"Talking Cures v ADs for Depression and Other Anxiety Disorders" - Discuss!

[MummyToSteven]

I think there is scope for a constructive discussion on issues raised by the earlier thread posted by MKM

my view is:-
counselling may not necessarily be appropriate for all anxiety disorders but can be helpful for mild depression

there is a scandalous shortage of qualified CBT practitioners in the NHS

ADs can be very helpful if they work, and at least are immediately accessible as opposed to being stuck on waiting lists for counselling and avoid the personal chemistry issue of seeing an individual counsellor

anyone have any opinions?

bump?

Agree with everything you say MTS. CBT should definately be more widely available. It should also be 'advertised' I feel. I had never heard of it prior to MN, and neither have a lot of others. Ludicrous really. And ADs have their place too as I said previously, not for everyone but in some cases.

Yep - and I really hope this thread turns into a debate, rather than a fight.

I agree with your points and also think that if someone's really low and seizes onto the idea of ad's it's not necessarily a bad thing. It forces them to see a GP, who may be very helpful (ok, some of them are rubbish but that's another story). And in the end, even being on ad's for life is better than throwing yourself off a bridge. Sorry to be blunt, but it's true. It seems to get forgotten sometimes in the dicussions about ad's that saying someone 'feels low' isn't just saying they're having a bad day - some people are literally at the end of their 'tether' and a solution that may not seem that good to you may literally be a lifeline to them.

anyone else????

No personal experience but friends have found both helpful.

I just wanted to say I'm glad you set up a new thread for this MTS.

I don't feel able to enter the debate because it's something I feel very emotional about as my lovely Mum committed suicide through depression.

I can't speak from experience as my GP and local mental health unit don't feel I would benefit from "talking therapies". I do agree with your points that counselling isn't necessarily appropriate for all depressive or anxiety disorders, although where there is a root cause for depression that can be traced to a particular set of circumstances, rather than a chemical imbalance, then I'm sure it can be very helpful.

I also agree with your point that there is a shortage of CBT practitioners in the NHS, and I suspect that this is the real reason that I am being denied access to one through my GP.

In my experience, ADs have been helpful, and of course your comment that they are at least immediately accessible is extrememly valid. When I initially refused ADs because I was breast feeding, I was quite literally left to cope on my own, because there was no other treatment available to me. I saw a psychiatrist, who basically told me to take the ADs or bugger off. If there is no choice, where do you go?

I haven't read the other thread and don't have any personal experience of ADs. However, I have recently had CBT with a great therapist (I had to go private though, it was not available on the NHS in this area). My GP said I was not depressed but would benefit from CBT.

The counsellor told me that CBT was very successful for people who suffered from mild depressive symptoms but for severe `organic' (her word) depression it would need to be used inconjunction with ADs.

What I think the CBT did was give me the tools to recognise when I am starting to have negative thoughts and to stop them taking over. The idea is that your lows will not be so deep or so long-lived. I have had a few times in my life when I've been low, and eventually I've come out of it naturally, but in the meantime I've felt pretty awful. Hopefully the CBT will help me deal with these episodes in the future. But it has its limits and ADs also have their uses.

It's a shame CBT isn't more widely available.

Talk therapy is my choice, mainly because ADs seem to exacerbate my heart arrythmia. In addition, I sometimes wonder about the long-term effects of seratonin reuptake inhibitors on the brain, not because I have any evidence to think they are dodgy, but just because I have a general mistrust of any drug (remembering, for example, Vioxx, which loads of people took confidently for years, including my dh, before it was recently puled from the market) even drugs used in alternative/"natural" medicine. A psychopharmacologist would say my fears are exaggerated and part and parcel of my disorders, i.e. I "don't want" to get better. Could be. But be that as it may, I feel like psychotropic medication will do me harm, except in the case of benzodiazepenes (eg xanax) which I take very sparingly & rarely (for panic attacks, or to stave off panic attacks) which don't seem to have bad side effects for me.

So for me it's talk therapy. But not so much CBT, which I didn't find that effective. (When they thrust statistics at you to try to show you that riding the tube, or x or y, isn't actually that dangerous after all, those statistics seem so beside the point for me, because I've built up so many layers of conviction that it is dangerous.) I find the more old-fashioned psychodynamic therapy, which is still widely practiced in New York (but diminishing, because insurance won't pay for it, increasingy), most helpful to me. It isn't cost effective, though, because it doesn't take just a few sessions, the way CBT does. But in a way it has the same effect as as CBT, because I recognize negative thought patterns and can then analyze and vanquish them. It's been very effective for me.

