The increasing openness about mental health has created a cultural identity where having mental health issues is seen as trendy, while over-prescription of ADHD medications during the pandemic raised concerns about accessibility without proper evaluation, leading to stricter regulations including prior authorizations and in-person monitoring for controlled substances.
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Is It "Trendy" To Have Mental Health Issues Now?Added:
it's like a new cultural identity to say that like you've gone through something in terms of mental health. Welcome to another episode of Ask a Brother podcast. I'm your host Jeff St. James and we're going to have a whole host of different people from different backgrounds [music] coming in because it really is about building a community of like-minded people that's just open to listening and hearing from other perspectives. The revolution is [music] going to be because of us.
Uh 2020, this was a big big year that I think shifted a lot of people's opinions and perspectives about trusting a lot of um regulatory boards, um trusting the FDA.
This is just a lot of questions that I think people are starting to have about what happened with the pandem- pandemic, how it was handled, um who's all involved in the decision-making with how this stuff in in in regards to our health. So, as like a licensed professional from your vantage point, have you ever wondered or disagreed with some of the standard approaches to how um the model that you're operating from like this is the standard approach of how we prescribe, how we diagnose, even down to like insurance companies with the requirements of what you kind of need to do or see or find in order for them to reimburse or cover services like is there anything that you've had questions about or or wondered or even re-evaluated like I'm not sure that I'm totally in agreement with this.
I mean, I would say that the biggest thing that comes to my mind is the stimulant shortage and why like nobody could get Adderall, it was because like during the pandemic there was a lot of telehealth services and companies where they you would go them and say I have focus issues and they're like here's an Adderall, you know, it was so easy to get it that anybody could get it without proper testing, without proper you know, evaluation. You could have like a 5-minute conversation with somebody and you have Adderall waiting for you. So, I don't think that that's good, You know, so there has been um more things in place to prevent that from happening. First of all, because there's such a shortage, a lot of insurance companies actually like ask for a prior authorization. And in that prior authorization, it asks like, "Are they diagnosed with ADHD? Is this properly documented? Is there testing?"
All these things. And then also another thing is that um I started to bring clients into the office at least once a year for in-person appointments for those who are on a controlled substance such as stimulants, like Adderall, Concerta, Ritalin. So, I feel like those are good things that we're implementing again because it's not just candy, you know?
It is a controlled substance. There is, you know, risk to it and abuse potential. So, yeah.
Good. Now, I I I appreciate it, and I'm trying to get in the habit when I find working professionals in the field, especially as it relates to psychiatric mental health and psychology in general, to really trying to get a gauge as to whether or not people are just kind of their heads in the sand and they're just working working working or if they're also thinking about the actual field itself. Is the field changing? How's it growing? How's it evolving? And do I agree with all of these evolutions? Um that's a big thing that I'm I'm starting to realize and and recognize now. And and like you said, when it came to the um ADHD medication, like Ritalin and and or Adderall rather rather, um I've been noticing it where I've I've noticed that in general, as society has moved more towards more and more people moving more into the to the mental health space and and wanting to do with therapists and saying, "I have a doctor.
I have this or have that." I've been noticing that people are starting to use and see this stuff as like a status symbol a little bit where when it comes to like everybody now has to have something wrong. Whereas like, "Oh, yeah, I've dealt with this or I have that." And and I'm like noticing now where it's like now it's a status symbol and it's like a new cultural identity to say that like you've gone through something in terms of mental health versus the people who's like I don't think I've ever gone through anything or have anything wrong.
Now they're the ones that seen as weird.
Um have you noticed that at all with like an influx of people just feeling like they need something from you even if they actually don't or you think it's pretty much normal baseline?
Yeah, I mean that's a good question. I think that I think for that reason I really try to get to know people and get to the root cause of what's happening. I mean if they're going to come see me, there's something going on that's bothering them or affecting their life or affecting their relationships and kind of getting [clears throat] down to what exactly is happening here, you know? Um I think that's really important. So when people ask me for certain things, you know, I would ask them why, you know, what do you think is happening? Why do you think you this would help you and kind of have that conversation to say you know, maybe we could try it or or I might say, you know, I don't think that makes sense or something along those lines. I would try to converse about it.
That's good. Um Orlando uh Orlando Abbe writes, is there a specific type of medicine medication for narcissistic personality disorder?
>> [laughter and gasps] >> I think a lot of people here. I think a lot of people want to hear about this.
You know, that's an interesting question. I think it's a good question, actually.
So sadly enough for personality disorders, whether it's narcissism or borderline, there's no like treatment for that. We're just treating symptoms at that point. So um people with narcissism, first of all, it it would be amazing if somebody actually like came to me and had start narcissism cuz a lot of people with narcissism don't even think that they have an issue. All right.
>> So, that it's like everybody else is a problem and they're perfect, you know?
So, so even acknowledging it I think will be like a really big step and then from there is kind of like how, you know, it it maybe like, you know, an antidepressant might help their anxiety level, maybe a mood stabilizer might help their reactivity to things, but there's no like treatment or cure for that. Yeah. Yeah.
Yeah.
>> And it's the same thing with borderline.
Like, you know, a lot of borderlines have similar similarity to like bipolar disorder. So, I I might give like a mood stabilizer or it it it may be like chronic PTSD and they are just like get easily activated or can't sleep at night or racing thoughts that I'm going to treat it like anxiety. So, I I appreciate that because um I've I've wondered that for a while too when it came to the personality disorders and, you know, how hard it is on the mental health side trying to treat and deal with the stuff. And I've always wondered from the psychiatric side what you all were thinking if anything at all and it makes sense to me where it's like there's an aspect where this is a combo of who they are. It's a lot of it's of course it's the whole nature versus nurture argument. Um but it but so much of it is like I think it's it's relating to what they're stimulated by and and and what spikes their dopamine um for me and it's like if they learn how to separate what triggers them from whatever the external stimuli is, they tend to just move better.
Um but when they can't and it's like when this happens I have to move this way or when this happens I have to like you said when it came to the um the prolonged PTSD, they feel like I have to now move out of fight flight freeze. I have to react out of out of terror, out of this feeling like this is reminding me of something when I was most vulnerable. I have to lash out and in a defensive mode. So, it's very interesting where it's like and I appreciate you sharing that where it's like medication can do some things, but it's not it can't work miracles. It can't completely completely transform personalities per se.
>> [music]
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