Monday, July 14, 2008

Meds Versus Therapy: Opening Salvo

Hello. This is my first blog. So, please excuse the blog-quality while I learn.
However, I know my content. Meds versus therapy. Specifically, in mental health / psychology / counseling / psychiatry, the heavy promotion of medications when psychotherapy, and other therapeutic interventions, may be preferred. I plan to also address the topic of non-medication interventions for other health care problems when there are decent interventions to be considered, and even preferred, over medications.

I am going to review research as it emerges to illuminate how Big Pharma works the marketing campaign to get research developed, executed, shaped, and dispersed to favor increased sales, whether helpful or not. And how psychiatry in general is involved in the ride.

Many people are blogging on this and similar issues. I believe I can contribute to this emerging discussion. Someone has to. The over-promotion of medications, and the pathologizing of phenomena that should not be pathologized, has gone to such an extreme that some sort of counter is needed. So, what occurred to me is the counter: therapy, versus meds.

Sure, there are lots of problems where medications help. And where medications are needed. Are life-saving. Are the best things going, although they may not be optimal. Yes, I believe mental illnesses exist. And should be treated with pharmacotherapy when indicated.

However, Big Pharma, along with the practice of medicine in general, psychiatry in specific, and also medical research as well as other parties, have really gone too far. They have gone too far.

Time after time, medication is provided, is heavily promoted, as the answer, when the answer ought to be therapy. Talk therapy. Psychotherapy. Counseling. Personal Effctiveness Training. Personal Financial Management. Parent Effectiveness Training. Stress Management. Relaxation Skills. Problem-Solving. Assertiveness. There are currently many problems where the evidence is there to indicate that decent therapy is about equal to medication. Yet, in practice, medication is promoted as the first-line treatment, with often no mention of talk therapy as a preferred intervention, a viable alternative, etc. There are circumstances where therapy should be prescribed along with medication. But therapy is never mentioned.

Why? Well, that is what I plan to blog about. I will probably get to sound like a broken record. Heavy marketing by Big Pharma. Pharma's well-planned manipulation of physicians and the educational media to which physicians are exposed. Our society's general desire to have a pill, versus hard work, to cure our problems. The lack of the field of psychology to make psychotherapy understood the way it should be. The misguided belief by people in general and by physicians specifically that physicians are scientists, and thus know how to consume science. The role of third-party payers in health care. The influence of Big Pharma money upon psychiatric research. Shifty, sneaky, misleading research. Lies, Darn Lies, and Statistics. Did I mention Big Pharma? OK. But Big Pharma has not been able to achieve their stunning success alone. Other stakeholders have been complicit.

Well, it comes down to this: sometimes, it is simply meds versus therapy, and sometimes the evidence says therapy wins, even though in practice meds wins. To me, that doesn't sound right. So I am gonna blog about it.

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