Would you like some pills for that? - the medicalisation of life

mike65

From the Irish Examiner

I told each of the doctors that I was struggling to find motivation to do my college work; was having trouble sleeping; and that I was reluctant to go out and socialise. All of the GPs I visited diagnosed me with a mild form of depression, stemming from the stress of my final year in college.

Of the seven consultations with GPs, whom I have never met or had correspondence with before, seven prescriptions were issued to me for a variety of antidepressants.

Several GPs failed to inform me about appropriate usage of the pills prescribed, and, in all cases, adequate information regarding the possible side effects associated with taking anti- depressants was not provided to me.

All of the GPs suggested counselling as a form of treatment but I received no referrals from any doctor I visited. One suggested that he felt I had “a handle on it myself” and felt I would benefit from a “mild old pill”. For the counselling to be most effective, it was felt that it would be in conjunction with taking antidepressants.

Another GP suggested that counselling could be looked at further down the line, acknowledging that the antidepressants were a “quick fix solution”, adding that prescribing the tablets was “not ideal — but right now, they’re what you need”.

So are doctors just lazy, over worked, or is the whole system geared towards the selling of pills for a given mental or psychological condition. How many head doctors are on the HSE books?

For years there has been a view that anti depressant prescriptions are handed out far too quickly and without any proper pause for re-evaluation thus leading to repeated prescriptions and no questions asked.

Any thoughts, there must be many families who are familiar with this sort of thing.

donvito99

As usual, a great watch.

jonnyfingers

All I know is that we don't understand everything about the brain but yet are prescribed drugs that alter the chemicals that make the brain work. Way too risky for me.

Duggys Housemate

Its funny that the conspiracy theorists worry about fluoride in the water, but not this - probably because a lot of them are medicalised.

Fact is - with the exception of people who are totally non-functional, or dangerous, or clinically depressed - nobody is really mentally ill. Any deviation from the norm can be medacilised or pathologised ( homosexuality used to be, for instance), or not depending on politics, not real science.

Shenshen

In all fairness, what did the person testing the GPs expect?
She described herself as overworked, stressed and quite apparently in need of a quick patch.
Several suggested counseling, but given her current situation they suggested to look into that later on, when her life was less stressful. No point adding an additional item to and already overfull calendar.

Mind you, I do find it rather worrying that so few of them provided her with instructions on how and how much to take of the anti-depressant, and none mentioned the side effects. That is certainly a big failure on their part.

conorhal

This kind of nonsense will continue untill you ban pharma reps calling around to GP's with freebies and invites to golf tournaments. They incentivise GP's not to prescribe generic drugs and to hand out others like smarties.
I actually left one practice I was attending when I heard the GP tell a patient ,in the most condescending manner possible, "we don't prescribe generics in this practice".
All I cound thinks was, 'why would it lead to the canellation of your four ball with the guys from Chem-Co?'

NothingMan

I don't know a whole lot about depression but I have seen the effects. People with depression can be lethargic and overly apathetic and genuinely in a lot of distress. It can be debilitating and for people around them, very hard to live with.
Saying that, I think it is very over diagnosed. In some cases a more active lifestyle, exercise, sport etc.. could help drastically. In others simply talking about it could really help but for some reason doctors first solution is pills. Is it because doctors themselves don't understand itor simply it's what they think is right. More worrying still is if it's lobbying by drug companies pushing their wares. Pills that effect how you think and feel should not be the first choice in any situation in any case.

jank

It's a symptom of western life in the main. We expect to be always happy, always perfect, always having it together. When we don't we freak out and want quick solutions to the problem. Just look at the medicalisation of kids. Little johnny throws a tantrum cause he doesn't get his way, well it must be because there is something wrong medically, nothing to do with th fact he's a kids that needs to learn boundaries.

Madam_X

Duggys Housemate wrote: »

Its funny that the conspiracy theorists worry about fluoride in the water, but not this - probably because a lot of them are medicalised.

Fact is - with the exception of people who are totally non-functional, or dangerous, or clinically depressed - nobody is really mentally ill. Any deviation from the norm can be medacilised or pathologised ( homosexuality used to be, for instance), or not depending on politics, not real science.

Fact? Genuine question.

I wouldn't dispute that there is overmedicalisation and often drugs thrown at problems instead of an alternative, but that should never overshadow the fact that anti depressants do help people. People may even give testimonies on this thread of how they were on the verge of killing themselves and now they're doing much better. But rest assured - a crowd who have never endured depression will be along to tell them they're wrong.

Duggys Housemate

Madam_X wrote: »

Fact? Genuine question.

