An interesting phenomena that continues to befuddle me everyday with almost every new psychiatric office consult: Why do so many practitioners write for so many different psych meds without thinking about the body that the meds must pass through before reaching the brain. Now do I, dear reader, need to repeat that? This in-your-face-fact of biomedical passage is so obvious that it defies dutiful repetition.
Why are we traveling up the mountain without looking for a moment at the path? The Sherpas would call such travel crazy.
Meds go through the stomach, the gut, the liver, and some, dear readers, like Vyvanse, through the red blood cells , before they are metabolized sufficiently to reach the brain. They have to travel through the marshes, they don’t just pop up there to the top of Everest.
And don’t answer that question by insisting that “the public demands it…”
Unmanaged care loves this mind confusion, and, like candida in the gut, thrives on sugar coated impressions. Everyone know this, but, while we get paid to help, they get better paid to neglect.
Refractory responses to psych meds are pandemic and remarkably unexamined. But the subsequent questions, the essential critical inquiry that should follow these clinical confusions and catastrophes, vaporizes more rapidly than morning summer fog.
Let me ask you… does Adderall = Aspirin?
The Mind Altering Temptation
And, moreover, an additional, somewhat seductive problem: the psych meds have a certain redemptive, almost spiritual power if they work right – and the operant word there, as you may have surmised: IF they work as easily as expected, without additional critical thought. You can see the healing in a day or two – so why not press on without question? Lemme think: those details don’t do matter. It’s too easy for a well meaning provider to be drawn to that apparent mind-magic.
Critical thinking, in its most defensible sense, is not simply a matter of cognitive skills. Moral integrity and responsible citizenship are, in turn, not simply a matter of good-heartedness or good intentions. Many good-hearted people cannot see through and critique propaganda and mass manipulation, and most good-hearted people fall prey at times to the powerful tendency to engage in self-deception, especially when their own egocentric interests and desires are at stake. One can be good-hearted and intellectually egocentric at the same time.
On A Personal Note
Personally I don’t write for any meds I don’t know enough about, period. Antibiotics, no. Cold formulas, no. Antihistamines, no. Birth control, no. The days when we used to think the brain, like the heart, was in some mysterious high Everest-like place are long gone. Now the brain and mind too often present problems scanned briefly like a troublesome hangnail… “Just take some of this and see what it does. – It looks like you may need a manicure.”
CoreBrain, our new training site [yes it's just under construction] plans to contribute to the resolution of these problems – why not show your interest, for example in the ADHD epidemic, and investigate some CME Training for the biomedical details? Sign up over there to keep informed on the evolving application of science – and just how simple critical thinking can both change your medical intervention systems, and take you away from unmanaged care, which thrives on Nonscience and cookie cutters solutions.
Informed medical citizenry, those following the rapid evolution of mind science, should take note: critical thinking, such as I have been encouraging at CorePsych is well underway. Let’s work together at CoreBrain,