Medicating Isolation

 

Yesterday, the Telegraph published an important article by Miranda Levy (right), under the headline: ‘We are a sedated society’: the rise in antidepressants during lockdown.

Miranda began by referring to the Association of Independent Multiple Pharmacies (AIMP), who stated that there has been a 10 to 15 per cent rise in antidepressant prescriptions across the country. The AIMP has also heard of struggles from pharmacies to meet increase in demand.

Leyla Hannbeck (left), the CEO of AIMP, said: “Around the beginning of March, doctors were issuing more three-month prescriptions than before. This echoes a worldwide trend: in medi-happy America, anti-anxiety scripts have risen by a third; antidepressants by a fifth.”

The main part of  Miranda’s article consisted of interviews with two of the country’s most trusted and influential experts in the field of mental health.

Dr James Davies (right) is a former psychotherapist and reader in Mental Health at Roehampton University. He is co-founder of the Council for Evidence-based Psychiatry (CEP), which is secretariat to the All Party Parliamentary Group for Prescribed Drug Dependence. He said: “Over the past 30 years, we have become used to ‘medicalising’ distress”. Now along comes the biggest crisis in living memory.”

Dr John Read (left) is a professor in clinical psychology at the University of East London, and is a fellow-member of the CEP. He said: “I’m really hoping GPs won’t continue to be trigger-happy. One in six of the population is already on antidepressants. Now consultations have largely moved online, and physical health is being prioritised – how could it not be? – I can only see more of these ‘quick fixes’.”

Last September, Public Health England published a report which, for the first time, accepted that antidepressants can induce dependence and cause unpleasant symptoms on withdrawal.

This report was seen as a big admission in an “industry” which had always denied that such negative effects existed. “Before Covid, we had hoped that Matt Hancock was going to announce more help for those with prescription-pill dependency issues”, says Prof Read. “Now, of course, that has been kicked down the road.”

Dr Davies added: “The coronavirus pandemic is bringing to light the systemic problems in the National Health Service.”

Both believe strongly that the answer to emotional struggles lies in non-medical solutions. Dr Davies said: “There is evidence that, in the short-term, certain drugs can be useful – if someone is in acute distress for example. However, many prescriptions are repeated. Also, it’s not just the severely ill who are being prescribed, but those with mild or moderate symptoms. The vast majority of people who go to their GP don’t want a pill. But there is little psychological provision on the NHS. All the money has gone into medical research.”

In 2019, 7.4 million prescriptions were written for antidepressants in the UK, compared with just one million referrals for psychological therapy. Because of the pandemic, dealing with emotional distress is a bigger problem than ever before.

Anxiety and fear are the understandable response to a collective crisis,” said Prof Read. “Distress is not a mental ‘illness’ and shouldn’t be treated as such. No medications can treat loneliness and isolation. And if you have lost someone, that is grief, and this cannot be fixed with a pill.”

Dr Davies added: ”What people are feeling right now is entirely understandable. We mustn’t pathologise our emotions. We are not ‘ill’ but responding in a human way to bad times”. He suggested that just recognising that what we are going through is “normal” might make us feel better.

Prof Read does not believe that the answers lie in “therapy”, as it’s traditionally meant – discussing and analysing a situation that is causing distress. He is an advocate of “social prescribing”: a more holistic approach which includes volunteering, group learning, gardening, befriending and a range of sports. “Of course, much of this has been impossible during the lockdown. And while social contact is still limited, it’s really worth taking advantage of online fitness classes, pub quizzes, and online chat rooms. Older people struggling with technology should ask for help if they can.”

The most important thing is to keep talking”, said Dr Davies. “To allow ourselves to be vulnerable, there is not something broken within us”.

Ultimately, said Dr Davies, the real picture on antidepressant prescription won’t really be known until later this month, and into June when GP surgeries open back up again. Diagnoses may also be made when, despite the end of lockdown, some people remain stressed or anxious. He added: “Doctors really need to start thinking in creative ways about how to manage distress caused by job losses and the threat of future pandemics.”

Prof Read concluded: “It’s become the cliché, but we really are all in this together, so we must take advantage of ways to take care of one another.”

 

 

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