I am so sorry for the late reply. Thank you for clarifying to me your qualifications and viewpoint. I understand your assessment and respect it greatly. I realize there is a much bigger picture for those whose life gets derailed, than just T levels.
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JT, honest question, how does the psychiatric community scientifically explain the much higher incidence of medicating for mental illness in the States, vs. throughout the rest of the world??
Is it actually possible that all these other countries have unmedicated crazy people roaming the streets, or are psychiatrists just "in" on the game that it's beneficial to convince so many Americans that they need medication?
An uneducated guess here: It’s because when life becomes too easy, people worry more about their feelings. With an abundance of resources, the majority of us Americans can survive pretty easily and as a result have more time to feel sorry for ourselves.
I wonder if depression was a problem for primitive man or if they were just elated to survive another day of getting chased by lions and shit.
It would be helpful to know the rates of treated vs untreated mental illness in various countries. It sounds like you may have those numbers. Please share some citations.
When we hear about “crazy people roaming the streets” we are usually thinking of people with schizophrenia, not depression. I do know that the rate of schizophrenia is about 1% across many countries and cultures, no matter how hard psychiatrists or other people try to convince those suffering that they do or do not have a mental illness. There’s a biology there that is mostly unaffected by direct-to-consumer advertising. Other mental illness like depression or anxiety disorders may be more “culture-bound” in how they are experienced, expressed, and treated. It would be a mistake to assume that the rates of prescription correlate tightly with the rates of diagnosable illness, as there are issues such as stigma and lack of access that are confounding factors.
Psychiatrists are “in on the game” of trying to help people who seek us out, with the tools we have available, including medication. We have more work than we can handle, and if you’ve ever tried to get an appointment with a psychiatrist, you’d know that we have no need to do outreach. We’re booked up. That’s why you’ll find that most SSRIs (first-line antidepressants) are prescribed by generalists, not psychiatrists. GPs may be a little quick to prescribe, but they’re probably trying their best to help with the little time they have with each patient.
You may be mistaking us for the pharmaceutical industry.
Well, look, we have our share of assholes, like every profession, but most of the problems I’ve personally seen in medicine can be traced to decent people working in a ridiculous system, trying to do the right thing, often with inadequate support and very high stakes. So shit happens.
Doc, that was a great post. I’ve seen about everything (well, probably not). There are a LOT of problems in medicine. I’ve seen some amazing docs and nurses. I’ve also seen some that make used car salesmen look like Sunday School teachers. As for pharmaceutical companies...I’ve heard horror stories on some that I bet would make even our good doctor here pause.
This has been a fascinating thread to follow. Thanks Doc for spending some time here with us. Thanks Rip for a great discussion.