How Drug Companies Helped Shape A Shifting, Biological View Of Mental Illness

  • 33 Replies
  • 8702 Views

0 Members and 1 Guest are viewing this topic.

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #15 on: May 06, 2019, 04:34:48 pm »
I would think that the placebo effect in psychiatry is significantly more important that it would be in other areas of medical science. For example, I can't imagine you'll get very far in local anaesthesia with placebos. But as for psychiatry, as H notes above, if placebos work better than drugs.....

Which actually does happen, except in the cases of the most successful drugs and even those don't often exceed the effect of the placebo by all that much in most cases.  I think many people would be surprised at how effecting placebos actually are.  And I think many people would also be surprised to lean that placebos can still work even when the person given them is actually told that they are placebos and are not actually drugs.  IT even works for things that would seem like they are not really treatable.  I've seen a case where someone was heavily medicated for constant migraines and the placebo effect seemed to manage to "stop" the migraines.  Another, where it mitigated the effect of severe eczema where medication had not.

Anecdotes, of course.  But it was scientific study and it was not completely unsuccessful in achieving results.  Which, even if it turns out the effect doesn't last, or is only effective in corner cases, it's still rather preposterous that it works at all, ever.  That is, if it is the case that say, consciousness is totally an "illusion" and there is nothing akin to an "internal" locus of control.
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

TLEILAXU

  • *
  • Old Name
  • *****
  • Exalt-Smiter of Theories
  • Posts: 731
    • View Profile
« Reply #16 on: May 06, 2019, 04:44:06 pm »
Quote
drugging yourself likely will not have the long-term effect one would likely want.
I completely agree.
Quote
My assumption, which could like be wrong, because who the fuck am I, but it would be that more "general anxiety" and "general depression" could be dealt with through a non-pharmaceutical approach
Does it have to be? I mean what about a case by case basis?

Quote
It is, to me, a mistake the even court the idea of a total "biological locus of control" for most cases of general anxiety or depression.  Again, this does not preclude that some cases might well feature such a thing.  But to default to the idea of that, is, in my opinion, a mistake, because it will tend to inform a lack of agency on the part of the sufferer.  Even if they are indeed largely a victim of circumstances outside their control, conceding even the small amount of control they do have, in my opinion, is a massive mistake.
Why? Maybe the incessant need to be in control actually fuels these things, and being told it's not your fault can be a relief.

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #17 on: May 06, 2019, 05:22:45 pm »
Quote
My assumption, which could like be wrong, because who the fuck am I, but it would be that more "general anxiety" and "general depression" could be dealt with through a non-pharmaceutical approach
Does it have to be? I mean what about a case by case basis?

Well, I think you are mischaracterizing my point though.  I am saying, that yes, any effectiveness will indeed be a case by case basis, but, my hunch is that there are more cases where a non-drug approach could and would work than are currently both proscribed and generally accepted by patients.  I think part of that could be because the non-drug approach is also a lot of work and will require changes in assumptions, world-view and manners of thought, which many people just don't want to do.  POeople really do seem to have a "just give me a pill" approach.  In the same way that where I live, most people have high blood pressure, but won't alter the slightest bit of their diet.  "Just give me a pill, I am not going to change what I am eating."

Forgive my bias, but I can't help but imagine that psychology can work the same way.

Why? Maybe the incessant need to be in control actually fuels these things, and being told it's not your fault can be a relief.

That absolutely could be the case, and in those cases, something like a drug will likely work to get one out of a sort of positive feedback loop.

But, on the other hand, if you don't learn how to think in a way that can get yourself out of the mind-space that demands such a need for control, means that once you'd habituated to the drugs, you are right back where you started.  Locus of control is really not about an "all or nothing" position.  I mean, I drive to work, some of what will happen will be within my control, so I can "worry" about that, but I can't control what a meteor from space might do, or what the guy on the other side of the road might do.  So, indeed, it is a matter of fact that one can be a "victim of circumstance" and have little not no control over what might happen.  But at some point, you will likely have control over something, be it your reaction, your way of thinking about how to overcome what happened, or what you can do in the present to effect a positive outcome in the future.
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

BeardFisher-King

  • *
  • Old Name
  • *****
  • Posts: 599
  • The 8-Trackless Steppe
    • View Profile
« Reply #18 on: May 06, 2019, 06:27:40 pm »
Why? Maybe the incessant need to be in control actually fuels these things, and being told it's not your fault can be a relief.

That absolutely could be the case, and in those cases, something like a drug will likely work to get one out of a sort of positive feedback loop.

