Social Question

wundayatta's avatar

Just because we can stop some pain, does that mean we should?

Asked by wundayatta (58367 points ) December 27th, 2009

In the area of mental illness, we have drugs that can control people’s pain and change their behavior into something that is more socially acceptable. We look at mentally ill people, who may be homeless, or addicted to drugs, or seeing hallucinations or really depressed or suicidal, and we think these things are bad and that the humane thing to do is to help them stop being who they are, so they can be a “successful” human being who contributes to society.

Because something can be controlled, does that mean it should be controlled? I’m talking about non-violent situations, where the only person hurt is the person who could be controlled is not controlled. Do we have a right to force “correct” decisions on other people? Is it even advisable for us, as a polity, to decide to do so?

I’ve got bipolar disorder, and I’m taking my meds religiously, and people consider me to be doing “well.” I’m not sure I want to do “well” according to their definitions. Crazy as it sounds, I may choose to be depressed or erratic or whatever I might be, and I might be willing to suffer the consequences, because I think those things that most people think are awful have a lot of value.

I have learned a lot from being depressed. I have come to feel empathy for others in ways I never had before. Then there’s the mania. Mine are mild, but I do enjoy them.

I have a lot of pressure to do the right thing, which means staying in a state where I can provide for my children and be a good father and do my part for the community. I think I can do those things even if I’m manic or depressed. I think that some of the things people call “symptoms” are actually essential parts of me, no matter how unacceptable they are.

I’m a good boy. I try to be a good boy. I do what people want me to do. I take my meds. I do my work.

Sometimes I fail to be “good” in certain parts of my life. Does that make me into a bad boy? Or can I be good, mostly, and bad sometimes? Does the bad outweigh the good? If I want to stop my meds because I value things that other people think are undesirable, should I be forced to stay “well” so I can fulfill my responsibilities?

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39 Answers

evandad's avatar

You’re complicating a simple plan. Yes, if you can stop pain you should.

Kelly_Obrien's avatar

No. Many of those anti-anxiety meds actually cause suicidal tendencies in the user(s).

dpworkin's avatar

@daloon This is a question that people must answer for themselves, unless, as I have said in another context, they pose a clear and present danger to others.

I have a friend who says that lithium makes him feel sort of dead, and he would rather not take it, and be symptomatic. He’s lucky enough to have this choice, because his symptoms have never (as far as I know) hurt another person.

But if an active schizophrenic is getting “orders” from his “voices” to strangle people’s cats, then I think he should be made to take neuroleptics.

Violet's avatar

Yes we should prevent and treat pain and mental illness. People who are mentally ill, and not medicated, should not have custody of children. And define good and bad.

Cheesefoot's avatar

Already some healthy normal good ‘pain-free’ upstanding citizens just don’t want to hear you @daloon. It doesn’t feel good at all.
In some cases, it seems to me the syptoms that are being medicated are an INCREDIBLE sensitivity to other people’s unhealthy mental states that invariably pass for normal.
The cause of the pain should be sought…there are fewer people capable of helping than there are profiting by ‘helping.’

cookieman's avatar

If you lived alone and no responsibility to anyone but yourself, I’d say go off your meds if you like. Experience your symptoms unedited and and gain whatever value from them you can. Odds are, you won’t effect anyone but yourself (and if your actions did, inadvertantly hurt someone, there’d be consequences anyway). So sure… Go for it.

However, since you chose to stay married and chose to have children, you must then choose to take you meds and keep your personality in check. Being mentally ill does not relieve you of that responsibility. So you do it for them. What you think you need, frankly doesn’t matter when weighed against the needs of your children, IMHO.

And yes, I know you think you can continue to provide for your family and be reliable while off your meds (best of both worlds as it were), but the very fact that you have a mental illness makes me doubt your ability to judge this properly. And, even if you’re right – I think it would be poor judgement to gamble with your children around.

That being said, seems to me your wife’s opinion on this adventure should hold more weight than any if ours.

How would she feel about your going off your meds and flying solo for a while?

StupidGirl's avatar

I see hallucinations and I won’t let anyone take ‘em from me.

Violet's avatar

do NOT go off your meds! Do you know what happens when someone bipolar goes off their meds?

Violet's avatar

@StupidGirl that is not smart. You allow yourself to be mentally ill? How old are you?

wundayatta's avatar

@Cheesefoot Could you flesh that reply out? Sounds interesting, but I’m not sure what you mean. Examples?

