papering over the cracks in a fractured society


Sort of disclaimer for talk about Psych Meds

Here at recoverynet.ca we believe that medications are not a moral issue.

Taking meds is not a moral issue – no more than not taking meds is a moral issue.

For each of us, whether or not we take meds is a choice that is best made by ourselves, hopefully with true informed consent – meaning with full knowledge of all our options and all the effects.

Medications are simply a tool – nothing more and nothing less- use them to the extent they work for you.  Anyone telling you otherwise is telling you you “should” / “should not”, really is behaving like a tool- so use them to the extent you find them useful too.

Basically, we believe that anyone who tells you that you should take meds or that you should not take meds should mind their own bloody business, and that’s being as polite as we possibly can.

Enough of all the should-ing alright?

 

The big crack in our society

That said, at a societal level, our current reliance on use of medications raises some serious questions about how we, as a society, create and maintain institutions and services, the options those services provide  and especially those that serve those of us who are less able- financially and otherwise- to serve themselves.

This article from  yesterday’s Guardian focuses on the now widespread use of the class of psychiatric drug known commonly as “anti-depressant” and does a very good job of highlighting the extent that the UK, like many other countries, now relies on drugs to paper over the cracks in a rapidly fragmenting, and increasingly fractured society.

In UK, there are now fifty million prescriptions per year for “anti-depressants” – almost one prescription, per person, per year.

Of course, if you can afford to pay yourself for services then you will always have more options and in time can likely find whatever services work for you.

Meanwhile, those less affluent must rely on publicly provided services and so are inevitably and invariably offered no options beyond taking the pill by choice or being coerced to take the pill –  and a long wait on a long wait list for talk therapies.

In absence of anything else, meds can help – somewhat, for period of some time,  and for some people.

But,  as the examples in the article illustrate there is almost always some connection with the experience of what we might call “mental illness” and the individual’s experience of life.

big crackWould we not do better to adopt approaches that deal with the cracks, the causes of the cracks – and even crack prevention?

Again, as the article states, progress has been made in “reducing stigma” where “stigma” is counted as the embarrassment or shame a person feels that prevents them asking for help- and is addressed by advertising people to come forward to ask for help. Yet what is “stigma” if not the impact of  the way society both discriminates against those who experience struggles and the continued failure to offer at best effective options?

Anti-stigma campaigns can indeed result in more people being persuaded to not struggle alone and to ask for help.  It is tragic that these people then find themselves  are offered little more than the drugs and a long wait on a long wait list, and now find themselves truly marked and separated from the rest of a society and those individuals who have yet to find themselves so marked.

So, the real effect of so called “stigma reduction” is more people taking more drugs so they can hang in there while waiting  for services to get round to offering more than drugs.
No wonder they are called “patient”.

These self congratulatory multimillion dollar advertising campaigns pride themselves for pushing more people into a dependence on drugs. Anti-stigma campaigns are sausage machines – effectively tax-funded advertising that subsidizes the operations of some of the world’s richest corporations.

As the title asks: are we, as a society, using mass drugging to paper over the very evident cracks in our fractured and fragmented society?

And, In doing so, do we not mask the price that millions of individuals -including children- must pay to paper over the cracks in a society that clearly works well for some but leaves the rest of us who have fewer choices taking drugs that might well leave us just comfortably enough numb that we can get through the day minding little enough about the injustice of a society in which a decreasing few increasingly grab all that they can for themselves while the rest of us pay with our health.

 

The Guardian, Sunday 13 April 2014

Are we using antidepressants to paper over the cracks of a fractured society?

Use of antidepressant drugs has become more common than ever before. Perhaps it’s time that we looked at the wider causes of this trend.

Prozac CapsuleMore than 50million prescriptions for antidepressants are written in the UK every year. Photograph: Alamy

The chances are that you know someone who takes antidepressants. Or maybe you take them yourself. If so, you are in good company. More than 50m prescriptions for antidepressants are written in the UK every year and, although not all of the pills will be swallowed – taking into account repeat prescriptions and failure to collect from pharmacies – the figure is still staggeringly high.

There’s a positive side to the 50m statistic, though. It suggests that as the stigma has decreased, people have become more willing to ask for help. And, for many, antidepressants work. However, while professionals are quick to acknowledge the benefits – which can be life-saving – many express concern about our growing dependence.

