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Tuesday, January 09, 2007
This is a partial transcript of “The Big Story With John Gibson,” January 8, 2007, that has been edited for clarity.
JOHN GIBSON, HOST: If you have been prescribed medication by a doctor recently, you’ll want to listen to my next guest’s story very closely. For five years she was prescribed more than 15 different medications to deal with her mood disorders. She says the cure was worse than the disease.
With me now is Gogo Lidz, a senior at Bard College. She’s been diagnosed with bipolar disorder. Also with us is well-known psychiatrist Dr. Keith Ablow, host of “The Dr. Keith Ablow Show.” We’ll talk to him in a moment, but first let’s start with Miss Lidz. So what happened to you? It wasn’t just one prescription was it?
GOGO LIDZ, DIAGNOSED WITH BIPOLAR DISORDER: No, I mean I was prescribed just like more and more first I was diagnosed with ADD and I just kept being prescribed Adderall and Ritalin and then the crashes were so hard and my mood swings were so hard from that, then I started being prescribed anti-depressants and SSRIs. But like later I’ve been diagnosed with bipolar and all of the anti-depressants just kept making my mood swings and my mood worse and I just kept getting more bipolar.
GIBSON: So the more medication you got the worse you got.
GIBSON: Dr. Keith, what is this?
DR. KEITH ABLOW, PSYCHIATRIST: What this is, No. 1, is a complicated case because there was not only a lack of clarity about her diagnosis, which is so important for people to be consumers of mental health care as well as passive participants in the process, but also she was using illicit substances and that clouds the picture, too.
So what it is, is that first psychiatrists need to come up with a clear idea: “What am I treating?” Secondly, they need to clear the decks and say we can’t have drugs present because that’s going to make it impossible to know: “Are the drugs causing this or an underlying illness?”
GIBSON: Was she layered with medications in such a way that her condition essentially worsened by the medications?
ABLOW: We will never know what her condition in terms of its natural course would have been without illicit substances and without so many medicines. Clarity was required. And I’ll tell you the other thing missing here is her life story. In other words, we never learned what happened to her to destabilize her moods as a younger person, what was happening in your life that would have complicated your symptoms as well as these medicines which do sound too numerous and too chaotic.
LIDZ: I mean, well, first of all I was put on substances that made me more and more impulsive and like amped up the mania in my bipolar. And, I mean, when you’re a college student and you’re made more impulsive, it’s hard. That’s where the illicit substances came through. I mean, I think it’s when you’re made already so crazy and there was I wasn’t like that. I mean, I’m not here to talk about…
GIBSON: When you ratcheted back from the layers and layers of medication that you were prescribed, did the fog clear?
LIDZ: Yeah, definitely. I mean, I’m better than ever now.
ABLOW: And I think the major lesson here is, you know, I have to say, I’m a psychiatrist but too many of my colleagues are ready to grab the prescription pad before they learn their patient’s life stories. And whenever there is a symptom that may even come from the use of one medicine, it is tempting and too many psychiatrists I think do prescribe another.
GIBSON: When you were getting all these prescriptions, did you think about getting a second opinion, do I need all this stuff?
LIDZ: No, I just like sort of like believed in what my doctor was telling me. He was recommended by my family doctor and like I just blindly followed my psychiatrist for years.
GIBSON: Does her story sound familiar? Are there other people who are getting overloaded with prescriptions in this way?
ABLOW: She brings many gifts to us. Yes, there are many people who are overmedicated. Yes, there are many people, by the way, who are medicated without somebody having a firm grasp of why psychologically are these people in my office to begin with. And thirdly, too many people blindly trust their psychiatrists. If you’re not doing well, you need to move on.
GIBSON: When you got off multiple medications and suddenly you were starting to feel better, what was your attitude about your psychiatrist and the way he was prescribing?
LIDZ: Resentful, obviously, but I mean, I’ve heard that it takes an average of like seven years or something sometimes to diagnose bipolar people so that is a view…
ABLOW: Well not in Dr. Ablow’s office or in a lot of my colleagues. I think that what’s called for is a kind of sitting back and really sitting with your patient. Unfortunately, a lot of the time you get 10 minutes with a psycho-pharmacologist once a month. That’s not care that any of us would want for our family.
GIBSON: Gogo, if you knew somebody else at school and you say, you have how many medications and you realize that they have three, four, five of them, what would your advice be there?
LIDZ: To get a second opinion from another psychiatrist because I don’t think people just keep being over like medicines are doled out look like candy these days and you don’t look at your deeper problems. And the medicine can just make people worse instead of better and I think this happens all the time. A lot of people have come forth and shared their stories.
GIBSON: Dr. Keith?
ABLOW: And I would say the second opinion is absolutely critical. It’s also important to know that her case included periods of desperation, in which she wondered whether life was worth living. We won’t know how her case would have proceeded without medicine. We’re glad she’s doing as well as she is now. That’s a great gift to us.
GIBSON: My thanks to Gogo Lidz, who came through this OK, and of course to Dr. Keith Ablow. Thanks Dr. Keith.
ABLOW: Thanks for having me.