Comments on: Antidepressants prescribed by psychiatrists only?

By: Karen

Karen — Mon, 26 Dec 2011 08:50:48 +0000

Over a period of 16 years I walked into a doctors many, many of times ‘feeling “not myself’ or “sad” and left without antidepressants unfortunately for me each time within a few days I would be in the bottom of that mental pit in the darkness warding off suicidal thoughts and going through the day to day motions in a zombie like blur to keep my family and home running. Again, I would start to feel better, decide I’ OK now, and merrily go on my way. Several months later there I would be starting to feel “sad” and “not myself” and knowing I was descending into that deep dark mental pit, make the appointment to see the doctor at which point the cycle would begin where I undervalued the horror of my depressive episodes (combined with thought of drugs with their side effects and the stigma of needing drugs to be normal)and walk o
Finally I did manage to get to the doctor and slid into the pit as I sat down in the waiting room. through blubbering tears I was finally prescribed the anti-depressants. It was extremely hard for me to keep going with them. It was a good 6 months before I felt like a normal human being, I realized then that even my “good” days were very poor. 12 months later I was weaned off and 9 months after that not a single depressive episode. I’m happy, i mean really happy now, something I’ve not experienced during the growth of my teenage children, since it was Post natal depression that I never managed to shake off (I think).I only wished I had a doctor that prescribed me them earlier when I sought help during my “sad’ and not “myself” stage instead of going through years of floundering in and out of that mental hellish pit.

By: Tricyclic Antidepressants

Tricyclic Antidepressants — Sat, 26 Sep 2009 00:55:42 +0000

Very interesting article and very good blog. Very much interested to know)
I’ll add this blog to RSS Reader

By: Neuroskeptic

Neuroskeptic — Sat, 20 Jun 2009 09:51:49 +0000

Thus a patient who entered a consulting room simply sad, and often unfortunate, leaves anointed as ‘depressed’ having now a stigmatizing mental health disorder, and as this is a disease that sits independent from a life narrative, other avenues of relief which might have otherwise been explored are tacitly discouraged.

This is an important point, and I think it’s the main argument against the over-prescription of antidepressants. Unfortunately it’s a rather subtle one. You often here people claiming that antidepressants shouldn’t be widely prescribed because of “side effects”, but this misses the point because it implies that if an antidepressant with no side effects were invented, it would be appropriate to hand it out like candy! And since SSRIs are, contrary to popular belief, very well tolerated, this is what actually happens.

The best reason to not prescribe antidepressants is that the patient isn’t depressed. But this is also a reason not to prescribe talking therapies (at least not ones that target depression)…

By: delcatto

delcatto — Wed, 17 Jun 2009 19:35:23 +0000

“Anyone standing next to you at a bus stop would tell you that if someone was already taking four psychoactive substances on a daily basis, then addressing these might be the first place to start. This is what I’d have said to them, but in this rights-based society if I think this and a patient thinks differently, who’s right?”

Both of you but alongside rights is responsibility. If the patient isn’t aware of the impact of multiple recreational drug and alcohol use she possibly needs to be made aware and ‘empowered’ to make some choices about dealing with her problems. After two years on mirtazepine and possibly several visits to her GP she must have some awareness of alcohol and drugs upon her mood? She may be using these to alleviate her misery or to blot out the pain but an honest appraisal of her current situation and a commitment to tackle it means having to accept responsibility for reducing and possibly stopping her use of drugs and alcohol. Ideally this would be with appropriate support but that opens up a whole can of worms regarding accessible and appropriate services.
I do agree that some doctors are only too ready to prescribe antidepressants inappropriately. It’s incredibly frustrating when someone is referred and they have been through a variety of short term antidepressant prescriptions “none of which worked for me”. There is a general tendency to pathologise the human condition and the lack of social and community support, 24/7 media & entertainment, diminution of established religions and a desire for quick fixes often leads to this result. A GP has several minutes and the quickest solution appears to be medication. It will be interesting to see how the use of CBT via the Improving Access to Psychological Therapies (IAPT) pans out and whether this will provide the desired outcomes.

