The month of May brings so many things to celebrate: better weather, May flowers, Mother's Day, Nurses' Week. But on a more sober note, did you know that it's also Mental Health Awareness Month?
Most people don't. That's because mental health is still considered something of a taboo subject in our society, even though 1 in 4 Americans has a diagnosable mental disorder and/or cares about someone who does. We don't like to talk about it because there is such a negative stigma attached; it's as if we keep quiet, "it" won't happen to us. But psychiatric illness is no respecter of income level, personal attributes or social status, and it can strike at any time during one's lifespan.
So if your last exposure to mental health issues was during your psych rotation in nursing school, get educated. Visit reliable websites such as Psych Central for the latest research. Read scholarly articles on mental health topics in nursing journals. Better yet, talk (and listen!) to someone you know who lives with depression, OCD, bipolar, or other mental illnesses. You will learn that people with MI can have full and satisfying lives, and that we're just like you---we work hard, love our families, and do our best to play by the rules even though our disorder(s) may make it difficult at times.
I hope to see lots of responses to this thread. The dialogue needs to go beyond the latest mass shooting and/or what to do with the vast number of mentally ill homeless people. The issues are much more complex, and nobody knows that better than those who struggle with MI, not only in May but every day of the year.
As far as the one in four goes... I dunno, I don't know many people who don't have mental illness. My Mama had ADHD and depression, my grandma has been on Valium since the '50s, my Dad is undiagnosed SOMETHING (pretty sure bipolar and ADHD and maybe depression), my brothers both have ADHD, one of 'em is an alcoholic, one of my multitude of cousins is bipolar, several are drug addicts, my grandfather was an alcoholic... You get the drift. My in-laws and my husband are pretty neuronormal, though. It's fun hanging out with them, they're so out of my reference zone!
As far as Big Pharma goes... for me, anyone who uses that term seriously gets relegated to the "ignore" and "zero credibility" lists.
I have a lot of pretty messed up family and loved ones. I am not unmarked myself. My brother somehow turned out normal, and we all marvel at him.
I'll avoid those words then, cani, and try to avoid sensationalized wording: The pharmaceutical industry is made of massive for-profit businesses. There are a lot of good, brilliant people involved who genuinely care about doing good, and there are also many who don't. For decades, drug companies have been waiting for patents to expire then re-releasing drugs that are enantiomers, metabolites, extended release, or just different enough to have a different chemical (generic) name under a new patent. Some medications, like Claritin, are only minimally more effective than a placebo. Many are not more effective than existing treatments. It's done for profit.
To keep it relevant, this affects people's ability to access needed medications related to their mental health. For example, the Medicaid patient who was prescribed escitalopram (Lexapro). Medicaid wouldn't cover it because it was only available in brand name when I worked in the pharmacy, but citalopram (Celexa) is a nearly identical medication that would have been covered as a generic. If memory serves, Effexor was released first, then Effexor XR, so people who were prescribed Effexor XR often could not afford it because it was not available as generic. I'm having trouble finding dates on that med, but I'll add a blip from an FDA page about it: "The prescribing information (label) for [generic Effexor XR] may differ from that of Effexor XR capsules because some uses of the drug and parts of the label are protected by patents and/or exclusivity held by the Effexor manufacturer, Wyeth Pharmaceuticals Inc." In other words, even if a generic is released, sometimes generic manufacturers can't even use the same claims as the brand because the patenting company still "owns" some indications.
We advocated for a change of med or for the doc to take steps to get the med covered (pharmacy plays relay; no power to get the insurance company to cover it, just to play phone tag), but doctors were usually blithely unaware of cost, and far too often refused to flex to meet the patients' needs.
I was burned pretty badly by "side effects" of an antidepressant in 2011 and will never take a psychotropic medication again, but they are a valid treatment option and should be accessible to financially limited patients.
I love Carrie Fisher (and her dog Gary Fisher). Her sense of humor is amazing. She embraces bipolar disorder and handles it with grace.
