Wednesday, April 24, 2019
Home Health The hidden injustice of depression | Daily Mail Online

The hidden injustice of depression | Daily Mail Online

We have a depression epidemic under control. At a minimum, you'd expect the latest numbers, which show rates, to rise faster than any other disease.

Although we live in an advanced, affluent society, free from war and hunger, we seem to be getting worse and worse, with one in ten affected on average.

In some areas of England, every sixth patient has been diagnosed with depression, according to new figures from NHS Digital.

That's a staggering number, and if that's true, it points to a broader public health crisis.

Blue Britain: According to the data, we get worse over time - but is the diagnosis correct every time?

Blue Britain: According to the data, we get worse over time – but is the diagnosis correct every time?

Doctors have warned that the rising numbers are putting further pressure on overburdened general practitioners who are struggling with the number of calls for help.

But are we becoming really depressed? I do not think we are. We should all be worried about it, because one in ten of us now have an antidepressant, and in many cases this may not be what is needed and could potentially do more harm than good.

There is no doubt that part of the sudden increase in depression rates is due to heightened awareness.

For years, psychological problems lurked in the shadows, and people were ashamed to step forward and ask for help, or they did not know that what they felt was a mental illness and deserved treatment.

Not a week goes by when a celebrity does not "carry everything" and admits having or having a mental health problem.

In one way or another, mental health is making news almost daily. For someone like me who works in this area, the turnaround was amazing and it's clearly a good thing that more people turn up who would otherwise have suffered silently.

Common: In some areas of England, every sixth patient has been diagnosed with depression, according to new figures from NHS Digital

Common: In some areas of England, every sixth patient has been diagnosed with depression, according to new figures from NHS Digital

The problem is that it is not always the people who need treatment or who are referred by psychiatric services. Too often, campaigns or awareness-raising take place only with groups that are already relatively good at asking for help, such as SMEs, articulate and educated people.

I know that it seems uninteresting to a doctor like myself working in the field of mental health who for years has been pushing for a better understanding of the mental illness, to suddenly resist and say that we all have a moment can stop, but I am.

I am far from being alone because I am concerned about the sudden increase in mental health. Sir Professor Simon Wessely, former President of the Royal College of Psychiatrists and current President of the Royal Society of Medicine, said last year, "Every time we have a mental health campaign, my heart goes down."

Not a week goes by when a celebrity does not "carry everything" and admits having or having a mental health problem.

This was confused by many. It was a coup that we certainly had on our side with the Duke and Duchess of Cambridge we care about. If it just could be that easy.

As Professor Wessely explained, "We do not need people to be more aware. We can not deal with those who already know it. "

Campaigns simply encourage people with milder symptoms to get in touch and get a treatment they do not need (antidepressants, for example, do not work in mild depression), while other groups suffer in silence.

Mental health is still strongly stigmatized in many impoverished, for example immigrant populations, which means that they often avoid seeking help or simply do not know how to mobilize help.

A hashtag campaign does not help the elderly. Similarly, men of the middle-aged working class were shamefully left behind. These men also do not tend to be on Twitter or Instagram.

A terrible study by the London School of Economics some years ago has shown that while mental illness accounts for almost half of all illnesses in under-65s, only a quarter of those in need of treatment actually get it.

"There is no doubt that part of the sudden increase in depression rates is due to heightened awareness," says Dr. Max Pemberton

Some of the highest under-diagnosis rates occur in middle-aged and middle-aged men, who also have the highest suicide rates.

A recent government investigation into suicide revealed that fewer than 10 percent of suicide victims had been transferred to mental health services last year.

But what about the apparent increase in numbers?

As the NHS reported last week, the most common home-treated condition is hypertension – with 13.9 percent of patients, followed by depression (9.9 percent), which rose from 9.1 percent last year, just ahead of obesity were .

My concern is that a significant portion of these people do not have depression.

Despite the government's budget, local psychiatric services are poor. Mental health teams will often see only the majority of patients who feel unwell, meaning that the burden of diagnosing and treating most patients falls on a family doctor. Many people who are diagnosed with depression will never see a psychiatrist.

More than 80 percent are only seen by their family doctor, who has spent a maximum of six months in mental health – some have none at all.

