Mentality of Medicating Gone Mad
AM, Noon, PM, Bed, PRN, BID, TID, with/without food…
Day in and day out, people are taking meds, and most of them don’t know what they are treating.
Ever wondered what the mindset was behind medication choices by and for individuals?
Me, too.
I have been blessed enough to be among the few in the 40-plus American demographic without a daily medication prescription. While pneumonia, UTI, tooth infection, staph infection, wart removal, and the like may pop up from time to time, there has been no required long-term medication for me to stay healthy-ish.
This is not the norm in America at this time. I have worked in the medical field for over half my adult life, from urgent care and ER to in-home care of the elderly and medically fragile infants. Across the board, I have seen a drastic increase in the medicating of our most fragile populations.
How is a medication “Born”?
The average American over the age of 40 has a 70% chance of taking 1 prescribed medication daily. Most common are medicines that treat hypertension (high blood pressure), hyperlipidemia (high cholesterol and/or triglycerides), depression and/or anxiety, chronic pain, and diabetes. While this number may surprise you, the real concern is when we address those who are “double dipping” into the pharmaceutical cauldron of wellness concoctions.
The reality of medications being added to the “approved list” and allowed to be prescribed and filled is that they each went through rigorous trials and had to prove their “worth” on the medical public stage. Telling someone that your small and easy-to-swallow pill will make them feel better and more like getting out of bed in the morning, whether the sun is shining or not, does not pass the muster of the FDA (Food and Drug Administration). But each medication must undergo and pass multiple stages of clinical trials, presenting its data from the trials to many professionals who are meant to pick it apart and look for anything the creators of said medication may have missed by accident or purposefully hidden along the way to make a larger and quicker profit.
In doing so, each medication is “niched down” to use freelancing language. Pursuing each test and data set by addressing a single concern that the creators believe they can treat. Depression may be too large an issue to address in this post, but hypertension is a BIT simpler to understand, and so we can look at it more clearly here.
Under pressure!
Did you just sing, hum, or at least THINK the 1981 tune from David Bowie and Queen? Doom-doom-doom duh-duh doom-doom…
Yeah, you are my kind of people! Okay, back to the topic at hand…
Generally speaking, your blood pressure is based on 2 things. First, the pressure INSIDE the vessels presses outward, due to the ratio of liquid to space available for the liquid to flow. Second, the pressure OUTSIDE from the vessel walls that hold the blood in place. We can break down the second one into the vessel wall itself, as separate from pressure placed on or around it from other forces. Think of forces against the vessels, such as flexing muscles, sleeping under a weighted blanket, or that pair of Spanx that your friends should have never let you buy.
Clearly, this is a very rudimentary assessment of the amazing system that keeps oxygen-enriched blood flowing at the proper rate and strength to each and every cell in your body from the deepest recesses of your brain to the tip of your big toes. Now that we are on the same page, we can assess what may cause hypertension, or high blood pressure. Firstly, If there is too much fluid in the tube or vessel (called arteries and veins - but not very important at this level of investigation), it will cause excess pressure. Just like when you fill a water balloon too full and watch as the plastic stretches and grows tight. Similarly, additional pressure from the OUTSIDE of the tube increases pressure as noted by the liquid being forced out with nowhere left to go, like when your kids experiment with the toothpaste only slightly capped and pointed at the mirror. The third effect on blood pressure is how flexible or solid the vessel is. Water flowing through a normal garden hose will have a different level of pressure than the same water flowing through one of those expandable pocket hoses.
A good medication could affect any one of these 3 major pressure points - pun intended - to make a difference. It would be tested, documented, proven, cleared for sale, and then sent off for a goofy and/or memorable jingle and commercial. At which point, every American learns there is a new drug on the market that can “fix” their blood pressure elevation problem. And when the process goes smoothly and honestly, this is good.
If one is good, two are better!
But then age continues to creep up on you, and more concerns affect your daily life. You are seeing changes in your body composition, shape, and how well it is (or isn’t) working. You realize the single medication you’ve taken for years, with no bothersome side effects, has been beneficial. So you make an appointment to ask the doctor for help with this new variety of ailment.
