September 9, 2014

Show Me The Pills.

Bite My Bark Rants 2 Comments

Ok I think it’s only fair to warn you that I’m still jobless. Not that I don’t have a job to go to but it seems my direct supervisor is on holidays for the next week and a half, so that leaves me here. I’m actually a lot less ragey, and a little more scientifically minded when I have no real work to do. The part of my brain that I use daily screams to be used, rather than the ragey side. So again today we have another more serious blog. Not that it’s not rant worthy, but my writing style changes dramatically, ok. Little I still curse, as you will notice. Some will find it more readable and others will miss the colourful flair of the really ranty blogs. Let’s just split the difference and call it even because this blog topic is actually a VERY serious one to me. It should be to you too.

You know what I should have been a bloody doctor. I know, I know you’re all thinking it’s cause I want to write myself an industrial sized prescription of Xanax. Which would be great, but no doctors can’t write themselves scripts like that. They need another doctor to do that, so Mr BmB would need to be a doctor too. Even then I think there would be ethical issues and some governing body, that would be the only one ever, would notice and act on it. Let’s face it our governing bodies, all but customs (at least here) are ass backwards. It’s a great old game of pass the buck or “that falls outside our jurisdiction” try x branch, to hear the same thing and be referred back to original governing body. Bloody brilliant. I’ve chased my tail so often trying to find which regulatory body does what with complaints, that I’m convinced that they all do nothing. Until they catch the token catch for the month. Great work plebs, stellar!

But back to doctors and the total mindfuck that is pharmaceuticals. No this is not a big pharma rant, I don’t think the government is trying to kill us, inject us with mind controlling substances or even generally trying to make a fuck load of money off us. I don’t believe in Chemtrails, I don’t think HIV and Ebola were created bio weapons and I really don’t think vaccinations cause more harm than good. Actually if you come at me with that I see instant red and am likely to fucken strangle you where you stand. I wit with children who have compromised immune systems and have had whooping cough myself as an adult. I was the walking (and pregnant at the time) dead, Master 1 who was vaccinated got the sniffles. But let’s save that for another day.

What I do believe is doctors hand out antidepressants, benzodiazepines and other mind altering substances on a whim. I DO recognise we have a largely depressed, anxious and diagnostic ridden society. Everyone gets a label and a script or 20. No questions asked. You feel sad? Here’s a pill, you feel anxious here’s a pill, usually here’s some Valium (the truth is you’re more likely to get Xanax on the black market here than from a doctor), you can’t sleep, here’s a pill. Actually some sleeping pills are over the counter.

Pills, pills, pills. This is where I feel doctors and big pharma have a lot to answer for. This is where they DO make their money and it’s in the most ethically fucked up way possible. See they are making psychological diagnosis based on a simple face to face meeting, no testing, no REAL questions being asked to actually really define and understand the said condition, how it’s affecting the patient, the factors reinforcing it and with no real understanding of how each of these antidepressants/benzo can affect a certain type of individual. Or any careful decision, see perceiving a last generation antidepressant over the new one? Stupid, think Effexor v Pristiq, which is basically the same drug but the molecular structure reversed. Pristiq is SAID to have less side effects and Effexor (both SNRIs) is said to have the most side effects. Both are as easy to come off as hereon FYI. Though true clinical data will show you Effexor generally does a much better job and Pristiq has the wonderful side effect of producing uncontrollable and near psychotic rage in up to 50% of the population. So which do you prescribe?  The answer is a SSRI (Lexapro is a nice starter) and then go to your SNRI. NEVE take Pristiq is the advice I’d give anyone. I’ve seen it in action and it was horrendous. And I’ve seen some really crazy psychological stuff. The best I can describe it is as a pure drug induced psychological break filled with rage.

