The real scandal about happy pills
WHAT hell it must be having depression. Not only do you have to contend with the illness, you also have to put up with everyone giving their two pennyworth on how you should deal with it.
From ‘pull your socks up’ to ‘go for a run’, people are full of asinine homespun advice on coping with an incredibly debilitating condition.
What’s worse, you also have to endure the never-ending debate about whether or not antidepressants are overprescribed and whether or not people should be taking them.
People with other illnesses don’t have to endure this kind of nonsense. You never hear anyone opining that chemotherapy is over-prescribed, do you?
The other day it was the turn of renowned psychiatrist Professor David Healy to stick his oar in.
In a scathing attack, he claimed that the scientific theory underpinning antidepressants — that depression is caused by a lack of the brain chemical serotonin — has no evidence to support it.
The logical conclusion to his argument is that we shouldn’t be prescribing antidepressants at all.
Yet this not only denies the reality that they undoubtedly work and help lots of people, but also generates fear and confusion.
After these kinds of controversies, there are inevitably some people who stop taking their medication and then deteriorate.
As an academic, Professor Healy doesn’t have to pick up the pieces. As a psychiatrist working in the NHS, I do.
Yes, it’s true that in some situations, antidepressants are given out too readily.
Harassed GPs faced with patients who have complex social problems, and eight minutes in which to sort them out, may reach for the prescription pad far too quickly. There is no pill or potion on this earth that is going to make your philandering husband change his ways, your screaming, ungrateful children be better behaved or your bored wife love you.
That’s not to say that these situations aren’t awful, but feeling down about such things is normal, not pathological. This isn’t an illness — it’s what I call ‘c**p life syndrome’.
Too often people who are just responding to unpleasant, stressful situations in a perfectly normal way are given a prescription and pushed out of the door.
Only last week I saw a patient who had been started on an antidepressant after he went to see his GP and started crying. When I asked him more, he explained that his mother had just died.
I wrote to the GP explaining I’d stopped the antidepressant because crying when your mother dies is normal. I’d be more worried if the patient had not cried.
But the flip side is that while antidepressants are being over-prescribed for some patients, in others — especially men aged over 55, who have the highest rates of suicide — depression is woefully under- diagnosed and under-treated.
AHORRIFYING study by the London School of Economics a few years ago showed 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.
Further research by Aberdeen University showed that GPs failed to diagnose major depression in half their patients.
And a government inquiry into suicide last year showed that fewer than 10 per cent of people who killed themselves had been referred to mental health services in the previous 12 months.
For me, this is the real scandal we should be concerned about — not whether serotonin is or isn’t to blame for depression.