Part of the problem with this is no clear treatment plan works consistently for everybody. Insanity is as diverse as cancer, and even the DSM is used as a rough guess as to what is going on, based on what mix-and-match set of symptoms.
Each psych med takes a month to start, get stabilized and see if that’s an improvement. If it doesn’t work right (typical) then the options are to add another drug (and then more drugs to counter side-effects) and test it as a cocktail, or get the patient off the first drug (usually two weeks to get sober, during which they’re symptomatic) and another month to start something new. I went through over a dozen SSRI combinations and for a while had to settle on a cocktail that wasn’t terrible and was slightly less bad than going sober.
Then there’s a matter that we often cannot escape the toxic situations we’re in, whether we can’t move out of a situation with contentious roommates or are working for a company with cruel middle management and scary toilets and stinks of insecticide. I’d think any physician might argue that someone with a lung condition should be moved out of the moldy house they live in, but when it comes to environments that are psychologically unhealthy, we’re all expected to just deal.
And this informs my job in the psychiatric sector which is as a peer councilor. When patients are stressed out and their professionals aren’t doing it for them, they come to me, and the first think I ask is are you safe? Most of the time, they are – as with the rest of the US population – in precarity, sometimes not even knowing where their next meal is coming from or if they’ll have a place to live next week. But scary parents, scary roommates and scary bosses are also super common, and we’re not really going to be able to treat or even manage the crazy when people are fearing for their survival.
Part of the problem with this is no clear treatment plan works consistently for everybody. Insanity is as diverse as cancer, and even the DSM is used as a rough guess as to what is going on, based on what mix-and-match set of symptoms.
Each psych med takes a month to start, get stabilized and see if that’s an improvement. If it doesn’t work right (typical) then the options are to add another drug (and then more drugs to counter side-effects) and test it as a cocktail, or get the patient off the first drug (usually two weeks to get sober, during which they’re symptomatic) and another month to start something new. I went through over a dozen SSRI combinations and for a while had to settle on a cocktail that wasn’t terrible and was slightly less bad than going sober.
Then there’s a matter that we often cannot escape the toxic situations we’re in, whether we can’t move out of a situation with contentious roommates or are working for a company with cruel middle management and scary toilets and stinks of insecticide. I’d think any physician might argue that someone with a lung condition should be moved out of the moldy house they live in, but when it comes to environments that are psychologically unhealthy, we’re all expected to just deal.
And this informs my job in the psychiatric sector which is as a peer councilor. When patients are stressed out and their professionals aren’t doing it for them, they come to me, and the first think I ask is are you safe? Most of the time, they are – as with the rest of the US population – in precarity, sometimes not even knowing where their next meal is coming from or if they’ll have a place to live next week. But scary parents, scary roommates and scary bosses are also super common, and we’re not really going to be able to treat or even manage the crazy when people are fearing for their survival.