To think gps push meds too easily for mh

I recommend reading ‘Lost Connections: why you’re depressed and how to find hope’ by Johann Hari. He covers the research into antidepressants and talks to lots of experts in the field.

In the meantime here is an umbrella review from 2022:

https://www.nature.com/articles/s41380-022-01661-0

Because if your daily work was your priority and not festering on negatives, then yes, this sunny morning would become a habit, a natural resilience and you would then just need to blow the cobwebs not claiming you have a whole mental disorder.

Can you refer me to an article or something online that I can read about this?

I'm always interested to learn new or alternative points of view.

I've been on antidepressants alot and usually when I start them I get the side effects (feeling sick, very tired, dry mouth) so surely they must be doing something and not just a placebo. Also i definately feel more in control and stable on them although i still get quite down just not as bad.

I'd also be really interested to know what depression is then if not the brain chemistry theory. Appreciate any pointers to where I can learn about this. Thanks

Oh and I agree with you. Trying to figure out what kind of help you need when you are already not well is difficult (if not impossible) and lots of 'therapists' don't seem to be any good. Thus why I'm considering the expensive clinical psychotherapists.

I also think there is even confusion among the mental health professionals as there does seem to be overlap between alot of conditions. I am still confused as to whether complex trauma means I have a disorganised attachment style ( i think it does) and also is complex trauma the same as having BPD as lots of the symptoms seem similar and overlapped.

Totally agree. The evidence basis for anti depressants is actually incredibly poor. It is the same or less effective than a placebo. The “neurotransmitter” / “brain chemistry” theory of depression is totally defunct. People need therapy and/or substantial life changes to feel better.

I've got the book on my kindle and have browsed it but not read it properly. I have read a few books though and watched lots of online content (by proper therapists).

I think I know what you mean. I have watched several online things about when you are 'triggered' usually because something has given you a flashback (although for most of my life I was not aware that's what was even happening).
The advice is when triggered don't try and speak or do anything rational just excuse yourself and then yes do something to soothe yourself which takes about 45 mins. I've heard various things to try from box breathing to various movements, going for a walk, listening to music. I have heard that shaking can release trauma not sure if that is what you mean.

I a big sponge of learning at the moment doing as much as I can to help myself. Learning alot. I removed myself from relationships many years ago as it was the only way I could make sure I stopped hurting people (and myself). Which of course is lonely and isolating and not really a solution.

The author of the Body Keeps Score is very highly thought of by many and I have watched some online content where he talks. Thanks for reminding me that I have the book but never properly read it.

There is only so much learning about this stuff you can take on a daily/weekly basis. It often makes me cry buckets which leads to exhaustion and fatigue but I think that is good. That is me 'feeling' it and hopefully beginning to deal with it.

I need the meds to get me to a place I can go to talking therapies and get out of bed to do exercise. A holistic approach works for me.

A lot of people being pretty patronising to the OP.

@Catatedog 's perspective is increasingly endorsed by a lot of mental health researchers. Lots of research papers out there, but also this article gives a bit of an intro to some of the issues with reliance on antidepressants, and some of the problems with what we've been told about the nature/cause of "depression".

https://www.newstatesman.com/the-weekend-interview/2023/04/joanna-moncrieff-im-not-convinced-antidepressants-have-any-use

OP, I think you have a really important and insightful point here, and also I hope you feel better soon.

I've been diagnosed with complex trauma from a chaotic and violent childhood. It has had a devastating effect on every aspect of my life.

I got told to come in and see the MH nurse after I upped my anti depressants to the maximum dose by myself. The MH nurse has referred me for therapy. 8 weeks later I have not even had my assessment appointment yet to confirm whether I will get therapy or not.

The MH nurse has me going into see her every month for 1/2 hour just to keep an eye on me which I'm not enjoying but I'm doing it (didn't really get a choice if I wanted to get the high dose of drugs)

So 8 weeks and counting and don't have any appointment time just to be assessed. Then even if I do get therapy how long will the wait be from the time I get the go ahead. I'm guessing months. Then after all that I am guessing it will be a limited amount of sessions before I'm discharged.

I've looked at the cost of private therapy with a clinical psychologist (which is what the MH nurse thinks I need) and its £130 per session which I think is 50 mins.

I did try going to a non clinical psychologist for about 6 months privately and quite frankly it did nothing for me. So I do think I probably need the expensive therapist.

So I'm waiting to find out what happens. If I get therapy on the NHS even if limited I will go of course (be daft not to) but I am fully expecting to need to pay for private therapy too.

This is a huge amount of money as I estimate I will need to go for at least a year. The option however is to stay as I am which hasn't worked too well really.

I'm already sad that so much of my life has been wasted as i didn't understand what was wrong with me for a long time. I don't want to waste the time I have left but I understand the NHS is under huge pressure.

So do I think they give out anti depressants too easily. Perhaps in some cases but in mine I've needed the help my whole life (benefit of hindsight) and I just struggled on destroying relationships, making terrible impulsive decisions and using unhealthy soothing behaviours (19 stone at one point and practically stopped going out).

I should say I've only been on job seekers allowance a couple of times in my life for a few months each. Apart from that I have worked and been financially self sufficient. I've never had any other benefits. What I mean is someone can look successful and normal and be completely messed up (for me I used to work myself to my limits so my employers would not be 'angry' at me for anything. I also used to try to be perfect as it was a way of trying to stop bad stuff happening. All this does is lead to failure and exhaustion)
At work I was highly thought of and well paid. In private I had OCD, eating disorders, was a control freak (again to try to keep safe) etc. My behaviour towards partners was shameful. Peaceful home life was unbearable for me so i would try to recreate the chaos I was used to as it felt 'comforting'. As you can imagine that was not good for the other person.