My sister-in-law is ... not so nice about mental illness. She was reading a story about Carrie Fisher and her struggles with mental illness and substance abuse in People magazine several months ago and was going on and on about how she couldn't believe how crazy she was, can you believe she takes Lithium, does ECT, people like that should just stay quiet about their disorder blah blah yadda. She was honestly looking at me like I would agree with her (she did not know at the time of my diagnosis of bipolar disorder). Before I could say anything, my mother-in-law said, "Whoops, I forgot to take my meds." Proceeded to the kitchen to get her psych meds (3 of them). Then said to my sister-in-law, "it's too bad there's no medication for you to take for your nasty attitude."
I love my mother-in-law. That was the first time she told anyone she was having troubles.
Carrie Fisher and your MIL are bad mothers. I don't mean that as an insult, I just can't swear here...
We should just start signing our names with our dx.
Glycerine, GAD, ADHD, NVLD, PMS, BSC! ;-)
I hate the taboo as well. We treat all sorts of issues that we can't "see". I don't see the difference between a pancreas that isn't functioning properly or an issue with neurotransmitters. *shrugs*
We should just start signing our names with our dx.
Glycerine, GAD, ADHD, NVLD, PMS, BSC! ;-)
I hate the taboo as well. We treat all sorts of issues that we can't "see". I don't see the difference between a pancreas that isn't functioning properly or an issue with neurotransmitters. *shrugs*
Amen. It's like you can only treat mental illness if there's a physical cause. Forget the idiopathic schizophrenias, bipolar disorder, etc. Those are perceived as "crazy" and are stigmatized. But if someone has a TBI or CVA that causes them to be emotionally labile, manipulative, etc, then it's a condition worthy of sympathy.
I have a history of depression & anxiety related to a sexual assault that occurred during my early teen years. Then there was also my extremely dysfunctional childhood, and my family history of mental disorders that no one talks about. My husband also suffers from terrible anxiety.
I worry for our children. I know how awful our mental health system is and I know how likely it is they will have similar issues as well.
I certainly hope you never had to deal with a family member with a mental disorder. Especially a child or grandchild.
My grandma was schizophrenic. My cousins daughter has bipolar disorder with schizoid personality disorder. My sister, mother and I all have depression. I have an eating disorder. My nephews have ADHD, and one has bipolar. We all live this reality. It has NOTHING to do with big pharma. It's hard to watch your younger cousins deal with a stigmatizing disorder.
Big pharma isn't making up these disorders. It's reality for millions of Americans. Most homeless have some form of mental disorders.
Do you think that postpartum depression is real? Or is that another conspiracy from big pharma?
I did not claim than anything wasn't "real".
Big Pharma makes money from people taking drugs for psychiatric disorders. Big Pharma puts pressure on [whoever makes new psychiatric disorders] to make a new disorder so they can come up with a new drug to treat that disorder.
Hope you never have to deal with a "made up" psychiatric disorder in yourself or a loved one.
I have generalized anxiety and chronic major depression.
*makes tinfoil sailboat*
Actually, mental illness didn't exist before 1247, when the Bethlem Royal Hospital opened as the first lunatic asylum. Since this was before Big Pharma, I suspect it was Big Hotel, who wanted residents that couldn't leave at the end of their vacation, that created mental illness.
The drug industry does some stupid things (like shift work disorder - your body wanting to sleep at night is a disorder? puh-lease) but you need to educate yourself before you claim mental health isn't a valid medical (and human) need.
This is the kind of thing I was talking about.
I don't recall ever sayin it wasn't a "valid medical need".
Thanks for bringing this up, Viva.
As far as the one in four goes... I dunno, I don't know many people who don't have mental illness. My Mama had ADHD and depression, my grandma has been on Valium since the '50s, my Dad is undiagnosed SOMETHING (pretty sure bipolar and ADHD and maybe depression), my brothers both have ADHD, one of 'em is an alcoholic, one of my multitude of cousins is bipolar, several are drug addicts, my grandfather was an alcoholic... You get the drift. My in-laws and my husband are pretty neuronormal, though. It's fun hanging out with them, they're so out of my reference zone!
