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    Suave
    Admin

    I read a fascinating book over Shabbos by Dr. Richard Louis Miller who highlighted the fact that many antidepressants, stimulants & anti-psychotics are prescribed by general practitioners & pediatricians rather than mental health specialists. Ultimately this leads to higher addiction rates and more severe withdrawal symptoms (which may just result in an endless loop of drugs being prescribed over & over again to treat a problem which may never have even existed in the first place)

    At least one study (based on data of 6.3 million children) found that significantly fewer children took psychiatric drugs than would be expected given psychiatric disorder prevalence rates.

    Some interesting data from that study shows:

    • Less than one percent of the youngest children took psychiatric medications, undermining the notion that very young children take dangerous drugs they don’t need.
    • 1 in 12 children have ADHD, yet only 1 in 20 took ADHD medications.

    This study conclusively undermines any claim that children are over-medicated. Indeed, it suggests that children may not be getting the psychiatric medications they need. Perhaps the question then is are we misdiagnosing children rather over-prescribing?

    I find that physicians (especially in the larger medical centers & clinics catering to the Jewish community) generally spend less than 15 minutes with the patient per visit, maybe less on follow-up visits. Is that enough time to properly diagnose a mental health condition? Should psychotropic drugs even be prescribed by nurses & physicians in the first place?

    Prozac was the first SSRI (serotonin-specific reuptake inhibitor) to hit the market back in 1988. It was touted as a wonder drug, and our society’s use of antidepressants and other psychiatric drugs soared dramatically. Today in the United States, more than one in five adults — and more than one in 20 children and adolescents — take a psychiatric drug on a daily basis. Yet even as more and more people have been getting medical treatment for psychiatric disorders, the number of adults on government disability due to these disorders has more than tripled since SSRI’s started to become mainstream. The number of children so disabled by psychiatric disorders has increased more than 30-fold during this period.

    Perhaps the Frum community has been slower to acclimate to this new psychotropic “paradise” due to stigma & limited access to mass media – which I believe is a blessing in disguise.  Pharmaceutical companies spend billions of dollars on TV commercials, magazine ads & other forms of advertising resulting in a surge of patients asking to be prescribed to specific medications. Does that mean that families in insular chassidish (hassidic) communities are better off because they are not bombarded by ads for Zoloft, Lexapro, Xanax or Ambien? Or are they just suffering in silence, unaware that a family member may be affected by a mental health condition that can be treated? Obviously we need to do more for mental heath awareness in the Jewish community, but to what extent?

    I find it fascinating yet sad that 40 million Americans & 1 in 4 children are affecting by anxiety disorders such as GAD (Generalized Anxiety Disorder), PD (Panic Disorder), SAD (Social Anxiety Disorder) etc. yet less than half are receiving treatment. Even more of a crisis than the number of those diagnosed with anxiety is the number of people who are addicted to the drugs that treat it — and the rising number of people dying from overdoses. Many mental health experts are claiming that benzodiazepine addiction is an epidemic as frightening and serious as the opioid crisis.

    We know that being an orthodox Jewish mother is a difficult job. Doing laundry for 8 young children, cooking festive meals fit for kings every Erev Shabbos, joining the workforce so that their husbands can stay in kollel, finding shiduchim in an ever changing marketplace, dealing with genetic conditions & chronic illnesses which seem to target the frum world exclusively, i can keep going…  All while maintaining a sense of normalcy and showing their family, friends & neighbors that everything is OK – often by suppressing emotional issues, ignoring obvious mental health symptoms and/or living in blissful ignorance or rather outright denial.

    I started writing this post hoping to get mental health experts to weigh in on whether we are over-medicating or misdiagnosing mental health concerns, but now it seems I have several new (perhaps contradictory) questions to ask.