I do sometimes wonder if I should start an AMA thread on mumsnet called something like I've treated lots of really good men like complete shit AMA. Just comes into my head sometimes when I see all the complaints about men treating women badly (and this of course happens so no disputing that). It's just that some women treat men really badly too (which I have to live with and the fall-out of)

I did ask the MH nurse what depression is. My understanding is that if you grow up in a scary home where there is no security, constant terror etc your brain literally does not form correctly. Some parts are bigger than they should be and other parts are smaller. Also parts of the brain which are supposed to talk to each other, don't. People like myself literally have the good hormones missing in my brain (serotonin etc). The anti depressants increase the serotonin but if you stop the tablets it just goes back to your 'normal' level.

If I had understood all this I would have gone on AD's in early adulthood and stayed on them so at least I could have had a normal life. Mental health knowledge though has come on leaps and bounds in the last 20 years and prior to that quite frankly people just suffered and probably drank to cope or something.

Obviously the ideal thing would have been to go on the AD's and get therapy too in my early life but as i didn't know what was wrong (or even that anything was wrong) I didn't even ask for help.

When you grow up in an environment where things are most definately not 'normal' you don't realise. You think what you see is normal and so you end up repeating the behaviours until enough consequences make you realise you can ignore it no longer.

So I take my tabs and I wait to hear about therapy. I also go out for walks each day (now, not always), trying to eat well and cut out shit food. This does not cure it though. It just helps a little bit and makes me feel like I have some control over it.

It's a tricky subject and I think GP's are not experts in mental health by any means. In fact I'd go so far as to say most of them only know the very basics (they are Jacks of All Trades after all). I never got offered any other help apart from when I upped my own tablets to the maximum dose and then it must have set off an alert that I needed help. I didn't do it for that reason. I just literally couldn't go on.

Anyway just my experience of living life with trauma and the resulting problems.

@RattyMcBatty I agree that's it's not always possible for people to get outdoors for a variety of reasons, and that it's very beneficial. However, I don't think that women are especially in danger going for a walk anywhere. I think young men are probably more likely to get into trouble in a city at night and the chances of anyone being attacked while walking in a wood or the countryside alone are probably far less than somewhere more populated.

Thank you for mentioning pies. I'm guessing you are anti weight loss injections for similar reasons?

If someone is severely depressed, telling them to get exercise and social contact probably isn't going to be enough.

If someone is severely overweight, telling them to eat fewer pies probably isn't going to be enough.

Both conditions (depression and overweight) are physiologically complex, and we don't fully understand them. The drugs work for many.

Yes massively. The same compound that treats depression to treat anxiety and stress.

Mental health is not mental illness.

They need to be properly funded to have enough time with people. Until then research yourself so you have an idea of what may help

Many years ago, I was beating myself up for not being able to make the CBT I'd been taught work. I was suicidal at the time. A kind psychiatrist pointed out that CBT was for mild to moderate depression, not what I had. And I think this is true for many. Online CBT used to start with a questionnaire that asked if you had suicidal thoughts, and if you did, it couldn't proceed. So what are the GPs to do? Not a wonder they are prescribing ADs because often by the time a patient gets to them they are where I was. Too ill for talking therapy.

First of all I will point out that ADs have been life changing - if not even life saving - for me.

I got them during lockdown. It was as simple as a phonecall, the call took 4 minutes. They checked on me a month later, all was good and I was starting to feel a little better, and ever since then they've just approved the repeat prescription every month.

So I've been on them for more than 4 years now.

And they were ridiculously easy to get hold of. In the first phonecall they mentioned talking therapy and asked if it was something I would be interested in. I said possibly, but I found the thought quite overwhelming at the moment so maybe when the meds had kicked in a little.

It was never mentioned again and, as I say, I've been left alone for 4 years now. This includes swapping GPs - my new one has never even met me, and still just signs off on the meds.

Antidepressants are used for other illnesses other than depression. I have crippling OCD and a disassociation disorder and I’m prescribed an SSRI, it saved my life.

I can’t stand the whole “lifestyle changes” brigade. It’s like telling someone who is deaf to listen harder.

Often it's a combination of everything that helps people- but ADs can give them enough a start to them make some lifestyle changes, or out into practice other skills they've been told about but haven't had the energy/motivation to change.

I can assure you that hospice care is not relying on heat packs for pain control.

OK some people might use them but generally the patients I see need proper drugs.

I do meet people who insist on not having them as they don't believe in them/want to embrace their spiritual journey/various other reasons. However to date all of them have been very happy to have proper drugs that actually work eventually.

I'm very much a supporter of the importance of getting outdoors each day and exercising. However, for a lot of people, that is not always possible. We all have to get to and from work, and the length of the journey, or physical ability, might rule out cycling for instance (which would give you both exercise and a bit of outdoors time). Our hours are so long sometimes that exercising when home, or before work, is also not possible.

In the winter, daylight hours are so short that for women, it's not always safe to get outside before or after work, or even alone at the weekend during daylight hours for a walk through the local woods etc.

So people are having to go down the medication route because they can't access the holistic routes.

I have actually spoke to gps about this through some work i was doing around mental health. And the reply was the same we dont know what else to do people are coming suicidal, completely overwhelmed by life and struggling to function. We can explain to them to self refer to talking therapies but wait lists are long and can take months/ years so the only thing we can do is offer anti depressants to try to help in the mean time. None of them wanted to be prescribing anti depressants the way they where but they had nothing else to offer.