Are we Overmedicating? Or is Our Health Care System Inadequate?

Are doctors over medicating? Or is it the system that sets doctors up for failure?

People who’ve read only the first part of my book, Beyond Blue, often categorize me as being “anti-med” or a “psychiatrist-hater,” because in the early chapters I describe the arduous journey through hell and back trying to find a doctor who could properly treat me.

The first six failed miserably.

Especially the one whom I dubbed “Pharma King” because his toxic cocktail of 16 or so pills a day nearly killed me. That was in addition to the Ativan he told me to pop every hour if I was feeling anxious, even though I had disclosed to him a history of substance abuse.

When people talk about overmedication in this country with respect to depression and anxiety – and this topic comes up a few times a week – I understand where they’re coming from. I’ve lived it. However, now that I’m working with an exceptional doctor who is none of the stereotypes that are pinned on psychiatrists today, I see the mental health care mess from a different, more nuanced perspective.

I think the problem is far more complicated than overmedication. In fact, I’d be more comfortable labeling it “really bad health care.” And if I had to pick a culprit, I’d point my finger at our health care insurance policies, not the doctors themselves.

Here’s the thing. Most good doctors don’t take insurance. They can’t. Because they can’t properly diagnose a person in 10 to 15 minutes. No one can.

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That’s when you get into medicating someone who maybe shouldn’t be medicated, or misdiagnosing the ADHD as manic depression. But you have to call it something by the time the ten-minute buzzer goes off. It’s a little like Jeopardy. You rush to collect the facts: Find out if a person is sleeping okay, eating okay, having sex, functioning at work, isolating from friends, thinking about dying, making plans to die, etc. And then you press the red button and give your best guess.

A few of the bad guesses I got back when I was shopping for a psychiatrist like a nanny were: ADHD, Borderline Personality, Major Depression, and NDBSD (Not Depressed But Sleep Deprived). Funny I never found that one in the DSM-IV.

On the contrary, my current doctor won’t accept a patient until he/she agrees to an initial assessment of two hours. Two hours. Can you imagine? Two hours to give a doctor your psychological history, family history, current symptoms – and an exhaustive reading of your non-verbal language as well – so that she can begin to paint the context or story around your illness that’s absolutely crucial in order to diagnose correctly. She keeps her patients accountable to things like diet, exercise, counseling, and meditation, and incorporates alternative therapies like omega-3 capsules into their recovery.

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Therese Borchard
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