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The drugs don't work

A

Apotheosis

Guest
http://www.guardian.co.uk/commentisfree/2009/jun/29/antidepressants-drugs

The number of people on antidepressants is soaring – we may be more miserable, but let's swap the pills for support and care

It may have been the happiest day of the year on 19 June, but we are already into the hangover. Figures obtained by the Liberal Democrats reveal that antidepressant prescription numbers are going through the roof – 36m scripts were handed out to patients in England last year, a rise of 2.1m on 2007. That's almost one for every adult. Lib Dem health spokesman Norman Lamb is right to describe the figures as "deeply disturbing".

Lamb has demanded improved help for people whose problems are recession-related. It's true that financial woes create more distress, but we shouldn't use the economy as a smokescreen for what is a longer-term malaise. Antidepressant use has been going up for years – prescriptions have more than tripled since the early 1990s. We have not become a Prozac nation overnight.

So what is going on? Are we genuinely becoming more miserable? That's part of the story – according to official statistics, the percentage of people with a "common mental disorder (pdf)" increased from 15.5% in 1993 to 17.6% in 2007 (that's a million extra unhappy people across the UK). Some of these inevitably wind up at the GP surgery, seeking relief.

But perhaps more instructive is what happens next. Most GPs respond to mental health problems by reaching for the prescription pad, even though guidelines from the National Institute For Clinical Excellence generally recommend psychological therapies. To some extent, doctors do this because they have little choice – more than three-quarters have prescribed medication despite thinking an alternative would be more appropriate. Most do so because there are no other options available – decent psychotherapy services are still few and far between, and often have long waiting lists.

However, medics also prescribe drugs because that's what they are trained to do – pills have long been their (and our) default response to depression. The dominant view of psychiatric illness is that chemical imbalances in the brain are mostly to blame, and that they can be controlled with pharmaceuticals. This line has been peddled hard by drug companies, and for a long time it was accepted almost without question — the reception which greeted the arrival of Prozac and the other SSRI antidepressants (which were supposed to counter the "imbalances") was nothing short of hysterical. Reality has been more prosaic: a recent review found the SSRIs barely more effective than a placebo pill. Still, the NHS bill (pdf) for prescribing them runs into hundreds of millions of pounds a year.

It's a crazy situation, and the tide may be turning. The dubious tricks used by drug companies to make their products seem more effective are becoming widely known (thanks in part to vocal critics from inside medicine, such as this paper's Ben Goldacre), while the government is beginning to invest in proven non-drug alternatives, such as psychotherapy. Research into the biological bases of mental ill-health is floundering – a study just released casts serious doubt on the existence of a previously heralded "depression risk gene". Meanwhile, there is a growing evidence base for simple, socially based steps everyone can take to improve their wellbeing. These include building good relationships, lifelong learning, being kind to others and exercise – not rocket science, but somehow we seem to have forgotten them.

And this week, renowned clinical psychologist Richard Bentall publishes Doctoring The Mind: Why Psychiatric Treatments Fail. In meticulously referenced detail, Bentall documents the shocking failures of biological psychiatry and the drug-based mental health system it perpetuates, and calls for an evidence-based alternative that offers patients support, care and respect. The book effects a courageous, comprehensive demolition of the status quo, and offers a radical vision of a more humane future for services – it should be required reading for everyone with a hand in mental health policy.

It won't be easy to make such radical changes in the way we approach wellbeing. It means giving up hope of medical "quick fixes", at least until they are as good as their makers claim, and turning instead towards methods that are far less financially profitable, and which require hard work on the part of professionals, patients, government and the rest of us. As well as an overhaul of services, it means tackling social fragmentation, greed-based economics and the stress created by a speedy, sensationalist culture. And it means starting a mature debate based on understanding rather than fear of the mind, promoting the ways we can look after our psychological as well as our physical health. That may sound like a tall order, but until we make a start, the queue of glum-looking folk at the chemist will just keep on getting longer.
 
A

Apotheosis

Guest
Why Psychiatric Treatments Fail ~

http://www.telegraph.co.uk/culture/...reatments-Fail-by-Richard-Bentall-review.html

http://entertainment.timesonline.co...tainment/books/non-fiction/article6619374.ece

http://www.timeshighereducation.co.uk/story.asp?storycode=407609

In an earlier book, Madness Explained, Bentall was at pains to distinguish his approach from other anti-psychiatrists – for example, RD Laing, whose radical views were discredited because of his flamboyant lack of rigour and attendant inability to accept criticism. Bentall, as this book attests, is a different kettle of fish. With patient persistence and without recourse to rancorous diatribes, he has appraised the scientific evidence for the success of contemporary psychiatric treatments and come up with a dismal report. It is probably the very balance of his approach that drives his opponents crazy.

Doctoring the Mind is an attempt to clarify the dense array of evidence offered in Bentall’s earlier work. The result is a much easier read. It is also, for that reason, more disturbing…

…Bentall’s thesis is that, for all the apparent advances in understanding psychiatric disorders, psychiatric treatment has done little to improve human welfare, because the scientific research which has led to the favouring of mind-altering drugs is, as he puts it, “fatally flawed”. He cites some startling evidence from the World Health Organisation that suggests patients suffering psychotic episodes in developing countries recover “better” than those from the industrialised world and the aim of the book is broadly to suggest why this might be so.