By: Sarah

Sarah — Wed, 17 Jun 2009 16:03:06 +0000

I think you misunderstood what I said. I’m not suggesting that people can’t or don’t carry on with their lives despite suffering from depression. In fact that’s sort of my point. People do it – soldiering on pretending nothing is wrong – because they are expected to.

But like I said, that doesn’t cure the depression, rather, as you pointed out, it only makes things worse. Prescribing antidepressants can be part of that pattern – too often the doctor writes the prescription, sends you to a ‘counsellor’ who you wait six months to see, and who tells you ‘you need some exercise’ and doesn’t understand the nature of true mood disorders. I’ve been there.

It’s even worse if you have an eating disorder. The resources are so limited that people are routinely told – “sorry, you’re not sick enough to get any treatment, come back when you’ve lost some more weight.” It’s like telling somebody with cancer “sorry, that tumour’s not big enough yet. we’ll treat it when it’s grown a bit more…”

By: S

Wed, 17 Jun 2009 13:11:27 +0000

the author may or may not be one of the enlightened few, but my psychiatric care is dismissive, invisible and lacklustre, my GP is the only trustable body.

i’m also on mirtazapine. for dual use, anti-anxiety and as an anti-depressant.

i’ve never had my issues taken seriously, and have only ever been written off as “emotional” in a hurried manner, treated like crap, told to just go for a walk. the “get up and get on with it” approach fails, i call up because everything is not working, and it’s back to the first sentence…

the only difficulty, is that my GP is only a gateway back into the same cycle.

and Sarah, you are utterly wrong… there are people that carry this problem with them with the smiliest of faces, i can assure you! if you don’t look the type to be depressed, you are *forced* to carry on, even when it leads to further breakdown and further depression, which leads to a breakdown in trust between yourself and the CMHT. this happens to a great many people it seems. it should be noted that the “survivor” movement isn’t called the “survivor” movement because of mental health problems alone. quite often it’s called the “survivor” movement because of getting through the psychiatric system itself…

it’s frustrating that everyone is after a simple concept. and it’s frustrating that the psychiatric system seems to be cherry-picking who it wants to treat and who it doesn’t…. of course, if they understood what the realtime experience was like then none of this would be of issue.

By: PJ

PJ — Wed, 17 Jun 2009 09:09:29 +0000

Unfortunately it is a symptom of the way that hospital medicine is practised that antidepressants are often just added in to the mix of medications after the consultant realises the patient has some poorly defined or investigated emotional issues. Although mirtazapine is an unusual choice – anything other than bog standard SSRIs or tricyclics is usually queried by pharmacy.

By: Sarah

Sarah — Wed, 17 Jun 2009 04:09:08 +0000

Antidepressants are definitely seriously over-prescribed. If you’re feeling depressed because of something crap going on in your life, you need talking therapy, not antidepressants. They are supposed to be prescribed only for Major Depressive Disorder. Which, from my own experience, means feeling so low that you’ve been lying in bed for two weeks, constantly thinking about suicide, you can’t concentrate on anything and your life is really severely being interrupted.

In my opinion, that’s roughly how depressed you need to be, every day, for weeks at a time, for NO good reason, to consider taking antidepressants. If your symptoms are mild to moderate, you probably only need cognitive therapy; preferably combined with a support group, a healthy diet, regular exercise (especially something like Yoga), avoiding alcohol and too much caffiene, perhaps some supplements and vitamins.

I don’t know if the public view ALL people as incredibly vulnerable. Rather, people mostly expect others to ’soldier on’ and get on with their normal lives despite personal problems. Our society has become so superficial that personal loss or depression are seen merely as inevtiable sources of hopelessly awkward social situations and those who suffer should be left well alone until they ’snap out of it’.

Whether you suffer from a mood disorder or not, it’s important to know that they are genuine medical conditions. Not something you can cure by pretending it’s not there and “soldiering on”.