Feb 12Liked by Awais Aftab

It's bizarre how mental health professionals can, simultaneously, hold these two beliefs:

1. Psych patients tend to be a suspicious lot

2. We shouldn't be too honest with psych patients. It's better to sugarcoat things or just not mention inconvenient truths, otherwise we might scare them away.

#notallclinicians, and obviously not you, but it's common enough. Better not talk to patients about potential bad side effects of their meds. Better not tell suicidal people that "reaching out" might land them in coercive care. Better not say this, better not say that, because it might scare people away from treatment.

Guess what OFTEN scares people away from treatment? This precise attitude! Psych patients aren't isolated islands. We talk to each other, both afk and online (you know the internet? It's a thing! It's been a thing for a long time now!) It's impossible to conceal inconvenient truths from psych patients by refusing to talk about them. But it IS possible to spread the view that psych docs are unreliable bastards who will lie and deceive and say anything to trick you into treatment.

Sure, people can be paranoid of psych docs regardless - I had some serious psych doc paranoia myself, way back in the distant time of 1993, before I had even touched the internet OR become friends with any other psych patients. But the above attitude does nothing but INCREASE the problem of patients not trusting clinicians.

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Feb 11Liked by Awais Aftab

Excellent piece. Thank you.

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Feb 15Liked by Awais Aftab

Mentioned this piece over lunch with a bunch of psychiatrists yesterday. They said in their experience, you don't scare people off just because you talk about all these side effects. Depressed patients will be like so what, I feel way too shitty for sex anyway, I want to try it and see if it helps.

Maybe this depends on exactly how bad a state the person is in, and maybe people with milder depression might be "scared off". But then again, it might be GOOD to scare people off who do suffer but not to the extent that they think easing their suffering would be worth the price of sexual dysfunction or other side effects. It makes sense to weigh the pros and the cons of medication, not just medicate everyone.

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I agree. In my experience, patients who are actively suffering are usually not scared away from treatment with discussion of uncommon or rare adverse effects.

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