Love this especially: “The dual nature of psychotropics is evident in the Greek word phármakon, which can mean a remedy as well as a poison. Fully appreciating this duality must be at the heart of a liberatory psychopharmacology”
Very old article, I realise, but I'm browsing the archives after subscribing, and this one struck me in particular because I've seen both faces of psychopharmacology — on the one hand, antipsychotics and antidepressants that produced nothing but side-effects, some of them debilitating, and on the other hand, stimulant medications for ADHD, that enabled me to pull myself out of a pretty bad situation and avoid institutionalisation.
I agree that the key to effective use of psychotropics is informed patient choice and collaboration between patient and clinician. More than anything, besides finding the right medication for one of my issues, what has helped is leaving appointments feeling like I'd been listened to and like I had a way forward that was not going back on the neuroleptics that gave me long QT syndrome or the antidepressants that inexplicably made me so profoundly parkinsonian that my psychiatrist was scared I was going to die under her care.
I'd say the least helpful thing I've experienced while in treatment is the idea — coming full-blast and in equal measure from psychiatry, from laypeople, from the media landscape, from academic takes — that I have ceased to be a person who can have opinions or, quite frankly, a soul. People talk about schizos (besides ADHD, the only diagnosis of mine that I am not skeptical about based on my own experiences is that I am some kind of schizotypal or somewhere else within the schizophrenic spectrum) as though we're husks, and whatever art or academic work or craft or whatever we produce is the detritus of a husk's animalistic, unaware existence. At best, people talk about such efforts as therapeutic but meriting no interest outside the altruistic interest owed to the work of the less fortunate.
But I've always been here. My problems of perception and interpretation are not ontologically different to the errors of judgements made by sane people — they are errors of judgement made in good faith, based on the only data I have access to.
The thing that frightens and distresses me in the general discussion of severe mental illness is how many people express a moral mandate to always medicate the Mad. And yet, if I were to come off my pain medication, citing side-effects and the moral discomfort of relying on opioids, nobody would consider that irresponsible, even though in my experience, chronic pain is a lot more impairing than a slightly shaky but mostly enduring remission from psychosis (obtained via learning metacognitive skills, ensuring community support and finding accessible, repeatable ways to address emotional distress without resorting to either prescribed or recreational substances). But choosing to stop neuroleptics and decline the option to try them again is treated as morally suspect, even though they demonstratively made me worse off. I'm as coy about taking opioids for chronic pain as I am about no longer taking neuroleptics.
I appreciate that this piece is addressed to the Mad and distressed and disordered and not to our caretakers and supervisors. Too often, people whose functioning has fallen below a certain poorly-defined threshold, or people who receive one of the "scary" diagnoses are consigned to the realm of perpetual objects, stripped of not only the opportunity for subjectivity but of the dignity of being considered capable of it. It's here that I consider my experiences of both Madness and neuropsychiatric disorder to converge — my parents had to yank me out of psychiatric treatment of any kind as a child, to eliminate the chance of me being judged too delayed to be allowed remain with my family, and I have to work hard to avoid frank psychosis lest I be judged incapable of deciding whether I want to experience cardiac side-effects in exchange for no subjective benefit to functioning, reasoning, or interpersonal relationships. I've been extraordinarily lucky that in the UK, my GP and the neuropsychiatrists at the neurodevelopmental disorders clinic who manage my ADHD treatment have all been more interested in my self-reported quality of life over metrics.
Old article but I just read it. Wonderful! Really resonates with my own, quite diverse and varied, experiences with psychotropics.
Love this especially: “The dual nature of psychotropics is evident in the Greek word phármakon, which can mean a remedy as well as a poison. Fully appreciating this duality must be at the heart of a liberatory psychopharmacology”
Thanks Carlene!
Very old article, I realise, but I'm browsing the archives after subscribing, and this one struck me in particular because I've seen both faces of psychopharmacology — on the one hand, antipsychotics and antidepressants that produced nothing but side-effects, some of them debilitating, and on the other hand, stimulant medications for ADHD, that enabled me to pull myself out of a pretty bad situation and avoid institutionalisation.
I agree that the key to effective use of psychotropics is informed patient choice and collaboration between patient and clinician. More than anything, besides finding the right medication for one of my issues, what has helped is leaving appointments feeling like I'd been listened to and like I had a way forward that was not going back on the neuroleptics that gave me long QT syndrome or the antidepressants that inexplicably made me so profoundly parkinsonian that my psychiatrist was scared I was going to die under her care.
I'd say the least helpful thing I've experienced while in treatment is the idea — coming full-blast and in equal measure from psychiatry, from laypeople, from the media landscape, from academic takes — that I have ceased to be a person who can have opinions or, quite frankly, a soul. People talk about schizos (besides ADHD, the only diagnosis of mine that I am not skeptical about based on my own experiences is that I am some kind of schizotypal or somewhere else within the schizophrenic spectrum) as though we're husks, and whatever art or academic work or craft or whatever we produce is the detritus of a husk's animalistic, unaware existence. At best, people talk about such efforts as therapeutic but meriting no interest outside the altruistic interest owed to the work of the less fortunate.
But I've always been here. My problems of perception and interpretation are not ontologically different to the errors of judgements made by sane people — they are errors of judgement made in good faith, based on the only data I have access to.
The thing that frightens and distresses me in the general discussion of severe mental illness is how many people express a moral mandate to always medicate the Mad. And yet, if I were to come off my pain medication, citing side-effects and the moral discomfort of relying on opioids, nobody would consider that irresponsible, even though in my experience, chronic pain is a lot more impairing than a slightly shaky but mostly enduring remission from psychosis (obtained via learning metacognitive skills, ensuring community support and finding accessible, repeatable ways to address emotional distress without resorting to either prescribed or recreational substances). But choosing to stop neuroleptics and decline the option to try them again is treated as morally suspect, even though they demonstratively made me worse off. I'm as coy about taking opioids for chronic pain as I am about no longer taking neuroleptics.
I appreciate that this piece is addressed to the Mad and distressed and disordered and not to our caretakers and supervisors. Too often, people whose functioning has fallen below a certain poorly-defined threshold, or people who receive one of the "scary" diagnoses are consigned to the realm of perpetual objects, stripped of not only the opportunity for subjectivity but of the dignity of being considered capable of it. It's here that I consider my experiences of both Madness and neuropsychiatric disorder to converge — my parents had to yank me out of psychiatric treatment of any kind as a child, to eliminate the chance of me being judged too delayed to be allowed remain with my family, and I have to work hard to avoid frank psychosis lest I be judged incapable of deciding whether I want to experience cardiac side-effects in exchange for no subjective benefit to functioning, reasoning, or interpersonal relationships. I've been extraordinarily lucky that in the UK, my GP and the neuropsychiatrists at the neurodevelopmental disorders clinic who manage my ADHD treatment have all been more interested in my self-reported quality of life over metrics.