An Open Call to Talk Frankly about Adherence
Sue Bergeson
Wednesday, May 14, 2008
Whenever
two or more psychiatrists are gathered together...they complain about treatment adherence. What
is adherence? It's the extent to which consumers stay on a treatment plan or
take a medication routinely. It seems I cannot be in a meeting of psychiatrists,
psychologists, psychiatric nurses ...
This entry was posted on Wednesday, May 14, 2008
orrb4
Thursday, May 15, 2008 at 03:58 AM
As a psychiatric nurse working on a locked inpatient unit, as a an individual who has been diagnosed myself with bipolar disorder for more than 25 years now, I frequently try to make the point with my clients that their feelings of being resistant to medications are no different than the diabetic who wants to fudge on his diet and take extra insulin, the person with the sinus infection who feels better and stops their antibiotic, or the man with hypertension whose blood pressure medication is affecting his potency- the negative feeling about having to adhere to a medication regiment is a HUMAN condition, not a psychiatric condition.
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JustJack
Thursday, May 15, 2008 at 05:23 AM
I've run the gammut with pdocs and tdocs and was unable to get my life together and my bipolar advantage harnessed until I met docs and alternative pros who were approaching BPII from a adaptive-advantage model rather than the medical-problem model. The medical-problem model approached meds from a compliance POV, the disroder was a horrible disability, and the goal was to drug me flat no matter the side effects, all of which I had to every single med prescribed. Guys like Thom Hartmann, George T Lynn, Tim Wooton and <a href="http://www.psycheducation.org/">Jim Phelps</a> helped tremendously approaching BPII from an adaptive-advantage model, which agrees and acknowledges the very dark side of the advantage gone haywire while focusing on tapping the adaptive genetics that is a major advantage once the excesses of the dark side are mitigated. They go beyond meds, using light/dark therapy, mood charting, introspection, putting the dis-order back into order, cognitive stuff where cognitive works, meds where meds work, all with the emphasis on evidence based management. I still cycle but I don't cycle as high or low, I'm on very little medication, and what little I do take, I take willingly and devoutly because I can see on my charts how it works and doesn't work. I should note that NO insurance, no govt assistance covers any of my multi-therapy care and none of my professionals and care providers take insurance (I spent years bouncing around insurance-sponsored docs only to find myself educating them on BPII, what a waste and a crime on the part of the "health care system"). NIMH and NAMI are well-intentioned but while I was with them for my "support" I was just another tragic problem in their medical-problem model, and in fulfillment of that POV, I was indeed. The other model helped me gain control, and make use of my gift. Any doc who talks compliance or adherence is automatically off my list of useful professionals. With such people no BP person can ever get well, they're just another problem.
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chato b stewart
Friday, May 16, 2008 at 12:39 PM
As a consume my main complain about treatment adherence is that many side effect of the meds. I did not take a pill to be sane just to get depressed about the weight gain.
No to mention all the runs to the bathroom.
Yet, with out the proper treatment adherence I could be back where i started.
Chato B. Stewart
Mental Health Advocate - Cartoonist - and a few other things!
http://www.mentalhealthhumor.com
“Using Humor to Heal and Educate with badly drawn cartoons.”
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Leonid
Saturday, May 17, 2008 at 12:43 AM
Good afternoon and happiness to You !
Please, help them.
All of them three are invalids and all of them need medical treatment and support.
We believe, that there are still hearty people, for whom the grief of another man is not means for action PR.
Help them anyway you can, if you can of course.
At least write them a letter with warm and kind wishes, so that they will be able to believe, that somebody thinks about them.
That means a lot for them too. Wish them health, happiness and well-being.
A kind word needs everyone.
We are passing by another man's trouble,
and then complain when a trouble comes to us.
This is a real situation and a straight appeal to You, as to a Man.
You make the destiny of that girl and her invalid parents yourself.
Have mercy on them, like Lord has it on You.
We beg Your pardon, but if You want to help this family, call:
+7 (3812) 673907.(Speak only Russian)
Ask, what You are interested in, to have no further doubts.
We ask You to write your answers only on adresses,
specified in the end of the letter.
This appeal, written by the group of students, is from Omsk.
We are united by the one goal: to make a kind act,
to find money for medical treatment of ill girl Maria.
Her parents are invalids.
"Asking from you - give" - the Bible says.
But many ones try to take away the last from those, who ask.
But the Bible tells, that even the dogs have crumbs from a table of the master.
Is this ill girl and her parents are worse than the dogs?
Do they deserve slow death from their illnesses?
