Daily Mail

YOU CAN’T FIX LIFE WITH A MAGIC PILL

- COMMENTARY by Dr Max Pemberton

Earlier this month it was claimed that Britain has turned into a nation of ‘pill-poppers’. Half of women and more than 40 per cent of men regularly take prescripti­on drugs, from statins and painkiller­s, to blood pressure and diabetes medication.

Today it gets worse. We’re also a nation of zombies, increasing­ly reliant on anti-depressant­s to ‘anaestheti­se’ us against life’s low points.

That at least is one interpreta­tion of the OeCD report that finds one in ten adults in Britain take anti-depressant­s.

So are these drugs being over-prescribed?

as a psychiatri­st who prescribes them every day, i know that for some people with moderate to severe clinical depression, anti-depressant drugs can be a lifeline, helping to normalise chemical imbalances in their brains.

But for harassed GPs confronted by patients with complex social problems and less than ten minutes to sort them out, it’s just too easy to write a prescripti­on for the ‘quick fix’ these drugs represent. and far too often, this group of patients – mainly women – fall into the category of what i describe as the ‘worried well’.

They are people who find coping with the travails of life, whether it’s personal relationsh­ips, the workplace, family issues or bereavemen­t, immensely stressful.

Yet there is no magic pill to make a philanderi­ng husband/wife change their ways, improve the behaviour of ungrateful teenage children, make a boss more understand­ing, or bring back a much-loved parent. That’s not to say these situations aren’t awful for those living through them, but the fact they make you ‘feel down’ is normal, not pathologic­al. it isn’t an illness and drugs aren’t the answer.

i believe social media is a factor in rising patient demand for anti-depressant­s. On Facebook, instagram, Snapchat and the like, we are endlessly bombarded with rose-tinted views of the lives of others.

everyone else seems to be having a wonderful time, all the time, fuelling an unrealisti­c expectatio­n that we too should be permanentl­y happy – and turning to medication when we’re not.

in contrast, previous generation­s had no such expectatio­ns. They knew life would be tough and had the resilience to deal with it without recourse to drugs. That said, there is no doubt that more prescripti­ons are being written for anti-depressant­s because cashstrapp­ed mental health trusts have cut back on ‘talking therapies’, such as cognitive behavioura­l therapy, that are so beneficial in helping depressed patients through a difficult patch in their lives.

a course of drugs is certainly cheaper than psychother­apeutic interventi­on.

The flip side of all this is that clinical depression remains an under- diagnosed and under-treated condition.

Research

conducted by the london School of economics found that while mental illness accounts for nearly half of all ill health in the under-65s, only a quarter of people in need of treatment get it.

a study by aberdeen University showed that GPs failed to diagnose major depression in half their patients.

large swathes of the population who might benefit from anti- depressant therapy are suffering in silence – particular­ly older men.

This is a group less likely to seek medical help or to talk about their symptoms when they do – and which also has the highest rates of suicide.

a 2014 confidenti­al inquiry into suicide showed that fewer than ten per cent of people who killed themselves had been referred to mental health services in the previous 12 months.

So while we are over-prescribin­g anti-depressant­s to some groups who would be much better served by counsellin­g services, we are failing woefully tens of thousands of others, many at high risk of self-harm, who really do need drugs and talking therapies.

For all the advances made in recent years in acknowledg­ing and accepting mental health problems, and empowering people to seek help, there is still a long way to go.

a first step would be a radical overhaul of our current anti- depressant prescribin­g policy.

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