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.

I shouldn't have said that hairy, I'd like to apologise and retract it

this is one of those rare things that isn't about me I'm quite well looked after, I have a cpn, I get direct payments to spend on therapeutic stuff (not actual therapy though) and the rest is up to me - take lithium, try to lead a balanced life, stay away from psychiatrists for as long as possible (as it happens I think I have got more than my share of PD traits but nobody ever agreed enough to add it to my existing diagnosis, which is just bipolar)

I just wonder why we are not being a bit more honest about the social inequalities that lead to one in six people in Blackpool taking antidepressants while in other areas it's (wild guess) one in twenty or thirty - it's a discussion rather than a search for the next magic bullet, which CBT became for a while, the whole country has been SSRI'd and CBT'd to death if it doesn't work for people then others tell them it is because of their own attitudes or unwillingness to cooperate

you can't make people fit into the treatments on offer, it should fit them

Someone said something about someone saying the problem was that everyone expects to be happy.

I should have addressed them directly,sorry.

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

You understand wrong LaGuardia - for many sufferers it's quite the opposite. When I was a SAHM my GP nearly jumped for joy when I told him I had a job.

If someone is so depressed as to be signed off, they are ill and cannot work.

FWIW, two members of my family are both on ADs and neither got on with CBT. I maintain that it was the therapist in both cases that was unsuitable for them though. I think it can be a while before you find the right one. I really clicked with mine and managed to stay off the ADs but not everyone is so lucky.

I was diagnosed with PTSD by a psychologist with whom I had EMDR therapy. This was all through Occupational Health. I have a very responsible job so at one stage they made me go to Occ Health weekly as well as the therapy sessions otherwise they wouldn't let me work.

I have been honest with my GP. I've been in hospital 4 times after suicide attempts. Doesn't get you a psychiatrist round here.

Well mitchy, fine line between BPAD and other diagnosis out there isn't there?

You invent the treatment that will fit everyone individually, on a limited budget, we will come. Suspect that if people knew exactly what made them well, they wouldn't need the health service though.....

And 1 in 20 elsewhere is spectacularly naive. It's actually more like a third of people have mild depression, but in some people the physical characteristics are more prevalent so that's what they go to the GP with. It is the number one prevalent health issue worldwide.

However, if one third have it that means that the other two thirds live in the same shit hole places in the same situations and are not depressed. So it can't all be circumstance can it?

cbt, talking therapies work well well much of the time but it is very easy to blame the therapist. at times it may be the therapist often it is people's resistance to therapy and to change it often takes more that 6 weeks for a client to feel comfortable and safe

psychodynamic therapy is being used more within the nhs and there are short term psychodynamic therapy courses available in some areas (not sure where) and this maybe available to more people in the years to come

Bloody hell Claudius, I'd go and sit in A&E then until they wheel out a psych if it was me. That's disgraceful treatment. And psychologists are a completely different kettle of fish and you need the right help at the right time. I'm telling you, camp out in A&E till the buggers get a psych to you. Am furious on your behalf.

freudianslipper - exactly!

sorry that 1 in 20 was rates of people taking antidepressant medication, I will see if I can find it, I think it was 1 in 29 for some random London borough as opposed to 1 in 6 for Blackpool but I'll have a look

what interests me, and I think is the premise of the article I linked to, isn't so much what new treatments might we develop (and of course advances are made all the time) but how we classify, respond to and understand mental anguish

If you are really depressed, the chances are you do not know it yourself. Just like if you had cancer.
Things are not "right" but there is nothing you can put your finger on.

even if someone where to camp out until they saw the right professional it would be a duty psychiatrist not someone you have been referred to with notes of your history

and right now its is as black and white as are you self harming and likely to make a serious attempt on your life or not in many areas as they are so overstretched

it is a very sad state of affairs

I don't know what you mean about a fine line between bipolar and what (?) though

All I've had in A & E is the junior doctor from the psych team who didn't really let me speak but instead said 'You won't do anything that silly again will you?'. Actually, he was on the medical ward as I was unconscious in A & E. Referrals from the nurse mean you see a CPN who then refers you on for CBT. It's joyous.

Then again I consider myself more fortunate than my sister who was forced to have ECT under a section. Swings and roundabouts I suppose!

I accept I'm not going to get better, but meds give me a bit of time to keep going, the chance to make better arrangements rather being driven to stupid ones that don't work because I am so desperate.

Mitchy i think it is much higher than that

and those accessing nhs therapies well many go private and not sure if that is counted in the numbers for taking ad's too

Yes Freudian, but then the psychiatric liaison team can refer to outpatients, so Claudius gets seen via the back door. Or at least that's how it works here. Maybe in other areas its different and if so that sucks.

Mitchy - between BPAD and borderline personality disorder. Diagnostic criteria share many of the same elements.

Claudius I've been under the care of psychiatrists on two separate occasions. I would not recommend it.

The most helpful person I''ve encountered was a fabulous cpn who really properly listened to me. She was the best listener I have ever encountered. It is such a rare skill. She helped me more in four hour-long sessions than anyone else in my life.

One person's 'right' therapist (or therapy, for that matter) is not the right one for someone else though. Mine insisted that our first consultation was us figuring out if we could work together or if we should agree for me to try with one of his colleagues instead. The therapist(s) my family members had may work well with other people but not with them.

Absolutely agree about the 4-6 week 'revelation'. Mine was week 5. I remember it exactly, as though a big torch had been shone back through my whole life and I could see the clear path and progression of my illness.

CailinDana - dissuading a person from seeking professional help????? Are you for real?

I thought you meant schizoaffective, that was my 2nd opinion diagnosis , but at least if I had borderline pd they'd let me have antidepressants and talking therapy.

Never given someone with borderline anti-depressants, and it tends to respond best to dialectal behaviour therapy. but that involves looking at how you contribute to your own behaviour. And if you have BPAD and take anti-depressants, there's a massive chance you would become extremely manic.

Not sure why you haven't been offered talking therapy for bipolar. Seems odd?

Brokenhearted55a - it's awful isn't it. Complete absence of hope. Hope you're feeling better now.

my consultant was old school, it was lithium and chlorpromazine all the way. poor me

but also I am going back several years, when people referred to bipolar as 'the american term for manic depressive illness', it wasn't really in common use until about 10 years ago - anyway eventually I did get him to refer me to someone for CBT but we mainly worked on relapse prevention and it did overlap with the MDF self management course (also probably a thing of the past) when what I wanted was for someone to say it was something a bit more fixable

I had another go at talking therapies a year or so ago, recently out of hospital, but they seem to think am beyond the reach of its grasp so fuck 'em

There is some pretty strong evidence that Vitamin D deficiency can have a serious impact on the mood disorders. This would explain why there is an increase in depression as people spend much less time outdoors these days and therefore are getting much less Vitamin D (only real place you get it naturally is from the sun). A increasingly large percentage of the population is Vitamin D deficient. It would probably be helpful for everyone with depression or other mood disorders to be taking 5000 iu of Vitamin D a day and see if that helps (give it a few months to take effect).

Mitchy - I'm so sorry, but that's because it's not actually fixable. All the stuff that's offered is to help with managing it, but that's as far as it goes at the moment. Someone with diabetes can't be fixed...they take their meds and watch their diet. Same sort of thing with knackered brain chemistry IMHO. Take meds and learn your relapse indicators.

I can understand why people get angry that they are not being "fixed" but its no-ones fault.