Aren’t you also making assessments about a particular person’s mental health? Whereas viney is speaking in generalities?
man I hate it when people do that, what you are doing specifically @Marigold. Just don’t be a hypocrite and we can disagree peacefully.
I dunno that I can agree that being so devastated by a potentially life changing event (or concussions) that one takes to one’s bed for four days, if one has the luxury of being able to do that, isn’t a normal response. If something is a true mental trauma, curling up into the fetal position and not wanting to have to deal with reality for a few days seems a reasonable thing to do to protect yourself.
I honestly didn’t think I was - my intention was just to take what someone disclosed as their own diagnosis at face value. That was the word she used in the interview to describe her condition.
If you think I’m being a hypocrite, please do clarify it for me (here or by PM). If I am, I apologize. It’s really something I try to avoid, and I’d genuinely appreciate the heads up.
Thanks so much for starting this thread and linking to the interview @kcmel .
I weighed in quite a bit on the initial thread. Although I don’t think I said anything that could be construed as “hateful”, I do feel a need to reevaluate my initial impression of this situation and JB in light of this interview. Frankly, she came across as very candid to me, and I have a lot of sympathy for her after listening.
So in terms of my initial reaction to this situation on the original thread… I think the 2017 EventingConnect (I think the name was something like that) blog post profoundly colored my opinion. It shouldn’t have… It was a problematic questionable “report” on it’s face, rife with innuendo and anonymous sources alluding to partying and people snorting lines of “something.” Additionally, for me personally, the mention of cancer in the same article comparing it to drug abuse as an “illness” really ticked me off. That’s a personal issue though.
After listening to Jennie’s interview, I come away thinking that “article/blog post” was really awful and unfair in more ways than I initially grasped. Social media influences public opinion in ways we don’t quite realize, I think. When you combine the social media profiles of HSB and JB … Complete with pictures of shenanigans of them out and about having fun while competing… When you combine that with the EventingConnect blog post alleging hard partying, it was easy to reach some negative conclusions about this situation. Even though one recognized that the EventingConnect blog was “fake news”, and approached it with skepticism- as I thought I did. Regardless… It left me with an impression of drug abuse and partying, and that really dovetailed with other factual pieces of information coming out about this situation, and led me to perceive JB in a very negative light.
As someone mentioned earlier, I don’t think we are ever going to know the whole “truth” of this situation, but after hearing from JB herself, it sounds like a lot of valuable lessons were learned, and she’s working hard to turn this suspension into a period of personal growth. She also sounded like she took her position as a role model for younger riders very seriously. I liked a lot of the realistic things she shared about coping with losses and injuries and the roller coaster lifestyle. I hope young people considering a long term future in this sport listen to that, and don’t just get caught up in the “image” they see of top riders. And I hope top riders are thoughtful about the images they put out there online, and how it can all create an impression of who you are, and what you’re about.
In terms of the meds she tested positive for, her issues with concussions, and her statements about initially getting a prescription from a general practitioner for a stimulant for ADHD symptoms… I think there’s a couple of big issues there. First off, I’m glad she spoke up in this interview about how people NEED to go through a SPECIALIST for meds like this if they plan on competing with a TUE. I would go further… I think people should go through a specialist PERIOD for meds like this. Clearly JB has some long term complicated medical issues after having multiple head injuries… Someone above and beyond a family doctor should have been reviewing and managing her case. Neurology, Psychiatry, and some form of PT/OT all seem warranted and appropriate. Yeah… it’s a pain in the you know what to go to multiple doctors for multiple appointments. And expensive. And hard if you’re busy. I get it - I went through complicated cancer and my life has been consumed by an absolutely obnoxious amount of doctors appointments for years on end. But serious complicated medical issues need to be treated by knowledgeable specialists.