    1. Psychiatrists: Do you think it is OK for general practitioners, pediatricians, nurses & other non mental health professionals to prescribe psychotropics, anti-depressants, stimulants etc?
    2. Psychologists: Do you believe we should focus more on non-drug treatment methods such as CBT (Cognitive Behavioral Therapy)?
    3. Do you think we are more immune to common mental health disorders due to our limited exposure to mass media, safer schools, more balanced lifestyle (due to shabbos, torah, taharas hamishpacha etc)?
    4. Are we benefiting from the fact that big pharma can’t bombard us with misleading drug advertisements as easily?

    Hello Suave,

    You are bringing to light some excellent points. The statistics speak for themselves in that we have multiplied significantly the usage of psychotropic drugs. There are a lot of factors that play into this and while people are certainly turning to drug use more readily, we have to look at the root cause. It is clear that there is more mental illness in general. Why is there such a significant rise of mental illness?

    Perhaps the same sociological factors that are contributing to more depression, narcissism, anxiety, and general psychopathology is also the culprit that lends itself to encouraging a “quick fix” rather than years of hard work?

    What are your thoughts on that?

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    LoyalYingel
    Participant

    The notion that the medical community is responsible for my addiction is futile

    Because

    It’s my addiction. The doctors are not going to solve it even if they wanted to. And here’s the kicker. If I’m gobbling pills there’s something wrong with me. Me. The substance abuse is merely a symptom. So much to the dismay of our modern society, we need to stop playing victim. Again. We need to stop playing victim. Looking back Will do nothing for you. Doctors will not solve the problem because if it’s addiction, the problem is not medical, it’s spiritual. It’s you. Like the recovering drunks and junkies say you need to find a power greater than yourself because you don’t have the power to live life without the substance. And like they say the joy is in the journey

    Yaakov

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    Chavy
    Participant

    I hear what you’re saying, but I think that even though the individual placed it on themselves, doctors can still help. I’m not sure why you’re of the opinion that they can’t help.

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    Chavy
    Participant

    I also think that you’re alluding to the 12 steps program in your post. That can most definitely be of help.

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    LoyalYingel
    Participant
    • Congrats. You missed my point. Like, woosh. Being addicted to a substance is as much my fault as being allergic to poison ivy. Really.  So how can a doctor solve addiction?
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    Chavy
    Participant

    A doctor can’t solve it but he can help it. A doctor can give a medication that will lower the desire for the drug. A doctor can help by offering support. Yes, and it’s also in the addicts hand. I don’t think it’s all-or-nothing.

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    LoyalYingel
    Participant

    Yes. We have drugs that cut down on the craving etc etc. This kind of treatment has a lousy track record for the simple reason that it’s not a cure for alcoholism or addiction only drinking and drugging. The disease of addiction is much deeper than the obsessive compulsive symptomatology.

    The support of a medical doctor is not nearly as valuable as the support of a recovering alcoholic or addict giving it to me straight. Mainlining hope. For free.

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    Chavy
    Participant

    In response to LoyalYingel's post #9316:

    For sure. That’s why AA is so important.

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    LoyalYingel
    Participant

    AA is a phenomenal light guiding the alcoholic out of the  shackles of misery and oblivion of alcohol addiction. There’s just one thing I don’t get. As far as recovery from substances, and if I were a drug addict, I would question for myself going to AA as so many addicts do. I would look very carefully into NA.

    Now I know what you’re going to ask me. Maybe even a few questions. But here’s the deal. People assume alcoholics and drug addicts are the same just one on booze and one on dope but nothing could be further from the truth. In my experience it’s a different personality, a different personality disorder. And as important as the group is, so important as a matter of fact that it breaks the addict out of the context and the framework of isolation and gives him/ her renewed purpose of living, it works best when I relate in personality to my group and it’s literature and the purpose and drive of it’s organization.

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    OnAndonAnon
    Participant

    Suave, I have to be honest – that was too wordy for me at this time of day :).

    But I think there is truth to what I seem to have understood. It is entirely possible that the 15-minute-insurance-billing medical practices Are over prescribing SSR’a and the like, that might lead to a dependency which is perhaps different than addiction.

    Chemical dependence is about the need for the substance, while addiction is an entirely different animal and is an escape through substance (or processes).

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