I live in the US, so I don't have any experience with the UK system (What is CBT?).

But in my experience I saw a psychologist before taking ADs. In fact it had never occurred to me to think about ADs until my psychologist said I was depressed and suggested that they might help, and she referred me to a psychiatrist.

WWB, I was breastfeeding at the time, so my psychiatrist prescribed Prozac as opposed to one of the newer drugs for just that reason.

In my case, the ADs were succesful (after some initial fiddling around to get the right dose). I didn't find my counselling sessions very effective, but short term use of Prozac (I was on it for about a year) got me through a very bad patch.

Kate, CBT is Cognitive Behavioural Therapy.

Not taking the Prozac that was offered while I was b/f was my personal choice - I wasn't happy for the drugs to be getting through to my baby. The point is that when I begged, almost on my knees, for alternative treatment I was told it was drugs or nothing.

Kateandthegirls, CBT=cognitive behavioral therapy. It's where you work with a therapist to change your thinking patterns. If you tend to think negatively or darkly, the cognitive behavioral therapist will draw your attention to those thoughts and "teach" you how to recognize and eliminate them. CBT can also be effective with phobias; the therapist gives you assignments that gradually put you in contact with thing you fear, until you cease to find the thing dangerous.

I am really sorry to have started a thread which has caused some people offence. I in no way wanted to offend people but wanted to start a discussion about something which I feel is worth discussing. I apologise if the way I put it sounded harsh, it really wasn't meant to, I just sometimes feel ads are discussed quite freely without substanciated medicalback up. And yes I get the point that everyone is talking from their own experience therefore not actually giving medical advice. I really thought this would be a valuable discussion and had not intention of upsetting anyone, I have been on antidepressants and yes they improved my situation dramatically. I do personally however wish I had gone ddown other routes none of which were offered to me. It is this that i am sad about, I was made to give up breastfeeding, and given no support through what I had actually been through. I believe ads can work but if problems aren't dealt with then when people come off of ads the problems still remain. Once again I apologise I can understand how offence was taken and it really wasn't offended. Lastly this was not named at anyone imparticular just a general feel I get sometimes.xxxxxxxxxxx

Had cbt and found it very difficult but it did help with the anxiety side of things and I'm now a lot more confident and can handle most of the things that I couldn't do a year ago.I couldn't,however, have dealt with cbt if I hadn't already been on ads and was beginning to feel the benefit of them.I'm now seeing a counsellor and I've been able to talk through lots of issues with her that again I wouldn't have been able to do a year ago. My depression is chemical- and atm I'm between ads and seriously considering not starting on the new ones that I've been perscribed( due to start them on tuesday)I have got a very supportive dh and some very caring friends and I'm sure that has made a big difference, also I'm a Christian and I'm sure I'd have committed suicide if God hadn't interviened in my life,not preaching, just trying to be honest!!

Thanks for the explanation re. CBT.

WWB, sorry I misunderstood. I thought you meant your doctor had refused to give you ADs because you were breastfeeding.

In may case, my doctor reassured me that the Prozac would not affect my baby, and I felt she would be better off with a mum who was able to function, with the help of ADs.

mykidsmum, glad to see you posting again on this topic.

as a matter of interest; you say that you regret taking ADs, although they sound to have worked pretty well for you. was this just in relation to the bfing issue or were there other reasons you felt uncomfortable with taking ADs? how long ago was it that you were advised to give up bfing? as a matter of interest, Prozac now appears to be regarded as safe to take while bfing. THis was certainly the advice I received earlier this year.

i think you hit the nail on the head about not being offered alternatives to ADs. Ideally people would be able to have CBT/counselling and/or ADs as best suits their circumstances. Unfortunately people are rarely offered an open choice/combination of therapies in practice, and as a matter of resources, if you need help immediately, ADs are unfortunately the only thing that can be set up quickly.

I have had serious depression and hae tried many different AD , some have kept me on an even keel but when I was ahving a bad day there wasn't a drug the world that could help, or in my experience. In fact being on AD when going through a real low period was pointless as I just overdosed on them.