The fact that a general practitioner did prescribe a controlled substance to a person with a serious complex medical history (repeated TBI is serious and complicated to treat appropriately, and if there is actually underlying ADHD or other mental health conditions, its even MORE tricky and challenging to treat)… That concerns me. It seems unprofessional. When you add to it that this person is a professional athlete with substantial ongoing risks, I’m left scratching my head over that part of this story. I hope others listen to her experience, and learn from it. I still think these meds are terribly over prescribed, and abused. I also think head injuries are a major issue in equestrian sports (as well as other sports), and most of the people competing at JBs level have probably have chronic issues on that score. I hope folks learning from her story will make a choice to go through qualified specialists for their care, and follow the TUE process. It seems like that’s what’s best for the sport, and individual rider’s health over the long term. Both are important considerations.
And lets not forget that even in the depths of depression there are ups and downs. You can be in the the pit, still have ‘happy moments’ and even laugh, to then tumble back into the shadows. The perception that one is purely depressed with no variation is a huge barrier to individuals realizing they need help.
ETA: If Jennie was being treated for the fallout from multiple concussions, she may well have been struggling with depression already.
Its a commonly missed trigger for depression, which happened to me. Within 6 months of my horse hitting me in the face with her poll, and the subsequent (undiagnosed) concussion, I started sliding into a major depression with no other complicating factor. I did the usual “I’m fine, I’m fine”. I got back on, continued riding my horse and drove 45 minutes home. In hindsight, I was far from fine on the day.
Thankfully, from previous bouts of depression, I have a checklist that I run through if I start sliding. The concussion was the only outlier, even my GP wasn’t familiar with the connection. That checklist has seriously helped more than once.
What WERE you trying to say?
I agree with Virginia Mom’s point about GPs prescribing for mental health issues. Medicine is so complicated that it has myriads of specialities, of which psychiatry is only one. A GP is not trained in the subtleties in the diagnosis of various mental conditions and, IMO, can do more harm than good by prescribing psychotropic drugs.
I personally don’t believe that medicalizing life and life experiences is a good thing at all.
I think the prescription drug use in this situation is a VERY gray issue.
After listening to the interview with JB, and after reviewing the FEI decision, I’m not going to condemn her. She got a 1 year suspension, has gone through a lot, and seems contrite. She also apparently will be following the TUE process from here on out. Fair enough, and it seems like she’s focused on trying to learn and grow from the experience, and come out of it a more mature professional. Good for her.
With that said… I think anyone leaping to the conclusion that these prescription meds were prescribed by a doctor, for a legitimate medical need, and therefore there was no competitive advantage or drug abuse issue with this whole thing… Well, I respectfully disagree with that attitude. JB herself said a GENERAL PRACTITIONER was prescribing controlled schedule 2 drugs to her. Publicly disclosed information about her issues reveals her case is complex, involving TBI, ADHD, and some degree of mood disturbance (maybe depression, maybe as a result of concussions, maybe short term anguish after a major life stress… Who knows - whatever). Bottom line, it’s a complicated case, and required an evaluation and treatment plan from a specialist. Which she didn’t have when she initially popped positive. Sure… The meds may have been necessary for daily functioning. But they also may have been an inappropriate treatment plan, or inappropriate doses for her situation, or inappropriate combination of meds with interactions… We don’t know. From the interview though, it doesn’t sound like the initial way she went about getting these prescriptions would have satisfied the TUE requirements.
We have a serious issue in our society with people “doctor shopping” in order to get prescriptions for controlled substances for both legitimate and illegitimate conditions. It’s at the root of the opioid epidemic. And there are serious problems with young people who have prescriptions for Ritalin and Adderall abusing their own meds in certain situations as well. I knew plenty of people in high school, college, and my Master’s program who doubled or tripled their dose of Ritalin in order to stay up and finish papers. Or who crushed and snorted lines of it when partying. I can think of two friends who had full blown ADHD, but doubling their dose of Ritalin most definitely DID result in an advantage when it came to crunch time academic situations. I co-wrote a college paper with one… So who is to say that the general practitioner prescribing a stimulant for a complicated case like JBs got the dose right on the initial prescription? Or even the combination of meds right? Or that the stimulant affected her in the same way it would affect somene without her history of concussions? To say that these meds were necessary for her to function, and THEREFORE there’s no element of drug abuse or misuse or competitive advantage… That’s simplistic. But she’s serving her suspension, is now committed to following the TUE process, and seems to be taking the whole thing very seriously, and actively advising other riders about how to address their medication needs in a manner that complies with the rules. So I don’t think anyone should beat the proverbial dead horse at this point.
