Hooked On Happy Pills

I’m afraid this is a classic example of modern medicine treating the symptoms and not the causes! There’s been a couple of articles in the Daily Mail this week about anti-depressants and both shake this cornerstone of current British medical treatment in the UK. At last, given that the articles are based around a scientific research study, there may be a crack in the rather complacent way that the medical profession deal with depression.

The rise in anti-depressants being prescribed is frightening: from 9 million to 34 million over the last 15 years. What’s worse is that according to the article “scientists have long been stumped as to why they fail to help half of the people who take them”. In fact, I was under the impression that it is accepted in medical circles that only 30% of people get real benefit from anti-depressants. A research programme published in The Journal of The American Medical Association last week, came to the conclusion that medication has “negligible” impact except in cases of very severe depression.

When you consider the side effects below, it is staggering that these pills can be handed out so willy nilly”!

Firstly, whilst not strictly addictive, people find them very difficult to get off. Many of my clients have been on them for 5+ years, some even over 10. The NICE (National Institute of Clinical Excellence) guidelines are that patients should be on them for a maximum of 9 months on the first occasion and a maximum of 2 years for those experiencing further depression. The research by University of Southampton referred to in one of the articles, estimates that 2 million people are taking them for more than 5 years, the largest group being women between 18 and 45. In fact, it is now commonplace for people to think they will be on them for the rest of their lives, just like medication for epilepsy or diabetes.

…which brings us to the second issue about side effects: the commonly known short –term side effects, which doctors do by and large make their patients aware of include drowsiness, dizziness and weight gain. Interestingly, I find that virtually none of my clients are aware that a common side effect is the increased likelihood of suicide. The first time I read that when I was looking up a client’s drug in a formulary book, I did a double take: “you mean they’re giving pills that increase the likelihood of suicide to some people who are already contemplating that course of action anyway!!!!!” Well the answer’s yes!

And yet in terms of longer-term side effects, research is now finding that anti-depressants can cause internal bleeding, strokes and birth defects, which has brought some disturbing parallels with “the mother’s little helper” scandal of the 70’s and 80’.

Let’s stand back a minute. Depression is an emotional problem, playing around with the body/mind’s chemistry for the long-term is bound to have some major side effects. Why does medicine have to be all about medication? I was amazed to find out that the most important A level for a prospective medical student is Chemistry…well that says it all! Surely biology is more important?!

To be fair, the NICE guidelines state that “the optimum treatment for depression is a combination of medication and talking therapies. I would argue that only talking therapies are going to help the patient overcome whatever it is that is depressing them. Medication should only be a short-term measure helping the sufferer with “mood”, while they solve the problem psychologically.

Again to be fair, doctors have an average of 7 minutes with a patient, which is completely insufficient for mental health issues, so of course the doctors end up handing over a prescription…what else can they do in 7 minutes? However, we should have realised that the system is selling people short years ago: 70% of doctors’ visits are for mental health issues. It is my humble opinion that science, the medical profession and the politicians (clearly the NHS has to change dramatically…it was set up to handle emergencies and diseases) have been too complacent about the issue of anti-depressants for too long.

Maybe, just maybe, they’ll start having a look at existing practices and wonder if a radical overhaul isn’t required. The real solutions for permanent escape from issues like depression, stress, anxiety, Eating Disorders and Self Harm are Hypnotherapy and NLP…but the medical profession is a million miles from accepting that at the moment. But this is a huge issue and changes aren’t going to come overnight. What is more, this is one change amongst a whole plethora of changes that need to take place if Western Civilisation is to become liveable again. But that’s for another day!

Teenage Alcohol - Under Lock & Key?

So the politicians are waking up to the problem of teenage alcohol abuse. But as usual their solution is to interfere and sensationalise!

Chief Medical Officer Sir Liam Donaldson has been in the news saying how parents must stick to the law and not allow their children to drink alcohol at home before they are 15, or preferably 18. In theory of course, he’s right: it’s the law!

However, he’s not showing any understanding of the status of alcohol in this group or the social ramifications of clamping down and demonising the evil liquor any more than it is already. I wonder if he’s got or had teenagers himself?

