There's a TL;DR at the end. If this is too much and off-topic, I'll move it. Essay on Pharma Drugs: Thoughts on the Patient's Choice between symptom control and side effects amidst asymmetric information.
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@Reverse
Reverse said:
"I think a healthy person has predisposition to any side-effects of any medication. Most likely, side effects of medications hit everyone. The only difference between people is the severity of the side-effect and which side-effect you will get."
If those side effects are tolerable that's one thing, but "tolerable" differs person to person. And advertising skews the general perception towards its "benefits" quite significantly. As do studies heavily focused on proving the benefits of medications rather than their ills. The problem is often a patient doesn't know what choice he or she is making. They don't know the risks -- and the doctors don't either. For instance I had drug-caused Mania from Effexor XR. My rookie psychiatrist has no experience compared to a veteran to it (or me). It depends on our value system and our schemas. A "Schema" is a pattern of thought or behavior that organizes categories of information and the relationships among them. Schemata help us understand our rapidly changing environment to quickly make decisions. Mine has changed a lot, throughout my youth and adulthood and was heavily influenced by medication experiences. My schema in dealing with physicians and medical issues as a whole changed due to my reactions to meds and how I was treated.
An "innocent" clean-slate at 18 isn't indicative of the same schemata that someone who is 21 and has been scorned by medication. Nor is a doctor's schemata of patient-drug relationships the same if they've seen many terrible adverse reactions or if they have rarely seen them occur. The physician in the first case would act differently than the physician in the second case. The first case would result in the physician acting less trigger-happy on prescribing medications than the physician in the second case. Just as someone who has never had any medication would act differently than someone who has had a lot, when faced with the decision to medicate or not. And someone with 1 or more adverse events versus someone with a similar medication history and zero adverse events would diverge in a similar fashion.
If the doctors are to blame: So are
Ad agencies, pharma (of course), and society at large, and the FDA (and similar organizations worldwide),
unbridled capitalism. for disconnecting people to the point that they need to seek chemical solutions to their problems. I'm sure meds have helped some though -- as per the drug ratings online and my personal life. Do I hate most? Yes.
-Former Big Pharma Chief Officers serve on the FDA.
-I'm blaming capitalism somewhat and I'm a capitalist myself.
Everything in our body is chemical (electrochemical and neurochemical?) and like
@Canari says - mostly none of us (or anyone) are free from "drugs"/chemicals on some level.
The problem is when the choice for something with serious ramifications is removed --- that's where a "crime" or injustice is committed. I know stimulants cause bruxism, insomnia, etc. I'm fine with it when healthy --- I wouldn't have 2 degrees without it, nor been able to pay rent back then. When side effects are not known, thought to be unknown, believed to be impossible, or simply anomalies, or that the patient is lying/crazy - that's a huge problem. And of course, there's no independence between drug research and big pharma (the makers of those drugs and holders of patents, with the singular right to produce, market, and sell them (for a time)). I know that smoking causes cancer, as a 20-year-old smoking -- it was a temporary crutch/ way to deal with anxiety. Same with drinking, I know it causes grey matter death. I didn't then, but now I can make more informed decisions about it.
I did not know of the risks of Effexor nor the likelihood that finasteride would affect my mood, cognition, and physicality. This is because of me listening to patient reports and because that information is
hidden. It's hidden by profit-maximizing firms (Pfizer, Merck, GSK, Novartis, Shire, etc). That intrinsic human right of "informed choice" was taken away from me. That's a crime.
-"Groupthink" is at play as well, as there are so many people that would say (online) "it's in your head bro."; "I'm fine, only lazy or out of shape people get side effects."Most of the world at large is ignorant, that's not an excuse - but a fact. People often don't have the resources, time, mental capacity, empathy, nor ability to think far beyond their own personal vicinity at times.
Also when doctors ignore or make that judgment call (priorities of benefits vs. costs)
for the patient, major problems arise. After 16 or so, I never left health up to family doctors nor basic doctors. This is because I saw how ludicrous they were. (Still didn't save me though). It's in my hands, the best I can control it. I was not made aware of the risks of Effexor XR and I thought I'd notice Finasteride sooner (I read up on it but I was really concerned with my hair). I only got into this situation because most "mood disorder specialists" have little to say about hair loss as a side effect of anticonvulsants. -- Had they researched like I did (especially after), they'd have better things to tell me or at least consider that this wasn't a choice I was willing to make. The psychiatrist's schema of what's wrong with a patient and
what's important and
unimportant is different from mine and what becomes of that patient later will similarly diverge.
