| "Want to know what you almost never see in the studies investigating the effectiveness of these “therapies”? Life outcome investigations. “Do patients doing CBT actually recover from their depression, as measured by educational attainment/employment/regaining employment?” That's actually exactly how they measure the efficacy of many psychological and psychiatric interventions for chronic mental health conditions, to the point of it being almost laughable, like if you managed to get a job or get better grades, that must mean you are doing better, everything else be damned. But I suppose that's the most objective metric there is. "They stay on the $200/session revenue stream forever and get a lifetime prescription to go with it" This is anecdotal, but every psychiatrist I've been to has attempted to titrate down the dose or remove a medication from my regimen if I've been on it a while, and observe if the improvements from those can be maintained. Similarly, most of the therapists I have worked with proactively suggested reducing the frequency of sessions once they've observed improvement. "often for a nebulous “condition” that is basically synonymous with descriptions of the normal human condition. “I feel anxious” gets you a script. Outside of panic attacks, it’s a normal feeling. “I have trouble focusing” gets you an amphetamine script. It’s a normal feeling. “I lack motivation and purpose” gets you an SSRI, with nary a blood test or a scan of the brain. Again, a perfectly normal part of being a human." It's attitudes like these that contributed to me failing to seek the proper mental health treatment until later in my life, until my very real, very observable, non-nebulous conditions reached a life-threatening degree. Something that is "normal" for some people some of the time can be disabling or life-threatening if experienced by someone most of the time. Most people experience physical pain at some points in their lives, but if you are in serious pain nearly every day, you would be right to seek treatment — and no, we don't have perfect tests for all kinds of pain either. The fields of psychiatry and psychology have many problems, but being a pseudoscience is not one of them. |
The SOP for every psychiatrist I've ever seen (and that's probably nearing 100 or so by now, over 30 years, 3 states and a dozen clinics) is to medicate until the patient is responding well, and to never ever even suggest that the patient should slow down, reduce or stop any medication. Because if the patient did so it would represent a clear and present danger and obstacle to recovery. The patient is seriously mentally ill and must take medications w, x, y and z for the rest of his life. Unless one of them creates a lot of side effects and then we'll tinker endlessly with new and different medications until he stops complaining so much of side effects, and/or he's too doped up and sleepy to care anyway.
It is absolutely preposterous for any psychiatrist to suggest that a patient titrate off drugs "to see what happens" or "just in case they've recovered". That's antithetical to their treatment methods which specify that chronic psychiatric illnesses must be treated with daily doses of medications with vague primary effects that can never be stopped.