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rhivolution) wrote2010-10-30 09:05 pm
rhivolution) wrote2010-10-30 09:05 pm
Entry tags:
How about 'Rally For Not Being Douchey'?
So I said two weeks ago after I got back from going to the UK shrink that I would write about it, and I meant to in this post, but I started ranting about the Rally For Sanity and why it pisses me off, instead. The first bit is about that, the second bit is about the UK psychiatric system.
I am leaving this post unlocked for people's reference.
Part One: Rally Round the Ableism Flag
It's so easy to call someone 'insane' when they disagrees with you in a way you consider irrational and dangerous. Their POV may indeed be irrational and dangerous. I confess that I snap to 'this is fucking crazy', myself, when riled, then catch myself.
Because it situates itself in the dominant societal mindset that marginalizes people with mental illnesses, implying that all our experiences are problematic, that we are all uniformly dangerous and just plain wrong. Yes, this is JUST semantics, but semantics are important because they reflect the dominant paradigm. Also, it fucking hurts to have people toss around words like that (see my rant on why I fucking hate when people say 'I'm so OCD' when talking about keeping their DVDs in alphabetical order).
Here is more on 'crazy' and particularly why it's fucking ridiculous to apply it to politics, from FWD. Also read the original profile of 'crazy', linked there.
So, a 'Rally for Sanity' not only is ableist in that way, but it carries on into something that particularly rankles me. English is such that 'sanity' and 'insanity' are polar opposites. You're sane or insane.
This is, of course, not how it works. There is a huge spectrum when it comes to mental illness--for example, my mother yells at me when I call myself 'crazy', because I don't fit her definition. But I have OCD and depression and...well, if you're the UK doctor, you think I don't have ADD, but whatever...and enough that if I'm not treated, I have a problem with my quality of life. This fits into 'insanity'. But it doesn't, because I can mostly pass for able-bodied. But it does, because I do have these conditions. But it doesn't...you get the picture.
So to say 'here is our rally for sanity' not only adds to crazy as a singular negative term that means Bad People, it also implies that only people who match these political ideals are 'sane'. Sane = good, insane = bad.
Honestly? The shit in US politics right now is just that--shit--and it's nice to know that there are people out there who are as appalled as I am. There were plenty of ways to do the same thing WITHOUT being a jackass about it. Unfortunately, this Insane Person Who Thinks The Tea Party Is Appalling didn't get her say and she had to read all kinds of tweets and shit about it and every time the name was mentioned, it made her itch.
Here is another person's post about the fuckedupness of the name.
Part Two: National Mental Health Service?
Honestly, I didn't have that bad an experience with the UK psychiatrist. She was very open and listened to me give my case history for the better part of an hour. It wasn't too hard to get to the mental health centre, and the wait for an appointment was literally two weeks, which isn't bad. I did have to wait for an age in the reception area, though. A newer building, clean, plenty to look at, toilets and a water dispenser...not so bad. Also, she was very open and responsive.
I recognize that this is MY experience, though, and I'm certain that there are plenty of people out there for which this is not true.
But there are certain bits that rankled:
Firstly: the UK and the US have different diagnostic criteria (ICD-10 Chapter V and DSM-IVR, respectively). She had to make sure I had OCD under their criteria, which was fine. I do. I'm fucking textbook. But as she said, they don't really make snap diagnoses 'like they do in the US'. They also don't like to medicate 'like they do in the US'. She was of the mind that my US doctor overmedicated me. (My opinion: he did the best he could.)
Which leads to my point: she doesn't think I have ADD. I'd be willing to accept this if there was another good reason why I go off into tangents and can't get anything bloody DONE in my life alternating with the fact that that I'm ridiculously hyperattentive, e.g. if it was because of the Prozac. I suggested it might be...but she doesn't think these symptoms match ADD at all. Therefore, she doesn't want me on pills for it. I explained that the pills for it not only help me concentrate, they predominantly keep me awake because I'm fatigued a lot. She thought cutting back on the Prozac (I was on 80 mg--the highest dose in standard use in the UK is 60 mg) would help with that, because the Prozac was raised because I was feeling depressed...there were some pretty good life reasons for that, namely being stuck in Wisconsin with little social interaction, which have been resolved.
So, no more ADD pills. I thought this was going to be a problem especially with HOLY SHIT OAD, but in terms of the fatigue, I've improved considerably on the 60 mg one pill over the last month and a half. I'm not YIPPEE ZOMG, but I'm less exhausted during the day. I still have wacked out hyperfocus and I still can't force myself to do shit that doesn't have a very deadly deadline, though.
That said, we get to the frustrating bit: she wants to start thinking about cutting me back further on the Prozac. Why? She thinks that either I have a ridiculous force of will or I may not have as bad a case of OCD as people think, because I'm so damn functional. I beg to differ, having known myself when the medication isn't working, but hey. It's not that I want to be on medication so badly that I'm clinging to it; I've done and managed on 60 before, but I got up to 60 in the first place because it was necessary. She wants to cut back on the Prozac further, well, she can see what it does to me.
