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Friday, 9 August 2013

Article in The Guardian as popular as Crocodile Dundee's snake in a lucky dip ?

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10 August

To my mind, such of the mental-health community as has been lashing out at Giles Fraser's article Taking pills for unhappiness reinforces the idea that being sad is not human has missed the point :

Typical comment on Twitter says that Fraser does not know what depression is, whereas I believe that those readers have not troubled themselves to understand what he is saying, and, therefore, he is just as misconstrued as those who experience / have experienced depression often are.

Far be it from me to defend Thatcher, whose beliefs and policies I despise, but I no more believe that her There is no such thing as society speech was given a fair press* than this article :

1. Fraser's first two paragraphs, i.e. setting the context for the rest of what he talks of, are about his behaviour at school, how children who behave like that now may be diagnosed with ADHD, and may even be prescribed ritalin.

2. Anyone who has watched the documentary Bombay Beach (2011) will have seen Benny prescribed with anti-psychotics, which I find even more horrifying.

3. The third paragraph I come back to, though the effective point is that, just as diagnoses of ADHD and prescriptions have risen sharply (there are nearly four times as many in just eleven years), so have prescriptions for anti-depressants.

I do not read what Fraser says here as saying that his experience amounts to depression, but the opposite, i.e. that it does not.

4. The fourth paragraph talks about how chlorpromazine (thorazine in the States) and other medications came to be used for the purpose of altering mood in psychiatry, and were originally used for treating infections.

I see nothing much wrong in inferring that, if a medication can be licensed, manufactured and prescribed for some other purpose, then the pharmaceutical industries have a motive for promoting them.

5. Fraser does not report them, but some recent studies have been quoted where it has been shown that the effect of anti-depressants is no better than a placebo. If true, that not only casts doubt on why the NHS spends money on them (or we take them), but also strengthens what Fraser is actually saying.

6. In his final two paragraphs, he brings together the industries' desire to make and market products with that of GPs to do something for patients (either because the patients are distressed and ask, or because, in any practice, there will be GPs who are 'more interested in' the physical side of health, and who maybe do not know better than prescribing when others would not).

7. Fraser has been demonized as if he does not know what depression is, whereas I follow him as saying that maybe things that are not depression are treated as if they are.

No one who knows how little training GPs (primary health, as it is called) are required to have in mental health would :

(a) Go to his or her surgery without establishing which doctors lean towards it, or

(b) Believe that the fact a doctor has prescribed means that it was appropriate, or that a referral to secondary mental health services, pressed as they are, would even be accepted.

To suggest that Fraser's article is really of a Pull yourself together kind is, I think, a hasty and ill-judged reading, stemming from anger and disappointment at believing depression to have been written off.

However, he would have done well to make clear that he is not disputing that depression exists, only that treating people as if they have clinical depression (i.e. without their having symptoms such as anxiety, waking too early or sleeping too much, not feeling much - or anything - emotionally, etc.) is not really doing them a favour.


* Since I gather that she meant just the opposite of what people claimed - still, it all helped remove her.

Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)

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