I ahve not had access to any talking therapies since moving north other than visits from a CPN. I was told years ago when I lived down south that I needed CBT. I have begged mt gp, offered to pay but have been told that there isn't any available. For the past few year and a half I have just treated myself, going to confidence courses, parenting classes etc and keeping ,myself busy. When I hit a low period it is like riding a storm but I knwo it won't last. When it is awful, which luckily has only happened once in the last eighteen months my partner gives me sleepers and I sleep through it. It makes me very angry how unequal the provision of mental healthcare is in this country, I can't think of another illness with possible life threatening consequences that would be ignored and left up to the patient to self treat.

Nikkim - you can find a CBT therapist privately - and you don't necessarily need a GP referral - its not cheap tho - one I found cost £50 per hour(!)

CAT me if you want any more info on this.

MTS, Kate - going back to the breastfeeding whilst on ads, I was told by the psychiatrist I saw that with Prozac, 30% of the drug passed through to the baby, which I considered was too high a percentage. I was offered another brand of ad, but this still passed 20% of the drug to the baby in the breastmilk.

Maybe this has been proved incorrect recently but it was certainly the information I was given at the time.

hi wwb - i was told that there were small traces of the prozac in breast milk but that it had no adverse effect on the baby; i was never given any percentage breakdown. the psychiatrist and consultant gyn/obs both agreed on this. apparently this was backed by recent research. possibly there has been research in the last few years since this issue arose for you? as i ended up on prozac at 30 weeks PG, the psychiatrist was actually very enthusiastic about me bfing, to reduce risk of withdrawal symptoms to the baby after the birth.

mkm, dont think it was the actual post but the way it came across...i do think this is a useful discussion. im sorry if i was one of the people you believed were attacking you, i didnt mean to at all, was just making a point anyway...i will come back to this discussion when my head isnt reeling from last night's alcohol and i feel capable of thinking straight! (could be a while then)

Hello Im new to mumsnet.

I have suffered for depression now for around 4/5 months. I have suffered from panic attacks since March 2003.
I have just started to take my 'happy pills' and are starting to kick in now ive been taking them for 3 weeks.

I have an eight month old baby who is called Freddie. I think if it wasnt for him then I would be in the local mental unit.
He is my World.

I also have another boy Charlie who would of been two this coming March but we lost him to Group B strep aged four days.
I think just the shock of losing Charlie so unexpectedly and so quickly has worn off.
I just cannot snap out of this black cloud over my head.

I have a wonderful husband, we have been married now for 3 years and together for 6.
He does support me but sometimes I feel that he does not understand and keeps asking me 'When is he going to get his wife back?'.
I have tryed councelling but they just dont help.

Anyone out there that understands???

Wozzle 1

hi wozzle, and welcome to MN. sorry you are feeling so down atm. It sounds like you have had a very tough time; I am so sorry that you have lost a child.

I think you will find some posters on here that can identify with what you are going through; you may also find it useful to post on the miscarriage/bereavement board as well. as this is quite an old thread you will probably get more of a response if you post a new thread on this board.

I am glad that you seem to be feeling the anti-depressants are helping you. It is a pity that counselling isn't helping. Do you think if you saw a different counsellor, that might help, or are you just not into the whole counselling process? Have you ever tried speaking to SANDs (a charity dealing with stillbirth and neonatal death) as they might be better at understanding what you have gone through?

bye for now
x

What an interesting discussion.

There's only been a brief mention of different types of counselling/psychotherapy so far (quick mention of psychodynamic theory). Different types of counselling work for different people and there are quite a few different theories and ways of working. Just because one type of counselling hasn't worked for someone doesn't mean to say that counselling per se won't work.

I know it's difficult to get an overview of what the different types are and that would be helpful for people before they commit to a counsellor. It is a huge commitment and it's worth doing a bit of research on the bacp website.

Also, I do think that the money factor is a big one - ads work quite quickly (3/4 weeks or so) whereas therapy can take a long time and is, therefore, a big financial commitment. I know that in the past, I've given up on counselling, even when I knew I was getting somewhere, because I couldn't afford it.

For me, I prefer not to take drugs unless I absolutely need them (and I do appreciate that some people really do need them) so I'll go the counselling route first.