I once had a doctor prescribe me BOTH Paxil and Zoloft in the same appointment. What they living fuck? These are both the same type of antidepressant drugs, best for depression and crap for anxiety, which is what I presented with! SSRI’s (selective serotonin reuptake inhibitors). Wow, had I taken both of those, as prescribed, I’d likely have ended up with serotonin shock syndrome and in the ER fighting for my life, which is rare but very very bad. Though would have been the outcome had I taken the drugs, especially at the dose he prescribed. I’d also still be anxious and likely now suicidal as well as hallucinating both visually and auditory. Would have made for fun times . He obviously wasn’t for the weaning in period either as both were standard mid range doses. Simultaneously. In short this doctor could have fucked my brain up so bad that god knows what could have happened, just like that, if I wasn’t versed in these drugs. Likely long-term too, fried. Luckily, I am smarter or at least more educated than said doctor in “brain meds”, though I can’t write scripts, oh the bloody irony.

I’ll be frank. I’m a lawyer/psychologist/behavioural analyst. I specialize in children but used to work with adults. Don’t start me on adults. I lost all perspective working in drug rehab, I’m not cut out for it because I don’t have the time or patience for excuses and no sense of personal responsibility. It didn’t end well for anyone. Children on the other hand, I can’t get enough of. Likely cause unlike adults, they don’t come with baggage, well except their parents and boy they can be hard work. But I do it for he kids. So these are things are way up my alley and probably will make me less anonymous than I’d like. I’m willing to take that stand and here is why.

I took Master 2 to the doctor yesterday. Like I said I’m NO doctor but the screaming from ear pain, temperature and history of ear infections, with the added bonus of having 3 other kids makes me an expert on middle ear infections. So yeah, stew on that awhile and any parents out there will agree once you’ve seen it once, you know it immediately the second, third or 100th time.

Now doctors are weirdly conservative when it comes to giving out antibiotics. I get the MRSA and super bug argument. I really do. But to be told, in an under 3-year-old where a burst eardrum can cause hearing loss is a real possibility “let’s just wait and see” made me all kinds of pissed. Come back in 2 days if not better, give ibuprofen for the pain and of for another $70 fee and we will give antibiotics that ARE needed now is fucking ridiculous. The kid had an ear infection. No temperature because the pain relief meds for the pain sure as fuck also covers temperatures. Catch 22. So do I bring my hysterical child into see you fuckwhit doctor unmedicated so he can scream your surgery down tomorrow? Or do you write me a script on the presumption I’m actually a smart parent, qualified to work with kids, you know this (would you believe I have and passed a federal police check?) or wait and see? Door number two seems more responsible. Less profitable for doctor and that’s the point isn’t it? I don’t believe for a second he was afraid of causing a super bug.

In said consultation I mention my anxiety. Yes I have it, yes I own it and it’s the remnants of a misspent youth, some untreated post natal depression and my history of yanking out huge chunks of serotonin and dopamine for recreational pleasure. Great times. I was under 25 so I blame my underdeveloped prefrontal cortex and the fact being fucking high felt good. Sue me. Oh anxiety? Here’s a script for 100 10mg Valium (big script) a repeat and some anti anxiety antidepressants to go with it. Now my file already says I’ve tried these antidepressants (and no they don’t target anxiety really like some better choice woukd) and they didn’t agree with me, like sent me all type of loopy, but “let’s try again”. Plus they are pretty much used for depression alone and anxiety isn’t something they are known to deal with. I’m not fucking depressed, so let’s amp up the already anxious patient, fucking brilliant.  Ok how about we don’t and say we did?

 

Truth be told I don’t need antidepressants for my anxiety, been that route WITH therapy and fixed my neural pathways. See I didn’t just go the band-aid drug route, I actually did the hard part of addressing the core issues. But hey, who’s going to do that unless you REALLY understand mental illness or have a doctor that s just not going to hurl pills at you? And Valium, being benzodiazepines are also very addictive pills. So great, lets turn me into a prescription pill junkie to get through life and deal with my occasional bouts of anxiety. Fucking doctor, you need your licence removed ASAP. No antibiotics for an ear infection, but here you go Mum become a prescription pill junkie.

