When meds don't work: Diagnostic confusion, trauma, sleep, hormones, and mistaken expectations

Back from the Abyss: Psychiatry in Stories

Craig Heacock MD

Psychiatry, Bipolar, Suicide, Depression, Ketamine, Psychotherapy, Science, Psychedelics, Health & Fitness, Addiction, Medicine, Psychology, Mental Health

4.8 • 452 Ratings

🗓️ 21 October 2021

⏱️ 27 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

When psychiatric meds work well, it can be nothing short of miraculous. Yet so often, patients accumulate a long list of med failures, leading to a sense of deep frustration and even hopelessness.Here Dr. H explores five central reasons why psych meds fail:1. Misdiagnosis, largely due to overlapping and confusing diagnostic categories and the general lack of a coherent nosology in psychiatry2. The role of trauma as the great imitator3. Sleep issues4. Hormonal status5. Confused and/or un...

Transcript

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0:00.0	Welcome to Back from the Abyss. I'm Dr. Craig Hecock.
0:16.0	I'm recording this today in Crescent, Ate, Colorado. I'm looking out the window.
0:23.0	The aspens are turning. The sky is brilliant.
0:26.8	And I'm here. I'm just about to start what I'm calling high mountain running camp.
0:32.5	Four of my very dear friends are arriving, and we're going to spend the next few days running,
0:38.7	hiking, biking,
0:46.6	and this is my attempt to improve self-care. A couple weeks ago before I left, one of my patients said, wait, Dr. H, you just went on vacation in August. You're leaving again? And I said, yes,
0:53.0	I am leaving again because I have to take care of myself so I can better take care of you.
0:59.9	And as you listeners know who've worked your way through these Back from the Abist episodes,
1:04.7	I have not always been the best at taking care of myself.
1:08.0	So age 54, I'm working on it. So this is a really cool place to record.
1:15.4	And before we jump into the mini episode, I wanted to read a couple recent emails that I got
1:21.8	that I thought you all might be interested in. Here's the first email. Hello, I found your podcast through Leah Barrett, and I was intrigued
1:31.0	because my brother has battled mental illness most of his adult life. He's had many ups and downs,
1:37.4	and the constant problem for him was going on and off his meds. He hated the way they made him feel,
1:43.4	so he tried to go without them, and then used meth when he couldn't battles. He hated the way they made him feel, so he tried to go without them,
1:45.4	and then used meth when he couldn't battle anymore. It was the cycle, and his delusions
1:49.9	always told him to jump. He jumped 15 years ago and became paraplegic, and jumped several times
1:56.0	after that whenever he had a psychotic break. Sometimes he was not able to jump, and he called that being
2:01.7	blocked. The last two years have been the best. He had a regular medical team, took his meds,
2:07.3	mostly, went back to school, was about to graduate with his BA. He even quit smoking, which he'd
2:12.9	never done. He had his 40th birthday, which was a major milestone for him, and all of us were in shock
	...

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