As far as Big Pharma goes... for me, anyone who uses that term seriously gets relegated to the "ignore" and "zero credibility" lists.
That's why I put it in quotes.
If you lived in my head for one day you would be begging the big pharma companies to come up with a medication that would just help you feel a little bit "normal".
Mental illness is very real for the people that suffer with it everyday.
As I do.
I NEVER said metal health wasn't real. I said they make up some things, such as the afore mentioned "shift worker disorder".
Forty years ago kids would be ADHD, just like they are now. My dad, who was a teacher and administrator, said that *I* would've been classified as such when I was a kid, but it hadn't been invented yet.
Kids had this, people dealt with it without drugs, most made it through ok. Everything doesn't need a new pill thrown at it.
We should just start signing our names with our dx.
Glycerine, GAD, ADHD, NVLD, PMS, BSC! ;-)
I hate the taboo as well. We treat all sorts of issues that we can't "see". I don't see the difference between a pancreas that isn't functioning properly or an issue with neurotransmitters. *shrugs*
Farawyn, RN, GAD, PDD, SAD, PMS, BLTOR (BLT on rye)
I have generalized anxiety and chronic major depression.
This is the kind of thing I was talking about.
I don't recall ever sayin it wasn't a "valid medical need".
That's why I put it in quotes.
As I do.
I NEVER said metal health wasn't real. I said they make up some things, such as the afore mentioned "shift worker disorder".
Forty years ago kids would be ADHD, just like they are now. My dad, who was a teacher and administrator, said that *I* would've been classified as such when I was a kid, but it hadn't been invented yet.
Kids had this, people dealt with it without drugs, most made it through ok. Everything doesn't need a new pill thrown at it.
Psych is not my specialty, nor is Peds, and I am all for meds. But I kinda agree with this, especially where kids are concerned.
Some kids need meds. Some may be better off going another route first.
I don't think there should ever be a stigma associated with meds for/and/or mental illness, however. Mental illness is illness.
I have generalized anxiety and chronic major depression.
This is the kind of thing I was talking about.
I don't recall ever sayin it wasn't a "valid medical need".
That's why I put it in quotes.
As I do.
I NEVER said metal health wasn't real. I said they make up some things, such as the afore mentioned "shift worker disorder".
Forty years ago kids would be ADHD, just like they are now. My dad, who was a teacher and administrator, said that *I* would've been classified as such when I was a kid, but it hadn't been invented yet.
Kids had this, people dealt with it without drugs, most made it through ok. Everything doesn't need a new pill thrown at it.
I see where you're coming from. As a society, we can be very quick to throw a pill at something. Interestingly enough, as someone mentioned previously, it's usually a-ok for everything under the sun (i.e. our hypothetical 'shift worker disorder') except for mental health. Then, stigma.
RE: ADHD and children, my daughter started taking medication several months ago. This is after her going to cognitive behavioral therapy for about 1.5 years for a variety of issues, having a 504 accommodation plan for depression/anxiety and for lack of attention for several months, having school testing done (no learning disabilities), and having psychoeducational testing done as well by both a school psychologist and child psychiatrist. The kid was flunking everything and was becoming even more depressed and anxious. Life sucked. Lo and behold, it was determined that it was most likely ADD (inattentive) so we made a tough decision to put her on meds. After a few weeks, she was a new kid. A happier kid, acing classes.
I provided her team at school with the info on her med, just to let them know. Reaction = "I can't believe you guys put her on a med." Huh?
So, the stigma still goes both ways. As a SPED teacher I've seen little guys as young as 3 way over medicated. But as a parent, I'm being judged for placing my child on a med after numerous interventions first (and which clearly works for her). Trying to protect her from the stigma is frustrating.