Now I often joke about taking Xanax on here, I really don’t, it’s for funnies. So no I’m not a junkie and I really don’t want to become one because of the over prescription by a stupid doctor! Though I did fill script, it’s likely pills will expire before I use even a quarter of them.

What the living fuck? Let’s sure just fuck with brain chemistry on a whim, but antibiotics? No I’m not a suicide risk and a referral to a psychologist makes FAR more sense than throwing pills at me! Or a psychiatrist, as they specialise in the drugs and what they actually do and which ones are used for what. All SSRI’s are not created equal, then you have SNRI’s and MAO inhibitors. All antidepressants and some anti anxiety, all doing different thing in the brain, trying to receive the same outcome but the mechanisms are WAY different. Side effects are very different individual and a good clinical history will let you know which ones to prescribe. Not a 2 minute consult.

No fucking way. Pure fucking illogical. Master 2 ended up with a perforated eardrum overnight, hospital visit, large dose non standard antibiotics and the warning that there is  hearing loss possible. Pass me those 100 Valium please, I know where the original doctor lives (not my normal one) and we are sleeping in your couch with the screaming child at your place tonight. If he has hearing loss, you better kiss your ass goodbye because medical negligence is a real term and I’m coming after you with all guns blazing. Its STANDARD practice to give an under 3 antibiotics for a suspected, or even “maybe” ear infection. I know this and I’m not a BLOODY doctor.

Which brings me back to antidepressants and all drugs related to benzodiazepines (think Valium, Xanax and anything that has the “pam” in it, temazapam) and the list goes on and on and on. Handed out like candy and no psychological testing needing. Pills all round! Antibiotics? Good fucking luck. Unless you’re 5 days in and the “it’s viral” just won’t cut it. Oh and of course that bacterial infection we see now? Side effect if original viral infection, regardless for the infected snot, pussing eyes or my favourite ever was “they grey you see on master 4’s tonsils, not puss spit” at the time of initial consultation. It was advanced tonsillitis, confirmed an hour after that consult and a recurring issue for master 4 (now 6) ENT took one look, almost died and they came out a week later after infection had subsided….

I hear the doctor counting his money as we speak! I’m not downplaying the risks of super bugs here, but to the part of negligence when it comes to treating a 2 year olds ear infection or infections of the head, bloody too close to the brain for comfort. Fucking ridiculous. Obviously the risk of perforated eardrum are greater than creating a super bug from an ear infection here…. Perforated eardrum proves my point…. But fuck I have 1000 or so 10mg Valium, that should calm me right?

We live in a culture where a lot a lot if anxiety and depression is STATE related or even TRAIT related. It’s a huge debate but what we do know is genetics play a huge part (trait). We all have different thresholds for what we can handle in the moment (state) but it’s highly influenced by trait or basically genetics or now set in stone anxious/depressed neural pathways. Too much anxiety/depression and our brain rewires it as a go to response. The same physiological reaction, say excitement, is interpreted as anxiety, because of pathways. The brain is wonderful and confusing all at the same time. Neural pathway dx interpret physiological responses or lead us too. So you can see if overused and highly developed how excitement is confused for anxiety. It sucks.

A great example of genetic and inherent predisposition to anxiety and depression is prenatal material exposure to cortisol levels (stress hormone) produced by the mothers and then the in utero it changes or damages the babies neural pathways in the brain as they develop. Baby now has high cortisol levels, so guess which pathways develop? So high maternal anxiety/depression in a pregnant mum ups the chance if these disorders in their children  as adults a few measly 1000 percent. Do we prescribe pregnant mothers antidepressant and SAFE anti anxiety meds? Fuck no, we live in a ligation happy society and one that judges the fuck out of pregnant Mum’s and a society where doctors don’t actually keep up to date with specific research like this, unless they are a specialist. Take a drug prescribed like an antidepressant during pregnancy, you get fried by both doctors who have no clue and the community at large. Though not eat food with a real risk of harming your baby and they accuse us of being paranoid and over-cautious. It’s fucked up. I actually know TWO women who lost babies late-term to toxoplasmosis. It’s a real risk, don’t doubt it.

