I’ve had a number of responses to the blarticle from January 13th (” . . . the good doctor was WRONG”). Seems what my ex-patient had to say hit a nerve. I’ve always been pretty aware of my own limitations as a mental health practitioner. Limitations on the effectiveness of the medications, limitations on the “power” of my voice to make real change in a kids life. I certainly do my best and, believe it or not, seem to get good results from both the meds and the advice I dispense. But I AM acutely aware of the limitations . . . and my powerlessness . . . in these situations. Having had experience on both sides of the mental health system has given me many insights. People who come to me (especially parents of kids who are not well) want me to fix things . . . and fast. Parents who have to watch their kids suffer with depression, behavior issues or addiction issues are in indescribable pain. The worry that is involved is excruciating . . . and the powerlessness of the situation is perhaps the worst end of it. I can personally put up with almost anything if the solution is at hand and I can see exactly what needs to be done. I can be very strong in mind, body and spirit . . . but if I don’t know what to do to help my kid . . . if the chance for mis-step is high . . . or if there is nothing I can do . . . the physical heart ache can be intense. And the physical heart ache can seem unending.
It is with this pain that people come to my office. Fix my depression. Stop the mania. Make the voices go away. Make my kid stop using drugs. Hurry . . . quick . . . before they die . . . or hurt someone else . . .
What is a shrink to do???
Getting kids and their parents to change is a monumental challenge much of the time. And much of it is that the kids are not invested in or interested in changing. (This is the part where I want some edumacation . . .) All of you ex-kids out there . . . be honest now . . . how would you have reacted if your psychiatrist had said . . . “I’m not going to give you medicine . . . instead . . . I want you to . . .
Stop using drugs . . .
Stop hanging out with all of your negative friends . . .
Start getting your homework done . . . every night . . .
Start spending time with your parents and talking to them about your stuff . . .
Start going to bed on time and not staying up till all hours of the night watching tv . . .
And, by the way, you need to take the tv out of your room . . . and
Start going to the gym and exercising for 30 minutes 4 times a week . . . and
Start eating right . . . like three balanced meals every day . . . and
Start reading inspirational books . . . and
Start meditating/praying/getting in touch with your higher power . . . and
Start going to therapy weekly to work on stress management and relationship communication issues . . . and
Then . . . I’ll have a separate conversation with the parents about how they need to . . .
Start enforcing the rules of the house . . . and
Not let the kids get away with stuff . . . and
Spend time with their kid playing games/music etc. . . . and
Make sure that meal-time is spent together . . . without the tv on . . . and
Get your own life together by whatever means necessary . . .
Is this going to happen if I say it should happen??? How would you respond??? How would your parents have responded??? Do you think you would “buy in” to that sort of a model of treatment and completely change your life to a healthy lifestyle that would probably help (tho it is impossible to predict if it would completely eliminate symptoms). I mean, look at your “healthy” adult lifestyle and how different it is from when you were a kid. How hard is it for you NOW to change lifestyle issues that you know you should change??? If I could kids to settle down and follow some . . .
r . . . u . . . l . . . e . . . s . . .
their life would be better.
Ok, so the chances of this are not great. Do we kick back and let things go??? You know . . . use the “kids will be kids” model of child rearing??? Let the hormones be the hormones and let the child learn by their mistakes??? What if you intervene and the kid wants nothing to do with your intervention? What if they think they know better and don’t want your input. What if they are failing at school” What if they have been suicidal or self injurious? What if they are openly disrespectful?
What is a parent to do . . .
What is a shrink to do . . .
I’d love to hear from ex-kids who had experience in the mental health system who now have kids and are trying to keep their kids out of the mental health system.
Someone . . . please . . . teach me a thing or two.
–Dan Hartman, MD
do you at least try all of the above suggestions? do you make it known that there are alternatives to meds if they choose to make lifestyle changes?
And do you know how to go about guiding those who want to make those changes or do you have someone you can refer them to who do know how to make changes?
I was not given that opportunity or information. I had to wait 20 years until I started realizing that the drugs were making me sick.
True informed choice would actually provide alternatives and direction if the patient/family are interested.
Gia–
Yes, I do make lifestyle suggestions to both the parents and the kids. Dare to guess what the % of people are who make lasting significant changes in their lifestyle??? Ain’t too big. Look back on your own life. What do you think you would have said if your shrink started talking about all these changes that are “in your best interest . . . ” I can make all the suggestions in the world, but, where the rubber hits the road . . . I have to try to be practical about my interventions. Most people who are very depressed/anxious/irritable/moody or just plain out of control do not have the internal resources to make significant changes at the point where it would help them the most. Then, when they do have the internal resources, they don’t have the motivation. Bottom line is that they are in my office and I have to try to get them some help as quickly as possible. I avoid meds when i can. Often, I cannot.
So, what WOULD you have done if your doc was straight up about the need for change?????
DH MD
you know dan, before psychiatry got their hands on me I went to a natural doctor for PMS and I did, at age 17, go on a strict diet and took nutrients which healed me. Maybe I’m an exception but I did it.
However, I went to college, messed around with drugs and had a manic/psychotic episode that was drug induced. I got suckered into believing I was sick for life and the rest is history.
It took me 20 years to remember that doctor I had at 17 (a GP treating my “psychiatric” PMDD symtoms and start to think about doing it again. And now it’s proving wondrous. I’m withdrawing from all my drugs and doing wonderfully.
