Sunday 29, January 2012
Are anti-depressants prescribed too easily?
One in four people in Britain are believed to experience some form of mental health problem over the course of a year.
Doctors are becoming more inclined to prescribe anti-depressants, but what treatments existed before people relied on a pill to make them feel better?
Mental health problems like depression are not new; people have suffered from them way before we had medication to alleviate mood disorders. So is anti-depressive medication handed out too easily?
Looking back, anti-depressants were discovered by pure chance. In the 1950s while scientists were looking for an anti-psychotic drug, they discovered the anti-depressant tricyclic and whilst looking for a cure for tuberculosis they found moniamine oxidase inhibitors.
Dr John Hopkins, senior mental health lecturer at The University of Manchester, said: “The idea of having medication is quite new, only electric shock therapy existed in the 1930s which is controversially still used today for schizophrenia.”
The idea of "environmental management" has been recognised for decades. If a person is in a tranquil and pleasant environment then they should instinctively feel happier and more positive. If a person is persistently in a negative environment it is not surprising that a person will feel low.
Dr Hopkins continued: “If you look at the large Victorian psychiatric hospitals, although the fact that in too many cases patients were kept locked in doors and didn’t really experience the surroundings of the hospital, the general landscape of the hospitals was perfect with grassy areas and woods and sports pitches.
“Also, it was desirable for psychiatric nurses or what they used to be called, lunatic attendants, to play a sport or be able to play a musical instrument. The idea of activity and sports has always been important.”
Many professionals in mental health believe that anti-depressants should be used in conjunction with other methods to alleviate mood.
Social worker and mental health professional Terry Hancock, based in Manchester, discussed the balance between medication and other treatments. “By dealing with the symptoms with medication it will still leave social needs unmet," she said.
“For example, in an instance where depression is caused by isolation, it is not going to go away just by prescribing medication, so it would be useful to attend support groups or other social support networks.”
Mr Hancock added: “I do believe that medication is prescribed too easily by GPs as it is readily available and access to other treatments such as counselling and cognitive behavioral therapy (CBT) are oversubscribed and have a huge waiting list, although in Manchester they have piloted computer based CBT with some success.
“I think there will always be a need for medication as it is a proven short term treatment, but it does not deal with the source of the problem as psycho-social interventions such as counselling or CBT do.
“Anti-depressants are often seen as a quick fix solution but do not deal with the root of the problem, however it is difficult to access things like counselling due to waiting lists.
"Medication can also be quite oppressive in keeping people under medical intervention when by using CBT can equip people to deal with their issues in the long term giving people empowerment.”
Helen Hampson, 24, of Burnage, was prescribed anti-depressants by her doctor after her three year relationship broke down. She explained: “I went to visit my local GP after feeling terrible for about a week, I was going through a rough time at home and when I broke up with my boyfriend it was the final straw.
“I didn’t know what to do with myself so I went to see my doctor because nothing I did could bring me out of the hole I was in.
“I hadn’t really contemplated anti-depressants but I would have considered anything to make me feel better. The doctor prescribed me with a course of three months and yes, I felt better within a few weeks but after I thought it was odd how unhesitatingly she prescribed them to me.
“After talking to other people in similar situations, I think counselling would have helped in that position but I took the doctors advice and once I was on them it was hard to choose the time when I weaned myself off them.”
Dr Hopkins added: “Over the last few years, people who suffer from mental illnesses like depression have been given anti-depressants which do improve your mood and can stop you feeling bad, but can also stop you feeling any other feelings as well.
“Although I believe that medication and alternative therapies in a lot of cases work, hand in hand in a person’s recovery, the problem is that people who are on medication do not want to take the risk by coming off them. What they remember about being without drugs is the low mood that they were in and they don’t want to go back to that, people still have that insecurity.”
The charity Mood Swings Network, based in Manchester, provides support and advice to people with mood disorders and works to aid their recovery.
A team of health professionals provide counselling but also operate a PALS scheme which looks at ways that people feel better without medication. The four scheme's four key words are people, activity, learning and sharing.
Tom McAlpine, founder of Moodswings, said: “Before turning to medication or whilst on medication, it is important for people who have mood disorders to ensure that they pro-actively do things to try and increase their quality of life. This is what our positive recovery programme is about.”
The charity runs weekly activity groups, including a singing group which allows users the opportunity to participate in group activities, Gavin Bailey, a senior support project worker, said: “It might just give people the boost to get out there and make plans with other people and gain the opportunity to try new things.
“If you’re not feeling great, sometimes you just cannot face going out of the house and having something a little bit out of the ordinary planned each week with other people can give people that confidence to get out there.”
While there are no right and wrong answers in the treatment of mental health and the subject is rife with grey areas, by tackling these four areas the charity aims to catch people before they reach the point of despair.
Dr Hopkins said: “If someone is feeling low because something has happened, like losing their job, they may not be clinically depressed but another person who has lost their job can feel suicidal. Then it would be important to subscribe medication to that person to improve their mood to stop them having suicidal urges.The key is to catch it early.”
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