All treatments should be a matter of weighing the pros and the cons. Of course you need empirical research to accurately know what kind of long-term risks to factor in, but you must also listen to the patients. Sometimes patients have thought really carefully about the risk of relapse vs the suffering caused by side effects, and conclude that they'd rather have an increased relapse risk than constant suffering, but they're dismissed by clinicians who think that relapse risk is EVERYTHING and quality of life is inconsequential.
“Sometimes patients have thought really carefully about the risk of relapse vs the suffering caused by side effects, and conclude that they'd rather have an increased relapse risk than constant suffering, but they're dismissed by clinicians who think that relapse risk is EVERYTHING and quality of life is inconsequential.” I completely agree!
In our joint paper, Zsuzsanna Chappell and I quote an autobiographical piece by Tom Todd, a Scotsman who was forcibly medicated under the mental health act for quite a long time. He suffered such horrendous side effects that he thought life wasn't worth living on meds. He argued that he'd rather be unmedicated, try his best to prevent relapse by alternative strategies, and if he still relapsed, he could be hospitalized and medicated for a while until he stabilized again and then once again taper off. Better to have the occasional relapse and hospitalization than 24/7 horrible suffering forever. Yet he pleaded in vain, the mental health tribunal insisted that he's better off on meds than off them, because what if he relapses?
It took QUITE SOME TIME before he found a psychiatrist who agreed and said yeah, sure, this is a rational decision on your part, and supported him so he could get off meds. (After our article was published he actually reached out to us and he's doing quite well now.)
Thanks for a nuanced post as always.
All treatments should be a matter of weighing the pros and the cons. Of course you need empirical research to accurately know what kind of long-term risks to factor in, but you must also listen to the patients. Sometimes patients have thought really carefully about the risk of relapse vs the suffering caused by side effects, and conclude that they'd rather have an increased relapse risk than constant suffering, but they're dismissed by clinicians who think that relapse risk is EVERYTHING and quality of life is inconsequential.
“Sometimes patients have thought really carefully about the risk of relapse vs the suffering caused by side effects, and conclude that they'd rather have an increased relapse risk than constant suffering, but they're dismissed by clinicians who think that relapse risk is EVERYTHING and quality of life is inconsequential.” I completely agree!
Extreme example:
In our joint paper, Zsuzsanna Chappell and I quote an autobiographical piece by Tom Todd, a Scotsman who was forcibly medicated under the mental health act for quite a long time. He suffered such horrendous side effects that he thought life wasn't worth living on meds. He argued that he'd rather be unmedicated, try his best to prevent relapse by alternative strategies, and if he still relapsed, he could be hospitalized and medicated for a while until he stabilized again and then once again taper off. Better to have the occasional relapse and hospitalization than 24/7 horrible suffering forever. Yet he pleaded in vain, the mental health tribunal insisted that he's better off on meds than off them, because what if he relapses?
It took QUITE SOME TIME before he found a psychiatrist who agreed and said yeah, sure, this is a rational decision on your part, and supported him so he could get off meds. (After our article was published he actually reached out to us and he's doing quite well now.)
I'm not arguing against you here, btw. :-) I think we agree.