I wouldn't dispute that there is overmedicalisation and often drugs thrown at problems instead of an alternative, but that should never overshadow the fact that anti depressants do help people. People may even give testimonies on this thread of how they were on the verge of killing themselves and now they're doing much better. But rest assured - a crowd who have never endured depression will be along to tell them they're wrong.

I did include clinical depression in my list just to thwart this kind of response.

conorhal

jank wrote: »

It's a symptom of western life in the main. We expect to be always happy, always perfect, always having it together. When we don't we freak out and want quick solutions to the problem. Just look at the medicalisation of kids. Little johnny throws a tantrum cause he doesn't get his way, well it must be because there is something wrong medically, nothing to do with th fact he's a kids that needs to learn boundaries.

There's something to that alright.

IMO We've imported that wierd American hippy positivism that combined with the 'self-help' industry some time during the 1980's which created a culture that stated bluntly that 'happiness is the norm, unhappiness is a deviation from the norm', so you must constantly strive to be happy all the time otherwise there is something wrong with you.

The reality is that happiness is not the norm, if you considered how you felt over your average day, it probably went:
*blah**sigh**blah**blah* *YAY!**blah**blah**sigh**blah*

If anything the norm, unless you're Tom Cruise or Cliff Richard is pretty much *blah* or at least vague contentment occasionally punctuated by sadness and joy. Personally I'd be exhausted by a near permanent state of happiness!

The worst thing about the view that 'unhappiness is a deviation from the norm' is that unhappines is seen as unjustified or something that must at the very least be quickly remedied.
It's perfectly justified to feel stressed if you have exams coming up, there are times in your life you can be considered perfectly justified in feeling depressed, it's all part of the natural order of things and only a problem if it has a clinical basis. Handing out drugs like smarties should never be the first answer to stress, sadness or depression.

Mr Benevolent

Duggys Housemate wrote: »

Its funny that the conspiracy theorists worry about fluoride in the water, but not this - probably because a lot of them are medicalised.

Fact is - with the exception of people who are totally non-functional, or dangerous, or clinically depressed - nobody is really mentally ill. Any deviation from the norm can be medacilised or pathologised ( homosexuality used to be, for instance), or not depending on politics, not real science.

I get the impression you've never interested with anyone with any type of serious mental illness. Is that armchair comfy?

Sauve

Shenshen wrote: »

Mind you, I do find it rather worrying that so few of them provided her with instructions on how and how much to take of the anti-depressant, and none mentioned the side effects. That is certainly a big failure on their part.

That's largely the job of the pharmacist.
The prescription given to a patient contains all the instructions necessary, and when the tablets are being dispensed for the first time, the pharmacist will (or most definitely should) have a consultation with the patient, advising on how to take them, possible side effects, and provide literature and answer any questions.
They have studied pharmacology to a much greater extent than the GPs, so are the ones most equipped for that part of the process.

Duggys Housemate

Mr Benevolent wrote: »

I get the impression you've never interested with anyone with any type of serious mental illness. Is that armchair comfy?

I did include serious mental illness in my list ( i.e. non-functional or dangerous), and clinical depression, to thwart this type of response.

Can anybody read?

this thread is about over-medicalisation of normal life, not over-medicalisation of serious mental illness. The number of pills being popped has increased, unless the incidence of serious mental illness has increased, thats an increase in prescription, all the more worrying in children.

Shenshen

conorhal wrote: »

There's something to that alright.

IMO We've imported that wierd American hippy positivism that combined with the 'self-help' industry some time during the 1980's which created a culture that stated bluntly that 'happiness is the norm, unhappiness is a deviation from the norm', so you must constantly strive to be happy all the time otherwise there is something wrong with you.

The reality is that happiness is not the norm, if you considered how you felt over your average day, it probably went:
*blah**sigh**blah**blah* *YAY!**blah**blah**sigh**blah*

If anything the norm, unless you're Tom Cruise or Cliff Richard is pretty much *blah* or at least vague contentment occasionally punctuated by sadness and joy. Personally I'd be exhausted by a near permanent state of happiness!

The worst thing about the view that 'unhappiness is a deviation from the norm' is that unhappines is seen as unjustified or something that must at the very least be quickly remedied.
It's perfectly justified to feel stressed if you have exams coming up, there are times in your life you can be considered perfectly justified in feeling depressed, it's all part of the natural order of things and only a problem if it has a clinical basis. Handing out drugs like smarties should never be the first answer to stress, sadness or depression.

While I would definitely agree to the notion that society shuns the non-happy, and also agree with the notion that this is utterly unnecessary, counterproductive and morally rather dubious, I'm not sure I find much wrong with seeking help when someone notices that their non-happy state of mind is starting to make a negative impact on their lives.