The cruel world, hard human harts,
indifference to the grief of the other man is
what we clash with during our searching for money for this family.
But, nevertheless, we also meet kind and sympathetic persons.
Several times we received positive answers.
The people, who wrote them, have found for this family not only warm words,
but also sent some food products, vitamines,some clothes for Maria,
school accessories.
Sometimes they send some money - 20, 50 dollars.
But the precipice between the good and the bad is still great.
Unfortunately, not in favour of good.
If you can somehow help them, do it, please. 100-300 dollars,
any summ you can spend, or if you can, please,
inform us about the adresses of organizations,
which really make assisstance to such poverty-stricken and
ill people like theses ones, in practice.
If You know some foreign languages, please,
translate the essence of their problems as You see it from this letter,
and send it to us, so that we'll be able to search for help in another countries.
They need a hudge amount of money for medical treatment for all three of them. We comprehend that not everyone can help an ill child, because she's not yours. But if mercy and kindness live in your heart, please, help them, anyway you can.
If you have a possibility, please,
place the information about this family in Internet,
the links are below and in the end of the letter.
http://www.komelagina.qsh.es/index_en.html
http://www.komelagina.narod.ru/index_en.html
Or you can send some medicine, vitamines, preparations for immunity,
some biologically active additives - everyhting which can help in recovery.
Or it can be some school acseccories, second hand clothes for the girl, food products.
They are sincerely grateful for any help.
If you have some old toys, and clothes - send them, they will alter clothes,
or if it will not suit at all, they will give it into the local children's hospis.
We sincerely believe that there is mercy in the world.
And we want to believe, that You'll have a hand in the destiny of this girl and
her parents.
Here's their adress:
Komelyagin Leonid, Elena and Maria.
y. 20 n/c - 51 A,k- 24.
Omsk - 53.
Russia.
644053.
Home telephone: +7(3812) 673907.(Speak only Russian)
Donations accounts:
For: SBERBANK Zapadno-Sibirsky head office,Omsk, Branch 8634/0195
Account wich institution: SWIFT: SABRRUMMTN1
Account number:42 307 840 6 4500 0334041
Name: Komeliagin Leonid Ivanovich.
Details of payments: Donations for Medical Treatment.
http://www.komelagina.qsh.es/index_en.html
http://www.komelagina.narod.ru/index_en.html
Faithfully yours, Evgeniy Filippov, Stepan Shpeht.
God will reward you for your kindness and mercy.
P.S.
In Russia they say - do not offend the poor.
We ask for the three poor. On the file You can read about their diagnoses.
Maria metabolism is broken from excessive acceptance of medicines,
she's very plump.
We ask you to send clothes of XL - XXL sizes.
lemk@rambler.ru
leonkom@pisem.net
leonkom@mail.ru
Thank you very much for your mercy.
And let God reward You for your generosity and
keep you save from any misfortune.
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Anonymous
Monday, May 19, 2008 at 10:33 PM
I have discovered through the DBSA Support Groups that I attend that untill someone makes the decision to try to stay as well and balanced as possible and take care of their Depression or BiPolar Illness FIRST then do other things, they don't adhere very well to any treatment plan.
The successful people THINK Treatment Plan First.
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everybodyknowsinertia
Tuesday, May 27, 2008 at 09:47 AM
It's true that very few psychatrists and therapists are less than patient-centered, but I don't think that's any more true than it is for regular doctors or specialists. How many doctors have you seen who've pushed you out the door without barely talking to you? My very best doctor has been a nurse practitioner who would actually call me at work now and then to check up on me and my state of mind. Furthermore, my psychiatric nurse practitioner is far more empathetic and capable of listening to my concerns than is my psychiatrist. So what does this say about the medical world in general? It's stumbling on the right people who care. The most helpful therapist I ever had was one I picked straight out of the phone book, and she was fantastic. I saw her for years.
Another concern I have in the medical-centered model versus the patient-centered model is that in the medical-centered model, patients are forced into self-education to make sure that their treatment isn't totally off the wall. And when you've been newly diagnosed, how do you know which medicines to ask for, which side effects to try to avoid? And if you dare try to educate yourself on the web, you're pft'd at and patpat'd on the head as if you were a child who didn't know any better. Step back and let the real doctor do his work. In a patient-centered therapy, I think psychiatric doctors need to reconsider the 10-minute, drive-through therapy. They need to provide the knowledge they have about treatment and how it affects your disorder, and perhaps, if people knew what the medicine was fixing and how, there'd be more logic in adhering to a regime of medicines that often have more side effects than knowable benefits.
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