To think gps push meds too easily for mh

DP went to the GP about his mental health. He was told to go to the library and read a book on self help and well being. A few days later he came home crying saying he wanted to end it all. Not all GPs push meds when I think they should.

Ah, thanks for clarifying. The psychosis must have been a heck of a thing to deal with, I've not experienced it myself but read a bit about it and schizophrenia. I have a friend with bipolar too and it does seem like a constant balancing act, rather than something meds can ever 'cure' as such.😔

Thanks, sorry just to be clear. Personally I had first episode psychosis ( suspected schizophrenia ).

A good friend of mine has bipolar. I actually think bipolar is harder to treat and I am not sure you can be med free recovered with that. The ledge seems to be very thin and between things going well and mania; so much less easily recognisable before it’s too late. Very sad and cruel illness.

This

Life style changes is hardly going to solve schizophrenia, bipolar, psychosis etc is it!!

Thanks for sharing, and I'm glad you managed to recover. I've never had to grapple with bipolar myself but it sounds like hell. I agree, 'protective bubble' is a good way of looking at the role of meds in recovering from MH issues.

After ten years of given the lowest dosage of medication and going through all sorts of counselling, CBT etc the only thing that worked was the medication I’m on now. It’s given my life back. So no actually not everything can be solved from talking and I think it’s harmful to demonise medication. Average time it takes to diagnose someone with bipolar - ten years. Exactly what happened to me! Mean time I was fobbed off with counselling. until I went private

Yes absolutely agree. I am not saying meds are bad. I needed them. I wouldn’t have been able to get better without them. When I was in my episode I was in another realm. Meds allowed me to see the ledge and climb back to reality. Helped me stay in reality long enough to move a safe distance from the edge of insanity and then; I wouldn’t even necessarily call it lifestyle. It was deep daily effort everyday for a good number of months that I would encounter triggers leading me to the edge again and having to actively calm myself and say no. Not going there. I think my previous practice of yoga and understanding savannah really helped here. And after that I did do everything you are saying. Got a job outdoors with daily excercise and sun etc.

The ledge it’s hard to describe to people who don’t understand. In psychosis you can choose to a certain degree to chase the delusion. Part of why I think bipolar is the cruelest illness. That feeling good and the mania makes it all the more likely someone will chase into it.

To clarify and use your broken leg analogy. To me meds are the cast which allows your body time to heal. A protective bubble. True recovery is in the hard years of rehab you do after; and maybe an understanding of risky situations that you can’t put yourself in like you had before - like playing football or skiing for example.

I'm genuinely glad you were able to pull yourself back, but I agree with a pp that this could be dangerous advice for some, there is no one-size-fits-all with depression. Talking therapies can work, but they can also do a lot more harm than good when administered by someone who isn't fit to be in the job. Personally I ended up in a worse state after CBT due to the 'therapist' making various judgemental and triggering comments during sessions, then looking at me blankly when I asked for advice on processing some of the stuff that had caused my depression to spike (and which she had just been judging me on).

Plus, as far as sleep is concerned, mental health conditions tend to worsen sleep (I dare say you may have experienced this yourself) plus it isn't as simple for some of us as 'getting' enough sleep, for some of us sleep disorders make this difficult/impossible, the demands of day-to-day life can get in the way too.

I know I sound very negative on this thread, so I will just say that I have applied some of the strategies discussed on this thread and found them moderately helpful, I can see that they might suffice to get a person out of a mild funk or a down period, but not severe depression which is a medical condition. What worries me about threads like this is that a lot of people fail to distinguish between the two (I don't mean you pp, it sounds like you have been through the mill) and other pps chatting shit about laundry and the life-changing magic of daily work risks making people feel that they're failing at life if they can't magic themselves out of depression via the simple joy of feeling the sun on their face. It's bullshit, to put it bluntly, and depressingly (pardon the pun) close to the old 'pull yourself together' mindset that I thought most people had educated themselves out of decades ago imo.

Clinical depression is an illness, and like many other illnesses it frequently won't improve without meds to correct the problem, and for people to claim there's no need for them is wrong-headed and, yes, dangerous. I can tell some people on this thread don't want to hear it, but for some of us meds are the sticking plaster you'd put on a broken leg i.e. the problem can't be corrected without them.

I work with families who have a lot of issues including traumatic childhoods, victims of abuse, substance misuse, domestic violence, the list goes on. My role is to support with the substance misuse mainly but I can honestly say we are often managing mental health and crisis. A rferrral for mental health support in my area is taking at least 12 months. These people need something now. So anti-depressants are needed.

I agree. They just label it as depression or anxiety without any investigation and throw medication.

I had undiagnosed bipolar when I was 19. I went to the gp begging for help and they gave me anti depressants. Well they made me so much worse and my depressive episodes turned into suicidal episodes and I tried to end my own life. If only they listened to my symptoms and helped me instead of labelling it as depression straight away.

I am assuming because the mental health access is so poor, you can’t see a psychiatrist, you can’t get therapy, you can’t see a specialist to get full mental health diagnosis. You see a gp who is often not specialised and you are expected to basically be on antidepressants for life as a mask instead of being able to get full help.

‘Claiming’? Are you referring to someone specific here, because all I can say is clinically depressed people do not ‘claim’ to have a mental disorder, they have one. And while nice weather and simple tasks can indeed be uplifting and some coping strategies can help, unfortunately they are not a cure for clinical depression ffs. I’m also not sure where you get off implying people with depression aren’t sufficiently focused on their daily work (which for many people unfortunately serves to worsen depression not improve it, FYI.) Also, what happens to your magical cure when the weather’s shit? Or in winter? How are we supposed to ‘blow the cobwebs away’ then? Just get a grip and pull ourselves together, I suppose?