I hear you thinking they are bad for baby. No, most (bar Xanax) fall in category B (A being safest and risk free and X being a total no go zone), like Panadol or Tylenol or amoxicillin I think you Americans call it Tylenol . It’s not like fucking category X drugs like Xanax and lithium. Personally I chose the class B drugs (with nothing to suggest there will be any damage based on animal studies because ethically they can’t test on pregnant women… Though your OB should be informed as baby has a very slight risk of breathing difficulties for the first 48 hours but we are talking like 1: 500 009) for the last two and I can tell you, no harm, no foul and the kid I had the most anxiety with Miss 4, we will walk the same bitch road in life. I went unmedicated due to anxious fear and she coincidently is my high-strung child. Peer reviewed studies have now come out to conclusively prove that an anxious or depressed mother is very likely to produce an anxious or depressed child/adult. But still they don’t medicate mum, because of the fear of litigation and because they don’t EVER explain this to Mum or that meds might long term be better FOR baby. Unless you get a doctor who really KNOWS their prenatal shit. In the words of my neonatal psychiatrist  “this one little pill will give you your life back and it will save that the baby you are carrying from walking the same path. There are just as many risks in taking this as a safe antibiotic”. That’s sure as shit changed my stance on medicating pregnant women on the spot AND I’m trained in this field.

This is all related but beside the point. Some sobering stats her 1:3 people are clinically depressed, 1:5 clinically anxious and it’s STATE related the VAST majority of the time. No chemical imbalance, life just sucks hairy balls. Now for some it’s chemical, imbalance of serotonin , norepinephrine, dopamine or a combo. Generally a combo deal. Chemical imbalances NEED antidepressants for a minimum 24 month to rebuild neural pathways and make the ones that fucking make us miserable able to function. This is peer-reviewed at 10% of the population who receive these meds actually NEED them for this. The other 90% (state) need therapy, to learn coping strategies and perhaps short-term anti anxiety/depression drugs to get them to a place where therapy is useful and workable. If a doctor tells you you need them for life, without a brain scan, walk out then and there and don’t look back. If a doctor tells you to stop taking meds, before 18-24 months because you feel better, same principle applies. They are idiots.

But nope throw them a fist full of pills, that will fix it, seems to be the current theory of GPs. You know they aren’t brain specialists right? It shows. Underlying issue be damned and the GPs just throw them at you like they are candy. Very rarely do they refer on to a mental health professional. So this is not a great long-term strategy and will also fuck big time with your brain chemistry and can go all types if bad. Children under 16 are known to have increased risk if suicidal thoughts when medicated with antidepressants (Paxil and Zoloft I’m looking right at you). So I’m left scratching my head at the prescriptions handed out like toilet paper. It’s a fucking travesty. Fucking with the brain chemicals in a developing brain of kids/teenagers, yeah that’s TollPriority type rage territory.  These doctors must be snorting some real good shit to sleep at night!

I do understand the irony of saying antidepressants shouldn’t be handed out like lollies but should be ok for pregnant women. But you see my reasoning is sound.

This brings me to the over diagnosis part of my rant and working with children I see it all the time. First it was ADD, then ADHD, then Autism Spectrum Disorder and now the more mind-boggling bipolar in children and conduct disorder. They are the “fad” diagnosis of the moment and the diagnostic rates increase far more than the rate if our understanding of these disorders in childhood. Yes they do exist, but in the fad numbers? Nope. Don’t get me wrong, all but ADD I’m convinced exist (peer-reviewed studies recently out if The Netherlands now call it mainly a variation if normal) Though yes there are outliers that fit ADD as a real diagnosis, not knocking that. Some kids really just so do need to move to learn. It’s not an actual mental or medical condition, it’s a personality trait. Hard to manage, but aren’t we all? Plus it’s NOT a disability AT ALL. You find these kids just think outside the box and given free rein they can have the potential that the rest of us only can dream of. Seriously.

