Spent millions foolishly, genius engineer - horrible story. Easily fixed.
If you have a health problem, you should do your best to get exercise, eat healthy, etc. However, that doesn't mean medicines are wasteful or pointless. People often greatly benefit from them.
I've struggled with ADHD, depression, and anxiety my whole life. And indeed, yes, the best treatment I've found is diet, weight training, and long-duration cardio. Which I do.
But people who are "in the hole" need medicines to dig them out. And also, people with kids/multiple jobs don't have as much time as I do. And these habits take years to finally stick. And I still need ADHD medication.
And the best treatment for things like this is to try every treatment you can together, but don't overwhelm yourself in the process (and it takes wisdom to not overwhelm yourself).
People on Twitter opine about this kind of stuff piss me off. They think their vague notions about what is right for society--that they have no experience with--should take precedence over my decades of (informal) research and lived experience. It's okay to have opinions and discuss things, but don't try to bully the people who actually know what they're talking about.
That said, there are way too many people out there who have no experience with conditions which require medication, who seem to think that those things are a substitute for medication rather than a baseline that must be kept up alongside medication.
I’m no psychologist, but I tend to assume that a driver to thinking this way might be the sense of safety that comes with self-righteousness. Similar to victim-blaming in crimes, where people pick at the personal faults of crime victims (however slight) in order to reassure themselves that a similar thing couldn’t happen to them. Imo it’s a coping mechanism for a world where long-term suffering can be brought on totally at random.
It is complicated. Some people have mental health conditions which are always going to require medication. Some people have mental health conditions which are never going to require medication. And some people have mental health conditions where it depends on environmental circumstances. For that last group, lack of sleep/diet/exercise/etc can be part of the environmental circumstances which makes medication required, so fixing that can make medication less required, and may even go some way towards making it no longer required. Even if certain other things can make medication no longer required, sometimes it is still helpful in the short-to-medium term to give you the space to implement those things
> but I tend to assume that a driver to thinking this way might be the sense of safety that comes with self-righteousness
There are serious concerns about iatrogenic harm in mental health due to overdiagnosis, misdiagnosis and overprescribing. Some people who are critical of medication are approaching the issue, not from some sense of superiority, but rather from negative personal experiences with the topic, for themselves and/or family members.
Taking psychiatric medication and being critical of it are not mutually exclusive-I myself do both. Medication is the least worst thing for me right now, but I hope one day I can solve some other problems in my life and remove some stressors and I may eventually wean myself off it. And simultaneously I believe a lot of people out there are being harmed by being prescribed the wrong medications. For example, the widespread prescribing of antipsychotics to adults and children without psychosis, by prescribers who are ignorant of the risks of brain atrophy [0] and who don’t communicate those risks to patients/parents. If you have schizophrenia, those risks may be the lesser evil; if you have a kindergartener with Aspergian traits and mildly violent behaviour, I’m not convinced it is. Maybe as a last resort once you’ve exhausted every alternative, but I know clinicians for whom risperidone is their first resort for such a patient not their last
[0] https://journals.sagepub.com/doi/10.1177/0004867418797419
That summer after my first year of college, I spent my days moving stuff around in a furniture store and golfing 9 holes after work was done, and weaned myself off of it. I haven't relapsed into the hospital in two decades since, despite more than a few high risk periods I've gone through over that time, and a lapse during fatherhood in my ability to keep up with exercise as much as would be ideal. I don't know whether my brain was sufficiently re-wired by those 9 months of pills or what, but it's a bit strange to me that essentially every psychiatrist would have insisted something like this was impossible.
Bipolar disorder disappears in some people spontaneously. Around 10% of people who have a first bipolar episode will not go on to have a second one, even if they permanently discontinue medication. And some people who have a second episode will never have a third, even if they stop taking medication, although I don't have an actual statistic on that. Let's suppose it is 1% of all bipolar cases – which is a figure I just made up, but probably in the right ballpark. Since bipolar is around 1% of the population, people like you would be around 0.01% of the population. That sounds insignificant, but in a country like the US there would be over 30,000 people like you, and worldwide could be over 700,000.
I think the psychiatrists who told you this is "impossible" probably knew that it actually wasn't. It is just that it is rare, and they don't want to give patients and their families false hope or encourage non-compliance with treatment, so instead of telling you the truth that it is 10% or 1% or whatever of all cases, they tell you a "white lie"/"simplification" that it is 0%. 90-99% of the time, their lie turns out to be true for the person they told it to.
In terms of whether 9 months of medication "rewired your brain" – it is impossible to say. It is possible that without medication you would not have gone into remission, and would have had further episodes. It is also possible that you were always going to remit anyway, and still would have even without medication. Nobody really knows. The fact is, for just about all psychiatric disorders, our knowledge of what causes them, and how the medications work, is extremely incomplete, and we don't know enough to answer those questions in individual cases.
This is key. As someone with bipolar disorder, I'm forever stuck in a cycle of stable with good habits -> episode happens -> can't keep the habits -> get worse -> medication changes/episode passes on its own -> I go back to good habits -> stable...
With mental illness you never know when it's going to act up and ruin your life, so the least you can do is use your energy - when you have it - to keep your body in a decent baseline.
Thankfully, this cycle takes many months to start again, so I live a decent life most of the time.
> To this day
> He is a stick of TNT lit from both ends
> Could describe to you in detail the way the sky bends
> In the moments before it’s about to fall
> And despite an army of friends
> Who all call him an inspiration
> He remains a conversation piece between people
> Who can’t understand
> Sometimes becoming drug free
> Has less to do with addiction
> And more to do with sanity
- To this day, Shane KoyczanWhat's common is to prescribe SSRIs and similar medication for all kinds of psychiatric illnesses, including BPD. The evidence that this would help in the long-term is vague to non-existant, and I'd avoid trusting it (as with almost all research on anti depressants).
The best-researched facts about SSRI antidepressants are the increase in suicide rates and the "side effects", which are still often underreported, and include problems with basically all bodily systems, because serotonine is an importat t neurotransmitter. Not to forget about
https://en.wikipedia.org/wiki/Post-SSRI_sexual_dysfunction
SSRIs can also reduce life expectancy.
Personally, after being on an antidepressant (Effexor) for 6 years, I can also say that they massively reduced mental stability and self-awareness for me.
There are many meta-studies about this by now, somehow ADs are still seen aa evidende-based medicine comparable to insuline for diabetes. This is far from the truth, the mechanisms of action are poorly understood and effectiveness has been painted in an unrealistic way by pharma companies who make these pills.
I currently have untreated inappropriate sinus tach where my heart rate is continually 100+ BPM. This will require a cardiologist to sign-off, probably for ivabradine since beta blockers are giving me depression. And it's my understanding that node ablation has a low success rate and I'm not interested in a pacemaker.
In fact, these medications can worsen a patient's condition.
OPs description of his friend ruining his life by not taking his meds seems more like bipolar.
Maybe because there are dependents that needed that money for school, shelter, clothing, or food.
There was a story in the news recently about a guy who spontaneously gave away $200k by throwing bills out of his car window. Seemed like a feel-good story, at first. It turns out that he gave away his family's life-savings and they're now destitute.[1]
Money can absolutely be wasted and spent foolishly.
[1] https://www.nbc15.com/2023/04/13/man-throws-200k-cash-out-ca...