To think gps push meds too easily for mh

[Catatedog]

while I appreciate Ads are really helpful for some ppl i feel gps push these before lifestyle advice and they know psychological therapy access is poor

@RattyMcBatty I agree that's it's not always possible for people to get outdoors for a variety of reasons, and that it's very beneficial. However, I don't think that women are especially in danger going for a walk anywhere. I think young men are probably more likely to get into trouble in a city at night and the chances of anyone being attacked while walking in a wood or the countryside alone are probably far less than somewhere more populated.

I've been diagnosed with complex trauma from a chaotic and violent childhood. It has had a devastating effect on every aspect of my life.

I got told to come in and see the MH nurse after I upped my anti depressants to the maximum dose by myself. The MH nurse has referred me for therapy. 8 weeks later I have not even had my assessment appointment yet to confirm whether I will get therapy or not.

The MH nurse has me going into see her every month for 1/2 hour just to keep an eye on me which I'm not enjoying but I'm doing it (didn't really get a choice if I wanted to get the high dose of drugs)

So 8 weeks and counting and don't have any appointment time just to be assessed. Then even if I do get therapy how long will the wait be from the time I get the go ahead. I'm guessing months. Then after all that I am guessing it will be a limited amount of sessions before I'm discharged.

I've looked at the cost of private therapy with a clinical psychologist (which is what the MH nurse thinks I need) and its £130 per session which I think is 50 mins.

I did try going to a non clinical psychologist for about 6 months privately and quite frankly it did nothing for me. So I do think I probably need the expensive therapist.

So I'm waiting to find out what happens. If I get therapy on the NHS even if limited I will go of course (be daft not to) but I am fully expecting to need to pay for private therapy too.

This is a huge amount of money as I estimate I will need to go for at least a year. The option however is to stay as I am which hasn't worked too well really.

I'm already sad that so much of my life has been wasted as i didn't understand what was wrong with me for a long time. I don't want to waste the time I have left but I understand the NHS is under huge pressure.

So do I think they give out anti depressants too easily. Perhaps in some cases but in mine I've needed the help my whole life (benefit of hindsight) and I just struggled on destroying relationships, making terrible impulsive decisions and using unhealthy soothing behaviours (19 stone at one point and practically stopped going out).

I should say I've only been on job seekers allowance a couple of times in my life for a few months each. Apart from that I have worked and been financially self sufficient. I've never had any other benefits. What I mean is someone can look successful and normal and be completely messed up (for me I used to work myself to my limits so my employers would not be 'angry' at me for anything. I also used to try to be perfect as it was a way of trying to stop bad stuff happening. All this does is lead to failure and exhaustion)
At work I was highly thought of and well paid. In private I had OCD, eating disorders, was a control freak (again to try to keep safe) etc. My behaviour towards partners was shameful. Peaceful home life was unbearable for me so i would try to recreate the chaos I was used to as it felt 'comforting'. As you can imagine that was not good for the other person.

I do sometimes wonder if I should start an AMA thread on mumsnet called something like I've treated lots of really good men like complete shit AMA. Just comes into my head sometimes when I see all the complaints about men treating women badly (and this of course happens so no disputing that). It's just that some women treat men really badly too (which I have to live with and the fall-out of)

I did ask the MH nurse what depression is. My understanding is that if you grow up in a scary home where there is no security, constant terror etc your brain literally does not form correctly. Some parts are bigger than they should be and other parts are smaller. Also parts of the brain which are supposed to talk to each other, don't. People like myself literally have the good hormones missing in my brain (serotonin etc). The anti depressants increase the serotonin but if you stop the tablets it just goes back to your 'normal' level.

If I had understood all this I would have gone on AD's in early adulthood and stayed on them so at least I could have had a normal life. Mental health knowledge though has come on leaps and bounds in the last 20 years and prior to that quite frankly people just suffered and probably drank to cope or something.

Obviously the ideal thing would have been to go on the AD's and get therapy too in my early life but as i didn't know what was wrong (or even that anything was wrong) I didn't even ask for help.