@cprevite I would never go off my meds while I have a family. You can look at this two ways. Either I’m a responsible person, or I’m too chickenshit to do what I really want to do. You can guess which one I think.

@Violet I know you’ve been burned badly by mental illness. I know you see things very influenced by your experience. I wonder what you would say if you could separate yourself from that particular experience.

@StupidGirl What do you like about your hallucinations that you are so protective of them?

Cheesefoot's avatar

‘Mentally ill’ is defined by the mentally ill. I’m almost guaranteed a more compassionate interaction with a non-medicated mentally-ill-diagnosed person than with my local Health Authority.

Violet's avatar

“If you have a chronic mental illness, it’s caused by an imbalance in your brain’s chemical and electrical systems, and it’s not going to go away on its own. The classic comparison is to diabetes. That doesn’t go away. It can be controlled by diet, exercise and medication, but failure to be responsible means you risk gangrene and the loss of eyesight, kidney function and life. Failure to be responsible for your mental health treatment risks such things as your family, your job, your home and, again, your life.”

http://bipolar.about.com/od/complianceissues/a/5badreasons.htm

“The bottom line is that if you have a mental illness, you have to take responsibility for your treatment”
Please read the article

Response moderated
Violet's avatar

@Cheesefoot are you really going to go there?! Have you heard of a little someone called science?!

Cheesefoot's avatar

@Violet they get things wrong sometimes, and have a hard time admitting it.

edit: Did I say always? Did I say Must?
I just got perfecto-fish award on day 2, I’m positively beaming!!
edited again: @Violet oh baby! You are out there!

Violet's avatar

@Cheesefoot so then AIDS must be something they got wrong too? And diabetes? How old are you and what is your education level?

wundayatta's avatar

@Violet What’s the difference between a chemical imbalance and just a significant variation from the mean? You may think it is a chemical imbalance, and I may think I’m fine. Why do you get to have your version of reality be the “right” one?

There are people who choose not to be treated for diabetes or any number of other diseases every day. We may look at them and think they are crazy, but we don’t know what their reasons are, and frankly, it is none of our business.

We have these socially informed consensuses about what is right and what is wrong. We have “responsibilities.”

I’m not opposed to any of these ideas, and I take my responsibilities very, very seriously. But I still think there is room for “irresponsibility.” People make choices, and not all of those choices are thought to be the best ones by others.

I just don’t think we should assume that it is always the best thing to take your meds or “fix” your mind or that your mind is even broken just because it is so different from other minds.

I really appreciate your comments, too, even if I don’t agree with them. I think you are bringing up some very important issues.

Violet's avatar

@daloon then why are you on medication?

Violet's avatar

@Cheesefoot so every doctor just happens to be wrong about bipolar existing?

wundayatta's avatar

@Violet Because I got really scared the first time this happened and I never wanted it to happen again. Then my wife wanted me to stay on, and I wanted to do it to make her feel better. Then I had a second incident, and I freaked, and I really started thinking about whether I should have. Now I’m not so sure. Hence, the question.

rooeytoo's avatar

I have a friend who would occasionally act manic. I never saw him seriously depressed. I knew him quite well, not romantically but very close friends. He suddenly turned into a sort of distracted, not quite there kind of guy. I asked him about it and he said he went on meds to stabilize his moods. I know he had a hellish childhood with a vicious alcoholic father and a mother who ran away when he was quite young. But we went to a lot of meetings and outwardly he seemed to be handling it all well.

Anyhow, he felt he needed meds so he got them. I thought it was sad to see him change from a vibrant feeling person into a straight line type automaton.

But I know I couldn’t be inside his head so it was not for me to judge.

You gotta know what you need to survive. Whether you live your way or the way you think you should live for someone else is a hard call. If I had to venture an opinion I would say you have to stay reasonably stable until your kids are out of the house, after that, it’s a new ball game.

Violet's avatar

@daloon you are not just “some guy”. You have a wife, kids, and a job. You have to think about others around you too.

StupidGirl's avatar

I’m not married and I don’t have kids. I can be as crazy as I want.

Violet's avatar

@StupidGirl ya, good luck with that

Cheesefoot's avatar

@Violet Bi-polar off the meds can be scary.
Isn’t it funny, though, how they are way wackier after the meds than before medication began? The cause is ignored, and I say that generally lies in thoughts that we cling to unknowingly. This is related to chemical imbalance, not caused by it.

edit: Sorry @Violet, the gap is too great, carry on without me, please.