Here it is important to explain something that is not always understood, which is that mental “illness” is not strictly comparable with physical illness. There are several reasons for this, one being that the aetiology (causation) of so-called mental disease is not yet identifiable in the way that, say, measles is. The precise causal relationship between or mind and body remains misty, but that strong emotional states have an impact on physical states is recognisable in everyday life. We do not feel fear because we have paled or experience anxiety because we sweat. We blush or, if we have penises, have erections because strong emotions trigger these normal physical responses.

The question then becomes this: are distressing mental states the result of impaired brain chemistry or is it the other way round? Does trauma, whether singular or chronic, as in the long misery of an abandoned child or the recurring anxiety of an assaulted one, alter the subtle chemistry of the brain to affect subsequent states of mind? This debate, as Bentall demonstrates, is not only still on, but is heated.
 
D

dreambuggieII

Guest
wow thanks for that

I'm going to try and buy that book. I was just wondering if you'd heard of Joanna Moncrieff, I had the nervous pleasure of meeting her at a debate once, which is available to hear on the net.

I'll try and find the link in a min.

I guess what confuses me the most in this mele are the contradictory statistical information. I've read a report from Kings College (skuuze I get em mixed up) which outlined the future of the COSTS of mental health care in the UK till 2026.

The crux of the report seemed to suggest that mental illness would rise in direct proportion to rise in population. Their quota and sampling method, seemed pretty robust. But I'm not an expert in this.

What you've said above seems to be the reality rather then the stats, if you get my drift.

I don't know, whether it feels psychologically better knowing that more people experience the illness, hence making me feel less of an outsider - is the reason why I favour your opinions.

I guess the only way I can find the truth of things is to look around my immediate world. For me that is proof enough. I work in admin, at a counselling centre and yes, we have a long waiting list.

Incidently, I worked in digital marketing for a short time, and managed to learn a few techniques in web research. I found a site that lists, what the world searches for!!! (wow), and under pharmeceuticals, anti-depressents came up in the top ten THREE times.

What I'm trying to say, is that we know statistics are in fact not as exacting as we would like.

Frankly the truth is out there to see and experience as we get older.

Its frightening and upsetting to know that people continue to suffer in their masses, but its the report writers and govt think tanks who write the stats, who seem to carry weight, when it comes to decision making in the NHS.

I hope that IAPT and other alternatives will gather momentum.

Thank you - for the tip on Richard Bentall. Will be reading that one asap. And for a great read in genral for a saturday brain munching...

Here's the link to the podcast if you have a few hours spare - I enjoyed the au deurves at the end of it. Thought they would have enjoyed them on the wards.

:)

http://www.iop.kcl.ac.uk/podcast/?id=238&type=item
 
A

Apotheosis

Guest
wow thanks for that

I'm going to try and buy that book. I was just wondering if you'd heard of Joanna Moncrieff, I had the nervous pleasure of meeting her at a debate once, which is available to hear on the net.
I have not heard of her - I will run a google search.

I guess what confuses me the most in this mele are the contradictory statistical information.
It is confusing. & the simple fact is that no one has all the answers. MH issues; & in fact anything to do with the mind are highly individual & complex. We, as a species, simply do not understand the workings of the human brain.

What would be rational is to suppose that there are a massive amount of influencing factors at play here - that there are combinations of psychological, physical, environmental & other factors that are at cause & influence on a MH condition.

I think that distinctions have to also be made. MH conditions can vary greatly in severity in individual cases. & what is at cause in one case; may not be at cause in another.

This whole subject; also cannot but raise deeply presently unanswerable questions as to the true nature of reality & consciousness.


Thanks for the link; I will have a listen.
 
C

chrissponias

Member
Joined
Oct 10, 2009
Messages
18
Location
Athens, Greece
Drugs provide provisory relief, while psychotherapy teaches the patients how to overcome their problems and build their self-confidence. Even though psychotherapy is much better than anything else, most people prefer drugs because they want immediate relief, without changing their behavior.

I believe that the mentality of our civilization has to change if we want to have a society that won’t be formed basically by neurotics and by depressed people, like today.
 
A

Apotheosis

Guest
Drugs provide provisory relief, while psychotherapy teaches the patients how to overcome their problems and build their self-confidence. Even though psychotherapy is much better than anything else, most people prefer drugs because they want immediate relief, without changing their behavior.
Yes, people want a quick fix, a pill to take that makes everything all better.

I believe that the mentality of our civilization has to change if we want to have a society that won’t be formed basically by neurotics and by depressed people, like today.
The only sane reaction to an insane world is insanity?
 
A

Apotheosis

Guest
[YOUTUBE]<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/3oRKvpZ7PjE&hl=en&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/3oRKvpZ7PjE&hl=en&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object>[/YOUTUBE]​
 
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