Gia–
Be specific . . . what diet and what nutrients???
–DH MD
Dan,
I’m sorry I don’t remember what I did exactly when I was 17 – 19 years old though I know I was off all simple carbs, caffeine and alcohol.
When I was later diagnosed mentally ill I had taken hallucinogens while pre-menstrual. So the hormonal issue remained but was overlooked.
Now I’m on a hypoglycemic diet. I eat every two hours protein and veggies mostly with a bit of whole grains only. Again, no sugar, white flour, caffeine, alcohol etc.
Because I’m withdrawing from drugs my nutrient regimen right now sounds excessive—it will all be greatly diminished once I withdraw. I have an orthomolecular doctor prescribing.
I will cut and paste a post I did for a withdrawal email group I’m part of to answer your question as the protocol is too much to write up again:
I have no problem telling you what I’m taking but do keep in mind it was prescribed particularly for me considering the drugs I’m taking and withdrawing from as well as my particular mental health history. This is not a recommendation for anyone else. For a very good synopsis of nutrients for mental health see:
http://www.healthrecovery.com/HRC_2006/Depression_06/D_shopping_for_relief.htm
Anyway here goes!
1000 mg of Vitamin C and hour with a small protein snack (they’ve used vitamin C to help people withdraw from heroine—I found one study referring to this but my doc knows the docs who used it–it was very successful)
500 mg B-1 two times a day with meals
Niacin 100 mg 3 times a day with meals (wanted that I take more but I don’t tolerate it—he says the no flush kind is important–I flush too heavy to take more—some people take as much as 1000 mg 3 times a day)
100 mg B-6 once a day
Calcium Pantothenate 500mg twice a day
Folic Acid 20 mg (don’t do this at home!!! I’m severely deficient due to one of the drugs I’m taking and I take it with B-12 injections—can otherwise deplete B-12)
B-12 1000mcg injection once daily
Vitamin A (fish liver oil, not beta-carotene) 25,0000 IU 5 days a week
Vitamin E (mixed tocopherals) 200 IU twice a day
A special multi-vitamin formulated by my doc
Zinc 80 mg a day (my copper is too high and this balances things out)
400 mg Magnesium (he recommended chelated magnesium–I’ve continued taking my slow release brand from Jigsaw Health because other kinds gave me diarrhea)
500 mg Calcium 2 times a day
L-methionine 500 mg
L Tryptophan 1000 mg morning and lunch 2000mg at bedtime
L-Glutamine 500 mg 5 times a day
GABA at bedtime
D-phenylalanine 500 mg a day
Borage oil
fish oil
primrose oil
Inositol 1 1/2 grams twice a day
melatonin at bedtime
probiotics
enzymes
I won’t be taking all of this throughout the whole taper—some is just to get deficiencies in order and then most of it will be cut out when my taper is done. This is heavy therapeutic doses. I will be on a fraction of this once I’m healthy. I know it looks overwhelming but it’s working. I cry sometimes I can’t believe how much better I feel even in the midst of a heavy much faster taper.
Most of this stuff is harmless, but some of it is NOT. And most of it is being prescribed for an acute situation. No one should copy this protocol for themselves. It is uniquely developed for me.
My drug tapering that I’ve been doing for a year and a half at a snails pace has now stepped up because of this protocol. I feel better than I have in a long time even though I continue to insult my body with the withdrawals from extremely harmful high-doses of psych meds.
The reason I originally asked if you refer people if they want natural methods is because natural methods are in and of themselves a whole other science from traditional psychiatry. My doctor thought is a psychiatrist and specializes in orthomolecular medicine (basically nutritional medicine) which was founded by Linus Pauling, two time Nobel laureate.
also the diet is all whole, natural foods. virtually nothing processed. (I will eat canned tomatoes for example, but I basically stay away from prepared food across the board)
So no additives. Especially artificial sweeteners and msg and the like.
I am lucky because I actually like to eat this way. I’ve always liked wholesome food, so the switch to 100 % wholesome food was not difficult. Cutting out caffeine and alcohol took a little work but now I tolerate neither.
I as a patient and as a teenager, have heard this over and over and over again. Maybe why we arnt all doing it is because it has been imprinted as another part of our brain, and we just put it aside. Or maybe it the time in our lives where we are so low we dont care. Whatever the reason why we all dont stop doing wrong for ourselfs and do right, the above is true. AND I can garentee each and every person who reads it, realizes it is true wherther they follow through is a different story. But it is only true to whom ever wishes to change there life. A person who has hit rock bottem can either chose to give up or take a new path, a person who hasnt hit rock bottem can do the same thing but with different motivations. Maybe like instead of “loosing my life all together and be dead”, I will “loose my marrage, or my smaller things”. People who get mixed up with drugs are into a whole other ball game as you can imagine, and they need more support and in different ways, than a stay at home mom with bipolor. When drugs are involved AND phyc problems the game goes into the 12 inning. Keeping your eye on the ball gets harder and harder and the coach needs to keep you on track. Shrinks are coaches, we are the players and the ball is our life and goals. Shrinks help us to focus on our goals and life…the ball, but ultimitly I think the rest is up to the player. Like staying off them to let the coach help the player keep their eye on the ball…and not mess their heads up drugs on top of shrink prescribed meds. Thanks for reading.