Obviously though, you need to work on developing the area’s of weaknesses these strengths can create. Hey no one is perfect right? We all have weaknesses and they aren’t thought of as disabilities, this is NO different!

Fuck a 6 year kid has the average attention span of 6 minutes, this generally goes minutes by age. But diagnostic rates are through the roof and the new DSM-5 have reigned this in or at least attempting to. Let’s see how that pans out. To put this in perspective the latest research out if the USA (peer-reviewed, let’s assume that the quality if the research I state from here on in, it’s tedious to keep writing) shows 70% of diagnosed ASD (did I ever define that, Autism Spectrum Disorder) especially the now defunct Asperger’s and the fall off and the very high functioning individuals (i.e. those like Master 6 who has quirks) are being reeled right back in are misdiagnosis or the new umbrella term Communication Disorder, which exists too I’m sure but to reclassify a quirky child with it cause you got it wrong to start with, I really want to cut you, bad. That’s fucking huge.

Then think about it now, fuck because this spectrum disorder has already been diagnosed it’s on your kids record for LIFE cause it’s impossible to have a diagnosis removed, unless they trade for another… Or you bang really hard on some fucking important doors. But I’m telling you as a professional, it’s as close to impossible as anything gets.

Yes Jenny McCartney you fucking bitch I’m talking to you. Your ASD diagnosis for your then 2-year-old IS Landau–Kleffner Syndrome. No you haven’t beaten science, cured autism but created a whole clusterfuck of parents wondering what they are doing wrong. The answer is NOTHING! LKF mimics ASD, the regression at the same points but has the substantial requisition of skills period between 8 and 12. Sound familiar? As a professional it’s as clear as day. So her whole anti vax, MMR causes autism (recently totally and definitely debunked and her epic back pedal ) is just a plethora of law suites waiting to happen. This is why playboy bunnies are paid to photograph and not talk. She has a whole  generation of unvaccinated children, likely deaths on her hands and her stupidity opens the door for a good old litigation case or a million. She always sticks to the line “he was diagnosed with ASD by professionals at 2 and now he’s better” Two points; ASD average diagnosis is 4.5 (unless very low functioning) before this should NEVER happen (unless very low functioning and then its a preliminary diagnosis to be reviewed AT 4)  and she never actually takes accountability, passes the buck to the doctors. She states he is ASD free now, no shit, he never had it to start with bitch. She has a great legal team obviously. Too bad she didn’t take the moral high ground and actually advocate for better diagnosis, admit they were wrong and inform the public of how it can all go horribly wrong. THAT I would respect, not the avoidance of lawsuits.

So to my next point. What are diagnosis? They are a label of random related symptoms that every child has to some degree, it’s whether it falls within the parameters of “normal for age”. Issues with term normal and the fact age as the yardstick, we all develop at different rates. Labels? They are a box. Pop kid in box and we are good to go, right? Wrong. Children and childhood disorders are not boxale, they are as unique as the child. They serve two main purposes, to appease parents and to get funding. Well fuck that. No one is sticking a label on my kid to make me feel better or unless they absolutely need funding. Given we have a great health care system and these service are bulk billed with a GP referral to a specialist. You know where the funding goes? To the schools OR the parents. Hmmmm.

If under 6 at time if diagnosis they get between 40-60k a year per child, needed or not. So you can see why schools push for assessment in children that might have some quirks. I went through this with master 6. I KNOW he has quirks, don’t we all but to appease his private school we spent crap load of money and wasted a professionals time, which could be better utalised just so we could give them the finger. No funding for you I’m afraid. Suck it. Also a big fat “I told you so, I do this for a fucking living and am getting a PhD in it, I’m not just talking out my ass and I’m WAY more educated than your Learning Services Coordinator in this stuff. Fucking listen to me ok?)