Follow JB’s own lead, and encourage people to seek any medications they need via appropriate providers, and to obtain a TUE prior to competing on these meds.
Taking prescription medication is not the same as doing illicit drugs or unprescribed meds.
I guess that being a dare kid, I was unaware that “don’t do drugs” was a confusing statement.
Can you clarify your last point? Do you mean that prescribing medicine for anxiety or depression based on a traumatic event? One that could be described as “life and life experiences”?
Would you mind sharing that checklist, or is it somewhat tailored/unique to you? It sounds helpful.
I can’t say for certain but my guess is that this poster believes we are overmedicating many people, rather than seeking more effective but also more expensive and time consuming therapies, particularly psychotherapy. At least that’s what the medical community also believes.
drug therapy saves lives, this is not at all being questioned, but it is not the best solution for everyone, and many patients would live better lives with alternative or supplemental therapies.
I think Viney was trying to differentiate between severe long term medical conditions like chronic depression, and acute short term issues like a severe mood disturbance after a traumatic life event that keeps one from getting out of bed for several days. If that was what Viney was getting at… I understand and agree there is a distinction.
Making this distinction does not mean that both are not real and tough… or that both don’t deserve compassion. Both can result in horrible serious outcomes such as suicide. But one is more medical in nature - requiring long term intervention using psychotropic drugs or tms or ect and management by a psychiatrist (an MD). The other situation, as JB herself described in her interview, may be mitigated by immediate social support from a close friend. She specifically mentioned her support system many times in the interview, and how helpful and meaningful that has been to her.
With all that said, after listening to the interview, it sounded like JB has been struggling with BOTH chronic medical conditions AND acute life stresses. And bluntly, my experience is that this is often the case with people - it’s a both/and issue. People who are vulnerable due to pre-existing underlying mental health conditions (like repeated concussions, or chronic mood disorders, or ADHD) can really crash when going through acute life stresses on top of it. That’s why counseling, and leaning on a great support network, in addition to medication - is often recommended as the best course of treatment.
Not to beat a dead horse, but it’s also why it is really inappropriate to get prescriptions for psychotropic medications via a GP. They are not as well versed at teasing through subtle differences, and symptom inducing life issues vs. a chemical imbalance of the brain as a specialist (psychiatrist). And my experience is that a good psychiatrist will also make sure that life stresses are being responsibly addressed via counseling CONCURRENT with the prescription of psychotropic medications.
Aside from depression… prescription of stimulants to children, who may in fact be dealing with life stressors more than ADHD is a VERY real issue. My brother has been a pediatrician for 20 years. He says this is a MAJOR issue he sees routinely in his practice. Parents bringing in kids who “can’t focus” and are having “academic and behavioral issues” in school. Apparently, standard practice is to first evaluate the patient’s lifestyle… how many rest hours and sleep hours a day does the child get at home? Are they in daycare until evening hours following school each day? Are they intensely scheduled with after school activities? If the answer is YES to those things, lifestyle changes are recommended PRIOR to going through ADHD testing and prescribing psychotropic drugs to the child.
Guess what? A lot of parents don’t care for that advice, get defensive about their child’s daycare schedule or activity schedule, and go looking for a different pediatrician who will more readily prescribe. To me… that dynamic is a prime example of people “medicalizing” a child’s reaction to life and life experiences… in a way that is possibly not in the best interests of the child.
I don’t necessarily disagree but i also don’t think we can paint everyone in the same light. So that person who may do just fine 95% of the time, managing their symptoms, has a flare up caused by something out of their control a simple “life event” and may need medication to get through it.
It may be “medicating for life events” but for someone who managed their mental illness through non medication and alternative therapies most of the time, there can be certain events that just pushes them past dealing.