But, on the other hand, if you don't learn how to think in a way that can get yourself out of the mind-space that demands such a need for control, means that once you'd habituated to the drugs, you are right back where you started.  Locus of control is really not about an "all or nothing" position.  I mean, I drive to work, some of what will happen will be within my control, so I can "worry" about that, but I can't control what a meteor from space might do, or what the guy on the other side of the road might do.  So, indeed, it is a matter of fact that one can be a "victim of circumstance" and have little not no control over what might happen.  But at some point, you will likely have control over something, be it your reaction, your way of thinking about how to overcome what happened, or what you can do in the present to effect a positive outcome in the future.
In my work as a driver, I'm often observing driving situations and reviewing what could I have done better or differently to achieve a better outcome (for example, a smoother merge). Collisions are way more preventable than most people think; after all, nothing "comes out of nowhere".

Personal behavior change is hard. Taking pills is easy. And the placebo effect strikes at the heart of consciousness and will.
"The heart of any other, because it has a will, would remain forever mysterious."

-from "Snow Falling On Cedars", by David Guterson

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #19 on: May 06, 2019, 06:44:13 pm »
In my work as a driver, I'm often observing driving situations and reviewing what could I have done better or differently to achieve a better outcome (for example, a smoother merge). Collisions are way more preventable than most people think; after all, nothing "comes out of nowhere".

Personal behavior change is hard. Taking pills is easy. And the placebo effect strikes at the heart of consciousness and will.

And also, what it actually within something akin to control, or really, likely an influence, even if it is not something we are radically conscious of.  Even just a minor shift in focus, or directed attention, could have a drastic result, in driving, or anything else (for the "better" or "worse").

My point though, is, that if we necessarily imagine that we are only victims of circumstance, than that is all we could ever be.  If we imagine that we have some influence on how things could be, no matter how small that influence might be, we have the chance to effect the outcome we desire.  Sartre would call the extreme of this position, a "radical freedom" that we are totally free, but it need not be so radical or total.  But the result could still be anxiety, or depression.  To imagine the opposite, that we are all just victims of circumstance or biology, has it's place, to give us reason to believe that we have no culpability in the state of ourselves, and relieve to some degree the responsibility that choice places on us.

While it stands to reason that one could be a victim of things totally outside one's own influence, I think the likelyhood at all things are necessarily divorced from your own influence is sort of absurd.
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

TLEILAXU

  • *
  • Old Name
  • *****
  • Exalt-Smiter of Theories
  • Posts: 731
    • View Profile
« Reply #20 on: May 06, 2019, 06:47:58 pm »
Quote
My assumption, which could like be wrong, because who the fuck am I, but it would be that more "general anxiety" and "general depression" could be dealt with through a non-pharmaceutical approach
Does it have to be? I mean what about a case by case basis?

Well, I think you are mischaracterizing my point though.  I am saying, that yes, any effectiveness will indeed be a case by case basis, but, my hunch is that there are more cases where a non-drug approach could and would work than are currently both proscribed and generally accepted by patients.  I think part of that could be because the non-drug approach is also a lot of work and will require changes in assumptions, world-view and manners of thought, which many people just don't want to do.  POeople really do seem to have a "just give me a pill" approach.  In the same way that where I live, most people have high blood pressure, but won't alter the slightest bit of their diet.  "Just give me a pill, I am not going to change what I am eating."

Forgive my bias, but I can't help but imagine that psychology can work the same way.
I mean, I don't necessarily disagree with the first part of what you said; if I had e.g. depression I wouldn't want to take any drugs myself, because I'd be too afraid of the side-effects. Still, by denying or downplaying the biology involved we're doing ourselves a huge disservice. Just take Mikhaila Peterson. Auto-immune problems, depression etc. all seemingly connected to some real weird gut microbiome phenomenon. It was never about changing the world-view in her case, it was just about changing her diet.

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #21 on: May 06, 2019, 07:04:21 pm »
I mean, I don't necessarily disagree with the first part of what you said; if I had e.g. depression I wouldn't want to take any drugs myself, because I'd be too afraid of the side-effects. Still, by denying or downplaying the biology involved we're doing ourselves a huge disservice. Just take Mikhaila Peterson. Auto-immune problems, depression etc. all seemingly connected to some real weird gut microbiome phenomenon. It was never about changing the world-view in her case, it was just about changing her diet.

But in her case, imagine that she had no intent on changing her way of thinking and behavior.  If she just insisted that she should do nothing different, but be given the pill to make her condition go away.  In fact, that sort of what is what happened with her as a kid, with the initial diagnoses and the poor results it gave her.  All the anti-inflammatory drugs in the world could not help.  Only once she started to think about the "problem" in a different way and changed her conceptualizing of the nature of the problem and her behavior, was she able to change the outcome.  See, she actually took control over her own health, rather than being a victim and demanding a pill to stop it.  So, I don't think your example proves your point, in fact, really just the opposite.

