To think that prescribing nothing but anti depressants to someone is a bit pointless

[reallytired]

Depression is a real illness and anti depressants save lives. However if the person does nothing with the emotional lift that anti depressants give them then their problems will never be solved.

Pyschological theraphies do not have to be expensive. www.livinglifetothefull.com is very good. Working through the modules is very effective.

I think its better than face to face councelling as the patient does not develop any kind of emotional dependence on a a theraphist. CBT teaches a patient to think more sensibly and that helps to prevent depression/ anxiety.

Why is it that man GPs are still reluncant to prescribe pychological theraphies. It has been known for years that drugs are rarely enough on their own.

Perhaps people who are depressed would rather have somebody to talk to instead of working their way through a course by themselves. The waiting time for cbt can be 1-2 years Antidepressants are the easy answer for most GPs who have little else to offer a depressed person.

You also have to be fairly non depressed to have the motivation to work through things yourself.

It probably depends on whether you think that depression can be an illness with a biological cause or not.

Can you provide some evidence to support the statement that drugs are rarely enough on their own?

Drugs sometimes be enough to lift the patients mood.

There is not always 'a huge cause' with depression,it can be a situational/seasonal thing.

I agree with therapy too but the NHS is stretched beyond belief with counselling services.

Here the waiting list is 18 mths at the very least.

Maybe it would be a good idea for more students to go into mental health and train in counselling and psychotherapy?

Any self help that a patient seeks on their own behalf is beneficial,be that a website or a book.

It's got nothing to do with Male GP's either.

You are wrong. Antidepressants can help in those with short term depression, one course of a month is generally enough for most.

Not all depression comes with underlying problems.

Having suffered for six years I had no underlying problems initially, however having BPD, Social Phobia and Anxiety since is what needs the treatment not the depression.

I am no longer depressed because I pop my pills they have in effect saved my life.

Not all depression is reactive, some is endogenous.

CBT does not work for everyone, not even close.

Not everyone has the skills/abilities/level of functioning to access computerised CBT.

GP's do not prescribe psychological therapies, they can only refer and the demand still outweighs the supply.

I would suggest a more individualised, holistic approach myself. Psychology may also not be enough on its own. You can have CBT and CAT and any other form of psychological therapy until it is coming out of your ears, but if you have to go back to a squalid shithole where no one ever talks to you and your therapy is the only human interaction you get, its not likely to help any more than just drugs is it?

Also if you are so depressed you are mute, incontinent, and hospitalised, psychological therapy would do zilch at that point, whereas medication and basic human caring would.

Mental health is so much more than psychology.

'one course of a month is generally enough for most.'

Most drugs take 4-6 weeks to work,I think most GP's would like to see patients on a 6 month course to see if it's beneficial to them.

ADs don't work but a website called 'living life to the full' does?

YABU.

What FabbyChic said.

Plenty of mental illness, and cases of depression, are psychiatric in origin, rather than psychological.

CBT is too short, and generally only lasts 12 sessions, it is good for anxiety/panic attacks but teaches you nothign you cannot do for yourself.

I had a breakdown 18 months ago, my second in 6 years the first through stress at work, the second emotional.

Anti-depressants saved my life and I believe they still do.

I am waiting for talking therapy for my BPD, changing my personality is not something I can do myself because at 46 I think a certain way through years of learning, and my BPD was caused by something that happened when I was 14. I cannot go back to 14 myself and change, someone has to help me.

I believe talking helps depression but sometimes we have no one to talk to.

Only deeper rooted issues can be helped with talking therapy. CBT so far as my experience has shown is actually real shit.

Thingumy I have known people to be prescribed a months course, some do work quicker than 4 to 6 weeks and it depends on the severity of the depression.

Not everyone gets an emotional lift from ADs. ANd i have been on a list for CBT for 2 years.

There are so many causes of depression - sometimes nothing obvious.

The NICE guidelines for depression are here and suggest continuing antidepressants for 6 months after remission.

Ah so all I need to do is learn to "think more sensibly" and I'll be cured. So that will stop the voices I hear, the crippling life draining anxiety that stops me going out, and the overwhelming feeling of despair I experience that make me spend most of every day wishing I was dead. If only I was more sensible I'd be cured!

I am not emotionally lifted from anti-depressants, they have stopped me looking at every single problem as if it was a mountain and not a little tiny thing.

I can live without worrying which is the difference, I have learned to take each day one day at a time and not focus on the bad all the time.

I think it depends on how your depression manifests itself as to how it is treated, so it really is not a cut and dried case of just anti-depressants, it depends how you are as opposed to who you are.

My ex gets depression but his is totally different to mine and manifests itself in a totally different way.

I agree with eviscerateyourmemory's post and my experience of having long term clinical depression.

'Why is it that man GPs are still reluncant to prescribe pychological theraphies'

I'm really not understanding this part of the OP's post.

I wonder if it is a typo and was meant to be 'many'.

Ive continually told my ex to take his pills but he refuses to, I have no idea how he expects to feel better when he just won't take them.

Sometimes you do need them for a long time, when he initially took them the GP told him a month. That was 15 years ago, and he is sicker than ever.

Thingumy - it won't really help if more people train to go into the Mental Health sector - there just aren't the jobs, not within the NHS at least.

I have looked into it myself after having huge problems over the years with getting the right help myself. Now I'm better I wanted to give something back - especially as I was/am BPD and the NHS are still "finding their feet" with regards to treatment of the condition. My CPN actually told me that I would not be a priority for treatment because treating BPD didn't always offer the "results" that they needed - it's not a great one for the yearly stats!!

In an ideal world mental health would be given far more funding. In the long term it would save the government billions from the knock on effect that can branch out into Benefits, Social Services and other areas of the NHS (A&E with overdoses etc).

Asteria, I like you wish to work in Mental Health because I understand it. Was a moderator on a Mental Haelth Forum for a year, and done online counselling.

I'd like to hear your experiences of BPD therapies if that is okay, can I PM you? Im waiting on three types of therapy at the moment been waiting six month already. Im like the Schema therapy idea.

Ah yes,it could be!

Anyway come back Op and discuss your thoughts some more.

Pills don't always help either - I actually became suicidal 3 months into a course of antidepressants. I actually think that patients should be given a full mental health interview before being prescribed drugs.

Also that there should be as much consistency as possible with the patient - a small team of no more than three per patient (one per patient is not really workable within the current mental health setup - but 3 could be done). I saw 17 people in 2 years - which doesn't help the treatment process as it takes a couple of sessions to really get into it. During that time I was misdiagnosed as being Bipolar. The trainee who was treating me (admittedly under the guidance of the head of mental health) at the time was most insistent that I should take Lithium and after much resistance I did - I was in A&E within 72 hours with partial blindness and was unable to stand upright.

fabby - pm away!

Considering how many people suffer from depression, I can't see them being reviewed before being prescribed anti-depressants that just would not work.

I was taking one kind of anti'd for six years, I changed that to something else within 6 weeks I had a breakdown that almost resulted in me taking my life, I didn't.

I rang my GP and they upped my doseage. A life saver for me, nothing else was offered at all.

They sent me to CBT for anxiety/panic attacks but I felt the first session was of no use and did not go back.

Because I am sick I cut myself off from situations which make me sick, this in turn has made me a recluse. At least by being a recluse I can manage what I come into contact with and who.

Therefore Im actually almost better. Not sure how I would cope in the outside world, but am looking for work so hope to find out soon.