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Will Self

I listened to a very interesting talk last night by the author Will Self. He has discussed his recovery from addiction in many interviews but last night he gave an excellent talk to Doctors and Psychiatrists to try and help them understand how they can help others with this problem. He made the very good point that when addicts are presenting in front of doctors and psychiatrsist they are often in denial of their own addictions and, even if not, will tend to keep them a secret because to admit them would mean accepting the need to stop. He pointed out that without this crucial piece of information Doctors and Psychiatrists will often make plenty of other diagnosis and, more worrying, prescribe plenty of psychiatric medication.

Of course Will Self accepted that mental illnesses can exist as well as addiction but not nearly as often as people imagine. In our own research we have found that nearly all people with addiction problems will display extreme psychiatric symptomatology on admission to our clinic. We studied this effect and retested our patients using psychiatric diagnostic questionnaires and found that nearly all these symptoms were reduced by half by simply removing the addictive process. In other words we should wait until the addictive processes have been dealt with before making other psychiatric diagnosis like depression or bi polar disorder. This may seem like common sense and indeed it is the standard diagnostic procedure in both the American and European diagnostic manuals and yet I think you would be horrified to discover how often people with addiciton issues are admitted to clinics and immediately given other psychiatric labels and, more concerning, put onto psychiatric medications without waiting to see what is really going on.  There really should be more care about this.

Robin Lefever

2 Responses to “Will Self”

  1. mrssymphony Says:

    im sorry but for all those who are mistreated like this, there are many more who HAVE problems like depression and are simply treated for addiction. much as i adore will self, he is not your average addict. it is quite difficult to get to actually see a psychiatrist on the NHS, which is the only avenue of help available to many addicts. pay privately and its a different matter. he maybe right in what he says about addicts not admitting the truth sometimes but i have met few addicts treated for the problems they had BEFORE becoming addicts.

  2. robin Says:

    Thank you for your comments but I still agree with Will. Far more people with addiction problems are misdiagnosed with other psychiatric ills than are ever diagnosed with addiction, let alone treated for addiction.
    We undertook a study of our patients using a psychiatric diagnosis tool ( BSI ) and found that our patients being admitted for addiction problems were *more* clinically disturbed on a wide range of psychiatric symptoms, especially depression, than patients in an in-patient psychiatric hospital setting so you are right to observe that people with addiction problems are frequently showing the signs of depression. When we tested them only a few weeks later all these symptoms were reduced by about half. If the people you know were lucky enough to get “proper” treatment ( not just be fobbed off with medication ) then they were very lucky because this treatment would cover both conditions anyway. There are a very small number of people with psychotic disorders or manic depression who sometimes don’t get screened or understood by these programmes properly as they should be but they are far fewer than one might imagine.
    I completely agree that it is very difficult to see a psychiatrist on the NHS but they are not the right avenue of help for addicts ( nor depressives for that matter ). The difficulty is that the “proper” treatments for addiction ( or depression ) that I refer to above are expensive because they involve using specially trained professionals whilst simply handing out repeat prescriptions of medication is cheap and easy. It’s hard to see how any government is going to change this now since spending more money on people who are “perceived” to have self inflicted problems is hardly going to be a vote winner in a time of cuts to budgets. I fear we will just have a growing tidal wave of a problem instead for future generations to manage.

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