Editorial Note: The image goes with a study headlined Doctors stop listening to patients several seconds into a conversation. This post is from one of the many PSSD sufferers who behind the scenes has been helping push research on this awful condition forward. It would be a lot easier if doctors did listen.
Just as the brain and the human nervous system are largely mysterious fields with much still to be discovered for today’s science, the way SSRI / SNRI molecules help depression has not yet been well understood and some researchers believe that the “serotonin theory” on these drugs is wrong.
Patients’ experiences show that for some these drugs work, for others they work a little, and for others they don’t work. It’s trial and error to find if there is one that is “suitable” for improving your mood.
The possible side effects are very subjective. And almost every side effect can be questioned, misinterpreted, or passed off by a psychiatrist as a symptom of psychiatric illness, even where the onset of the symptom was in the direct experience of the patient clearly linked to taking the drug.
The psychiatric patient is easily treated as a person whose word and ideas are not reliable. So if the patient reports the onset of a side effect caused by the psychiatric drug, the psychiatrist often first likes to question whether it is a side effect – it could also be a symptom of the disease.
If this happens with side effects common and present in the leaflets, consider what happens in the cases in which the person claims the harmful consequences of taking a drug persist after its suspension.
Withdrawal syndromes and post-SSRI syndromes are still poorly documented in the literature, not present on the illustrative leaflets and most psychiatrists ignore them, and instead consider the patient who worries they have been “ruined” as unreasonable, and needing to be put back on psychotropic drugs as soon as possible.
We enter the field, we could say, of a “perfect crime”.
The drug has damaged you in a way that is evident only to you who live it on your skin, and not because you are an imaginary madman, but because there are not, to date, diagnostic tools capable of highlighting the damage that you are suffering.
Where is the problem, when someone who has previously taken an antidepressant finds himself, practically, chemically castrated, with genital anesthesia, erectile dysfunction and anorgasmia or orgasm without pleasure, never experienced before?
The clinical experiences of these patients, the rotation through manymedical offices have shown that the common tests and instruments fail to highlight the condition and the etiology of the symptoms. Therefore, there is currently no diagnosis of post-SSRI sexual dysfunction.
And if you listen to the doctors, the psychiatrist will tell you that these are psychic symptoms and that you are being treated with psychiatric drugs … maybe even the same ones that caused the problem.
Many psychiatrists are convinced – or prefer to believe – that the iatrogenic damages caused by their (adored) prescriptions do not exist.
Yes, perhaps far away, some rare case of tardive dyskinesia with some antipsychotic … But if you, mentally ill, stop taking an SSRI and now come to complain because you no longer have a whiff of an erection despite wishing to fuck like before, I can only tell you that you have a bit of a problem with anxiety, depression and psychosomatisation to be cured by summarizing the drug.
There’s no point explaining that before the drug you had never experienced not a whiff of such dysfunctions!
Do you know, dear psychiatric patient, that low libido is a very common symptom of depression?
Do you know that premature ejaculation and erectile dysfunction are common symptoms caused by anxiety?
Do you know that the more you think about it and focus on the problem and the less chance you have of recovering?
Do you know that hypochondria…? Do you know that psychosomatization…? Do you know that on the internet you find everything and more?
It doesn’t matter: it’s in one ear and out the other, explaining that “before the drug”.
Your word is not reliable, my impotent patient dear; or deep down, maybe… it is too easy and convenient denying that you may have been ruined by my prescription.
You stretch out some papers with medical literature studies you found on the internet and beg me to read them, I reject them telling you they are just “anecdotal cases”. Are you trying to question my skills?
Look at you… you keep trying to “make me understand”! What do you want me to say to you? That yes, maybe you’re out of luck? Did I give you a poison that ruined you forever? And that now I don’t have a shred of solution to offer you to repair this damage? It wouldn’t solve your problem and above all I would admit my guilt for not having informed you of the risks, I’m not that stupid. In these cases, better to beat around the bush, confuse the truth, keep Pandora’s box closed.
You had blood tests and the hormones are in place; I am a psychiatrist and I tell you that genital anesthesia (here, however, a grin escapes me) is in your brain! and this is why I can help you (I feel puffed up) because I am a doctor who understands it, and based on your symptoms I prescribe you an adequate psychopharmaceutical (and here I rub my hands), then see how it goes.
Yes, see how it goes. Because risking being permanently damaged is included in a harmless and shallow “see how it goes”! In case of undesired effects, you can always stop it; so there is no risk of finding yourself spoiled by just a few doses.
And if it ever existed, it would be something so invisible and secret that I would be safe anyway. Because even if you were ruined you will have no way to prove it; no one will recognize it, I will not recognize it, I will not believe it possible or I will prefer not to believe it, or, maybe secretly I will believe it … but I won’t feel guilty! I followed the label and the indications of the pharmaceutical company, I did my job well, full stop.
How unfortunate are the lives of these psychiatric poor guys… But the last thing we need is to be conscientious and feel guilty, in that case I would be the one who needs to be treated!
A number of studies and articles have come to hand recently on the more general issue of doctors listening. One features on the Mad in America website this week – How patients solicit medication changes, which has an accompanying article.
This doesn’t paint doctors in such a bad light – perhaps because it had to get published.
There is a wider literature dating back 20 years from the Institute of Medicine and others saying that doctors just don’t listen – about any side effects. So its not just a RxISK discovery. One of the best articles on this is called The Silence.