Seriously, this is one of the most ignorant, clueless and prejudiced posts I’ve seen on MN recently, which is saying something. You sound like one of those people who go through a phase of feeling a bit miz, manage to get out of it with a few coping strategies and decide they’ve found the cure for depression.

True depression wrecks lives and sometimes ends them. I can’t imagine there’s a single depressed person out there who has any interest in staying depressed if they don’t need to, and if you’re buying into that myth then you really do need to educate yourself.

I've no idea what the wait is in my trust, but the max that primary care can offer here is 6 sessions with a counsellor/therapist.

If you want or need more than that, you have to fund it yourself, or convince your GP that your MH issues are so severe that you need to be referred to a psychiatrist. And if you do manage to get a referral, God only knows how long the wait is for an assessment.

MH services where I live are stretched to the max, and the Trust area has a population of around 1.7m, so that's a lot of people.

It’s not advice. It’s what I did. Against NHS advice and thankfully I am well and med free.

I never got to the stage of having a schizophrenia diagnosis. But I am not convinced I didnt have the early stages. As terrifying a thought that is. The onset age was perfect and it just came out of nowhere.

My doctor told me they are quite sure I have it but they are going to give me one last chance as it is not a good diagnosis to have and can cause issues for me.

It’s an interesting field. I dont know how to describe it but if you want to bring up cancer I suppose it is a bit like that. Schizophrenia being akin to a Stage 4 diagnosis. They give you that diagnosis and no one believes you will ever get better. FEP is like a pre-cancer or an early stage 1. You can reverse that most of the time. And yes I did take meds; for months instead of the multiple years NHS wanted me to.

So what happens to people in stages 1-3? Current practice does not believe they exist. So there is no interest in getting them to a stage of full med free recovery. That takes more than just meds. We need more research but its hard to do because many go awol due to the condition.

That's stupid & dangerous advice.

If someone with schizophrenia or cancer followed your advice they would end up severely unwell in hospital or dead

Work can make some people very unwell. That is why some people with MH issues are unable to work. It is a struggle enough to deal with the very basics without work on top of that.
I think it is toxic to say that work should be the absolute priority, even over your own health.

Hallelujah - I’m cured. My life long depression due to bullying, anxiety and low self esteem has totally vanished because I pegged the laundry out, @TheGentleButFirmMadonna.

Oh wait - it didn’t cure me. Work didn’t cure me. Walking the dog on a sunny day didn’t cure me. Sadly therapy didn’t cure me.

If I come off my ADs, I become deeply, darkly depressed, and start thinking about killing myself. At best, I hope not to wake up each morning. Even on the ADs, I’m not that great - but at least I can see some point in my existence.

And how do I know this? Because I listened to people who said that I shouldn’t rely on ADs, and decided I could come off them, because I was feeling better. Spoiler alert - I was not fucking better. Each time I tried to come off the medication, I ended up sliding into deep depression. I am now on a combination of 2 different ones, and I am going to take them for the rest of my life. I am not willing to take the risk of coming off them, and feeling suicidal again.

I think that is the case nowadays as the waiting list for therapy is so long... they have to be seen to do something other than send you on your way with leaflets.

Of course, if you don't think ADs will actually help, then you are free to not get the prescription filled.

And some people are depressed due to Shit Life Syndrome. Practical help is what is needed with that, but your GP can't pay your bills for you.

I would suspect that’s because you asked for an antidepressant so the GP surmised that you wanted one and that you would not be pleased to receive lifestyle advice (as indeed the majority of people are not I’m afraid)

This describes a lot of the patients I see. It's rubbish. But I can't prescribe a break, or a holiday, or more money, or the control over your life that you need. So we give antidepressants, which help a bit. It's not ideal.

Exactly! Not just an antidepressant, one of the worst for adverse effects etc - TBH I can't think of a single patient who has been helped by a tricyclic.

I’ve had this, was useless. My depression comes from having fuck all practical support with disabled children including no school or childcare. No one can prescribe be a Mary Poppins so ADs had to do.

i have done talking therapy and home start and multiple other things but what I actually need is a break form the constant stress and overstimulation.

Do you really think depression is just feeling a bit negative and is not a real mental health problem? Do you really think people are faking it when they 'claim' they are depressed?

Yes, talking therapies may be just as efficacious for some people, @Catatedog - but they are NOT easily available, and most people will have to wait months, or even years to get therapy - so maybe ADs are sensible to help people survive until therapy becomes available. And if it’s going to take ages to get therapy, and ADs are going to be as effective as the therapy, why is it bad for the GP to prescribe the thing that the patient can start immediately, when the alternative is making them wait, suffering with their mental health all the while, until therapy is available?

I hope so. The HPC were lining up to take this on about 15 years ago. But then government priorities changed and it got dropped. At about the same time that investment in MH started to be eroded. I hope it gets picked up again.

A lot of people train in therapy now because it is the only way they will get a band 7 role in the NHS. And the NHS favours OTs and nurses for this type of training and role. So you get a nasty little cycle going on.

It really needs better oversight and government regulation. Not to say that even with that it will all be great- there will still be crap therapists. But a lot of the really poor people will be weeded out.