See, this is why I see the "I'm not going to change anything I think or do, just give me a drug to make it stop hurting" is not going to work, long term.  You need to get down into the more "fundamental" roots of things.  If the way you think causes problems, all the drugs in the world won't work.  If the fundamental problem is just a biological mis-working, then sure, it can work to just take a pill.  My hunch though, is that there are far more people in the former camp, than in the biologically malfunctioning camp.

If fact, I think many people with poor health, are in this camp.  They don't want to stop eating bad food, they don't want to stop over-eating, they just want a pill to make these things have no consequences.  It seems plausible that it could work the same sort of way psychologically for a variety of issues, in many cases.
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

TLEILAXU

  • *
  • Old Name
  • *****
  • Exalt-Smiter of Theories
  • Posts: 731
    • View Profile
« Reply #22 on: May 06, 2019, 07:48:01 pm »
I mean, I don't necessarily disagree with the first part of what you said; if I had e.g. depression I wouldn't want to take any drugs myself, because I'd be too afraid of the side-effects. Still, by denying or downplaying the biology involved we're doing ourselves a huge disservice. Just take Mikhaila Peterson. Auto-immune problems, depression etc. all seemingly connected to some real weird gut microbiome phenomenon. It was never about changing the world-view in her case, it was just about changing her diet.

But in her case, imagine that she had no intent on changing her way of thinking and behavior.  If she just insisted that she should do nothing different, but be given the pill to make her condition go away.  In fact, that sort of what is what happened with her as a kid, with the initial diagnoses and the poor results it gave her.  All the anti-inflammatory drugs in the world could not help.  Only once she started to think about the "problem" in a different way and changed her conceptualizing of the nature of the problem and her behavior, was she able to change the outcome.  See, she actually took control over her own health, rather than being a victim and demanding a pill to stop it.  So, I don't think your example proves your point, in fact, really just the opposite.
I mean, I see what you're getting at but no, haha, I don't agree. She didn't 'will' her condition away, it wasn't about world-view or having a positive outlook on life, it was about physical illness caused by some weird digestive shit. I agree that the drugs didn't help, and in that case you do what you have to do (been there myself, googling, experimenting with my own solutions when the doctors and the pills kept not improving anything), but I don't think this has anything to do with 'control'. Just because something is not in your control doesn't mean you have to lie down and be a fatalist victim, I mean, why should you? On the contrary it can be a liberating experience since you don't have to feel guilty about not 'controlling' your life the proper way.

Quote
If the way you think causes problems, all the drugs in the world won't work.  If the fundamental problem is just a biological mis-working, then sure, it can work to just take a pill.  My hunch though, is that there are far more people in the former camp, than in the biologically malfunctioning camp.
But are you sure of that? And what of everybody in between, who need that joint therapy?

Quote
If fact, I think many people with poor health, are in this camp.  They don't want to stop eating bad food, they don't want to stop over-eating, they just want a pill to make these things have no consequences.  It seems plausible that it could work the same sort of way psychologically for a variety of issues, in many cases.
I just don't agree here. I don't think anybody actually wants to be a fat fuck. They might rationalize it (because they're in control of their lives after all, aren't they?), but I don't think anybody genuinely wants to be stuck in these unhealthy behavioral loops.

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #23 on: May 06, 2019, 08:27:56 pm »
I mean, I see what you're getting at but no, haha, I don't agree. She didn't 'will' her condition away, it wasn't about world-view or having a positive outlook on life, it was about physical illness caused by some weird digestive shit. I agree that the drugs didn't help, and in that case you do what you have to do (been there myself, googling, experimenting with my own solutions when the doctors and the pills kept not improving anything), but I don't think this has anything to do with 'control'. Just because something is not in your control doesn't mean you have to lie down and be a fatalist victim, I mean, why should you? On the contrary it can be a liberating experience since you don't have to feel guilty about not 'controlling' your life the proper way.

Well, no, I wasn't trying to say that she "willed" it away.  What is "willpower" anyway?

You say though, that it has nothing to do with "control" but really, she did take over responsibility for her own health, took to influencing her own outcome rather than passively handing it off to a doctor, or anyone else.  So, indeed, if you don't like the word "control" don't use it, but she certainly did exercise influence on her outcome.  That's the point.  If you don't like the notion of "locus of control" call it whatever you like, the outcome is still the same.  Rather than be passive and think of things as just happening to her, she took action and changed behaviors and got better results for it.  Maybe people do not do that.