And I cannot honestly say I disagree with asking for or prescribing an anti-depressant as an interim solution for such a person.
Note that I'm saying interim. I do not believe that anti-depressants do anything at all to help with any potential underlying internal or external problems. But they can bridge people over until such problems can be addressed properly.

Sauve

Duggys Housemate wrote: »

an increase in prescription, all the more worrying in children.

I've worked in this area for over ten years and have not seen any increase in anti-depressants being prescribed for children. Where are you getting your info from please?
Furthermore, I've yet to see a GP prescribe anti-depressants straight off to children. There has always been a psychiatrist involved in an initial diagnosis.

Chuck Stone

No evidence for the 'chemical imbalance' theory.

Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature

[Excerpt]

Contemporary neuroscience research has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency. Modern neuroscience has instead shown that the brain is vastly complex and poorly understood [11].

While neuroscience is a rapidly advancing field, to propose that researchers can objectively identify a “chemical imbalance” at the molecular level is not compatible with the extant science. In fact, there is no scientifically established ideal “chemical balance” of serotonin, let alone an identifiable pathological imbalance. To equate the impressive recent achievements of neuroscience with support for the serotonin hypothesis is a mistake.

plosmedicine.org

Placebo shown to be as effective in mild to moderate depression.

Research that shows the efficacy of AD's in a questionable light deliberately ignored.

Vulnerable people seeking help for often debilitating symptoms.

Living in a quick-fix society with scarce resources and a lack of access to alternative treatment.

Low supply of medical people who tend to focus on the 'bio' rather than the 'psycho-social' aspects of mental health.

Multi-billion dollar P/A industry.



Before someone inevitably goes there I'm in no way trying to diminish the trauma and suffering people experience from depression - there are just too many question marks around chemical treatments for them to be ignored when it comes to the issue.

zeds alive

Antidepressants are great.

lazeedaisy

Madam_X wrote: »

Fact? Genuine question.

I wouldn't dispute that there is overmedicalisation and often drugs thrown at problems instead of an alternative, but that should never overshadow the fact that anti depressants do help people. People may even give testimonies on this thread of how they were on the verge of killing themselves and now they're doing much better. But rest assured - a crowd who have never endured depression will be along to tell them they're wrong.

How on earth can you be on the verge of killing yourself and wait a few months for your meds to kick in!

There is not one anti -D that works that quick. It can take weeks or months to regulate meds, as someone with experience of someone wanting to take their life - it took 3 months for their meds to regulate.

Anti-D's are deadly and should not be given out willy nilly and can destroy lives - trust me I know, their lasting effects go on for years, not to mention coming off them can take years.

They are easily thrown at both children and adults as a quick fix, the people perscribing them (i would work in an industry that encourages paed quick fixes in mental health) should tell the person they are giving them to - exactly what they are giving, the side effects - sure if that pharmacist is that not too late! and how they affect your life. its not a question of taking a tablet and stopping when its all rosy in the garden!

syklops

For the short period of time that i was on anti-depressants, I was surprised to see that one of the documented side effects of anti-depressants, was depression.

Honestly, in my case the sleeping pills were what fixed it for me. One of the first things that happens when your stressed is you stop sleeping properly. Two weeks of decent nights sleeps and things improved.

lazeedaisy

The problem with Anti-D's though is your sleep is disturbed greatly because of the ability to have very weird dreams,

I suppose its like everything else - the ones i am talking about are given out long term - the ones that it takes 6, 9 12 months to come off not the short term ones,

kunst nugget

Sauve wrote: »

I've worked in this area for over ten years and have not seen any increase in anti-depressants being prescribed for children. Where are you getting your info from please?
Furthermore, I've yet to see a GP prescribe anti-depressants straight off to children. There has always been a psychiatrist involved in an initial diagnosis.

Pffft, I'm not going to let your real world experience get in the way of my mounting hysteria. Do you know that they are now giving them to babies to stop them crying!!! THEY'RE GIVING THEM TO BABIES!!!!

Madam_X

lazeedaisy wrote: »

How on earth can you be on the verge of killing yourself and wait a few months for your meds to kick in!

There is not one anti -D that works that quick. It can take weeks or months to regulate meds, as someone with experience of someone wanting to take their life - it took 3 months for their meds to regulate.

Well I'm only going by the people who have written testimonies on these threads saying they would not be alive today only for anti depressants.

Anti-D's are deadly

That's massive misinformation - it depends on a number of factors: the dosage, the anti depressant type, the degree of illness. Depression is a very broad spectrum: it spans from the equivalent of chronic respiratory problems to asthma to cystic fibrosis. They do not always cause severe side effects, or even side effects at all (that are noticed anyway).
It's so individualised that the "one size fits all" approach is not appropriate.

kunst nugget

Madam_X wrote: »

That's massive misinformation - it depends on a number of factors: the dosage, the anti depressant type, the degree of illness. Depression is a very broad spectrum: it spans from the equivalent of chronic respiratory problems to asthma to cystic fibrosis.