Violet's avatar

@Cheesefoot “This is related to chemical imbalance, not caused by it.”, “The cause is ignored”
then what is the cause?
“they are way wackier after the meds than before medication began?” and who are “they”? Are “they” part of your research group at your lab? Or do you know this from personal experience?
“lies”
what lies?
How exactly am I “out there”?

SeventhSense's avatar

It raises an interesting question because on the one hand there is a matter of the usefulness of certain conditions and of their importance or malady in a life. On the other hand there is the question of whether the afflicted is the best person to make this decision. I had a friend who was bipolar and was at one time forcibly hospitalized. Years earlier he was a driver who transported hazardous materials, chemicals, petroleum etc. He was very miffed that he could no longer get a job as a hazardous materials driver and wanted no other tractor trailer job.
Sadly he commit suicide during an apparently deeply depressed or manic period. In retrospect it seems that his denial of the driving job was for the best. He may have hurt others in a moment of suicidal rage.

But I do think that medication is not always the best course and often our society uses it as the most expedient means to adapt an individual to “society”, never imaging that the environment that makes up society can also be adaptive to its members. And no where is this clearer than in the field of mental health. The nineteenth century world of medicine, psychology and pharmacology is almost indistinguishable from that which exists today. So perhaps the squeaky wheels do create change and in a direct way transform the praxis of mental health itself.
@daloon
good question as always…i’m still trying to formulate the question i need to ask..not that i don’t try..i just seems to get more and more frustrated

fundevogel's avatar

Pain is not innately good or bad. It is merely and indicator that you have in issue, either physical or emotional that needs dealing with. Unless the mechanism that recognizes pain is faulty or the cause of the pain is untreatable I think the healthiest choice it to treat the cause of the pain. Though, depending on the situation, it may be reasonable to treat the pain as you treat its cause .

Violet's avatar

@Cheesefoot so you have no real answer to any of my questions, and you have no proof backing up your claims..

fundevogel's avatar

@daloon I’ve always been rather fuzzy on bipolar disorder. It always sounded like dramatic mood shifts—high highs and low lows. I’ve known plenty of people with those, some could handle them without meds some couldn’t. Unless moods are simply beyond coping I don’t really understand why medication would be absolutely required.

Is my perception of bipolar disorder completely wrong?

wildpotato's avatar

No, I don’t think that pain and mental imbalance should always be controlled. As my physician parents emphasize, one should treat the patient, and not the disease. That is, if symptoms are livable, and you are okay with living with them, then the treatment is usually not necessary. And if treatment is not necessary, then it should not be used – or at least, it should not be the immediate and only option.

In this case, it sounds as though you might want to explore somewhere along the spectrum of less-aggressive-to-no treatment, because you seem to find your symptoms livable, and even valuable. This does not make you bad, just confused. It’s ok to be confused.

I find myself in a similar boat, actually – I should be on the brain medicine to stay symptom-free, but I don’t mind most of my symptoms and like the part of myself that the treatment for them takes away. So I tried not treating them for awhile and found it to be livable.

Maybe you could try a break from the meds, under your doc’s supervision? Your family may be put more at ease by such an approach.

SeventhSense's avatar

@fundevogel
Bipolar condition (formerly manic depression) is a very serious condition and often very successfully addressed with medication.

dannyc's avatar

Since you are smart enough to answer this question better than 99.999% of people, seems strange you are asking it…

Violet's avatar

@daloon “I really appreciate your comments, too, even if I don’t agree with them. I think you are bringing up some very important issues.”
That is very nice of you to say. : )

Dr_Lawrence's avatar

@daloon I respect your desire to have the right to choose for yourself. The severity of the Manic and Depressive phases of bipolar disorder vary over time from cycle to cycle.

I’ve known of patients in the manic phase to gamble their families into horrible debt or take extreme risks that may kill themselves or others. Of course, those in the depressive phase may attempt or succeed in killing themselves. This disorder dramatically affects a patients family and untreated makes it impossible for a patient to hold a job and support themselves.

If you life alone and have nobody in your life who cares about you and if your excesses while in a manic phase impact no one but yourself, then if you choose to forgo treatment it may not affect any other person. There is no legal compulsion for you to be responsible so long as you don’t hurt anybody else.

Having spoken to bipolars who no longer suffer the severe cycling of phases, many feel so much less a helpless victim of their disease.

I would not compell you to live as I say but I hope you find a solution that works well for you.

