Health Wanted: Sea Ailments

The Episode

Bleeding gums, disability stigma, Polly Lobster, the volleyball scene from Top Gun. What do they all have in common? An inextricable link to the foundation of public health. 

This week on Health Wanted, we’re setting sail on a course to educate you about the unbreakable bond between public health and those who commit their lives to the high seas.

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The Listener Questions

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How hard is it to go off psychiatric medication, and are they always a doctor’s first choice? 

The general answer to this question is: it varies.

Starting with the question of if psychiatric medication is the first choice: the American Psychiatric Association (which is the main professional organization for psychiatrists and trainees in the U.S.) has a few different guidelines for how to approach treatment of different conditions.

For example, for the treatment of something like schizophrenia or other psychotic disorders, they recommend a person-centered treatment plan that involves treatments that are both pharmacological and non-pharmacological, which includes considering a patient's goals and preferences for treatment.

Most treatment plans for psychotic disorders tend to involve medication along with therapy or support, but both interventions should be things that a person is comfortable with. Someone might choose to forego medication and instead have a care plan detailed in case they experience a crisis and that might involve emergency medication.

For non-psychotic conditions, like anxiety or depression, those also should involve thorough evaluations before a treatment plan is made. And some doctors might offer medications up front, but some might want to see if non-pharmacological interventions are a viable option. Again, in either case it’s really important that any decisions are made as a team between the patient and doctor because there are some medications out there that are harder to come off of than others.

This all depends on what we’re talking about. For example, if your question is about getting off of something like an antipsychotic because someone is "cured," it depends on if someone has primary or secondary psychosis. Someone with primary psychosis that doesn’t have an underlying cause, like schizophrenia or bipolar disorder, might manage their condition with medication long term. Secondary psychosis might be a psychosis that happens as the result of something like substance use disorders, or a medical condition that then affects the nervous system or brain. In those cases, someone might be on antipsychotics for a time until the primary source of the psychosis is treated, and then they might come off.

But even in cases where someone does get to taper down their antipsychotics, or other psychiatric medications, it needs to be done really carefully, because even something like antidepressants might have a risk of adverse symptoms if they are stopped abruptly. This doesn’t mean someone is addicted to this medication. Addiction results in uncontrollable use of a substance that impacts someone's ability to function. But psychiatric medications do cause an adjustment in your brain, so stopping them suddenly can cause a tough period of readjustment.

This is why it’s important to not only have the supervision of a qualified medical provider when stopping or changing medication, but also when starting it, so someone can have a comprehensive discussion with full informed consent. Because, for a lot of people, the harm that would happen from not starting a medication is far worse than the risk of adjusting back off it.

So there are plenty of people out there who approach their mental health challenges without medication, or try it and change their mind, and there’s also people for whom the medications are life saving interventions. It just varies person to person.

Why did the CDC change the way it reports measles deaths?

The CDC used to report measles deaths using the National Notifiable Disease Surveillance System. It’s a system that funnels information directly from local health departments to the CDC about individual cases in real time. Now, they’ve decided to use data from the National Center for Health Statistics (NCHS), which is a system designed to look at mortality trends over time, not to confirm individual causes of death. 

The change was announced after a report by Reuters found that Health and Human Services Secretary Robert F. Kennedy Jr. asked CDC director Erica Schwartz not to count two deaths in infants from Pennsylvania. This is despite the coroner attributing measles as the cause of death in one infant, and saying the other death was “measles related.”

Now, there have been two more confirmed deaths attributed to measles: one in an unvaccinated 40-year-old woman with chronic obstructive pulmonary disease who had contact with a known case and hallmark symptoms before she died, and another in an unvaccinated 18 year old who died of rare severe neurological complications from measles. But those deaths will likely remain unreported on the CDC’s measles page for a while, because the NCHS has a much slower reporting and validation process.

People are getting so caught up in the died with/died from debate, but this didn’t even used to be a conversation. Prior to 2025, we had one measles death in the last 27 years, and now we’ve had at six in the last two years. This is the most measles deaths in a year since 1992.

There are three months left in 2026 and we’re already 1,000 cases over the record for 2025. Only 16 of those cases are imported from foreign travel. The rest are locally acquired as the result of huge outbreaks in places like South Carolina, Utah, and Pennsylvania. The federal government can do all it wants to try and obscure or deflect but the reality is that measles went from being a very controlled disease to one that is completely out of control.

Catch all the listener questions and Laurel’s answers on the full episode of Health Wanted by:

• Streaming at wabe.org or the WABE app
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