Hint: it ain't pretty.
Of course, I can speculate all I like about whether or not the UK system is set up predominantly to wean people off mental healthcare due to cost, or whether the US system is set up predominantly to make better money for big pharma. And, for that matter, both of these cultural attitudes are set up to feed into those systems (just as the attitude towards standard healthcare in the US is to 'ignore it until you fall over' for a reason). Both of these are probably true, and frankly, both of them are probably going to implode eventually.
Still, in terms of paying, this is probably better for me, personally. I don't need talk therapy at the moment (frankly? it only works so well for me, and was mostly a place for me to destress...which, coincidentally, helps the OCD) and therefore I fit really well into the UK system. I can just see where it would fuck people over big time, and I'm also really not thrilled with the lack of societal acceptance regarding treatment for mental illness in this country, regardless of the reasoning, and regardless of the effort put forth by charities, the NHS, and Stephen Fry. I mean, the centre I went to was sort of in the boonies, and this was the nearest one to me?
Time will tell.
I am leaving this post unlocked for people's reference.
Part One: Rally Round the Ableism Flag
It's so easy to call someone 'insane' when they disagrees with you in a way you consider irrational and dangerous. Their POV may indeed be irrational and dangerous. I confess that I snap to 'this is fucking crazy', myself, when riled, then catch myself.
Because it situates itself in the dominant societal mindset that marginalizes people with mental illnesses, implying that all our experiences are problematic, that we are all uniformly dangerous and just plain wrong. Yes, this is JUST semantics, but semantics are important because they reflect the dominant paradigm. Also, it fucking hurts to have people toss around words like that (see my rant on why I fucking hate when people say 'I'm so OCD' when talking about keeping their DVDs in alphabetical order).
Here is more on 'crazy' and particularly why it's fucking ridiculous to apply it to politics, from FWD. Also read the original profile of 'crazy', linked there.
So, a 'Rally for Sanity' not only is ableist in that way, but it carries on into something that particularly rankles me. English is such that 'sanity' and 'insanity' are polar opposites. You're sane or insane.
This is, of course, not how it works. There is a huge spectrum when it comes to mental illness--for example, my mother yells at me when I call myself 'crazy', because I don't fit her definition. But I have OCD and depression and...well, if you're the UK doctor, you think I don't have ADD, but whatever...and enough that if I'm not treated, I have a problem with my quality of life. This fits into 'insanity'. But it doesn't, because I can mostly pass for able-bodied. But it does, because I do have these conditions. But it doesn't...you get the picture.
So to say 'here is our rally for sanity' not only adds to crazy as a singular negative term that means Bad People, it also implies that only people who match these political ideals are 'sane'. Sane = good, insane = bad.
Honestly? The shit in US politics right now is just that--shit--and it's nice to know that there are people out there who are as appalled as I am. There were plenty of ways to do the same thing WITHOUT being a jackass about it. Unfortunately, this Insane Person Who Thinks The Tea Party Is Appalling didn't get her say and she had to read all kinds of tweets and shit about it and every time the name was mentioned, it made her itch.
Here is another person's post about the fuckedupness of the name.
Part Two: National Mental Health Service?
Honestly, I didn't have that bad an experience with the UK psychiatrist. She was very open and listened to me give my case history for the better part of an hour. It wasn't too hard to get to the mental health centre, and the wait for an appointment was literally two weeks, which isn't bad. I did have to wait for an age in the reception area, though. A newer building, clean, plenty to look at, toilets and a water dispenser...not so bad. Also, she was very open and responsive.
I recognize that this is MY experience, though, and I'm certain that there are plenty of people out there for which this is not true.
But there are certain bits that rankled:
Firstly: the UK and the US have different diagnostic criteria (ICD-10 Chapter V and DSM-IVR, respectively). She had to make sure I had OCD under their criteria, which was fine. I do. I'm fucking textbook. But as she said, they don't really make snap diagnoses 'like they do in the US'. They also don't like to medicate 'like they do in the US'. She was of the mind that my US doctor overmedicated me. (My opinion: he did the best he could.)
Which leads to my point: she doesn't think I have ADD. I'd be willing to accept this if there was another good reason why I go off into tangents and can't get anything bloody DONE in my life alternating with the fact that that I'm ridiculously hyperattentive, e.g. if it was because of the Prozac. I suggested it might be...but she doesn't think these symptoms match ADD at all. Therefore, she doesn't want me on pills for it. I explained that the pills for it not only help me concentrate, they predominantly keep me awake because I'm fatigued a lot. She thought cutting back on the Prozac (I was on 80 mg--the highest dose in standard use in the UK is 60 mg) would help with that, because the Prozac was raised because I was feeling depressed...there were some pretty good life reasons for that, namely being stuck in Wisconsin with little social interaction, which have been resolved.
