Why you cannot trust your GP with your Depression?

Your GP will be doing his or her best and his or her heart will no doubt be in the right place. Yet your GP on Depression is the wrong person to help you recover. You cannot have confidence in your GP’s capacity to help you with your depression.

This post was originally a monster post – so I have split it into four.  These cover the four very different reasons why your GP should never have been put in the situation of being in the front line against depression.  Now a warning – if you find that I do get quite strong and opinionated at times, it is because I am angry as I see what the medical profession do, even if for the best of motives, to people who are depressed and who make the mistake to trust their GP.

Of course I am generalising. You might be fortunate to have a GP who understands that depression is not really an illness and who translates his natural suspicion of antidepressants (which most GPs have) into a policy that will rarely prescribe them. You may also be fortunate to have a GP who is not only aware that Cognitive Behavioral Therapy (CBT) is not delivering the results that were promised, but also understands why that is so.  Finally you might have a GP who has the time and human understanding to know that depression is a reflection of a life that is not working and so takes a holistic approach to your healing.

Yes you might be lucky to have a GP like this and who therefore goes against all the official advice as to how depressions should be treated– but best not to bank on it.

The four reasons why your GP cannot be trusted with your Depression

  1. Depression is not an illness and therefore a medical approach is not the right way.
  2. The evidence is clear – antidepressants don’t work that well.
  3. Cognitive Behavioral Therapy on the NHS is not delivering and there are very good reasons why that is the case.
  4. Our depression epidemic has to have a social dimension and doctors cannot be expected to help – afterall, that is not their job.

And now let me expand on the first of these.

  1. Is Depression an illness?

This post is not an academic treatise and of course there are a lot of theories around depression. So many in fact, that maybe it is more than one thing. But even if this is the case, then nonetheless one things remains clear – which is that depression cannot be an illness as conventionally understood.

One reason is that there is no medical test for depression, like there is for diabetes or high blood pressure.  And the chemical imbalance theory of depression might be OK in a Sunday magazine article but beyond that, it is so drilled through with holes as to be meaningless. And remember, researchers have been trying and failing for years to come up with a decent medical explanation and a biological or chemical test.

And if depression is medical, then how can you possibly explain why we have a depression epidemic – apparently exploding out of nowhere over the past 30 years? In the absence of a deadly virus or complex genetic abnormality, surely the only possible explanation must lie with the effects of our rapidly changing society?

Depression can best be understood as a malfunction or disorder perhaps but not an illness.

And if depression is not medical and not an illness, then why should you trust your GP to sort out your depression problem?

The training and instinct of your GP is to pathologise and diagnose and then prescribe standardised treatments. And so for a typical GP, rushed off his or her feet and having no real idea what depression is about, the temptation to follow the herd and prescribe either antidepressants or CBT which he is told has hard evidence in support of it, will surely be irresistible.

There will be more next week – when I expand on the second (of four) reasons why your GP is the wrong person to deal with your depression – which concerns the weak evidence in support of antidepressants. In the meantime and if you need help that you know your GP cannot give, then contact me now.

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