Last week I spelled out why it was most unlikely that depression is an illness as conventionally understood and given that, doctors who are trained in the medical model are out of their depth when attempting to treat depression. To remind you, here is the list of the four reasons why in my opinion your GP cannot be trusted with your Depression.
- Depression is not an illness and therefore a medical approach is not the right way.
- The evidence is clear – antidepressants don’t work that well.
- Cognitive Behavioral Therapy on the NHS is not delivering and there are very good reasons why that is the case.
- Our depression epidemic has to have a social dimension and doctors cannot be expected to help – afterall, that is not their job.
Second Reason: What we know about the effectiveness of antidepressants?
This is the best summery of the evidence on antidepressants that I have found – by the Human Givens Institute:
Antidepressants work in aggregate about as well as placebo which means about one third of people benefit. But of course they do not pretend to treat the root cause and so there is a high rate of relapse. And a quarter of users will do less well than placebo.
And there are side effects – from an increased suicide risk, loss of sex drive, dizziness, nausea, fatigue, headaches and so on Finally, a third of those taking anti-depressants will suffer withdrawal symptoms.”
And this is what Charles O’Connell has said, taken from his comprehensive survey:
Overall, antidepressants have not been shown to substantially improve the plight of patients with low mood and are associated with many unpleasant and potentially harmful side-effects. It is little wonder that SSRIs have spectacularly failed to treat a condition for which they are marketed, but it is still extraordinary that antidepressants are the eighth most prescribed drug in the world with sales of $19 billion in 2009.
So antidepressants can help, but you never know in advance if you will be one of the lucky ones – helped by them and with no serious side effects or withdrawal symptoms when you stop. And of course antidepressants might make you feel worse.
There is also the problem of the unhealthy codependent relationship between doctors and the large pharmaceutical companies who supply these antidepressants and who make mouth watering profits. The evidence is clear from the brave work of independent researchers –Big Pharma suppresses and manipulates the evidence shamefully. Suffice it to say that most of the evidence in favour of antidepressants comes from the pharmaceutical companies themselves and they know very well how to play the system so the evidence looks far stronger than it is and the apparent independent academic confirmation is no such thing.
It is absolutely shocking and a great scandal.
There will be more next week – when I expand on the third (of four) reasons why your GP is the wrong person to deal with your depression – which concerns the failures of Cognitive Behavioural Therapy (CBT).