“Prescription levels have gone through the roof,” says Dr Matthijs Muijen, head of mental health at WHO Europe. “On the demand side, people know antidepressants work. I would even argue there’s a degree of fashion about antidepressants. On the supply side, antidepressants have become cheaper and more easily available. Doctors now know it’s easy and ‘good’ to prescribe.”

Key to arguments around antidepressant use are questions about what constitutes “normal” sadness and where the boundary lies between this and clinical depression. There is no cut-and-dried answer, and this ambivalence around the use of antidepressants seems to be characteristic of those taking them. “It’s not ideal, but I just make use of the resources available,” is a characteristic response.

Lisa Cunningham, 45, was signed off on sick leave and prescribed Prozac after suffering problems at work. Soon afterwards, she was attacked, leaving her with facial injuries and even deeper depression. For nearly 11 years, Lisa remained on medication, becoming steadily more withdrawn, until she barely left the house.

Cunningham’s story has a positive outcome: after being referred to a volunteering scheme by her GP she got involved in a gardening project which led to a full-time job. She then felt able to stop taking her medication. “Antidepressants did a vital job and I definitely think I had clinical depression,” Cunningham says. “But I was a nervous, anxious child.” She explains that while growing up, she was subjected to physical aggression from people close to her, “so it was almost inevitable I’d get depression. Looking back, it would probably have been better if I’d had some sort of psychotherapy in school.”

For Darren Ellis, 40, life events and mental health have been similarly linked. Ellis lost his father at 16 and at the time was not offered any support. Ellis’s depression and anxiety developed and he was prescribed medication after medication. None of the drugs worked and he twice attempted to take his own life. It was only this year that he was able to get the one-to-one cognitive-behavioural therapy (CBT) that, he says, is finally helping him to recover.

Ellis believes things could have been different; that the depression could have been prevented. “I’m sure I could have avoided taking medication if I’d had therapy immediately,” he says. “I was confident – the life and soul of a party – until my dad died.”

The link between life events and depression is of course not disputed, but it is of particular relevance now. A report by The Health and Social Care Information Centre revealed that in many places in the UK – including Barnsley, Durham, Middlesbrough, Redcar, Salford and Sunderland – approximately one in six adults are prescribed antidepressants. By comparison, in affluent Kensington & Chelsea, it is one in 21.

Since the recession began, Mind has reported a dramatic rise in the number of people calling its phone line. “There are clear links between unemployment and depression,” says Sophie Corlett, Mind’s director of external relations. “After six months, one in seven unemployed men will develop mental-health problems. People are falling into debt and there’s a reciprocal relationship between debt and mental health.”

While almost everyone with experience of antidepressants reports finding them useful, many could have made use of alternative forms of help. “We know that people go to the doctor because they’re feeling low, and the reasons may be domestic violence, debt, bereavement, marriage breakup, difficulties from past trauma,” says Corlett. “Some of these are practical and could have practical solutions, while some are deep-rooted psychological issues that need dealing with. Antidepressants are not always the answer.”

For mild to moderate depression, unless it is persistent, the National Institute for Health and Care Excellence (NICE) does not recommend medication as a first resort. However, despite the government’s investment in the Improving Access to Psychological Therapies programme, in some parts of the country people wait months for access to CBT or similar treatments. Likewise, it does not appear that people’s prescriptions are always reviewed every six months, as NICE suggests.

There are many problems with prescribing antidepressants when there could be an alternative solution. Antidepressants have side-effects that we are only just discovering and, although prices have dropped as patents expire, the cost to the NHS is still huge.

It is impossible to gauge whether we live in a more stressful age than that of our grandparents. What is certain is that attitudes and access to drugs have changed. On balance, this is a good thing. But as the economy continues to flounder, the number of people struggling with mental-health issues is likely to increase, almost certainly leading to the writing of yet more prescriptions.

“My worry is that we are medicalising all forms of sadness in the belief that antidepressants are a safe drug that you just prescribe,” says Muijen.

Mind has called for accurate research to be carried out into how many people are taking antidepressants, how long they take them for and whether they are receiving any other treatment. It is a serious problem, Corlett says, that this data does not exist. Antidepressants are a vital tool. But if, in many cases, we are simply papering over cracks, we should, as a society, face up to the depth of the problem.

See original article @ The Guardian

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One Response to papering over the cracks in a fractured society

  1. Christine says:

    Just look at the consequences of Fort Hood and possible medication link. What a sad but may of been a very preventable outcome. My heart goes out to all involved.

    Like

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