I think as a society we need to become better versed in mental illness; when we become better versed we better treat it, when it's better treated the stigma lessens. My daughter's team knows so much about the hyperactivity part of ADHD but not the inattentive part -- those kids get kicked to the curb. For the large part the public cringes when they hear "bipolar" or "manic depressive." I even see posts on AN that tell a person suffering from MDD that nursing may not be for them which I think harsh. I think that's why I become frustrated when "Big Pharma" gets thrown out there. "Big Pharma" has created a path to better treatment which has definitely lessened some of the stigma, at least for me. It's nice to be successfully treated ... without the tremors, massive weight gain, and the like. Definitely fade into the mainstream more. More tremors and the like = more stigmatizing.
Specializes in LTC, assisted living, med-surg, psych.
Being treated successfully is a wonderful thing indeed. It's another thing entirely when you go to a new provider who doesn't know anything about you, and the first thing they want to talk about is your psych history. I once went to urgent care with a broken toe, and the doctor played 20 questions with me about my psych meds before he even looked at the toe. I'm on five (six if you count my PRN) so yes, that is quite a lot of medication; he seemed amazed that I was so "normal" and even made a comment to that effect. Well, I was managing my condition well, but it had nothing to do with the fact that I was there for a busted TOE.
Another time I had to check into a hospital lab for thyroid tests because my psychiatrist wanted to know if there might be a medical cause for my persistent depressive symptoms. The patient registrar was very friendly with me until she saw my bipolar diagnosis on the orders. Suddenly you could almost hear snow falling in that office. She wouldn't even look at me. I was half-tempted to tell her I don't bite, at least not until I know someone better, but she was obviously ill at ease with me so any attempt at humor wouldn't have helped. I thought maybe she was inexperienced and ignorant about people with psychiatric illnesses...sure hope she got over it, because I wasn't going to be the last mentally ill person she would ever meet.
Specializes in ER/Critical Care/Accrediation/PI/Quality.
And there is an 8 hour course anyone can take called Mental Health First Aid. I am an instructor and have taught a number of classes. Very well received by nurses so far. Google mhfa usa for more information.
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NotAllWhoWandeRN, ASN, RN
791 Posts
I have a lot of pretty messed up family and loved ones. I am not unmarked myself. My brother somehow turned out normal, and we all marvel at him.
I'll avoid those words then, cani, and try to avoid sensationalized wording: The pharmaceutical industry is made of massive for-profit businesses. There are a lot of good, brilliant people involved who genuinely care about doing good, and there are also many who don't. For decades, drug companies have been waiting for patents to expire then re-releasing drugs that are enantiomers, metabolites, extended release, or just different enough to have a different chemical (generic) name under a new patent. Some medications, like Claritin, are only minimally more effective than a placebo. Many are not more effective than existing treatments. It's done for profit.
To keep it relevant, this affects people's ability to access needed medications related to their mental health. For example, the Medicaid patient who was prescribed escitalopram (Lexapro). Medicaid wouldn't cover it because it was only available in brand name when I worked in the pharmacy, but citalopram (Celexa) is a nearly identical medication that would have been covered as a generic. If memory serves, Effexor was released first, then Effexor XR, so people who were prescribed Effexor XR often could not afford it because it was not available as generic. I'm having trouble finding dates on that med, but I'll add a blip from an FDA page about it: "The prescribing information (label) for [generic Effexor XR] may differ from that of Effexor XR capsules because some uses of the drug and parts of the label are protected by patents and/or exclusivity held by the Effexor manufacturer, Wyeth Pharmaceuticals Inc." In other words, even if a generic is released, sometimes generic manufacturers can't even use the same claims as the brand because the patenting company still "owns" some indications.
We advocated for a change of med or for the doc to take steps to get the med covered (pharmacy plays relay; no power to get the insurance company to cover it, just to play phone tag), but doctors were usually blithely unaware of cost, and far too often refused to flex to meet the patients' needs.
I was burned pretty badly by "side effects" of an antidepressant in 2011 and will never take a psychotropic medication again, but they are a valid treatment option and should be accessible to financially limited patients.