When you grow up in an environment where things are most definately not 'normal' you don't realise. You think what you see is normal and so you end up repeating the behaviours until enough consequences make you realise you can ignore it no longer.

So I take my tabs and I wait to hear about therapy. I also go out for walks each day (now, not always), trying to eat well and cut out shit food. This does not cure it though. It just helps a little bit and makes me feel like I have some control over it.

It's a tricky subject and I think GP's are not experts in mental health by any means. In fact I'd go so far as to say most of them only know the very basics (they are Jacks of All Trades after all). I never got offered any other help apart from when I upped my own tablets to the maximum dose and then it must have set off an alert that I needed help. I didn't do it for that reason. I just literally couldn't go on.

Anyway just my experience of living life with trauma and the resulting problems.

A lot of people being pretty patronising to the OP.

@Catatedog 's perspective is increasingly endorsed by a lot of mental health researchers. Lots of research papers out there, but also this article gives a bit of an intro to some of the issues with reliance on antidepressants, and some of the problems with what we've been told about the nature/cause of "depression".

https://www.newstatesman.com/the-weekend-interview/2023/04/joanna-moncrieff-im-not-convinced-antidepressants-have-any-use

OP, I think you have a really important and insightful point here, and also I hope you feel better soon.

I need the meds to get me to a place I can go to talking therapies and get out of bed to do exercise. A holistic approach works for me.

Thanks for this article. It has helped me understand my thinking better. I was not really given answers to questions like what per cent of people do they work for and what choices are where diarrhea is a less coon side affect purely encourraged to be on them for 6 to 12 months.

The problem is until you have had enough of the right sort of therapy its hard to know which support you needed. Have you read the body keeps the score? Someone from my work eap suggested shaking after flashbacks and does seem to make them feel less stuck.

No Oi am not against any particular drug I do think its problamatic when lack of health education means drugs are pushed as first line treatment. The nhs were much more inclined to prescribe drugs rather than offer physeo for example. In the short term i am sure it costs more but in thelong term its surely better we societally support wellmness.

I've got the book on my kindle and have browsed it but not read it properly. I have read a few books though and watched lots of online content (by proper therapists).

I think I know what you mean. I have watched several online things about when you are 'triggered' usually because something has given you a flashback (although for most of my life I was not aware that's what was even happening).
The advice is when triggered don't try and speak or do anything rational just excuse yourself and then yes do something to soothe yourself which takes about 45 mins. I've heard various things to try from box breathing to various movements, going for a walk, listening to music. I have heard that shaking can release trauma not sure if that is what you mean.

I a big sponge of learning at the moment doing as much as I can to help myself. Learning alot. I removed myself from relationships many years ago as it was the only way I could make sure I stopped hurting people (and myself). Which of course is lonely and isolating and not really a solution.

The author of the Body Keeps Score is very highly thought of by many and I have watched some online content where he talks. Thanks for reminding me that I have the book but never properly read it.

There is only so much learning about this stuff you can take on a daily/weekly basis. It often makes me cry buckets which leads to exhaustion and fatigue but I think that is good. That is me 'feeling' it and hopefully beginning to deal with it.

Totally agree. The evidence basis for anti depressants is actually incredibly poor. It is the same or less effective than a placebo. The “neurotransmitter” / “brain chemistry” theory of depression is totally defunct. People need therapy and/or substantial life changes to feel better.

Oh and I agree with you. Trying to figure out what kind of help you need when you are already not well is difficult (if not impossible) and lots of 'therapists' don't seem to be any good. Thus why I'm considering the expensive clinical psychotherapists.

I also think there is even confusion among the mental health professionals as there does seem to be overlap between alot of conditions. I am still confused as to whether complex trauma means I have a disorganised attachment style ( i think it does) and also is complex trauma the same as having BPD as lots of the symptoms seem similar and overlapped.

I dont mean drugs arent used.but feels other things are not available. Pepermint and a heat pack on the houlder did so much when i had a private lap and combined with pain medds got me moving much quicker. Ythe nhs dosed me with high doses of opiates and then meds for nausea, antihystamines and laxitives when other treatments may have complimented pain meds

Can you refer me to an article or something online that I can read about this?