I live with severe chronic pain despite having tried a wide array of treatments, I still need many medications every day just to avoid being totally miserable. I have not been able to sleep in a bed like a normal person since early 2004. I sleep in a chair and not well.

I would welcome something to stop my pain and let me lead a more normal life.

Janka's avatar

In principle, I think that 1) if something you do only hurts yourself and not others, you are free to do it, and 2) mild “imbalances” are sometimes better coped with than medicated away.

That said, it is typical for people suffering from the bipolar disease to have phases where they feel they are not sick, and do not wish to continue medication, and that being manic is so fun that it is worth it, and such things—so typical that this sort of “anosognosia” (lack of recognition that one is sick) is by some considered a symptom of the disease.

For this reason, not knowing anything about you except your diagnosis and that you are on meds, I would strongly advice against going off your bipolar medication against the advice of your treating psychiatrist and your loved ones, as (based on general information of the condition) it is very likely they have a better idea of how you will be without them than you do yourself. “Trust the people who know you at least as much as you trust yourself when deciding what will probably make you happy” is good advice for anyone, and more so for a person with bipolar disorder.

wundayatta's avatar

@fundevogel Bipolar disorder comes in many shapes and sizes. I have the form that has very mild mania (hypomania), and fairly serious depression. There are people who experience hallucinations and delusions and get very violent against others or against themselves.

I got a bit impulsive and irritable. Not majorly. I actually hit my son for the first, and so far only time in my life. My wife says I was very snappy and she grew somewhat fearful to confront me. I don’t remember this. My perception was that I was weaker than ever,

I was also able to stay at work, and I never missed a day due to the illness. This is unusual. However many people are able to hold jobs even though they are unmedicated. There are two in my group. There are other ways of coping with the symptoms besides medication.

I am perhaps unusual in that I learned quickly to notice my symptoms, and I have always been open to talking about my concerns. So when I felt I was getting manic for the second time a few months ago, I immediately went to my shrink and got the meds readjusted in time to save me from much of a depression.

I’m not going off my meds, because of my family. But if I were to find myself single, for whatever reason, I would try. Of course, in such a situation, it could be dangerous if I were depressed, so maybe I’d wait a bit. But eventually, I’d want to see what I could do. Maybe because I feel like I am studying the disorder, and trying to write as honestly as I can about it, And I am starting to lose some sense memories. Maybe because I want to see if I have learned how to handle it. Maybe because I like being a little crazy.

Simone_De_Beauvoir's avatar

Well, no, to answer your original question, we don’t need to stop pain just because we can – obviously, what is defined as mentally ill is as time bound and culturally bound as defining gender norms…there is an authority we put into the world of medicine and into social structures so if you want to be part of this world, you have to ‘fit in’ or else…we know all of this background…now the world of medicine has never been objective or outside of society…it has flaws…right now it has a severe dependence on big pharma and that’s not helping our situation and interaction with mental disease…

my life has been ruined by a random physician’s ‘gift’ of a Paxil sample (I told him I was depressed because of my brother’s death and he gave them to me, he was a primary care doctor)...my body was not at all prepared to deal with the dose (what was normal for others was not for me)...it numbed me in multiple ways…life on meds was worse than life without…so I quit them cold turkey and almost killed myself…you can say I was one of the statistic…I’m one of the reasons they now attach a warning to these meds describing an increased risk in suicide…

It took a while for me to trust someone again to give me meds…he helped me, the meds helped me, I was better…then as you know I had severe postpartum depression and needed them again…I didn’t live when I had pospartum…I lived because of meds…that time they saved me…the second pregnancy around, they prevented my postpartum depression from returning…I took a risk and risked my infant’s health…the risk paid off and now my case will be written up and used to present as some evidence that it could be helpful for pregnant mothers with a history…

So…I feel ambivalent, very ambivalent…I wanted to have a rich life…I take meds now to maintain my sanity…I know that without meds, I can’t function as effectively because my emotions and responses get quite extreme…are they abnormal? no, just a different reality…but I don’t want that reality…so I create a new one with meds in my life…I have given up the guilt that goes along with that…

rooeytoo's avatar

I have always felt weird but have tried any sort of meds. Probably because I am chicken and stubborn and want to do it myself dammit!!!

It is so generous of you all and helpful to me to hear you share the insides of your heads and how you have come to be who you are.

I know it can sound trite, but I sincerely mean, thanks for sharing.

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