Alcohol is the new cigarette at school today: it’s cool…it’s grown-up…it’s the 2 fingers (or perhaps 1 finger these days!) to authority. It already has a rebellious and aspirational status. The attitude today is that young people go out at night with the specific objective of getting “slammed”! This has changed since their parents’ day…where we went to meet our mates and may well have got drunk on the way. We didn’t step out of our front door saying ”I’m going to get absolutely pi**ed tonight”

Getting parents to abide by the letter of the law, not allowing their kids to drink at home until that magic date of their 18^th birthday has 2 problems:

• Firstly, it’s shutting the gate after the horse has bolted: they’re doing it with their mates anyway
• Secondly, it’s making elusive, forbidden alcohol even cooler.

The French don’t have this problem; for them a glass of wine is a normal part of life! They start drinking a glass of watered down wine at an early age at a special family gathering…it’s normal!

We need to take the same approach. It’s not something to be heavy-handedly controlled, but gently introduced as part of growing up. In fact, this isn’t just about alcohol abuse, we need to give our teenagers more respect and (within reason) treat them as adults.

We’ve never made a big thing out of alcohol in our house and my girls have seen their Mum and Dad occasionally worse for wear! But they can genuinely happily go out and not have a drink, if they’re driving …and still enjoy themselves. Yes, my oldest is at Uni and does have a bit much occasionally but I remember doing the same myself at that age. It just wasn’t a big deal!

The Holly & The Anxiety!

I was interviewed on BBC Radio Essex on 23rd December 2009 to give some gems of advice on how to avoid stress over the festive period.

It’s all supposed to be idyllic isn’t it, Christmas? In reality…well not quite so!

There are 5 basic reasons why Christmas is actually a very stressful time:

Problem: The first problem is our expectations: we’re supposed to have this warm cosy glow surrounded by our family. Well this is what it looks like in the glittering TV ads and so we assume that that’s what everybody else is experiencing. The trouble is we’re so geographically mobile in the UK, most of us don’t see our family from one month to the next and so to expect us all to get on like a house on fire is asking an awful lot. Little Freddie will knock of the Christmas tree and Grandpa will be grumpy! But then everybody else will be the same.

Solution: Adjust your expectations and expect things to be difficult; this way you can make plans for when the arguments do come!

Problem: The second problem is that because we don’t see each other often, we don’t communicate very well or take into account others feelings or viewpoints.

Solution: The first thing to do is find out what everybody is expecting. The best way is for everybody to do the following quick exercise: take a blank piece of paper and draw a line vertically down the middle. Then on the left hand heading write “Things I love about Xmas” and on the right hand side “Things I hate about Xmas”. Then compare notes and let everybody see everybody else’s preferences. It’s essential everybody’s honest. You’d be surprised what a difference this little bit of knowledge makes to our behaviour.

Also Mum should ask for help and be prepared to delegate: we don’t mind peeling the veggies if everyone’s in the kitchen talking anyway.

Problem: The third reason for stress is that we assume that because Xmas is about relaxing with the family that we shouldn’t need to take care of ourselves. Actually with all of the eating and drinking we need to take care of ourselves even more than usual.

Solution: A good brisk walk after a big Xmas lunch is invaluable, as is plenty of me time…reading a book for example. Getting enough sleep and drinking plenty of water is equally crucial.

Problem: The fourth reason Xmas is often more stressful than we’re expecting is that with the busy lifestyles we all lead, we don’t get enough time to plan, so we end up doing the shopping at the last minute…along with the rest of our local populace! We also fail to set a budget and end up getting depressed over the January credit card bills.

Solution: Plan, plan, plan! Budget, Budget, Budget! And there’ll be no nasty surprises. Do the pressie shopping by mid-December at the latest and agree budgets with everybody, so that we don’t end up trying to outdo each other! Do the food shopping a week before Xmas; if you really need to, then leave the fresh stuff, so you can nip in and out with a basket, while everybody else is doing “trolley wars”!

Also if you have young kids, try and stick to their routine or schedule; if your kids are happy, then you’re happy too!

Problem: Lastly Christmas can be a very lonely time if you’re on your own, especially if you’ve just lost a loved one.

Solution: Firstly make sure you stay busy…plan things to do. Go to any of the local community events: for example, the local carol service. You won’t be the only one on your own. Also you can still keep in touch with people by phone or even e-mail; the key is not to shut yourself off. Also know that the media hype Xmas terribly; everybody else isn’t having the most amazing family time, so you don’t need to feel envious or left out. Lastly, even if you’re on your own, it’s still worth making an effort with the Xmas lunch.

Christmas can mean a well-earned rest, but being realistic and planning is essential and make the difference between the family threatening not to speak to each other ever again and actually enjoying each other’s company.