To be staggered at how many people are prescribed Anti-depressants.

[TheoriginalLEM]

People who seem to be pretty much on the ball with ok lives.

At my place of work there are four of us, that i know of, on the same medication (There are only about 20 employees in total)

Another mother at Dd's school, my friend who i met at dd's playgroup.

My friend from a previous job and both of her children.

So these are people who i know are on meds. People who have been happy to disclose this information to me. I don't have a large circle of friends or aquaintances so the sample group, if you like, is small.

Both my mother and my eldest Dd have both been offered Ad's.

I suffer from long term anxiety and depression and feel like the ADs help me. My Dr has expressed the view that this is something I will need for life.

Thats a lot of people who i KNOW are medicated. Why is this ? is it because life and expectations are such that people are suffering from mental illness or are people being given drugs when they are dealing with life events and should be offered strategies to cope. My personal experience is long waiting lists for counselling that wasn't that effective and given drugs to help in the absence of therapy.

I can't help but wonder why this is, what the statistics are.

Fruitcider would be interested to know where your information/knowledge is from to be so certain that many mental health professionals are wrong?

I do find exercise helps me a lot, however at my most anxious I wouldn't go running for fear of a panic attack if I couldn't get home quickly. I am working now in a job that I enjoy and feel safe in. Its a physically and mentally demanding job so I don't get time to exercise, even though I am more physically active than I was.

Not everyone can access exercise. Timedf, money and location are factors here. I could never go to a gym, hate swimming but am lucky enough to live somewhere where I can stick a pair of trainers on and run or cycle somewhere nice (either along the beach or in the local woods), I couldn't imagine anything worse than running in a city environment. So I am lucky in that respect, not everyone can run either.

Thing is there is so much money for drug companies to make from depression.....

Exactly.

I was talking to.a young man yesterday, very distressed about being detoxed from the magic trio - diazepam, pregabalin and mirtazepine.

"Miss I need my medication. If you don't give it to me I'm going to kill myself. I can't live without it".

My response?

"yes you can! Mr X, you do not have a mental health problem. You should never have been prescribed these medicines in the first place. Your stress is caused by your addiction. The way to treat addiction is not to give more drugs. At some point we have to take the drugs away. And that begins today".

As you imagine, this did not go down too well. He smashed up his TV and cut his arm. I sympathetically sutured his arm, whilst he cried and cried and cried.

Unless we break this cycle of overprescribing, things will not change. But I understand community GPs want an easy life, after all they are very time restricted, and realise that by prescribing something, it makes people feel like they have done something.

Psychiatry is still stuck in the outdated biomedical model. There is not really a place for it in modern mental health care.

Take schizophrenia for example. A pilot study showed that 1/3 of people experiencing non affective psychosis may make a spontaneous recovery without medication.

www.google.co.uk/amp/s/digest.bps.org.uk/2009/03/18/treating-schizophrenia-without-drugs/amp/?client=safari

With depression, a systematic review has found that around 23% of people with prevalent depression will go into remission within 3 months.

www.ncbi.nlm.nih.gov/m/pubmed/22883473/

So why are GPs still quickly prescribing these medications, I wonder?

I have lived with severe depression and anxiety for around 17 years. I was medicated and sedated for 10 years. The result? I felt NOTHING. I wasn't happy nor sad. That was worse than being depressed. I came off citalopram 7 years ago. Yes, I have weeks where the urge to take my own life is very strong. I draw on my support networks during these times. I leave reminders around my flat which I have wrote in happier times, telling me all the good things about myself. I have a photo album with pictures of my friends and family and I, with little notes inside it that they have written to me about the things they like about me. For me, all of this stuff is far more powerful than medication. This is the future of mental health care, this is what we should be promoting.

Fruitcider would be interested to know where your information/knowledge is from to be so certain that many mental health professionals are wrong?

See my post above!

Re the "no better than placebo" comments, once when starting a new drug, I said that I felt better straight away, probably the placebo effect as I know most ADs take 4-6 weeks to reach full effect. The doctor said no, these are powerful drugs, that can begin to work straight away.

For mild depression, feeling like you're doing something to help is probably a boost, so seeing a GP and asking for help and getting meds feels like a big step forward and a weight lifting off

But for those of us with lifelong serious depression, it is not a placebo effect, those little pills save lives.

Fruitcider - you are incorrect but I can understand where you are coming from to a degree. Depression and anxiety are indeed due to an imbalance of chemicals in the brain, it is very complex and a fine balance.

It is difficult to explain but it is quite a vicious circle. Life events can indeed affect the levels of hormones and neurotransmitters that are produced. So there you have someone with a chemical imbalance that renders them unable to respond to stress in a way that they may have done previously. Some ADs work in such a way that they don't actually replace the chemicals (if they did they would become addictive) but change the way the body responds to these chemicals and restore the correct level of feedback loops at the cellular level.

People with actual "chemical imbalances" that yourself and another poster have alluded to, would most likely have more serious mental illnesses that absolutely do need medication, but possibly not the types of anti-depressant/anxiety medication that I was referring to in my OP.