It is not the fault of primary care physicians, but many have limited knowledge of mental health and can easily diagnose mental illnesses other than depression. For example, the symptoms of personality disorder often mimic depression, and patients complain that they feel empty and hopeless. However, the treatment of personality disorders is very different and requires specialized, intensive and long-term psychotherapy.


While it is normal to feel downcast on occasion, people with depression may feel dissatisfied for weeks or months.

Depression can affect at any age and are quite common – about one in ten will experience at some point in their lives.

Depression is a real state of health that people simply can not ignore or break out of.

The symptoms and effects vary, but may be constantly upset or hopeless, or lose interest in things you've enjoyed in the past.

It can also lead to physical symptoms such as sleep disorders, fatigue, loss of appetite or sex drive, and even pain.

In extreme cases, it can lead to suicidal thoughts.

Traumatic events can trigger this, and people with a family history may be at greater risk.

It is important to see a doctor if you think you or someone you know is suffering from depression as it can be resolved through lifestyle changes, treatment or medication.

Source: NHS choices

I have often met people who have tried countless antidepressants for years, all to no avail. They therefore believe that they have "untreatable" depression if they actually had a personality disorder and have therefore received the wrong treatment.

But it's not just a misdiagnosis that underlies this apparent increase. I think a much bigger part is overdiagnosis, and this refers to mental health problems in general, and especially children.

Child and Adolescent Psychiatric Services – specialist teams that receive referrals from primary care physicians for children with serious mental health problems – are chronically understaffed. Colleagues working in these services, however, describe that they are flooded with referrals, not from patients with the worst symptoms who urgently need help, but from patients who have mild symptoms and whose parents demand that they be seen , The reason for this lies in the fact that normal suffering and agitation is called "mental illness".

Lately, there have been several reputable investigations that give the impression that about 50 percent of children have mental health problems.

I've worked in children's psychiatric services and the results are perfect

This is something Professor Sir Simon Wessely has spoken for, especially a National Union of Students report that three quarters of the students were mentally ill.

He said, "One wonders what happens when 78% of the union's students say they have mental health issues – you have to think," That seems unlikely. "

Exactly. This is really about the medicine of stress and normal emotions. To feel bad because your friend brings you or your friends to bowl without you is not a mental illness. You do not have depression.

Sometimes life is uncomfortable and unpleasant and does not work the way we want it. A teenager recently told a colleague of mine that it was "cool" to have depression. No it is not. It is absolutely overwhelming.

Of course there are children who really have mental problems and do not think for one minute that this "awareness" helps them. In fact, there is a risk of damage.

They trivialize the true horror of the mental illness of adolescents. Do not try to get angry that you are failing GCSE geography with early schizophrenia. Psychiatrists have tried to defend themselves against this creeping overdiagnosis.

As Professor Sir Simon Wessely says, "We are well aware of the dangers of over-sterilizing normal emotional issues … [psychiatrists] People who try to maintain a sort of boundary between sadness and depression, eccentricity and autism, between timidity and social phobia. "

But a combination of more awareness and celebrities "voicing" about their mental health problems means that many people ask for a diagnosis, a label, to confirm their problems. It is much better to have "clinical depression" than just a bleak life.

Social media do not help – not because they trigger a mental illness, but because they maintain unrealistic expectations of a rosy life.

When people examine their own lives and find that they are short in comparison, they assume that something is wrong. The majority of people who have a hard time are not mentally ill, we only experience life.

We should talk about the realities of life and aids to be resilient, not push anything and give prescription pills that they do not need.

Antidepressants can be life-saving for people with depression. However, they have serious side effects and we should not take them out unless there is clearly a clinical need.

I saw a young man who had been given an antidepressant after going to his family doctor and starting to cry. When I asked him more, he said his mother had just died. I wrote to the family doctor and said that I had stopped the antidepressant because the crying is normal after her mother died and I would be more afraid if he had not cried.

Of course, I am pleased that people with a mental illness can now openly talk about it. Of course it is a good thing that we have more understanding and sympathy for those who are struggling with mental illness and that people feel able to ask for help.

But the heightened awareness was not the panacea we had hoped for. Unfortunately, it has created so many problems as it has been cured.


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