I'm always interested to learn new or alternative points of view.

I've been on antidepressants alot and usually when I start them I get the side effects (feeling sick, very tired, dry mouth) so surely they must be doing something and not just a placebo. Also i definately feel more in control and stable on them although i still get quite down just not as bad.

I'd also be really interested to know what depression is then if not the brain chemistry theory. Appreciate any pointers to where I can learn about this. Thanks

Yes i meant shaking to release trauna. Agree its exausting to have to do all the research and dicide what to impliment. I think a nhs resource by clinical psychologists on things to try instead of or as well as meds would be super useful.

Because if your daily work was your priority and not festering on negatives, then yes, this sunny morning would become a habit, a natural resilience and you would then just need to blow the cobwebs not claiming you have a whole mental disorder.

Here is a UCL article on brain chemistry point. www.ucl.ac.uk/news/2022/jul/no-evidence-depression-caused-low-serotonin-levels-finds-comprehensive-review

I recommend reading ‘Lost Connections: why you’re depressed and how to find hope’ by Johann Hari. He covers the research into antidepressants and talks to lots of experts in the field.

In the meantime here is an umbrella review from 2022:

https://www.nature.com/articles/s41380-022-01661-0

Sorry that was in response to @WasItLoveOrSomethingElse

I also feel both the Anxious Generation and Dose effect are good books on how to combat societal pressures which dont support wellness.

Agree and its not like a scan or blood test shows which you have and the best treatments.

One of the most helpful things from therapy was thinking about activities in terms of if they soothe or cause stress. I had never really thought of this balance so would push and push until meltdown.

why the rapid increaase

Services for MH are in freefall crisis. Waiting times have increased so much that even people in crisis may have to wait. IME when GPs knew that people may be seen quite quickly they were more ready to suggest waiting. But in the absence of other services, offering meds at least feels like doing something which may help.

That paper has been heavily criticised for bias
Joanna Moncrieff has made a career out of being against antidepressants. I would take anything she says with a huge pinch of salt.

https://www.nature.com/articles/s41380-023-02093-0

and lots of 'therapists' don't seem to be any good

So, any profession will have good and not so good practitioners. But this is why 1. psychotherapist and counselor should be protected titles. 2. Accreditation should be done by the HPC. 3. Consumers should be better educated to interview potential therapists.

In this country we also have a glut of people who only have a narrow focus or one theoretical orientation. Instead of people who have a good solid base in common with people who practice but who may use a different orientation or approach. IAPT services did not help. There are a lot of people claiming to be psychotherapists who only have training in CBT, and not very good CBT at that. It got highjacked by some professions such as nursing or OTs, who do not necessarily come in with a psychological focus.

In most areas you can self refer to NHS Talking Therapies so you don’t need a GP for that. What else have they really got to offer apart from meds?

I agree it’s the lazy option sometimes.

I do believe in psychiatric medicine. But I think it should be seen as acute firefighting rather than necessarily long term (obviously there are many exceptions).

I had first episode psychosis. Thankfully I had a friend who guided me through it. After I was medium recovered they said you need to get off these meds. Sent me the papers to back it up. He was right. Newer research shows people with the right support who stop antipsychotics after a short period with FEP; do have better long term outcomes.

However the NHS don’t want to put in the leg work, and they don’t want to risk it.
Stopping the antipsychotics increase the short term relapse rate. And every relapse makes the situation more likely to develop into longer term conditions like schizophrenia. But statistically as a whole cohort; the cohort who do stop are better off in long term stability and relapse.

Its tough. I am super grateful I had that extra support and whilst the early intervention in psychosis service is world class it still has a way to go imo.

Mine didn’t. When I’ve spoken about my health anxiety over the years, my GP has told me she doesn’t think I need meds - the decision to start them took place after lots of discussions.

She is very balanced - I now take them. But it wasn’t a quick decision and wasn’t seen as a quick fix.