Fruit cider - so the remaining 2/3 and 77% who won't go into remission need to suffer unnecessarily?

Fruitcider - you are incorrect but I can understand where you are coming from to a degree. Depression and anxiety are indeed due to an imbalance of chemicals in the brain, it is very complex and a fine balance.

I am yet to come across research that proves this point. If you have, please send it my way.

That was in response to your previous post Fruit cider.

Fruit cider - so the remaining 2/3 and 77% who won't go into remission need to suffer unnecessarily?

I don't remember stating that anywhere in this thread. I was raising the point of unnecessary early intervention. There will ALWAYS be people that need medication. But we know that 1/3 / 23% are taking it unnecessarily.

That was in response to your previous post Fruit cider.

Yes, I understood that. I disagree as i have not seen any evidence for a chemical imbalance. If you have any, please share it. I work from an evidence base and change my practice based on the evidence available.

You really haven't read research pertaining to serotonin and dopamine's involvement in anxiety and depression? Being that most of the medication that is prescribed in GP practice for anxiety is an SSRI, I am surprised. There is a lot of it out there. I think it has been proven for a very long time.

I was put on ADs and the waiting list for 10 sessions of CBT last year when I presented to the GP with depression/anxiety.

I actually had a significant trauma history that I had largely blocked out. I have had hours and hours of private therapy, which helps enormously.

I honestly don't know what I'd have done if I hadn't been able to afford private therapy.

I got off ADs within 6 months, as they were clearly never going to resolve my issues. However, if they work for some then great, I support anything that helps anyone with a MH condition to get through the day successfully.

Despite taking an overdose and spending a few days in hospital, I still couldn't get on a waiting list for counselling.

Ad is the only way I can function.

Definitely not proven. Like I said, feel free to point me in the direction of research studies. Even the royal college of psychiatry and Mind admit there is no hard evidence.

here is a review www.ncbi.nlm.nih.gov/pubmed/11414547 Ive only read the abstract but I am just going to read it all, seems interesting.

TBH I think YABU...

You say that the people are "People who seem to be pretty much on the ball with ok lives".

I have a responsible job, am planning a marriage and am open about being on medication.

I also have bipolar disorder....I'm 'pretty much on the ball with an OK life' because of the medication. Without it I'd either be dead (via suicide) or be curled up in a ball having panic attacks.

I've requested the full text from research gate. It does not appear to be primary research or a systematic review/meta analysis though.

Fruit, I am sure you are as aware as I am, that for every article supporting your point of view I can do a quick google and find one that contradicts that, and vice verse.

But at a absolutely basic level, every process within our body will be either electrical/chemical. Every thought we have, so to say that depression isn't caused by or as a result of chemical imbalances seems a bit odd. Maybe chemical imbalance is a poor choice of words.

The thing is, we could debate the cause all day long and I don't profess to have any more knowledge than you do (although a PhD in neurobiology, albeit it regarding development rather than anything to do with neurotransmitter deficiencies do give me enough background to feel confident in my views)

Corey

"I think the whole "isn't it shocking that one in x people needs antidepressants" has something to do with the stigma of MH disorders. I know a fair few people who are or have been on AD's, but I know even more people who have or have had cancer. Isn't it shocking that so many doctors prescribe cancer medication? Doesn't the fact that so many people take cancer medication prove that it is over-prescribed? Errr...not really.

And as a historian I see plenty of evidence of people suffering from anxiety and depression in e.g. the Middle Ages. They turned to saints or made pilgrimages."

^^Yes, totally agree with this.

Also...given that the biggest killer of men under 50 is suicide one could strongly argue not enough people are on ADs

It's interesting that the NHS account of depression doesn't once use the phrase "chemical imbalance":

www.nhs.uk/Conditions/Depression/Pages/Causes.aspx

This page from Harvard Medical School is quite useful:

www.health.harvard.edu/mind-and-mood/what-causes-depression

"Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals. Rather, depression has many possible causes, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. It's believed that several of these forces interact to bring on depression."

For what it's worth, all the people I know who suffer from depression and/or are taking anti-depressants are coping with difficult or traumatic life events: bereavement, redundancy, poverty, unhappy marriages. I can't think of anyone I know who has an outwardly OK life who is taking anti-depressants.

Suicide is also the leading cause of death for people between 20-34.

This being the case I think there is a strong argument for prescribing anti-depressants more often if anything.

stumbly, I accept your YABU with good grace. Maybe I proved my own point there!

From the people I know who are on ADs, some I think, yep, I can see why you need those and others I'm like, really? but we are all different aren't we and none of us knows what goes on in other peoples lives. People are stunned when they learn I am on medication.

From my own experience, my anxiety appeared to come from a time when everything was just piling on top of me, PND, bereavement, trying to write a thesis with a newborn, illness, debt and the very real threat of becoming homeless all piled into one year.

But looking back on my life, I can see evidence in my own mind that the anxiety, or the predisposition to it, was there all along, I just didn't recognise it. But then maybe we are all like that.

Fruit - I will definitely agree with you that psychs absolutely don't have a real handle on treating mental health disorders yet, I bet most of them would agree.