5 ms·

I hate these articles. While yes, this is true, it's also true that _many_ people have severe, untreated illness that they're just "toughing it out." My friend

I hate these articles. While yes, this is true, it's also true that _many_ people have severe, untreated illness that they're just "toughing it out." My friend with BPD ruined his life because he's "stronger than the disorder, I don't need to take my meds" Spent millions foolishly, genius engineer - horrible story. Easily fixed.

valachio 3y ago
There is no guarantee that pills would've helped your friend. In fact, these medications can worsen a patient's condition.
deleted 4y ago
[deleted]
asdfman123 4y ago
There is a fine and very important distinction to be made here. 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.
- gms7777 3y ago
  Yeah, as someone with ADHD, good diet, exercise, sleep, etc. are critical for managing symptoms. They're also effectively impossible to maintain consistently without medication.
  - maleldil 3y ago
    > They're also effectively impossible to maintain consistently without medication. 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.
- escapedmoose 3y ago
  Diet/sleep/exercise/sunlight are always the first step, and if you don’t at least get those, you’ll be hard-pressed to feel decent no matter what else you do, regardless of whether you have other medication-dependent conditions. 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.
  - skissane 3y ago
    > 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. 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 https://journals.sagepub.com/doi/10.1177/0004867418797419
- Doxin 3y ago
  This sort of stuff always reminds me of this passage: > 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 Koyczan
birdyrooster 3y ago
Who are you to say that spending your millions is foolish this way or that way? We all end up as dirt. Why not live eccentrically and take risks? It makes for a good story which you have conveniently cast as horrible. I bet that story is plenty interesting and worthwhile as is yours.
- doodlesdev 3y ago
  You clearly never met anyone with BPD.
  - Zircom 3y ago
    When you say BPD are you referring to borderline or bipolar? Because borderline is usually treated with therapy as the first-line treatment, while meds are definitely the norm and most effective for bipolar. OPs description of his friend ruining his life by not taking his meds seems more like bipolar.
    - throwaway743 3y ago
      Eh, could be either really
      - kevviiinn 3y ago
        But they are very different in their presentations
- quintushoratius 3y ago
  > Why not live eccentrically and take risks? 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-car-window-onto-interstate-police-say/ https://www.nbc15.com/2023/04/13/man-throws-200k-cash-out-ca...
spondylosaurus 3y ago
Yeah, I don't think people realize how many conditions exist that are highly treatable now but were prolonged, miserable death sentences less than thirty years ago. Taking "too many pills" sounds bad on the face of it, but it's an infinitely better alternative than letting your intestines slowly rot inside your body or your nervous system fray itself to pieces.
1letterunixname 3y ago
Exactly. Nuance is the missing ingredient here, no pun intended. 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.
moritzwarhier 3y ago
As far as I know, there is no evidence-based treatment for BPD based in medication, except for basically what amounts to tranquilizers. What'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 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. https://www.bmj.com/content/370/bmj.m3200 https://www.bmj.com/content/370/bmj.m3200
- jvm_fan 3y ago
  [flagged]
schwartzworld 3y ago
Reminds me of Steve Jobs. He had the extremely rare TREATABLE form of pancreatic cancer, and the money for the best treatments, but died because he chose green smoothies over medicine.

valachio 3y ago

There is no guarantee that pills would've helped your friend. In fact, these medications can worsen a patient's condition.

deleted 4y ago

[deleted]

asdfman123 4y ago

There is a fine and very important distinction to be made here. 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.

gms7777 3y ago
Yeah, as someone with ADHD, good diet, exercise, sleep, etc. are critical for managing symptoms. They're also effectively impossible to maintain consistently without medication.
- maleldil 3y ago
  > They're also effectively impossible to maintain consistently without medication. 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.
escapedmoose 3y ago
Diet/sleep/exercise/sunlight are always the first step, and if you don’t at least get those, you’ll be hard-pressed to feel decent no matter what else you do, regardless of whether you have other medication-dependent conditions. 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.
- skissane 3y ago
  > 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. 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 https://journals.sagepub.com/doi/10.1177/0004867418797419
Doxin 3y ago
This sort of stuff always reminds me of this passage: > 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 Koyczan

birdyrooster 3y ago

Who are you to say that spending your millions is foolish this way or that way? We all end up as dirt. Why not live eccentrically and take risks? It makes for a good story which you have conveniently cast as horrible. I bet that story is plenty interesting and worthwhile as is yours.

doodlesdev 3y ago
You clearly never met anyone with BPD.
- Zircom 3y ago
  When you say BPD are you referring to borderline or bipolar? Because borderline is usually treated with therapy as the first-line treatment, while meds are definitely the norm and most effective for bipolar. OPs description of his friend ruining his life by not taking his meds seems more like bipolar.
  - throwaway743 3y ago
    Eh, could be either really
    - kevviiinn 3y ago
      But they are very different in their presentations
quintushoratius 3y ago
> Why not live eccentrically and take risks? 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-car-window-onto-interstate-police-say/ https://www.nbc15.com/2023/04/13/man-throws-200k-cash-out-ca...

spondylosaurus 3y ago

Yeah, I don't think people realize how many conditions exist that are highly treatable now but were prolonged, miserable death sentences less than thirty years ago. Taking "too many pills" sounds bad on the face of it, but it's an infinitely better alternative than letting your intestines slowly rot inside your body or your nervous system fray itself to pieces.

1letterunixname 3y ago

Exactly. Nuance is the missing ingredient here, no pun intended. 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.

moritzwarhier 3y ago

As far as I know, there is no evidence-based treatment for BPD based in medication, except for basically what amounts to tranquilizers. What'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 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. https://www.bmj.com/content/370/bmj.m3200 https://www.bmj.com/content/370/bmj.m3200

jvm_fan 3y ago
[flagged]

schwartzworld 3y ago

Reminds me of Steve Jobs. He had the extremely rare TREATABLE form of pancreatic cancer, and the money for the best treatments, but died because he chose green smoothies over medicine.