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Healthcare: medical card holders on anti-depressants rose by 50,000 in five years

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  • 01-09-2017 11:03am
    #1
    djPSB
    Closed Accounts Posts: 6,299 ✭✭✭


    http://www.thejournal.ie/anti-depressants-ireland-3573829-Sep2017/

    Worrying trend. While anti depressants are an important part of managing mental health, the adminstration rates seem excessive?

    I would think we need a more holistic approach to our mental health services rather than just medicating people.


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    #2
    Wanderer78
    Registered Users Posts: 28,805 ✭✭✭✭Wanderer78


    djPSB wrote:
    I would think we need a more holistic approach to our mental health services rather than just medicating people.


    Completely agree, but sadly I don't see this changing anytime soon, if ever. We 're stuck in highly complex socioeconomic systems that exasperate these issues, even creating them.


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    #3
    Sam Russell
    Moderators, Science, Health & Environment Moderators Posts: 19,362 Mod ✭✭✭✭Sam Russell


    I remember a story of the medical card patient waiting to see the doctor. The one sitting beside her asked what she was there for, and she replied 'My anti-depressants'. The other one said - 'Do you know how much they cost?' The first one said 'Yes, of course I do - and if they gave me the money instead, I wouldn't need the anti-depressants at all'.

    Probably not true, but some truth in it. Poverty is not good for mental health.


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    #4
    Samaris
    Registered Users Posts: 6,544 ✭✭✭Samaris


    (Have had a certain amount of experience with anti-depressants.) Thing is, antidepressants are rather given out as a panacea and there are so many reasons why any specific sort may not work on an individual - and in some cases can make them worse, especially when changeovers have to be made because the first set were giving people depressive fits, sleeplessness, anxiety attacks and the rest of it.

    A lot of people have some reason to be depressed over the last few years. I'm talking about environmental causes of actual depression rather than natural frustration. Almost a decade of people coming out into the workplace to no jobs, economic tension, societal tension, the poverty trap (and the constant ire of those who do have jobs treating those that cannot get them with contempt). On top of that, the general world insanity affecting people to greater or lesser extents in many countries. Then personal issues, like illness or family deaths or relationship difficulties or anything else that can act as a tipping point or contribute to the problem.

    Given both that antidepressants get prescribed easily as a potential solution to the problem and the sheer amount of environmental problems that can contribute at the moment for people vulnerable to depression as well as a (welcome) lessening of stigma around mental illness pretty much guarantees a huge increase like this. While the lessening of stigma is a good thing in its own way, the overall approach is worrying.

    Mind you, anti-depressants didn't work all that amazingly for me, although it helped a couple of issues. It was getting back into the workplace and having some sort of structure as well as a reliable income that did a lot for me. That won't be enough to help everyone though.


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    #5
    Cookie_Monster
    Registered Users Posts: 24,469 ✭✭✭✭Cookie_Monster


    Kinda ties in with the huge increase in disability seen in Ireland in the recent past:
    http://www.davidmcwilliams.ie/2013/04/04/the-mystery-of-disability


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    #6
    AnneFrank
    Closed Accounts Posts: 1,827 ✭✭✭AnneFrank


    A more holistic approach, don't make me laugh, what do you suggest, counselling and psychiatrist sessions, the problem is cost, plain and simple. Anti d's cost ten euro a month, a more holistic approach would be multiples of that with many professionals taking advantage for money


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    #7
    Harika
    Registered Users Posts: 4,410 ✭✭✭Harika


    AnneFrank wrote: »
    A more holistic approach, don't make me laugh, what do you suggest, counselling and psychiatrist sessions, the problem is cost, plain and simple. Anti d's cost ten euro a month, a more holistic approach would be multiples of that with many professionals taking advantage for money

    That is shortsighted, yes anti depressants will solve individual crisis in the short term but as the underlying causes of the problem are not addressed the patients are not getting off the medication. It needs to go hand in hand, else the 10 euro a month will sum up over the years.


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    #8
    wordofwarning
    Closed Accounts Posts: 697 ✭✭✭wordofwarning


    Cookie_Monster wrote: »
    Kinda ties in with the huge increase in disability seen in Ireland in the recent past:
    http://www.davidmcwilliams.ie/2013/04/04/the-mystery-of-disability

    If David McWilliams looked at other European nations, he would be shocked to discover a massive increase in disability there too...