I think people with a mental illness that has been diagnosed by a specialist in mental health fall into a completely different category. I do not consider transient depression a mental illness.
Part of being an adult is learning to cope with life events which are inevitable. Every person probably develops different coping tactics, but learning how to deal with bad experiences without falling apart is part of growing up. Seems to me that coping through psychotropic drugs inhibits that part of maturation.
Which brings up a completely off topic thought I just had, It was customary for centuries in the West for people who had the death of a close family member or even friend to wear something to indicate the death. IIRC for a family death mourning wear was solid black for six months, then black and gray for another six months, then gray, white and violet for another six months. That let the whole world know that the person was grieving, and (it seems to me) that it acted as notice to the person’s support group that their support was needed and would be welcomed. Friends wore mourning armbands for the same purposes.
Sure!
My checklist if I start spinning into anxiety or slipping into serious depression.
Once there was a substitute of one generic supplier for another which resulted in the beginnings of suicidal ideation by the 2nd week. Ran the list, medication only recent change, see doctor.
Last time I started feeling like I was ‘living behind my eyes’, almost feels like I’m operating my body at a bit of a distance. (disassociation) I ran the list and the only change was the hit to the face within 6 months. Get medication adjusted, move on.
When I run the list and the issues are life related, I start drilling down on how/what to rebalance life-wise.
It may be inappropriate, but is all to common. Depending on one’s insurance (US) or ability/timeline to get a specialist referral (Canada). Treatment via a GP is often one’s first or only recourse. Your experience with a psychiatrist is vastly different than I’ve seen. My experience is you only see a psychiatrist to address the chemical imbalances and a non-prescribing psychologist to address non-chemical approaches.
Should one be foregoing treatment when specialist access is not available or not available in the near future?
Virginia Horse Mom, you’ve made some really great posts so my apologies that I am only quoting one of them. I think a few things were going on when the news first broke in December. We only knew the basis that the riders had tested positive, and of course there was historical information available via the riders’ social media and first-hand observers. Pair that with the fact that the riders, including JB, were all tight-lipped about additional details (understandably so, given the fact that they were subject to an investigation and were retaining lawyers) created an environment where we all could kind of just go nuts speculating on what was going on. Add the EventingConnect article, it makes sense why the rumors raged the way they did. Not giving an excuse, just observing the context.
I had always liked JB before this all went down (have met her a few times and she is a real sweetheart), but that was definitely shaken when all of this went down. I think the biggest takeaway I have gotten from this is that judgment really has to be reserved until more information is available. We can certainly talk about the problematic issues such cases expose, but we really need to try to leave the people out of it until the investigative process wraps up. Regardless, it seems like she has definitely learned the lesson we could have hoped for. We just weren’t aware of it until more recently, when Jennie came forward to speak up.
I agree that seeing a complex case like Jennie’s not referred to a specialist is troubling. She should have known, as per her responsibilities as an FEI rider, that a specialist was necessary as part of the TUE process - but if she HADN’T been an FEI rider held to those standards, I am not sure I would expect the patient to know that she has to see a specialist. I think there was definitely an issue with her Primary Care Provider taking it upon him/herself to try to sort this issue out with these medications. It feels a little more like mad science than medicine at that stage. PCPs are great for simple, noncomplicated stuff and kind of reconciling all of the information that comes from a patient’s specialists, but this seems like a case where it clearly warranted a referral to a neurologist or a psychiatrist (or both). I want to clarify that I am not a physician nor any kind of health care provider, but there’s a reason specialists exist and it’s for cases like this. Of course, this is a much bigger problem than eventing or even horseback riding in general.
Odd. I am an insulin-dependent diabetic and got teased a LOT when I was a teen about “taking drugs” because I used syringes.
I do agree there is a difference, and some lack of clarity here on how various eventers are/were using medications.
I think the eventers themselves lack clarity as to how or why they are on the meds haha but it seems that at least some of them now have valid prescriptions for at least some medications and will now have tues in the future, and are serving a not insignificant suspension. It’s a good lesson for everyone.
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