Continuing this 88 year old bipolar manic's reply of 7/21 at 5:16pm:
Most of us don't have the nerve to interview a psychiatrist to see whether we'll hire them. Despite that we can ask some questions during the first interview. Taking along a list, a cheat sheet, is a very good idea. It helps remind us of questions to ask that are important to us. It also reminds us to tell the psychiatrist things we want him to know---that we think are important.
The psychiatrist also has his cheat sheet. If he's experienced enough it resides in his head. If not, it's either in his hand or on his desk. His cheat sheet is the quite standardized outline of a psychiatric report of a first interview. It starts, logically enough with something like "This 48 year old 6' 1" male entered the office, smiling, and assuring me of his desire to cooperate in his treatment." That is probably quite close to the first sentence the female psychiatrist wrote (or dictated) after her first interview with me in 1971.
The report then goes on listing salient points in the interview. What is salient for the psychiatrist and for the patient are quite different. The psychiatrist's training has taught him a sequence he believes in and acts on in the interview. Diagnose first, then treat. The correct treatment follows directly from a correct diagnosis. Depressive reaction, treatment---an anti-depressive, Anxiety reaction, anti-anxiety pills, Psychotic schizophrenic reaction, anti-psychotic pills.
This medical model of treatment tends to ignore, except to make a diagnosis, how the patient is living his life, the problems he brought to the psychiatrist's office. The medical model works quite well for physical illness. I, and many others believe it does not work well for what is termed mental illness. There are other models than the medical.
For most of us replying in this anti-psych Forum, this neat formula that resides in most psychiatrist's head does not always lead to correct treatment. As often as not, it leads to treatment that makes the patient worse, impairs his level of functioning, makes it harder for him to get a job, and gets him on a permanently disabled list. How many in Psych Forum are on a permanently disabled list? A show of hands would be interesting, but is a fantasy.
Despite the above, many patients firmly believe that psychiatric meds are helpful. What I believe they mean by helpful is that they feel less---less anxiety and fear if that's why they went to the psychiatrist's office, less depressed if that took them there, even less psychotic if psychotic behavior got them there as it did me in 1971.
The feeling less, I believe, is a direct result of knocking out, stopping, inhibiting the verbal thinking, the words going through a patient's mind that are the cause of the anxiety, depression, paranoia, etc. In doing so it is also inhibits many very valuable functions that non-patients find very useful in living. To overgeneralize, it inhibits some percentage of a patient's intelligence.
Many here in Psych Forums, probably most, find the upside of psychiatric meds, feeling less, , outweighs the downside, lower intelligence and functioning level, less energy, less endurance, feeling tired that most in anti-psych have experienced. This pro-psychiatry majority is because a larger majority of those who have gotten off psych meds don't bother to write replies here in Psych Forums.
Next, I'll write about the valuable functions lost as a result of taking psychiatric medications. Then I will go to what is by far the most popular model of mental illness--the spiritual model. That's true in this country and almost everywhere. Then I'll go to a description of a very similar profession, bartenders and their clients.