I thought they were saying they were deadly because they were a good buzz.

666irishguy

I can't see anything wrong with what occurred by reading that article. The patient presented and gave symptoms of depression. Seven GP's more or less gave the same diagnosis based on what the patient described and prescribed an anti-depressant to help. I'm sure if they thought she was at risk to herself they would have gone further than giving medication. It seems remarkable to me that this person has gotten seven medical opinions and is still in doubt as to whether she was getting the right treatment. How could it have not been explained how to take the medication? The doctors more than likely broadly told her the most common side affects and described that they may need to take the tablet once or twice a day. If nothing else it would be printed twice on the box. I have a friend who is a doctor and I can tell you that the idea that doctors will just casually fire out a prescription to anybody who wants anti-depressants is nonsense. I think this young woman more than likely researched what she was going to tell the GP's in detail and presented as text book, was clearly not at risk and hence they prescribed the only realistic treatment they could immediately give her to help alleviate her symptoms. The whole thing just seems like a non-story blown up by a journalist student who wants to make it to the papers (harsh I know). I also feel annoyed that she basically wasted seven doctors time for her story.

RDM_83 again

Sauve wrote: »

I've worked in this area for over ten years and have not seen any increase in anti-depressants being prescribed for children. Where are you getting your info from please?
Furthermore, I've yet to see a GP prescribe anti-depressants straight off to children. There has always been a psychiatrist involved in an initial diagnosis.

Ok this took me two seconds to find on google

"The UK has seen the fastest rise in the prescribing of antidepressants and other mind-altering drugs to children, a study of nine countries shows."
http://news.bbc.co.uk/1/hi/health/4017321.stm

its a it old though 2004 and from the UK, but Ireland does have a tendency to follow UK trends, in general and there has been a huge increase in illness benefit for mental health issues in the last number of years (an indicator of decreased mental health in society in general or simply increased medication of society) as well as more benzo's and antidepressants being prescribed in general.

However since this paper

http://www.bmj.com/content/331/7530/1451

shows a downward trend in antidepressant prescription rate in ROI to children between 2001-2004 with certain exceptions, I'd really like to see if there's any studies been done recently on this?

Duggys Housemate

Sauve wrote: »

I've worked in this area for over ten years and have not seen any increase in anti-depressants being prescribed for children. Where are you getting your info from please?
Furthermore, I've yet to see a GP prescribe anti-depressants straight off to children. There has always been a psychiatrist involved in an initial diagnosis.

I am talking about Ritalin etc. Which is a medicalisation of ADHD. Maybe not so prevalent in Ireland, but huge in America.

Sauve

RDM_83 again wrote: »

Ok this took me two seconds to find on google

"The UK has seen the fastest rise in the prescribing of antidepressants and other mind-altering drugs to children, a study of nine countries shows."
http://news.bbc.co.uk/1/hi/health/4017321.stm

its a it old though 2004 and from the UK, but Ireland does have a tendency to follow UK trends, in general and there has been a huge increase in illness benefit for mental health issues in the last number of years (an indicator of decreased mental health in society in general or simply increased medication of society) as well as more benzo's and antidepressants being prescribed in general.

However since this paper

http://www.bmj.com/content/331/7530/1451

shows a downward trend in antidepressant prescription rate in ROI to children between 2001-2004 with certain exceptions, I'd really like to see if there's any studies been done recently on this?

We don't follow the UK trends with regard to medication afaik, our own IMB do their own thing.

Also, my point was referring to GP 'willy-nilly' prescribing rather than psychiatrists prescribing to children after a proper diagnosis.

Sauve

Duggys Housemate wrote: »

I am talking about Ritalin etc. Which is a medicalisation of ADHD. Maybe not so prevalent in Ireland, but huge in America.

But the thread is about anti-depressants, the Ritalin debate is a whole other issue altogether.

RDM_83 again

Sauve wrote: »

We don't follow the UK trends with regard to medication afaik, our own IMB do their own thing.

Also, my point was referring to GP 'willy-nilly' prescribing rather than psychiatrists prescribing to children after a proper diagnosis.

Yeah thats why I looked further and found the second paper relating specifically to Ireland, the first study wasn't just UK though I think it showed all countries studied were showing an increase so I wonder why Ireland appears to buck the trend.

Maybe the poster is confused between antidepressants and other medication like anti anxiety and ADHD etc medication.?

Steve O

Life is short, why not make it a little better.

Take medication .









From the desk of DR. Steve O