This was first published in the Finnish Medical Journal in 2021
Written by Jani Kaaro, a well-known Finnish investigative journalist.
Doctors, allow me to introduce you to a young man called Ville. Ville is an expert with lived experience, and the experience I am about to tell you also says something about doctors. It tells us what can happen to a young man who is pro-medicine in a system where there are always new medicines on offer.
Ville’s background is not difficult. He had a happy childhood, but somewhere in high school his grip started to slip. He drifted away and failed at everything. School became a game, and when that ended, everyday life became sleeping, checking his cell phone and playing on the computer.
When Ville was 15, he was told he had depression. That’s where he got the idea. He knew that depression is treated with medication, so he asked his doctor for it. The doctor said no. But Ville knew that if he tried to commit suicide, he would be admitted to the ward and then he would get the drugs.
Ville was enthusiastic and interested in drugs. When the urge to change his medication came, he knew what to do. “I said I was suicidal, went to the ward and then went home with the new drugs.” This is what Ville did when he broke up with his girlfriend.
The following year, the drug-addicted man got a stroke of luck. He was admitted to ADHD trials and as a result his arsenal of drugs grew: VIlle was first given venlafaxine and bupropion, then modafinil with special permission, and finally methylphenidate. When the dose of methylphenidate had reached its upper limit, it was replaced by the antihypertensive drug clonidine. “The best way to get the drugs was to say this is not going to help.”
In the years that followed, the drugs kept piling up. Valproic acid, mirtazapine, clomipramine, moclobemide and amitriptyline, among others, were prescribed at different stages and for different indications. For the long-term pain remaining after the operation, he received tramadol injections, gabapentin and finally pregabalin 600 mg. When Ville said “this doesn’t help”, he was offered buprenorphine and oxycodone, which he refused, and eventually a combination of tramadol + clonazepam was chosen. Several of the above drugs can be used as sleeping pills, but levomepromazine and hydroxyzine were also prescribed for sleep.
In 2017, Ville was a basic healthy 26-year-old with eleven medicines in daily use.
But what happened then? Ville met a kindly pensioner who realised what was wrong with Ville’s life. Ville had no life. His life was diagnoses, symptoms and problems. He slept when he could and was awake when he could.
The man started talking to Ville about life in general, not about treatments. He suggested, “What if Ville ate breakfast? Juice soup and a banana? What if Ville fixed the bed – the back pain might go away. What if Ville got new shoes? It would be more comfortable to move around.
Ville calls him an everyday coach. He taught Ville that everyday life has a rhythm. The rhythm of everyday life brought meaning and a sense of achievement. “I didn’t need medication,” he says. “If I had had this kind of help from the beginning…”
Now Ville is doing well. All that’s left in his arsenal is pregabalin, which is being phased out. Now 30, a father of two, he likes life, especially everyday life. I wonder if there are more people like him? (around the world, my added words)
****
Mad in the UK hosts blogs by a diverse group of writers. The opinions expressed are the writers’ own.