So, no more ADD pills. I thought this was going to be a problem especially with HOLY SHIT OAD, but in terms of the fatigue, I've improved considerably on the 60 mg one pill over the last month and a half. I'm not YIPPEE ZOMG, but I'm less exhausted during the day. I still have wacked out hyperfocus and I still can't force myself to do shit that doesn't have a very deadly deadline, though.
That said, we get to the frustrating bit: she wants to start thinking about cutting me back further on the Prozac. Why? She thinks that either I have a ridiculous force of will or I may not have as bad a case of OCD as people think, because I'm so damn functional. I beg to differ, having known myself when the medication isn't working, but hey. It's not that I want to be on medication so badly that I'm clinging to it; I've done and managed on 60 before, but I got up to 60 in the first place because it was necessary. She wants to cut back on the Prozac further, well, she can see what it does to me.
Hint: it ain't pretty.
Of course, I can speculate all I like about whether or not the UK system is set up predominantly to wean people off mental healthcare due to cost, or whether the US system is set up predominantly to make better money for big pharma. And, for that matter, both of these cultural attitudes are set up to feed into those systems (just as the attitude towards standard healthcare in the US is to 'ignore it until you fall over' for a reason). Both of these are probably true, and frankly, both of them are probably going to implode eventually.
Still, in terms of paying, this is probably better for me, personally. I don't need talk therapy at the moment (frankly? it only works so well for me, and was mostly a place for me to destress...which, coincidentally, helps the OCD) and therefore I fit really well into the UK system. I can just see where it would fuck people over big time, and I'm also really not thrilled with the lack of societal acceptance regarding treatment for mental illness in this country, regardless of the reasoning, and regardless of the effort put forth by charities, the NHS, and Stephen Fry. I mean, the centre I went to was sort of in the boonies, and this was the nearest one to me?
Time will tell.
no subject
I'm sorry you're having to battle the psychiatrist for your own diagnosis. That's so frustrating, ugh. Especially b/c she has no history w/you! As you said, she hasn't seen you when you're not on the right kind of meds or right dosage.
My GP gave me the same superior sort of line about not handing out pills like candy like they do in the US.
When I went to talk therapy it was this v. annoying kind of CBT where the therapist acted like the response to, say, racism, was largely to change your reaction to it, b/c you can't change other people, blah blah blah. Which is, uh, kind of antithetical to the whole notion of social justice activism? So yeah, it didn't do much for me. :/
Given that & the crap dentistry service I've gotten here (the dentist gave my teeth a VISUAL INSPECTION ONLY & told me that getting one's teeth cleaned at the dentist too often--I told him I hadn't had them done in at least a year or more--was bad for them!!!) I am not excited about sampling other parts of the NHS. Mind you, it's awesome that everyone can go to the dentist (er, if they can afford to--it's not free anymore), & to psychiatrists, etc. (& I mean, I've had bad healthcare experiences at home too) buuuuut yeah. Not impressed.
no subject
Anyway, thank you for saying this--while she's been right so far about the Prozac, I really don't feel comfortable with taking it down any further than this, and I feel like...yeah, I don't know. Maybe the US system is over-dependent on medication (as I've mentioned before, I was started on SSRIs at 12 or 13, which now is pretty much anathema due to studies showing suicide risk), but I don't think it's entirely wrong, like the UK system isn't entirely wrong.
Bah.
no subject
My coworkers seem to think that the NHS will take any steps it can to minimize expense (hence me not getting a cleaning or x-rays or anything I take as standard when visiting a dentist, particularly for the first time--basically I paid 16 pounds to have the guy stare inside my mouth & berate me for wanting my teeth cleaned). So... yeah. I dunno. Pushing pills like candy isn't good (nor is ppl not having access to doctors b/c of cost), but the possibility of w/holding them to save money isn't either.
no subject
I think we use the DSM here mostly, but I do know that the WHO ICD is also used -- likely to cross reference, seeing as the DSM-IVTR SUCKS in some respects.
no subject
also: total icon adoration! gankable?
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There's some serious suck in the DSM (I did my American Studies major seminar on the history of mental health in the US), but at the same time, there's suck in the ICD, from what I can see. Hm.
no subject
If you haven't yet - get Driven to Distraction and the related books by the two authors. It's got diagnostic and coping advice and I found it very useful.
[sigh] I really should finish off my degree and all that, shouldn't I?
no subject
I used to think JStew was really funny; I still think he is; but I no longer see him as an ally. *seethe*
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This is so well said I felt like putting it in sparkletext.
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I sometimes try to talk about these difficult, abstract concepts, but I feel inadequate to the task, and unfortunately I tend to jump into it when I'm feeling particularly upset by something, which makes it even harder to argue coherently.
That's why I appreciate it very much that you write about this, and do it so well.