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Some see the hand of Big Pharma behind the rise in prescriptions. I just see drugs that work
Here we go again. The number of antidepressants prescribed has been increasing for years. The latest figures show a 43% rise since 2006, and this has been put down to the rise in anxiety caused by the economic downturn.
Whenever there's a such an increase, the backlash from psychotherapists and psychologists who most passionately advocate talking cures is never far behind. Surely not all the extra seven million prescriptions can be justified, the argument goes; this prescribing simply pathologises normal life. GPs and psychiatrists are fobbing patients off with pills – worse still, with pills that don't even work. It is as if the worst thing that could happen to someone is to be prescribed antidepressants.
Allow me to list a few others. Crippling panic attacks where you are shaking with fear and unable to get out of bed; uncontrollable sobbing; an overwhelming sense of futility; an inability to sleep; the terrifying awareness you have lost touch with reality; the thought that sometimes turns into belief that you will never feel any other way and would be better off dead.
This is not a defence of Big Pharma. Drug firms profiteer from any condition they can, from cancer and HIV/Aids to depression. Fact. Nor is it a defence of GPs and shrinks, though in my experience most prescribe with care. There is no simple test for depression: it is a collection of symptoms. Many professionals have just a 10-minute appointment to assess their severity, and antidepressants are generally a last resort. But what else are they supposed to do? Tell desperate parents that they're sorry, mental health budgets have been slashed but they will put them on the lengthy waiting list for cognitive behavioural therapy?
No, this is a plea to back off for those who have made a living out of being professionally well and only have experience of mental illness at second hand. The mentally ill can get along without you. We don't need you to tell us what we're supposed to think; we can see for ourselves what does and doesn't work.
Three years ago came the supposedly definitive research that antidepressants worked no better than placebos. That must have been news to all those other researchers who had been spelling out the dangers of suicide associated with some antidepressants for the previous 10 years. Not to mention to the countless others whose studies had shown that antidepressants made people feel like zombies. That's quite some placebo effect. In any case, if there is a placebo effect, why the rush to knock it?
Nor is the idea that the medicalisation of mental illness is a bad thing in any way helpful or revelatory. Lots of conditions have been medicalised over the last few hundred years as treatments have improved. Were we better off before we understood anaesthesia or after it? So if we can treat depression pharmacologically then why not? It's not as if it's a case of either/or, anyway. Few doctors prescribe antidepressants without pointing their patients in the direction of some kind of therapy as well. And take it from me, the therapies are just as hit and miss.
Just because people like me are mentally ill it doesn't mean we're stupid. We understand that treating depression can be like shooting at a moving target because no two people will respond at the same rate or in the same way to the same drugs. We understand professionals are often guessing which antidepressant is likely to be the most effective. We understand there is no cure-all, and that the episodes of depression may well return at some point in the future. Indeed, many of us are absolutely certain they will. But we don't care. We'll take the antidepressants anyway.
You see, we've been there before, and they've worked for us. Because when the symptoms were at their worst, when getting through the next 10 minutes was struggle enough, we had something; the possibility that the antidepressants would work, sooner or later. To be told by my shrink there was nothing he could do and I would either survive the depression or not would have almost guaranteed I didn't. I believe antidepressants have saved my life on several occasions, that they have allowed me to function normally. More or less. The professionally well might say I am deluded, that I am the victim of a medical conspiracy. Possibly I am. But rather deluded than dead.