To suggest therapy over meds for MH problems?

[AliceScarlett]

Maybe it's just me but it feels like when people talk about mental health problems, (depression in particular) the default position in response seems to be suggesting medication. Or seeing their GP. All very useful and helpful suggestions don't get me wrong. But I wonder why the general trend isn't to suggest therapy? Is it seen as something to be ashamed of? A friend of mine told me she was suffering from anxiety and when I suggested CBT she got pretty defensive and said "I don't need my head looking at thanks". Maybe the insult "you need your head looking at" is causing people to think therapy is somehow wrong?

If anyone asks for my advice in the future I'll still suggest therapy because I think it could be more/as beneficial as meds, but I'm kind of worried people will be insulted

I see it to be the same as, idk, physiotherapy. You hurt your back, you go get some treatment as well as take painkillers. I feel like I'm missing something here.

I think MH services are generally not great as resources are so limited.

I have zero time for NHS secondary MH care in my experience they are arrogant pill pushers.

My guess is many people that present to the GP with 'mild' conditions like depression or anxiety are actually quite normal and their 'illness' is a natural reaction to shit life circumstances such as poverty, loneliness, abusive partners, workplace bullying, bereavement, etc.

6 weeks of CBT by a crap IAPT worker is not therapy. Many private 'therapists' are poorly qualified and basically in it for they money and/or their own self-satisfaction (i.e. they have more unresolved issues than the client).

But from NHS perspective £5 worth of citalopram is a lot cheaper than proper therapy (months/years) and ongoing social support to enable the person to make real life changes.

Of course GPs have to overlook the fact that many meds prescribed for anxiety/depression are barely more effective than placebo in the population they are most commonly prescribed (this is obviously different for those with severe illness). Plus depression most often resolves itself over time and those that do develop chronic depression are difficult to treat anyway.

My post above makes me sound like an anti-psychiatry nut job, which I am not. Meds have their place but my instinct is (fwiw) too many basically normal people are on anti-d for what are actually normal emotions.

Also it is quite scary how the latest trend is for psychiatrists to give 'atypical' antipsychotics for so many conditions that were not originally intended.... insomnia, bipolar, depression, anxiety.... even children with higher functioning autism.

I know four people who are private therapists. One was an American guy called Oliver back in the 1990's, who was a domestic abuser and in the press. Another is a school friends sister, they have a dysfunctional family and are fakes with huge PA issues. Another was a former colleague with huge issues. Finally my ex sil, her dsis is continually in the local paper abusing a position of trust and slept her way into a six figure salary the comments from the public match what she confided in us. Exsil used to pull her hair out. Her db, ex, is an emotional and financial abuser. None of these people have their own shut together, they would not be helpful to anyone vulnerable.

I tried 2 months of cbt (paid myself) after initially refusing to take medication for pnd at the start of the year. It helped but I only started feeling normal again, started sleeping again, got rid of intrusive thoughts and crippling anxiety when I finally allowed myself to take the antidepressabts. They turned me around. I think for many a combination of meds and coynselling is the answer.

Depends on the illness. Bipolar, schizophrenia, and stuff like that need meds just to function, therapy alone won't help in that case.

For things like depression or anxiety that are temporary illnesses, yes. Therapy is good hand in hand with meds. Just therapy might be too overwhelming with someone with an anxiety disorder who can barely get out the door, so meds can help with that. Most people already know meds aren't a magical fix, but they certainly can keep heads above water.

A lot of MH solutions are a lot like physical therapy. You have to work at getting better and changing your thought patterns. You are most likely going to need medication to help you work at it. Ideally, you'd go to therapy and start weening off the meds as you got better. Some people need to be on them longer, some shorter. I think of meds more like crutches. Good for when you need them, but they shouldn't be a permanent thing once your foot heals.

I think therapy is generally a good suggestion, if for nothing else a therapist will help monitor the effects of the medication.

When I had depression medication helped keep me steady whilst therapy helped address the underlying issues and provide me with coping mechanisms. It was very much a two pronged approach. Thanks to that I have been able to self manage my MH using techniques learnt in therapy, which I wouldn't have been able to do without medication. I certainly think the two should be used together.

Something that doesn't get promoted enough imo is exercise therapy.

I made faces at Drs when they suggested exercise to help with my anxiety. But having recently started running, my God it helps!! The only problem is when i don't get out to do a run, my anxiety rockets and ive run too much and buggered my hip. :( I hope it doesn't stop me.

Of course, a depressed, highly anxious person often struggles to get out of bed so a suggestion of exercise is pretty insulting when a person is in that state.

I dont think exercise will replace meds for me because there have been times when i would be too anxious to go out and run for fear of a panic attack.

Alice, it's odd that in your OP you say maybe it is the insult of 'needing your head looked at' that puts people off, yet you later refer to your helpful psychiatrist as a 'shrink'. Maybe you need to examine your own prejudices a bit before you condemn other people.

bulbasaur 'things like depression and anxiety that are temporary illnesses'

WTF!!!!!!!! My father, my sister and I all have debilitating anxiety disorders that are NOT based on circumstances, and are life long conditions that have led to suicide attempts, self harm, agoraphobia.

Severe anxiety and depression are serious mental illnesses in the same way as schizophrenia etc. FFS. Talk about fighting a losing battle against stigma.

I hope that bulbasaur meant cases of depression and anxiety that are temporary, perhaps due to circumstances, rather than suggesting that all cases are temporary.

Some depression and anxiety are not temporary. I have been on ad for over 10 years as my mh was so bad.I have tried to come off them but my mh plummetted severely. My depression got so severe, my anxiety and ocd were out of control making my depression even
Worse. Iv been on same meds, same dose for few years now. I see them simply as a drug i need to stay alive. I still suffer with anxiety and ocd, but i am able to keep them under control now mostly. Therapy and cbt didnt help infact due to an issue have made things worse.
When i am really anxious i try to distract myself.
I find my animals help also.