\u00a0As if those people with depression <\/a>didn\u2019t have enough to contend with, anyone who switched on BBC<\/a>1\u2019s Panorama this week will have been confronted by one of the most irresponsible and stigmatising pieces of television made in years.<\/p>\n
A Prescription For Murder? looked at an alleged link between antidepressants and violence and mass killings.<\/p>\n
My heart sank because these kinds of programmes are so unhelpful \u2014 sensationalising the subject matter as if it was a crime show. Yet they get commissioned because they claim to be doing a public service; airing an important concern.<\/p>\n
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Actually, all they end up doing is resonating with people\u2019s prejudices about those with mental illness: that they are all axe-wielding maniacs. They do nothing except cause fear and worry for a vulnerable and misunderstood group of people who really don\u2019t need this.<\/p>\n
Now don\u2019t get me wrong, it is absolutely the right of others to express their view. And even though I\u2019m a doctor and I prescribe antidepressants every day, I don\u2019t think they are the be-all and end-all.<\/p>\n
Depression is complex, and an approach that tackles it from several angles is the most effective. This means psychotherapy is important, too.<\/p>\n
But television programmes like this play on the idea that such medication is, by its very nature, dangerous; and on the insidious idea that those with mental illness should be feared. It then goes that if antidepressants are evil, those who take them are tainted by association.<\/p>\n
The usually perspicacious, measured and penetrating Panorama lost all perspective and got sucked into perpetuating stigma and \u2018pill shaming\u2019.<\/p>\n
What upsets me is that after these kinds of programmes, there are inevitably some people who stop taking their medication and, as a result, they deteriorate.<\/p>\n
It\u2019s not the producer or, indeed, anyone at the BBC who has to see the fallout. It is the GPs, psychiatrists and psychiatric nurses working on the front line who have to deal with patients who are suicidal as a result.<\/p>\n
Of course, the pharmaceutical industry has not covered itself in glory, and this makes their products easy targets for spurious claims. We know that over the years they have cherry-picked the data they use so it ensured more favourable results.<\/p>\n
This has made the job of clinicians very difficult because it means that truly evaluating how effective these drugs are is tricky. It\u2019s problematic anyway, because the brain is such an incredibly complex organ that we don\u2019t fully understand how it works \u2014 nor, indeed, fully the mechanism by which antidepressants work.<\/p>\n
But the fact is there is no clear, definitive evidence to link antidepressants with violence. The programme relied entirely on anecdote and hearsay and the speculation of individuals who had experienced awful crimes and, understandably, wanted something to blame.<\/p>\n
This is not evidence, though. Where was the empirical research demonstrating clear causation? There was not even a whiff.<\/p>\n
And I worry about how all this affects those in desperate need of treatment. It is true that in some situations antidepressants are given out too readily. Harassed GPs faced with patients with complex social problems and eight minutes to sort them out reach too readily for the prescription pad.<\/p>\n
There is no pill that is going to make your philandering husband change his ways, your screaming, ungrateful children better behaved or your bored wife love you. This isn\u2019t an illness, it\u2019s what is termed \u2018rubbish life syndrome\u2019.<\/p>\n
But the flip side is that while antidepressants are in some quarters overprescribed, in others depression is woefully underdiagnosed and under-treated.<\/p>\n
A horrifying study by the London School of Economics a few years ago showed that while mental illness accounts for nearly half of all ill health in the under-65s, only 25 per cent of those in need of treatment get it.<\/p>\n
Further research by Aberdeen University showed that GPs failed to diagnose major depression in half their patients. Some of the highest rates of under-diagnosis occur in middle-aged and older men, who also have the highest rates of suicide.<\/p>\n
A National Confidential Inquiry Into Suicide showed that fewer than 10 per cent of people who killed themselves had been referred to mental health services in the previous 12 months.<\/p>\n
This is the true scandal about antidepressants that Panorama should be focusing on: the fact that we are failing to identify and treat people who have a crippling and life-threatening condition.<\/p>\n
\u00a0Send luvvies into care homes!<\/p>\n
