Medical and Mental Health Gaslighting and Iatrogenic Injury

Shirley,

Thanks for the article illuminating this issue!  As someone who has dealt with mental health obstacles since their teens, I have felt the frustration of unintentional iatrogenic injury from a series of mental health and medical providers.  When I was a college student and later a young adult with limited health insurance, my options for care were the campus clinic or the local urgent care.  Screenings were often cursory due to high patient load and expectations of quick turn-around time.  Treatment usually entailed a progressive dosing of whatever flavor-of-the-month broad spectrum antidepressant/antianxiety meds were currently being promoted by the pharmaceutical reps, with ineffectual, or occasionally dangerous results (not to mention negative side effects like weight gain and lethargy).  A week into taking Wellbutrin, I ran my car off the highway in the middle of the day because I'd lost focus on what I was doing at the time - no injuries or serious damage occurred, but I was deeply shaken.  I'm sure the providers I'd been seeing meant well, but their limited "one-size-fits-all" approach  felt like throwing darts blindfolded and hoping something would stick.

Several years later, I was in the position to receive treatment from a more experienced clinician who provided a thorough diagnostic across a range of mental health domains.  She determined my core diagnosis to be adult ADHD (inattentive presentation) - anxiety and depression were a result of untreated symptoms stemming from this.  Prior to beginning any medications, I was given a genetic test to find out exactly what my biochemistry profile looked like.  These tests are becoming more commonplace, and can often be performed at reduced or no cost if patients lack insurance.  Results may not provide answers as to the exact medication and dosage needed, but have allowed providers to take off the blindfolds prior to breaking out the prescription pads.  An invaluable component of this test is knowing which pharmaceuticals would be potentially harmful for the individual - in my particular case, Wellbutrin stood out in the "Red" column on my test report. 

People in crisis may not be able to afford the luxury of trial and error to get the mental health help they need, nor can they be as selective in the choice of their providers. My hope, though, is to see greater access to genetic testing and other quantitative means of assessing mental health.  I've often heard attempts to de-stigmatize mental health disorders  by comparing them to the chemical imbalances experienced by a person with diabetes.  However, the diabetic patient has the benefit of a blood glucose monitor to help determine how much insulin to take.  Perhaps one day we'll all have neurotransmitter monitors, but until then, I urge people to research the availability of current testing and try to find providers trained to use results to make informed treatment decisions.  Options such as these may help seriously reduce medical gas lighting and iatrogenic injury.