Are psychiatric advance directives worthwhile
moncler outlet uk Do you think it is worthwhile to have a psychiatric advance directive? moncler outlet uk
For several years I have experienced bouts of depression. I worked with my primary care doctor; psychiatrist and moncler mens jackets psychotherapist to treat it with varying degrees of success. So far, I have not needed to be hospitalized. However, as much as I hate to think about it, that may happen. I had a medical advance directive for years and decided to add a psychiatric advance directive to it. To my surprise, my primary care doctor, psychotherapist, or psychiatrist had never heard of a PAD. They are accepted in my state. The main reason I have one is to state in writing that moncler outlet I am willing to have electroconvulsive therapy my family is horrified at the thought of it. My primary care doctor and psychotherapist do think it is a good idea to have one. What is your experience with PADs do you think they are worthwhile?
I don have much personal experience with psychiatric advance directives, because they are not well established where I practice. The question of how effective they are in general is too complex for this brief column, so let me Moncler Outlet focus instead on a topic more directly relevant to your situation, and that is whether you in particular would be likely to benefit from having a PAD.
moncler outlet sale PADs are really most appropriate for people who suffer from periods of psychosis as a result of their psychiatric illness, cheap moncler coats during which they are not competent to make decisions regarding their treatment. With a PAD, people in this situation can specify their desires for future psychiatric treatment during a period when their illness is in remission and they are, therefore, in a normal state of mind. moncler outlet sale
moncler jacket sale For example, years ago I took care of a woman with bipolar disorder who was remarkably rational when not in an episode. She was a sweet, thoughtful woman who tended toward shyness. She had complete insight into her illness and took her medications like clockwork. Unfortunately, while the medicine normalized her, it didn protect her very well from having episodes. moncler jacket sale
cheap moncler outlet Each time she became manic, she went through a brief phase in which she cheap moncler jackets knew she was slipping but still had her wits about her. And then suddenly she would become hostile and enraged. She wore a trench cheap moncler sale coat 24 hours a day, slept with strangers, fought with cops and often got arrested. She became convinced that she was Eva Braun Hitler wife and the Virgin Mary. And she was certain that I was part of a plot to rob her of her glory. Each time she got sick, it took a while to get her into the hospital because she lost her understanding that moncler outlet online she needed help. How wonderful an enforceable PAD would have been for her. cheap moncler outlet
cheap moncler coats Your situation, as it appears from your brief description, seems quite different. You may become depressed enough someday to need hospitalization, but it doesn sound moncler outlet store like you have a history of losing your insight. If you had moncler outlet sale a number of depressive episodes and this hasn happened yet, it not very likely to happen. So I not sure that you would benefit much from a PAD, because you moncler sale would most likely make the same choices if you were in hospital as you would in better times. cheap moncler coats
moncler outlet Having said this, I don see any downside to getting a PAD together, other than the work involved, so if you feel strongly that you want one this also seems reasonable to me. moncler outlet
In the NAMI (National Alliance on Mental Illness) consumer classes, there is information about a PAD. It highly recommended. It addresses contacts, where you want to be taken hospital or facility, medications and dosages that work well, medications and dosages that don work well, insurance info, and is signed by the client, advocate and primary clinican/psychiatrist. It called an Advance Directive for Mental Health Treatment. It makes a lot of sense to me, especially the information about what medications work and don work, because so often that a huge issue for people entering a facility.
moncler sale March 15, 2011 at 16:14 moncler sale
moncler outlet online Re psychiatric advance directives, I was put into mental units illegally twice. I asked about the PAD and was told I could fill in anything I wanted, but if I was on lock down against my will, they would not even consider what I written no matter what my state of mind when I wrote it. I suffer from severe chronic depression, but was illegallly diagnosed w/ 4 pshcyoses and dementia when my kidneys failed causing mental status changes the buy moncler jackets illegal part was making up a mental history on the spot because the attending did not listen to my doc re my odd reactions to ALL meds except about a half dozen. They gave me over 30 meds all for misdiagnoses and left my doc out of the loop. I was dying from the meds, and the doc didn want that on his watch. Hence the made up psychotic history to get me to die on someone else watch. My doc of 30 years told the attending that I am not, nor have I ever been psychotic. I was not aware I cheap moncler outlet was living for 3 weeks, but my subconscious mind was quite active I refused the meds that were killing me. The illegal part was, of course, taking no physical conditions (of which I have too many), into account; and the main one in question was no mention of kidney probs which of course caused the mental probs. Other than those 3 weeks, I never been in a state of mind when I was not totally if severly depressed. The repercussions of that one major lie have destroyed anything that was left of my life. The point is that PAD are only in play if one signs oneself into a mental unit. moncler outlet online
cheap moncler jackets March 15, 2011 at 16:20 cheap moncler jackets
moncler factory outlet Psychosis is psychosis whether organically, psychiatric or pharmacologically caused. There is a difference between and Yours sounds like misdiagnosis. Remember that most people who are psychotic do not have insight and ramble and rave about how they are fine and don need treatment. If your psychiatrist diagnosed you as non psychotic at the time and indicated this to the kidney guy, they should have come up with an appropriate treatment plan. Maybe they did and you were so out of it, it seemed inappropriate to you. moncler factory outlet
March 24, 2011 at 20:02
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moncler sale outlet I have never been hospitalized but feared the possibility. IN my case this was not observed over time and the only effect was a severe negative impact on function and coping skills. moncler sale outlet
moncler outlet jackets I filled in an advance directive and brought it to my psychiatrist for discussion. It was detailed and outlined the many negative experiences I had on the medications I tried and my desire, should my condition ever deteriorate that far, to avoid ect and avoid all but sedation for an emergency outburst (I never had one but I was trying to take into account what might happen). moncler outlet jackets
cheap moncler jackets sale I was told that no facility would honor my request or the directive. The doctor herself dismissed it. cheap moncler jackets sale
For each medication I offered both an explanation of the negative impact it had created, the lack of effect on symptoms, and the concerns I had over long term and short term use.
I was quite rational at the time. It made absolutely no difference whatever. Yet, when patients note this and request not to have the burden of the side effects added to the already considerable https://www.moncleronlineoutlet.com burden cheap moncler of the illness itself, they are forcibly overruled.
This is one of my greatest fears. It remains unaddressed.
moncler outlet store I have no objection to those for who the medications create a positive effect taking them, I think its wonderful that at least moncler sale outlet some find them a relief. But it is wrong to enforce them in cases where they do not generate a benefit, and even more wrong to dismiss the wishes of patients to not take them after they been demonstrated to be a problem moncler outlet store.