I find it quite ironic that negative patient accounts of their experience with psychiatry and medication—because it’s considered anecdotal evidence—is often dismissed completely.
Frequently, positive accounts or success stories are advertised by mental health advocacy groups or the media. I don’t believe it’s a good example of the “scientific method” when positive anecdotal reports far outweigh negative ones.
It’s especially ironic when one considers that the basis of the psychiatric relationship with a patient primarily consists of anecdotal evidence: a patient (whose mental and emotional state may be subtly or significantly impaired due to the nature of their symptoms or medication) reports their symptoms to the psychiatrist, relates changes and attempts to convey any side effects they’ve experienced since their last visit. Based solely on that information, the doctor decides on medication changes.
There is no blood or brain test in the majority of cases to determine any type of biological cause of symptoms presented by the patient. If the patient has been on medication and reports a worsening of their symptoms, the psychiatrist adjusts the medication in the hopes that it will be more effective. It’s universally accepted that psychiatric medications act on people differently, and it’s extremely rare (if ever) that the effects (negative or positive) can be predicted.
From the patient’s or the psychiatrist’s point-of-view, it’s virtually impossible to prove whether a medication has contributed to the worsening of symptoms. But what usually happens is that the psychiatrist will increase the medication, and/or add a different medication (and sometimes more than one) during a single session.
As for the therapist-patient relationship, again, most information is anecdotal. For example, if a patient relates the details of a disagreement they had with a friend, family member, or partner, due to human nature and the potential fallibility of human perception, the account may be skewed (either a little or a lot). As a result, the advice from the therapist (if applicable) or the course of treatment will be based on unreliable data.
When I think back to high school science, I recall that one of the first steps in gaining facts is observation; from there, form a hypothesis, then a theory. If the theory can be proven consistently, it becomes fact. Because of the lack of scientific data in post-clinical trial use of medications, and because there’s no scientific method for knowing with absolute certainty how a patient’s condition is being affected by medication, I think it would be wise to observe both negative and positive accounts. It seems to me that independent, scientifically-controlled studies to more accurately measure the benefits versus risks of psychiatric medication are absolutely warranted.