can get within the constraints you have.


Rev. Katie

For Some Additional Reading:
Antidepressants Over Prescribed in Primary Care
Should Family Doctors Treat Serious Mental Illness?

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