Let’s pretend that your birthday gift from your body was to add anxiety to your life. Not the kind that comes from noticing your crows feet, your teenager becoming an adult, becoming a grandparent while still feeling too young for that, or the like. I’m talking about the anxiety that grips your soul and squeezes. The kind that makes you believe, beyond all common sense and visual proof, that a fire is consuming its way through the grass field next door and is determined to kill your entire family if you don’t get out of the house now. At 1 am. — Maybe a little too realistic, and a story for another time, but this is the kind of radical fear-based emotions that can drive a person mad. Call the doctor. Well, maybe wait till morning…
Most likely, your doctor will ask you a bunch of questions when you see him or her. Ruling out any situational or controlled environmental stressors is extremely important when prescribing a new drug to a person’s body, even if it has a track record of helping long-term anxiety. So let’s say you and your doctor decide on a low-dose medication to relieve the anxiety. The goal is to release the grasp of fear on your chest, allow you to breathe easier, sleep more soundly, and give space for your joyful and relaxed personality to show up more often. Sound great!
But how does it work?
Don’t get scared. I promise to go easy on you. Yes, this is where things CAN get exceptionally science-y. But we are going to dip our toe in, just enough to understand the concept we have been addressing here today. You may know, or maybe not, that there are MULTIPLE types of antianxiety medications. Just like we stated that ANY drug created to cause ONE effect on the vessels and therefore blood pressure, so too, there are many sides of feelings/depression/anxiety. Too much for today. Each of these medications works differently, at different locations in the cycles of human feelings, thoughts, interactions, and reactions.
One type of antianxiety BLOCKS the uptake location (think used bin) of a hormone that makes you happy, therefore leaving more floating around your brain and making you feel happier. The complication comes when you realize that this SAME hormone also increases blood pressure when “hanging out” instead of being hauled off as it would at your body’s baseline.
Another medication type treats depression and anxiety by similarly playing with the amount present and treatment style of those happy hormones, which can cause a drop in blood pressure. For some, this sudden drop anytime they go from sitting to standing becomes a life-changing effect that they are not willing to live with. But it is known to work better in patients for whom other anxiety control medications have not given any assistance. Give and take, I guess.
So pick your poison. Live with new negative symptoms for life, or play cauldron collectables with medications from your doctor to find the right balance that is livable for you? This is the issue that so many lovely people are facing as they try to age gently into their 50s. All too often, if you return to the doctor to readdress your concerns, he or she may talk about a third medication that can help stabilize and calm the storm of the two meds you are currently taking. This can often lead down the slippery slope that has been traveled by of 20% of Americans who take at least 1 med, and state they take 5 or more meds daily. Just like adding another block to the top of a tower, it becomes more and more fragile.
This got me wondering…
Once upon a time, grandparents took vitamins and ample water daily, adding a pinch of salt, flavor, and joy to stay healthy.
… Are we medicating the fragile, or making the medicated fragile? My experience in all aspects of the medical field: from cradle to the grave, from the daily grind to life or death decisions, and from the stranger I treat according to my years of experience and training to talking with my own mother…
The more medications that become a daily event for a patient, the more complications we find along the way. Each of these medications was never vetted to be used in conjunction with the others. Most doctors don’t address their interactions with each other, and those that do get pushback from the patient, “I’ve taken that for years with no issues. I can’t stop taking it.” Add to this the number of specialists (cardiologist, endocrinologist, ophthalmologist, neurologist, and more) that we collect on the way, who never discuss the treatment of their patient as a whole with the others doing the prescribing. And we wonder why our elderly are more fragile than they once were.
This is called Polypharmacy, and it becoming a real issue for the aging people of our country.
So what can be done?
There are multiple directions of conversation from here. Like a spider’s web, the world of medicine and health care is intricately woven, and changing one part will inevitably change tensions on another. Yet, I believe our bodies are ready to heal themselves when possible. I believe that nature and nurture have much to do with an individual’s health. I believe we have been distracted by having science fix everything, and forgetting to ask the question once posed in Jurassic Park.
My call to the masses is to LEARN how your body works, how you can do little things to improve its function, and how even the most well-meaning - and well-educated - in the medical field may not have the ONLY answers.
Follow me as I address hormones, diet, exercise needs (or lack thereof), mental health, schedule, and relationship management, and more. I will make the human body and its vastness of processes and inner workings to be understood by all who are willing to read and learn. Set aside time to learn about how your body CAN function when managed well. Let’s grab hold of our futures together.
