Friday, September 14, 2012

Recovery - The Medical Model Continued

Last week I began scavenging my upcoming Mental Illness Awareness Week presentation Recovery: Rewiring the Brain for a series of blog posts.  I left you in the middle of the Medical Model.  The graphic is on the left.  The narrative left off as the person with the broken brain was reading the patient information sheet, gulped at that list of side effects, remembered the doctor said she should weigh her costs and benefits, and then discovered that, according to the patient information sheet, the doctor had already done the weighing for her, and all she had to so was swallow the damn pill.

The Chemistry Experiment

The way it actually happened was this.  The sixth antidepressant my doctor wanted to try, she said, I get really good results with this medication.

So I wanted to know, remembering the results I got from her last brilliant idea, or rather, from the samples she had just received from the last sales rep, What kind of results will I get?

And she said, We won’t know unless we try it.

You know, you want to believe what the sales reps say.  And indeed, for some people, these meds have changed their lives.

But, honest to God, and I am quoting Dr. Ken Duckworth, NAMI’s (National Alliance on Mental Illness) medical director, if these meds really worked as well as promised, NAMI would have gone out of business a decade ago.

The pharmaceutical companies are no longer trying to develop new drugs with new promises, because National Institute of Health won’t fund the clinical trials.  (Clinical trials are when they give some people the poison pill and some people the sugar pill, and measure whether their scores change on the symptom check list.)

Rewrite Your Research Grants

NIH now makes grants for basic research into the causes of serious mental illness, in the hope that when we understand the underlying neuropathology, not just what the chemicals do to the symptoms, we may find new treatments that really do restore people to full functioning.  We have new tools, brain imaging, the human genome project.  It’s time to start again.

Anyway, hope springs eternal.  Maybe there is a silver bullet out there.

In the medical model, elimination of symptoms leads to recovery, full functioning, normal life.  The people for whom this model works, who take their pill in the morning and are good to go, frankly are very, very fortunate.

And I do not begrudge them their good fortune.  I can name fourteen meds I have tried in my intense desire that taking a pill would give me my life back.

But I have not received my intense desire.  And you may know or you may be another whom this model has helped, but we simply can’t climb to the top of the ladder.

The Recovery Model

So next week, we will tell this story again.  The second version was developed by people who have a mental illness.  It offers a different understanding of recovery and how we get there.

Again, you start with the broken brain.  You take it to the doctor.  You ask, What the heck happened?...


Note added on 01/02/13 -- Links to other posts in this series are below:

Is Recovery Possible? - Kayla Harrison Continued August 25, 2012 -- The judo champ's story introduces the concept of recovery.
Seventeen Keys to Recovery August 30, 2012 -- Guest blogger Margalea Warner describes her journey in recovery in schizophrenia.
Recovery - The Medical Model September 7, 2012 -- Introduces the doctor's agenda, covers the first half of the story.
Recovery - The Medical Model Continued September 14, 2012 -- It was a great idea.  If only it worked.
Recovery Redefined September 21, 2012 -- People with a mental illness have our own definition of recovery.
Recovery - From What? October 1, 2012 -- You have to know where you are going if you want to get there.
Stages of Recovery - AKA Hope October 5, 2012 -- We recover in stages, and need different tools for each stage.
Neuroscience of Meaningful Work October 10, 2012 -- Oh goodie!  Here come the dendrites!
Hope for a Cure? Or Not? October 18, 2012 -- We finish the series with questions left unanswered, like, What is a cure worth?

graphic created by Willa Goodfellow, James Potash the source
flair from Facebook.com
fMRI images represent activation in an emotional Stroop task, and used under Creative Commons license

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