I guess though, we can ask, if one is "not control their life in the proper way" by their own metric, and feel "guilty," again by their own metric, should they?

But are you sure of that? And what of everybody in between, who need that joint therapy?

I never precluded that such a thing could not happen.  In fact, just the opposite.  I already said that sometimes drugs can and likely do help people get out of positive feedback loops.  But I do think (note: think, not know) that drugs alone will likely not "cure" a number of common psychological maladies, such as general anxiety and depression. 

I just don't agree here. I don't think anybody actually wants to be a fat fuck. They might rationalize it (because they're in control of their lives after all, aren't they?), but I don't think anybody genuinely wants to be stuck in these unhealthy behavioral loops.

No, of course they do not want to be in a state such as obecity.  But they are also not, generally, open to modifying their behavior.  So, of course they do not want the disastrous consequences of overeating and eating unhealthy, but they do still want to do those things for a variety of reasons.  Take your above example, lets say that Mikhaila Peterson said, "Look, I don't want to keep losing joints, but I won't give up eating carbs.  It's just not something I can do."  It's not that she wants to loose the joints, be in pain, just that her perceived value in continuing her behavior (eating what she wants) is greater than the perceived negative value of the pain.

Honestly, I see this in action all the time.  Likely that skews my perception of it.  But I know people with diabetes that have literally said, "I'd rather die than not eat sugar" and I even know someone who did.  I know people who smoke, knowing full well the damage it does to them, and still will not modify their behavior.  Now, we can absolve them of any compliance in their own undoing, and to some degree that might be true, but I'm not willing to buy the idea that they could not stop if they actually wanted.

So, no, I don't buy the idea that the majority of people who are suffering something like general anxiety or depression, are biologically determined to be so.  Even if they are biologically predisposed to it, there is almost certainly, in my mind, something they could do, psychologically, to ameliorate it.

No, I don't have empirical data.  No, I don't know it to be a certainty.  No, I am not saying that it must be all psychological.  But there is no real evidence that something like anxiety is 100% biological either.  My point is that, in my opinion,  the way you frame the problem is going to determine what could even possibly work.

So, there is some confluence between biology and psychology.  If there were not, either drugs or therapy would work 100%.  But neither does, so there is some relative values between.  My point is, that in my opinion, our "empirical worldview" too often makes people believe that the only possible effective one would be drugs and wrongly so.
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

TLEILAXU

  • *
  • Old Name
  • *****
  • Exalt-Smiter of Theories
  • Posts: 731
    • View Profile
« Reply #24 on: May 06, 2019, 09:18:35 pm »
Quote
You say though, that it has nothing to do with "control" but really, she did take over responsibility for her own health, took to influencing her own outcome rather than passively handing it off to a doctor, or anyone else.  So, indeed, if you don't like the word "control" don't use it, but she certainly did exercise influence on her outcome.  That's the point.  If you don't like the notion of "locus of control" call it whatever you like, the outcome is still the same.  Rather than be passive and think of things as just happening to her, she took action and changed behaviors and got better results for it.  Maybe people do not do that.
She changed behavior in the sense that she changed her diet but that's not the same as the "dude just be more positive" that you often hear. I mean, maybe I'm misunderstanding what you meant with control and agency, I took it to mean control of your own mentality, so to speak, which is where Mikhaila's case is so interesting because it wasn't about any of that, it was about diet.

Quote
"I'd rather die than not eat sugar"
I mean, shouldn't that tell us something about how deeply people are stuck in these things? I'm reminded of the Bakker example with the moth flying into a bug zapper. It can't resist the light.

Quote
there is almost certainly, in my mind, something they could do, psychologically, to ameliorate it.
I mean, I don't disagree, but I see this more as behavioral re-wiring rather than assuming some locus of control or whatever.

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #25 on: May 06, 2019, 09:48:31 pm »
She changed behavior in the sense that she changed her diet but that's not the same as the "dude just be more positive" that you often hear. I mean, maybe I'm misunderstanding what you meant with control and agency, I took it to mean control of your own mentality, so to speak, which is where Mikhaila's case is so interesting because it wasn't about any of that, it was about diet.

Well, that is the thing, something like CBT is not "dude just be more positive" at all.  And if that is what one is getting out of it, than certainly it will fail.  Because that is not what it should be.  The thing is, one's method of thinking, the frame of mind, is a sort of process akin to behavior as well.  If you change that way of thinking, you can change the metal outcome.  So, sure, it is something of controlling your mentality, but it's also about changing that mentality.  So, again, if she had the mentality that she should not have to change her diet, then certainly her outcome would have been different.

