Schizophrenia Treatment and Shared Medical Decisions

  • SMD.  This shorthand sounds pornographic like S&M.


    SMD however is Shared Medical Decisions. You can go on the Informed Medical Decisions Web site to read patient guides and see for yourself how you can become your own self-advocate.


    I recommend everyone read The Treatment Trap about how the overuse in America of risky and dangerous treatment kills people or causes them to become living vegetables for the rest of their lives.


    As far as psychiatry goes: if you don't get the right treatment right away it robs you of the equal opportunity to succeed.


    You get no treatment: you risk not getting to recovery. You get the wrong treatment: you can be held back and your life could be hell.

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    My signature story is the I got immediate treatment within 24 hours and the symptoms completely stopped three weeks later.


    I'm a big fan of SMD because I kept refusing to go along with a doctor's automatic continual pleading that I start to take Zyprexa or at least Risperdal even though I'd gain monster pounds.


    I had no symptoms and no side effects from the Stelazine and was doing fine so I repeatedly nixed his requests for me to switch medication. It seemed like using a sledgehammer to kill a mosquito.


    His rationale for the switch was that "everyone's doing it." This didn't sway me. Everyone was doing a brand new dance called the locomotion in the 1970s. And I have two left feet. I dance like a washing machine. I can only do a twist or a variation of the twist.


    So I wasn't going to go along with this dangerous new dance. I was a rebel who spoke up with her doctor to champion what I thought was right.


    The kicker with this doctor was that it seemed like I was girlfriend bait to him. At the end of the 15 minute session I would be ready to get up and go and he would ask his own version of a "doorknob question" : "Are you in a relationship?" Every session ended with those creepy words.


    I wondered why this was important to him and why he kept pressing me for an answer. I was afraid I was some kind of girlfriend bait and he was angling for a kiss. It didn't help that in the sessions he lifted his left leg over the tubular arm of his chair.


    I might have been outspoken yet I was most likely too terrified to ask why he lifted his leg up that way during every session.


    Now you see why I'm a big fan of SMD and getting the answers to your questions about treatment options so that you can make an informed decision about what you want to do.


    I realize the ex cathedra nature of the doctor and patient relationship can be intimidating. I'm just as guilty of being convinced a professional might be reputable because he's wearing blue scrubs or a white coat.


    This is human nature to be taken in by the image of a trusted professional.


    Yet because of my experience with this kind of subpar treatment and clueless approach to treating a patient I will always champion SMD for everyone who enters a relationship with a doctor or other professional.


  • It goes without saying that it's unethical, immoral and dangerous to enter into a romantic relationship with the professional that is treating you for an illness or for any other reason.

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    SMD indeed. I urge readers to get on this train and go on the Informed Medical Decisions Web site and familiarize yourself with what you can do to become your own self-advocate.


    Now: I don't recommend engaging in risky behavior that will jeopardize your mental or emotional or physical health. I don't endorse treatment non-compliance when the right treatment can greatly improve your life so that you are no longer in pain.


    SMD. Something to think about.


    For a detailed review, read my SharePost Communicating With Your Providers.


    I will end here by telling you it's possible to find members of your treatment team that will take a conservative approach to treatment and or an integrative medical way to practice.


    My primary care doctor routinely recommends OTC or over-the-counter supplements to see if they'll do the trick before she prescribes medication with her trusty pad.


    My pdoc raised the Stelazine from 5 mg to 10 mg before it was time to switch me to an atypical.  At this time, he switched me first of all to an atypical that was thought to not cause weight gain.  Dr. A has also stayed faithful to my request that I'm not given a habit-forming or addictive drug.


    He honored and approved of my choice to use cognitive behavioral therapy instead of anti-anxiety medication.  He gave me a relaxation and stress reduction workbook off his bookshelf for me to read.


    You might have to research reputable providers to find a professional that's true-blue like Dr. A.  Yet you will be rewarded double when you start and continue treatment with trustworthy members of your treatment team.


    Our providers are not adversaries: they're supposed to be our allies.


    I don't recommend acting belligerent or hostile to your providers.  If the relationship isn't working out and merits a change, you have the right to fire a member of your team and replace him or her with another person.


    I recommend keeping an open mind about the benefits of treatment.


    The Positive Psychiatry Movement will be the focus of a future SharePost.  I will also interview psychiatrists working in the field for their take on helping patients recover from a professional's side of the story.


    The next SharePost will be a book review and debate on the topic of Saving Normal.


Published On: January 06, 2014