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Interesting article. I've been diagnosed with bipolar type 1 myself. I still struggle with accepting having that particular mental illness for two reasons; the

Interesting article. I've been diagnosed with bipolar type 1 myself. I still struggle with accepting having that particular mental illness for two reasons; the way it is depicted in media and popular culture, and it being seen as a lifelong thing you can't possible get rid of. This despite having a psychotic episode twice. You'd think these things are clear cut. But they're not. The first part of the article is spot on, really. Even medical professionals have strong biases that are pretty visible even when you're institutionalized. Mentioning drug use is almost guaranteed to put you in a certain classification bucket. What's more, once a history is taken, while being psychotic or (hypo)manic, you are once again put into some kind of classification bucket, despite not being well enough to frame things properly. I don't mean to be completely negative here. Once you are institutionalized, this is needed to get things back on track, start some kind of medication or figure out some first line treatment. However, the stigma afterwards is very real. GP's, psychologists, even surgeons take in this information after the fact, and its almost factual. And the effects the author mentions are very much there; imagined or not, they are there for the ill person. Being extra careful not to seem overly rash, overly emotional, too impulsive around doctors. Just because they have your best interests at heart, doesn't mean they're free from bias.

cmehdy 6y ago
One of the most fantastically positive things that happened to me on a journey for better mental health was to encounter a seasoned psychiatrist who did two amazing things: (1) He didn't try to always resort to whatever is brand new but actually gave choices and explanations that include treatments considered "old" and misunderstood to be ineffective (for example in my case, going with MAOI/RIMA for depression instead of the ever-so-new fancy SSRI of the day - and that alone was a life-changer already). (2) He actually had an open ear for my personal experiences with a (very) wide range of things in a "non-medical" environment, and used the input in a non-judgmental way to calibrate his understanding of my subjective reports and to find better treatment strategies - also including me in the process, therefore making me the main actor of my own healing process. On the other hand, I've stepped into rooms with a psychologist and shared about experiences with a wide range of drugs (mainly focusing on empathogen-entactogen and psychedelics for the heavy experiences, but I've covered a wide range) and gotten the regressive "this is all shit/poison" rhetoric, thus solidly ensuring that I would mentally check out when they turn around and try to offer tools to address cognitive biases and practice mindfulness, both of which they can't even apply to their own selves.
- kayodelycaon 6y ago
  I have to second your two points on finding a seasoned psychiatrist. I also found an extremely good therapist who didn't case judgement on my experiences. Between the two of them, I was able to take charge of my own treatment and be able to help myself instead of being backed into a corner. Poor mental health treatment just makes things worse. I have friends who badly need therapy and coping skill but can't get over a therapist who hurt them in the past.
- reify_null 6y ago
  Interesting. I have a negative bias towards psychiatrists myself. Experiences with psychologists weren't that great either until I went into therapy with an analytical psychologist. None of this mindfulness stuff, which I practiced myself for years already, but a complete focus on actually figuring things out and understanding why I see things the way I do. I don't think there is a single answer for everyone (not implying that you think so). The psychologist doesn't really stop me from talking about experiences with drugs, but doesn't really see it as something helpful. I currently see my illness as existing of two components; genetic and environmental triggers. Stress and drugs, together with past trauma interact with my genetic disposition towards psychosis/mania. Drinking less coffee, sticking to a routine, no drugs (particularly psychedelics), and sorting through my internal web of views with a psychologist, it looks liek that's the solution for me. Medication is part of it, mainly to provide some stabilization while I sort things out. It doesn't really jive well with how psychiatrists go about things though, in my experience, since they seem to think I have to be on it til the end of time. I would love to have contact with a psychiatrist I trust, so I could make some sense out of the medication part of my healing process.
  - kayodelycaon 6y ago
    > In my experience, since they seem to think I have to be on it til the end of time. Easily explained by survivorship bias. They only see the people who need to be on it for the rest of their lives. There are people who will need to be on medication their entire lives. I'm probably one of them. My psychosis and primary insomnia hasn't been treatable with anything else.

cmehdy 6y ago

One of the most fantastically positive things that happened to me on a journey for better mental health was to encounter a seasoned psychiatrist who did two amazing things: (1) He didn't try to always resort to whatever is brand new but actually gave choices and explanations that include treatments considered "old" and misunderstood to be ineffective (for example in my case, going with MAOI/RIMA for depression instead of the ever-so-new fancy SSRI of the day - and that alone was a life-changer already). (2) He actually had an open ear for my personal experiences with a (very) wide range of things in a "non-medical" environment, and used the input in a non-judgmental way to calibrate his understanding of my subjective reports and to find better treatment strategies - also including me in the process, therefore making me the main actor of my own healing process. On the other hand, I've stepped into rooms with a psychologist and shared about experiences with a wide range of drugs (mainly focusing on empathogen-entactogen and psychedelics for the heavy experiences, but I've covered a wide range) and gotten the regressive "this is all shit/poison" rhetoric, thus solidly ensuring that I would mentally check out when they turn around and try to offer tools to address cognitive biases and practice mindfulness, both of which they can't even apply to their own selves.

kayodelycaon 6y ago
I have to second your two points on finding a seasoned psychiatrist. I also found an extremely good therapist who didn't case judgement on my experiences. Between the two of them, I was able to take charge of my own treatment and be able to help myself instead of being backed into a corner. Poor mental health treatment just makes things worse. I have friends who badly need therapy and coping skill but can't get over a therapist who hurt them in the past.
reify_null 6y ago
Interesting. I have a negative bias towards psychiatrists myself. Experiences with psychologists weren't that great either until I went into therapy with an analytical psychologist. None of this mindfulness stuff, which I practiced myself for years already, but a complete focus on actually figuring things out and understanding why I see things the way I do. I don't think there is a single answer for everyone (not implying that you think so). The psychologist doesn't really stop me from talking about experiences with drugs, but doesn't really see it as something helpful. I currently see my illness as existing of two components; genetic and environmental triggers. Stress and drugs, together with past trauma interact with my genetic disposition towards psychosis/mania. Drinking less coffee, sticking to a routine, no drugs (particularly psychedelics), and sorting through my internal web of views with a psychologist, it looks liek that's the solution for me. Medication is part of it, mainly to provide some stabilization while I sort things out. It doesn't really jive well with how psychiatrists go about things though, in my experience, since they seem to think I have to be on it til the end of time. I would love to have contact with a psychiatrist I trust, so I could make some sense out of the medication part of my healing process.
- kayodelycaon 6y ago
  > In my experience, since they seem to think I have to be on it til the end of time. Easily explained by survivorship bias. They only see the people who need to be on it for the rest of their lives. There are people who will need to be on medication their entire lives. I'm probably one of them. My psychosis and primary insomnia hasn't been treatable with anything else.