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.

Surely treating the underlying cause is a better long term solution?

One of my underlying causes is a child with autism. Not sure how I can go about eliminating that one. I was also suicidal. Maybe not the best choice but I'm still alive so that has to be good surely.

I have huge respect for anyone with a PhD in neurobiology. I have done one undergraduate module and it nearly broke me! But I still disagree that it is proven to be caused by a "chemical imbalance".

That is definitely a good thing MrGrumpy!!

Fruitcider I'm afraid I find it hard to respect your opinion given you're basing it mainly on your own personal experience (which you seem to contradict yourself on) and the hubris of the newly qualified.

I too have been struggling with numerous mental health conditions for many years. My medication is not a placebo.

I've also worked with the mentally ill over a number of years and while a SMALL amount may have been wrongly diagnosed (as in the case of missed anemia, thyroid conditions and similar)

Many have hugely benefited from treatment with drugs as well as other therapies and would be dead without them.

It's easy to blame big pharma but drugs do have their place. And as a pp said if it were eg cancer we wouldn't be questioning half as much. Why is it acceptable to take whatever's prescribed for physical illness but for mental illness 'is it really necessary'

As for the scenario you described with the guy you ended up giving stitches to, you didn't seem to care much for his experience or distress.

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

Exactly yet according to fruitcider this is reason enough NOT to prescribe lifesaving, distress reducing drugs that not only help the patient but make things so much better for those caring for them too

I always staggered how quickly they are recommended like some sort of prop rather than I guess getting to the bottom of what actually is the real problem.

I have friends who are medics who are very very reclucant to prescribe and if the belief you're never the same again once you've had them.

Thanks LEM I'm not out the woods yet but I'm getting there.

"But I still disagree that it is proven to be caused by a "chemical imbalance".

So do I!!! However it IS definitely a factor, and a chemical imbalance IS seen in people with depression/anxiety. I doubt it is the cause, but it is an affect, symptom if you like and treating with things to attempt to restore this balance surely is a sensible approach? Gotta be more affective than trying to work out how many shades of blue are in the sky!

I don't think the answer to trying to lower the incidents of suicide is prescringing more ad's

It's having more support and changes in our society toward dealing with mh issues

When dealing with people who are Feeling suicidal (and by that I mean it is taking up a lot of their thoughts, plans being made, have made an attempt ) they need far more support that simply giving them a few tablets, if they are struggling to look after themselves (which isn't always obvious) not taking their tablets can be a form of self harm or that their life is so chaotic they forget can have terrible side effects that can make them feel in an even more confused state of mind

In our family, there appears to be a strong link between high anxiety/depression and Ehlers Danlos syndrome (which is known to be co-morbid with depression/anxiety). It's genetic and incurable. It also means exercise can be difficult.

We have none of us had particularly tragic lives: we tend to have very happy marriages, experience few tragic bereavements and have interesting jobs and hobbies.

I think it is also worth considering if sometimes the unhappy life events, particularly the poverty and breakdown of marriages, may not actually be caused by the MH issues rather than the other way round.

I was pretty much dragged to my GP during an extremely stressful time of my life and have been taking ADs since May. I'm reducing them now.
Exercise (I am a keen, competitive runner) has done WAY more for me that the ADs.

I hate being on them. I hate that the situation I was in rendered me unable to cope. But I admit they have helped.

Enthusiasm, have you ever spent several years as a family member trying to support someone who is suffering from high anxiety and depression? Have you any idea how draining that is?

By the time dd finally got her AD's, I was physically exhausted, my career was in tatters, my pension contributions were minimal, and I kept catching every bug going. She had access to CBT but was completely unable to make use of it.

If there is a genetic problem, family members may well have to do this more than once: first as children of the sufferer, then as siblings, then as parents. That will be a large chunk of your life spent on propping other people up.

If mental illness is NEVER completely caused by chemical imbalances explain why they are a known symptom of eg anemia and thyroid issues!

The brain is an electro chemical organ.

I choose to believe the MANY health professionals I have been treated by and worked with who believe it IS a significant factor so that often the first thing they recommend (and I'm talking mental health experts not gp's) is to have the right medication organised.

Many mentally ill people can't even make full use/advantage of talking or other therapies without medication in place first. Particularly with the more serious conditions where they may not even know what planet they're on!

Also not everyone can exercise, not everyone has a support network, talking and other therapies can take months to access and are massively underfunded. If drugs weren't prescribed there'd be more suicides, more self medication with drugs and alcohol, more acute admittance to in patient facilities. Which is not only awful for the patient but bloody expensive!

It's not just personal experience, I have been working with people with SMI and/or addiction for over 10 years. The reason why I went into this line of work is because of my own personal experiences. My own experiences, whilst they shaped my view in the early stages of my career, are not relevant to my current practice. My practice is based on the evidence base available. And all the guidelines suggest a stepped care model, which includes self help right at the beginning, followed by low intensity psychological therapies, followed by high intensity psychological therapies and medication. Medication should not be a first line treatment, unless it is clearly obvious that someone has SMI.

Most people presenting to a GP stating they are depressed will not have clinical depression. Antidepressants are not really effective for the "worried well". This group of people would do much better if they were referred to mutual aid groups such as Changes, or were "prescribed" a structured support programme, or even offered some stress tolerance training.

