to think the over-diagnosis of depression is hardly news?

[Mitchy1nge]

in torygraph today it's claimed depression is more likely to be over than under diagnosed - something this blogger describes as social suffering apparently something like one in six people in Blackpool are on anti-depressants

is this only in the news this week because everyone is supposed to feel a bit crap in January? The study came out a few weeks ago.

[RandyRudolf]

I think it's fair to say that a lot of GP's are happy to write out prescriptions for anti depressants quite readily. Why this is, I'm not sure.

[Mitchy1nge]

the article I linked to seems to suggest that, among other things, the concept of general misery has been sort of eaten up by the ever expanding definition of depression

[HoratiaDrelincourt]

Randy I'm guessing that's because the waiting lists for talking treatments are measured in months if not years, and happy pills can bridge the gap for some people.

[Mitchy1nge]

I thought IAPT was supposed to make it easier for people to get some sort of talking treatment, however crap, like a sort of one-size CBT over the telephone for example?

am sure social inequality has a lot to answer for but scared of becoming too left wing in my old age (isn't it usually the other way around?)

[LaGuardia]

Telling you GP you are depressed gets you a few weeks months off work, I understand. This could be why it is so popular.

[Queenofknickers]

Actually GPs aren't stupid - you don't "tell them you're depressed" they actually diagnose you and there are strict guidelines around doing this. I live with periods of severe depression - believe me it is as far away from "January blues" as a scratch is to a broken leg. Depression is a REAL illness with many different causes. Please stop perpetuating this myth that anyone who is a bit fed up can get signed off. Those of us who do occasionally have to take time off are then treated even worse.

[Mitchy1nge]

I got the impression that much of this 'social suffering' was undergone by people out of work or stuck at home with demanding pre-schoolers or caring for elderly or disabled or whatever

am sure a few weeks away from that would be a big help though

[HairyPloppins]

Depression is really common though. The WHO have it as one of their most prevalent illnesses.

And I'm from Blackpool and it is blummin' depressing. Lots of ex-forces, homeless, alcoholics, drug users end up there and it's a very transient community.

Couldn't wait to get out of there.

[MurderOfGoths]

IME doctors tend to prescribe anti-depressants fairly easily, but not refer for any sort of counseling and when they do it'll be limited to 6 weeks max, with long waiting lists even for that. Usually only CBT as well, so if you've tried that and it doesn't work they tend to leave you with just the pills.

The pills seem to get used as a way of putting off doing much else, so maybe they are over prescribed rather than depression being over diagnosed.

[MurderOfGoths]

Agree with others saying you don't just get diagnosed with depression just because you say you are. Depression is an actual medical illness and certain conditions need to be meet to reach the diagnosis.

[HairyPloppins]

I tend to find that people are referred into CBT or other psychological therapies, and in our area, its about 12 sessions that people have or longer if needs be.

It's not like anti-depressants take people's cares away, they just stop the low mood from being so low that someone can't function.

That's my experience anyway.

[Mitchy1nge]

I don't think I linked to the actual paper, just a related article, but it's by a Liverpool GP who says that GPs are diagnosing every day sadness as depression which can't be helpful for anyone

[MurderOfGoths]

Hairy Good to know it's not nationwide this reluctance to send people for therapy, maybe this leaves some hope for areas with poor mental health support currently.

[Mitchy1nge]

anyway his point was that the qualifying symptoms were so common pretty much everyone is 'depressed' within the current classification at some point in their lives

[MurderOfGoths]

Those sound like some crap GPs then, wonder what else they misdiagnose?

[HairyPloppins]

Mitchy - seems then like that's a matter of GPs needing more training, though if they use the recognised assessment tools they are objective evidence of whether depression is evident or not.

Murder - it tends to depend on whether there is a specialist mental health trust in your area. If so, provision tends to be better. And it makes more sense to get people into services early so that they can get bet quicker, which is cheaper in the long run.

[HairyPloppins]

Mitchum - completely have to disagree with what the person wrote. No way can the criteria apply to almost anyone.

[Mitchy1nge]

it's not about training GPs so much as how far we want to medicalise everyday feelings of unhappiness surely? and the system we use to classify mental illness generally

[HairyPloppins]

Ooh, mitchy not Mitchum

[Punkatheart]

i have had the complete opposite. My daughter has been seriously depressed since her father left in 2011. It was clearly a reactive depression and I went to get her help. I did not want or expect pills for someone so young - but I did not expect to be passed to CAMHS and then be on a waiting list for months and months. Eventually, she was given CBT - despite the fact that she was now suffering from hallucinations and sometimes could not function at all. She ran away, she tried to chuck herself under a car and there were lots of quite serious physical things.

TWO YEARS LATER - we got a shrink appointment and had confusing and contradictory advice. The shrink thinks that it MIGHT be organic, as my daughter does not have her periods yet. But she says that it IS depression - very serious depression. Then in the next sentence told my daughter that she must go to college even if she is depressed/having hallucinations.

That was a month ago and since then we have heard nothing of the report, of the doctor's referral that was promised. My daughter has lost her place at college - she was unable to function. The sleeping pills do not work and make her feel sick and do not help the insomnia. She is scheduled for therapy.

TWO FUCKING YEARS this has taken. Still no real progress and my daughter is now in limbo.

I am all in favour for trying lots of different avenue for low mood/depression. But when someone cannot function and it stretches over such a long period, it's the time it takes that really makes me angry.

So no - not my experience at all and we need to be careful about flippantly saying that everyone gets a depression diagnosis and a pill. It is simply not true.

[HairyPloppins]

Well that's it, depression is not everyday feelings of unhappiness. Believe me, there is a massive difference between the January blues and clinical depression.

[MurderOfGoths]

Seems this is the criteria.

[MurderOfGoths]

" how far we want to medicalise everyday feelings of unhappiness surely"

Well the criteria they should be using seems to protect against medicalising everyday feelings of unhappiness.

[Mitchy1nge]

sorry to hear about your daughter punkatheart

I have had a lot of dealings with CAMHS for two of my three children and adult services for myself - it's something else entirely, this isn't about people with serious mental illness but, as the article says, people who are struggling and demoralised and who need help of some sort but are probably not unwell in any sense

[Piscivorus]

Without wanting to detract from those who genuinely suffer mental health issues I think there is nowadays an expectation from many people that we should, on the whole, be happy. Any deviation from being happy is then seen as abnormal health and has to be solved so the poor GP ends up expected to make people feel better again. Many people also have an expectation of "a pill for every ill". Previous generations lived hard lives with incredible adversity but they just had to get on with it, it would never have occurred to them that their feelings were anything other than normal.

In areas of social deprivation, like Blackpool, there are all the problems of poverty, unemployment, poor housing, etc along with higher rates of illnesses like heart disease, COPD, etc that accompany them so it is no wonder that people are not happy. Depression is a very logical consequence of the lives that many people live in these areas. Unfortunately, instead of addressing the societal problems, the person is medicated so the symptom is treated rather than the cause.

I remember a GP friend complaining about this in a difficult area of Manchester years ago, saying his patient was undoubtedly anxious and depressed but anybody would be in their circumstances. Antidepressants are an expensive sticking plaster for a significant proportion of people prescribed them.