    Except the OECD believes that the level of disability is not increasing, but rather Governments are massaging the stats by classifying long term unemployed as 'disabled'. There is a massive trend of a decline in long term unemployed in the Netherlands and UK and a subsequent increase in disability.

    AFAIK there are far less checks and balances on someone claiming disability versus the dole in Ireland. It is far easier to go on disability with a "bad back" or "depression", than to be hauled into the welfare offices every few months to be questioned on the dole on why you don't have a job.


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    #9
    Manach
    Moderators, Society & Culture Moderators Posts: 9,664 Mod ✭✭✭✭Manach


    Slightly tangential but in recent years behaviour modification drugs have been in vogue in countries such as the US to deal with schoolchildren. The use of such seems to be a way to dampen social pressures from people who are adjudged disruptive. The OP seems to tie into this trend.


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    #10
    Samaris
    Registered Users Posts: 6,544 ✭✭✭Samaris


    (edit: Too much personal info there!)

    But I can see why the option to go onto disability if there is reason to would be tempting, and even feel like the only place to go, if even the thoughts of trying again bring on reactions or exacerbation of depression. And on top of failure, there is always the contempt of fellow members of society to deal with, which really helps while already on a knife-edge mentally. There was a long time of needing a lucky break rather than a job being the norm after graduation or if trying to get back into the workforce.

    I am sure that there are those gleefully milking the system. But I reckon there's plenty in the catch 22 situations too.

    Medical intervention and societal intervention regarding depression - which easily could be an epidemic given the issues I raised in the last post - is spotty, not hugely well understood, often misunderstood by society and misdiagnosed or mistreated (generally innocently). Some of the most obvious treatments may also be counter-productive and be contributing to making things worse if people are lead to believe that applying some antidepressants to the disease will solve everything, including the underlying factors actually causing it. Some people do not respond well to certain types of antidepressants and it may not even be known that they're contraindicated if the person they are being prescribed to doesn't realise it and tell their GP.

    Antidepressants are a tool, but not the solution and often not even a solution, just a (perhaps needed) crutch.

    Edit: And agree with you there, Manach, there is a similar mentality for bringing children into line in the US; medicate and that solves everything, regardless of underlying causes for the issue.


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    #11
    djPSB
    Closed Accounts Posts: 6,299 ✭✭✭djPSB


    Simple things like increasing excercise, improving diet can make a big difference too. These need to be considered as part of treatment rather than just throwing tablets at people. That's just an easy option for the doctors.


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    #12
    Junkyard Tom
    Registered Users Posts: 10,117 ✭✭✭✭Junkyard Tom


    GP's should be allowed to prescribe placebos which are almost as effective as AD's.


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    #13
    WinnyThePoo
    Closed Accounts Posts: 3,417 ✭✭✭WinnyThePoo


    Junkyard Tom wrote: »
    GP's should be allowed to prescribe placebos which are almost as effective as AD's.

    Really?...

    Personally as someone going through the ringer of depression in the past and present.

    I feel they certainly aren't enough. I find going to aware support groups and individual counselling to have helped me massively.

    Though they certainly help people at the beginning. Making the body feel and mind feel a bit better.

    Though to help myself I needed to seek other forms of help.


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    #14
    Junkyard Tom
    Registered Users Posts: 10,117 ✭✭✭✭Junkyard Tom


    WinnyThePoo wrote: »
    Really?...

    Yes and more than that they may be harmful.

    Conclusions

    SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects.

    bmcpsychiatry.biomedcentral.com

    Also the whole brain 'disease theory' is unproven. I don't like engaging in these debates because questioning the efficacy of AD's seems to elicit annoyance and this forum may not be the best place to discuss it.


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    #15
    Brendan Bendar
    Registered Users Posts: 19,060 ✭✭✭✭Brendan Bendar


    Harika wrote: »
    That is shortsighted, yes anti depressants will solve individual crisis in the short term but as the underlying causes of the problem are not addressed the patients are not getting off the medication. It needs to go hand in hand, else the 10 euro a month will sum up over the years.

    Have to agree with that basic synopsis, it's a bit like prescribing a slab of beer for someone who is depressed.

    The underlying causes need to be addressed and it's not always lack of money.

    It's a very difficult and expensive problem to solve.


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