So, if she had this idea that her original diet, which was making her sick, was so ingrained in her mental identity, that she could not even think of giving it up.  But that is a way people think about themselves.  Even though, there is no reality to that.

I mean, shouldn't that tell us something about how deeply people are stuck in these things? I'm reminded of the Bakker example with the moth flying into a bug zapper. It can't resist the light.

But are people really as incapable of modifying their thoughts and actions as an insect?  Are they really incapable or just unwilling?  I think we are bound to always disagree if you want to take the line that people are no different than biological machines with no agency to modify their thoughts or actions.

I mean, I don't disagree, but I see this more as behavioral re-wiring rather than assuming some locus of control or whatever.

Well, if that's what you want to call it, sure.  But in either case, it is something you do to not be a "victim of circumstance."  It's where you dictate how things will be, to the maximal degree which is possible.
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

TaoHorror

  • *
  • Old Name
  • *****
  • Posts: 1152
  • whore
    • View Profile
« Reply #26 on: May 07, 2019, 03:16:19 am »
I would think that the placebo effect in psychiatry is significantly more important that it would be in other areas of medical science. For example, I can't imagine you'll get very far in local anaesthesia with placebos. But as for psychiatry, as H notes above, if placebos work better than drugs.....

Well, if they indeed do work better, we're taking the author's statistics on this for granted as "true". How many and which drugs was this the case? I like Beard's example, there are some drugs/situations no one would want a placebo. Would like to see more of the research on that before throwing in the towel on medications. Just so much can go wrong with such a study - is it based on the reporting of the psychologist, the patient or from where? Is it long term success of the placebo? This just has the odor of lining up the data to support what you want to believe ( may not be the case, but would want to understand more before entertaining the ramifications if true ).
« Last Edit: May 07, 2019, 03:30:38 am by TaoHorror »
It's me, Dave, open up, I've got the stuff

TaoHorror

  • *
  • Old Name
  • *****
  • Posts: 1152
  • whore
    • View Profile
« Reply #27 on: May 07, 2019, 03:19:35 am »
And I think many people would also be surprised to learn that placebos can still work even when the person given them is actually told that they are placebos and are not actually drugs.

I've read about this before and I find this amazing. And those who still think they work try to get more to continue treatment. I wish I could remember how they explained how and why this is.
It's me, Dave, open up, I've got the stuff

H

  • *
  • The Zero-Mod
  • Old Name
  • *****
  • The Honourable H
  • Posts: 2893
  • The Original No-God Apologist
    • View Profile
    • The Original No-God Apologist
« Reply #28 on: May 07, 2019, 12:33:37 pm »
Well, since I got myself all worked up, I went and got the book.

I'm only on the introduction so far.

Quote
Instead of reflecting on the extent to which the Freudians had lost credibility by insisting that they could be experts on everything, the new generation of biological revolutionaries repeated their mistake: they declared themselves the new experts on everything. No one suggested that it might be prudent to decide which forms of mental suffering were best served by a medical model, and which might be better served in some other way. Revolutionaries don’t cede ground.

So, I think the author, like me, is not against the idea that there is biology involved, or that pharmaceuticals can help people, rather, that things are too often made out to be "all or nothing."
I am a warrior of ages, Anasurimbor. . . ages. I have dipped my nimil in a thousand hearts. I have ridden both against and for the No-God in the great wars that authored this wilderness. I have scaled the ramparts of great Golgotterath, watched the hearts of High Kings break for fury. -Cet'ingira

TaoHorror

  • *
  • Old Name
  • *****
  • Posts: 1152
  • whore
    • View Profile
« Reply #29 on: May 07, 2019, 08:38:21 pm »
Well, since I got myself all worked up, I went and got the book.

I'm only on the introduction so far.

Quote
Instead of reflecting on the extent to which the Freudians had lost credibility by insisting that they could be experts on everything, the new generation of biological revolutionaries repeated their mistake: they declared themselves the new experts on everything. No one suggested that it might be prudent to decide which forms of mental suffering were best served by a medical model, and which might be better served in some other way. Revolutionaries don’t cede ground.

So, I think the author, like me, is not against the idea that there is biology involved, or that pharmaceuticals can help people, rather, that things are too often made out to be "all or nothing."

So you see that, you're saying - the psychiatric industry are pursuing drugs too much, like way too much, too much everywhere? I don't know, just seems like medical malpractice to prescribe drugs the doctor knows likely won't work - or is that the point, too many psychiatrists genuinely are too all in with prescription drugs to treat psychological maladies? I guess that falls under "mistake", but even errors are malpractice if the doctor is "supposed to know better". You're saying they don't know better?
It's me, Dave, open up, I've got the stuff