Strengths and weaknesses parents is what SHOULD be looked at. Putting  a label on your child that defines them, they grow into, limits then and stigmatises them. Why? The label means shit all really. That’s my professional standpoint. Your kids are not a label, they are an individual person and need to be viewed and treated as such. I strongly advise parents to avoid getting a label no matter the force they put on you unless ABSOLUTELY NECESSARY! I do admit in 20% if cases it’s necessary. It’s like saying “your kid has a virus”…. Ok great it gives you a general idea of what to expect but not much more than general. That’s what these labels do. The sad part is they come to define the individual and put limitations on them, through others perceptions of the condition or even the child’s own self beliefs. They ise them as a way to identify themselves. A bit of understanding is ok but to identify as a label, no! It’s NOT a good thing, trust me. As a parent yes you might feel some relief at knowing WHAT is going on, but I strongly  urge you to stop at the SUSPECTED part of the conversation and never get the formal diagnosis. You know, they know but your child isn’t boxed, labeled or limited for life. It’s all about working on strengths and weaknesses.

So this rambling brings me full circle to over medication of addictive drugs, under prescription of antibiotics and handing out brain altering drugs to children (Ritalin/Adderal are now either now off the market for being unsafe or being investigated for safety, imagine that, clean amphetamines being unsafe on a daily basis) and a society that thinks pill cure-all and a diagnosis in children is a good thing. Parents push for diagnosis, trust me I’m not the clinician for you if you come seeking one, you can see the dollar signs in their eyes. Oh there are more if those parents than you would even care to believe. I hate them! A pay check for a diagnosis? All types of disgusting and my door WILL hit you on the ass as fast as I can get you out of there AFTER giving you a piece of my mind and I will NOT hold back! Looking for meds as a first resort and you’ll be lucky if you can walk out of my office. Medication is NOT the answer 99% of the time, behavioural analysis and individulised intervention is. Sure it goes against the pop a pill to cure culture we live in, but guess what? Just because culture is one way doesn’t mean we should accept it. This is a prime example. Medication for children? LAST fucking resort, no exception.

Just throw a pill at it, mask the symptoms and lets not recognise that if we had medicated “quirky”  people throughout history some of the greatest minds would have been dulled back into “normal” territory. You think Einstein wasn’t on the spectrum? You think Stephen Hawking isn’t on the spectrum? The list goes on and on. But we didn’t medicate these minds to fit the mould that is “normal” and yes while they struggled, with our better understanding of mental health and greater services available, all those kids out there who might fit a diagnostic label, they will be the ones who achieve great things. Just because they see the world differently and have different struggles is NOT a bad thing, the difficulties can be managed but you don’t do that by medicating the things that make them what they are and stifling their potential also.

See having a diagnosable condition is NOT a curse, it sure as shit hits the parents hard because they all want a “normal” child, what they fail to see is they have an exceptional child. Of course low functioning children and parents of them I’m not taking away from your heartache and struggle. I’m talking to the high functioning, mid range functioning parents. Master 6 could easily have been diagnosed as Asperger’s, just like his Dad had I not been trained enough to implement strategies early, so he didn’t qualify. But this child that would have been labeled as Autistic and ADHD? 4 grades ahead in math, in science, in reading and I swear is brighter than myself and Mr BmB put together. I’m not dumb. Plus giving a 5 year kid a progressive matrices test to test IQ? Stupid and poor clinical practice, but it’s done every day.

I urge parents to be informed, do not ever let anyone label or medicate your child or see them as a diagnosis or a funding ticket. They are way fucking more than that! They are a little being with undefinable potential and it’s your responsibility to make sure no one medicates’ or labels them and takes that away. You owe it to them.

The world is fucking demented and ass backwards!