\u00a0The arts aren\u2019t there just to entertain \u2014 they can actually make us feel better, according to a report this week from the All Party Parliamentary Group On Arts, Health and Wellbeing.<\/p>\n
It presented some astonishing research: 82 per cent of people enjoy greater wellbeing after engaging with the arts and 77per cent take more physical activity.<\/p>\n
Even more striking, a project called Arts On Prescription resulted in a 37 per cent drop in visits to the GP and a 27 per cent reduction in hospital admissions. Furthermore, dementia patients\u2019 medication rates drop and their levels of engagement with those around them increase.<\/p>\n
Various prestigious organisations have taken part in projects, including Wigmore Hall, Bournemouth Symphony Orchestra and Liverpool Philharmonic.<\/p>\n
As someone who\u2019s spent years working in nursing homes, first as a care assistant and later as a doctor, I think anything that can do this has to be welcomed.<\/p>\n
All too often, staff reach for the chemical cosh for \u2018difficult\u2019 behaviour, but the notable risks include stroke.<\/p>\n
Given the benefits, why can\u2019t GPs prescribe art programmes?<\/p>\n
Part of the problem is that the NHS doesn\u2019t view things holistically, and there is no mechanism whereby money saved from fewer consultations, say, is ploughed back into arts schemes. It\u2019s all so woefully short-sighted.<\/p>\n
I think we should encourage artists and performers to visit hospitals and care homes as a sort of community service.<\/p>\n
The new report goes some way here, recommending that Arts Council England supports cultural organisations in making health integral to their work. Surely those in care homes deserve more than hours sat ossifying in front of daytime TV?<\/p>\n
\u00a0How hallucinations can help heal the pain of grief<\/span><\/p>\n In a particularly poignant confession, the singer Celine Dion said this week that she still feels the presence of her beloved husband, even though he died in January 2016.<\/p>\n This is incredibly common, with many people reporting actually seeing their partner after their death. This isn\u2019t a ghost or anything scary, but something far more romantic and wonderful.<\/p>\n I first came across this as a junior doctor in AE. I\u2019d been asked to see Mr Simcock because he had pneumonia but was refusing to be admitted because he had to \u2018get back to see his wife\u2019. Perfectly reasonable, except that his wife had died six months before.<\/p>\n \u2018He says that he sees her every evening and wants to get back to her,\u2019 I was told.<\/p>\n Mr Simcock, who was in his 70s, had been married for nearly 50 years \u2018with no time off for good behaviour\u2019, he chortled as I assessed him. When his wife died, suddenly, he didn\u2019t know what to do with himself.<\/p>\n \u2018And then \u2014 she\u2019d probably been buried a week \u2014 I saw her,\u2019 he said. She visited him most evenings, he explained, just as he was dropping off, and sometimes they talked.<\/p>\n \u2018She was always a bit of a nag, so I suppose she feels she needs to keep her eye on me.\u2019<\/p>\n He didn\u2019t find the experience unsettling but, rather, a comfort. Such hallucinations are wish-fulfilment, the brain\u2019s way of giving the bereaved what they so desperately want.<\/p>\n I asked Mr Simcock what his wife would say if she knew he was risking his health for her.<\/p>\n \u2018She wouldn\u2019t be happy about it,\u2019 he replied, slowly. \u2018And if I\u2019m honest, it would be nice to get away from the old battleaxe for a bit.\u2019<\/p>\n With that settled, he was admitted.<\/p>\n These tricks of the mind in response to the pain of bereavement are testament to the power of love. They also show what an amazing organ the brain is.<\/p>\n \u00a0<\/p>\n","protected":false},"excerpt":{"rendered":" \u00a0As if those people with depression didn\u2019t have enough to contend with, anyone who switched on BBC1\u2019s Panorama this week will have been confronted by one of the most irresponsible and stigmatising pieces of television made in years. A Prescription For Murder? looked at an alleged link between antidepressants and violence and mass killings. My Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-191893","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/191893","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/comments?post=191893"}],"version-history":[{"count":0,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/191893\/revisions"}],"wp:attachment":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/media?parent=191893"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/categories?post=191893"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/tags?post=191893"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}