"Another issue is that doctors will rarely link a patients side effects to the drug they were prescribed. Why? Firstly, it jeopardizes their reputation. Second, doctors are most likely taught to only diagnose an issue and not spend their time checking if a drug caused it. Doctors are also brain washed to believe things are rare."
I agree with this statement 100% because I've changed the minds of some doctors and showed them that what they think is not based on pure scientific reasoning. They aren't taught that much about every single possible side effect. I think that to get closer to being able to make a proper choice --- ask a doctor with that condition and ask if they take the medication, or would they put their son or daughter on it?
A lot of it is willful ignorance.
Many people want to believe they're doing the right thing, doctors who grew up being altruistic want to believe that on net they are helping people and that the person with
SJS,
PFS, PSSD, PAS, seizures, etc. from medications are the "rarity". The schema of doctors in relation to their patients, their product vendors (pharma), and that of society with respect to pharma must change. It doesn't end there though.
Also there's the scarcity of time. I myself put myself first, due to lack of time -- all the time, because you can't literally save/help everyone if you can't help yourself.
-When teaching hospitals are funded by pharma and lunches are afforded by young, attractive pharmaceutical sales reps, what do we really expect?
(Mostly) Everyone has a price. Whether it's time, income, status, or just job security.
My own family and some former friends still think I just have it was "anxiety"/"bad decisions" on my part (Effexor issues). In actuality, it was drug-caused (medication), why I left home overnight in the middle of a winter term. Some of them are willfully ignorant. Explaining wtf happened with finasteride to specialists is hard for me let alone to family members and largely a waste of time. So society at large? So if it's a "waste of time" -- then of course it’s not taken seriously. People can only hold so much attention in their "mental space", at the end of the day human beings are selfish. People act based on self-incentive and that often means self-protection as well as putting their needs ahead of others. Even so, someone should be held accountable. Maybe, the entire system. The system that makes parents think "Of course, let's try Accutane!" for their acne-afflicted teen, the system that makes young men reach for finasteride to keep their hairline in check. And the system that says some anxiety or depression or not being like everyone else is not okay. The system with the "quick fix" pill and happy people laughing it up on TV ads, and the doctors who mention that side effects are "temporary", because the drugs are "well tolerated" according to their lectures and textbooks and patient-information sheets, thereby spreading misinformation and enabling asymmetric information to flourish between the drug suppliers (Pharma) and the users (the patients and customers).
TL;DR
It's a systematic lack of empathy that causes most of the suffering in the world. This is true of medication syndromes. The patient becomes a victim of the "good-intentioned" system.
And some of us become like "them", because we can't beat them. For what it's worth - Hackstasis has restored some of my faith in humanity. I'm excited there are a lot of highly intelligent and disciplined people here working on these issues. I actually wish I had access to such minds when I was still a kid.
Postface:
As far as I'm concerned it's me versus everything. Or it was, but every time I tried to get "medical" help (medication), most of the times it ended badly. So even though eventually
I knew better, I made the same mistake more than once. It's my schema that's affected and perhaps inescapable at this point, because it's become so ingrained. Not the "quick-fix" mentality of searching for a "chemical solution", but rather the damages to opportunities, relationships, and finances, and most of all time that has occured because of medication-illness. There is hope though. We must fight "the system" out there, but also the one that's been imprinted inside of us. One thing that might stop major adverse drug reactions and persistent illnesses like PSSD, PFS, and PAS is genetic testing and screening of patients to ensure they will not react badly. There are some screenings available right now (at CAMH for instance) but it is far from perfect and is significantly underutilized as of this writing.
-sorry for the long reads. I'm really bored right now. Also sorry if this is jumping around a lot. I had better points about the "schemas" and such, but it was getting too long. So I leave this slightly messed up.
"I don't mind, then i go to the doctor, it is free with my insurance, and it is fixed with a pill." 