I'm not denying that medication can be life saving, I'm certain that citalopram saved my life in the very acute phase of my illness. But did I really need to be on it for 10 years? No. And the evidence shows neither do the majority of people. By all means, prescribe medication for those who really need it. But it should not be forever. People can and do make a full recovery. Once that idea is accepted, it is much easier to look at alternative treatments to medication in the long term.

Re: chemical impbaloance

"So do I!!! However it IS definitely a factor, and a chemical imbalance IS seen in people with depression/anxiety"

Any chemicals may be a symptom rather than a cause - for example hormones, especially like adrenaline. Time is needed to look into the causes which are often better treated by other methods than anti
-depressants.

The pill has caused a lopt of depression. How many young girls are given a low grade throw it out there pill, then got depressed, then been prescribed anti-depressants? How many people are pumped with adrenaline from an abusive relationship with a partner or circumstances at work, then prrescribed an anti-depressant? Or sit in front of a screen for hours, and never get out? The list of things leading to a 'chemical imbalance' could go on.

A high sugar diet, altering the chemicals of the body obviously, can often be a factor in bi-polar disorder and even in symptoms of schizophrenia.

And when has a doctor ever given a blood test for low seratonin gefore prescribing anti-depressants?

I definitely think the answer is not to address the issue with a polarised view....it's not 'everyone who is feeling a bit low should be prescribed antidepressants' vs. 'just go for a run and have a cup of tea dear'.

The problem is that people need to be more aware of their language when making statements as a lot of posters (myself included) are coming across as either pro ADs in all situations or vice versa.

I suspect most of us would actually agree that there is a continuum of mental health/illness, some places on that continuum would be better treated with a bit of CBT, exercise and changes in lifestyle. Others need quite serious medical intervention before that would even be possible.

The issue is that some medical professionals hand out ADs for people who wouldn't need them if they had other support (which rarely exists in the NHS) and others are quite old fashioned and will not diagnose a mental illness even when there clearly is one.

"The issue is that some medical professionals hand out ADs for people who wouldn't need them if they had other support (which rarely exists in the NHS) and others are quite old fashioned and will not diagnose a mental illness even when there clearly is one."

This. And add to this that while this "everybody gets ADs too easily these days and people need to learn to deal with life"-narrative is prevalent, people like my relatives (and their families) will just struggle on, because they don't want to be lumped in that category.

Drs rarely do blood tests even for physical illness they often base a diagnosis on presenting symptoms or at least prescribe treatment before a diagnosis is confirmed by blood test or other tests. Yet in the case of physical illness this isn't questioned.

It comes down to the stigma attached to mental illness. The mentally ill are expected more than the physically ill to 'help themselves' as if they are to blame for their condition even mental health clinicians are guilty of this.

As for alternative/other treatments even IF you accept that's a 'better' course (which I don't necessarily, depends on the illness and the severity) they're often just not available. Waiting lists just for talking therapies are ridiculously long, not all therapists are good at the job and some do more harm than good. There's a shocking lack of diversity in the types of therapy available (cbt seems to be seen as some kind of cute all within the nhs) and if you get a therapist you at best don't gel with or at worst is critical, unsupportive and negative it's incredibly hard to get a different one and usually results in being put to the bottom of that long list again! So what are the mentally ill meant to do? Put up and shut up? Quietly commit suicide?

*cure all

I would hope, fruit that in your career, you don't make a habit of making MH patients go cold turkey from medications such as mirtazapine. That is very worrying indeed. Whilst non-addictive, it is not a good idea (to say the very least) to stop taking SSRIs or similar medications quickly, rather taper to a lower and lower dose.

How do you tell (in a 10 minute consultation) the difference between the so called worried well and the "really" ill though?

And what happens if the doctor gets it wrong? (Pretty likely given they only have 10 minutes)

The other major major issue is that the medical profession is just generally quite detached from what the reality of life is. I've heard them telling people on benefits to shop in better supermarkets to reduce weight and be in better health. They've just no clue and nor really is it their job to offer that support. The sure start programmes etc saved money in the longer term because I imagine less people presented at the GP with MH issues and required meds. But of course they all got cut.

By all means, prescribe medication for those who really need it. But it should not be forever. People can and do make a full recovery. Once that idea is accepted, it is much easier to look at alternative treatments to medication in the long term.

My psychiatrist told me I'll need to take medication for the rest of my life, and no doctor I've found has contradicted that.

I believe I can make a full recovery and get off these drugs in the future. It seems you agree with me rather than with my psychiatrist, FruitCider. But how do I convince my doctors, when the time comes?

corythatwas

yes I do

but I am not sure what you read from my post. My reply was to people saying that increasing prescribing ad's might help reducing the suicide rate I do not agree its not that simple when dealing with people who are suicidal they need far more support than being given a prescription for ad's

unfortunately your daughter didn't get the support she needed or you needed in supporting your daughter. the system is failing many people simply because the resources are not there

the answer can not be to drug people who are depressed on high doses to prevent feelings that might at some point have it is to work with the feelings and emotions they are experiencing