So a warning – this blog is going to be controversial! Although saying that I am actually on the same “song-sheet” that many other psychologists are “singing” from. In fact I would not be so bold as to say the drugs don’t work – this is a line from a song by The Verve, but I would say only some drugs work for some people with regards to mental health problems. When you have a headache you take a paracetamol and usually it works, but with something more complex like joint pain taking ibuprofen etc is not enough – you have to visit your physio and do the exercises – in other words in order to improve or get better you have to work at it; it is rather an immature viewpoint to think that drugs work like a magic wand and it is the same for mental health as it is for physical health.However I would be so bold to say that maybe it should only be psychiatrists who prescribe drugs for mental health problems and not GPs and that unless people are suicidal they should be required to attend at least 6 weeks therapy (usually CBT) before being put on drugs.If there is too long a waiting list for therapists then the NHS should employ more (including health psychologists!) Or people should be more prepared to pay privately – like they do for their hairdresser or their osteopath.
Unfortunately society seems to be fascinated by “brain porn” at the moment – in other words they think that the MRI scans etc. tell the whole story – you are mentally unwell if you have a “faulty gene” and therefore you just have to find the right drug to correct that gene. There are three things wrong with this attitude: (a) the brain is plastic and is affected not just by your genetic makeup, but by other things e.g. exercise and social context (and by exercise I mean the sort where you get out of breath – not a stroll to the car from the office!) Also (b) if we take depression as an example it will never be down to just one gene, as it is not a discrete condition but rather on a continuum; and finding faulty genes is not going to always help deal with the problem, as for example they have found the gene that causes Huntington’s disease, but are still no nearer to finding a cure for it. And (c) there are so many other things which could cause or exacerbate depression, such as lack of social support, loneliness, unemployment, alcoholism, an unhappy childhood, traumatic life events, poor cognitive coping styles (usually learnt from parents) etc. – the list goes on. Also we are too quick to put people into categories. I wish I had a pound for every time I have heard that one in four people have a mental health problem – well if you look at the personality variables at least 75% of us will score more than 2/10 on the neuroticism scale, so there are lots of people out there who could potentially struggle with anxieties etc.Whereas some people with depression might like to think they are out of the ordinary and nobody else could possibly understand them, there are a lot of people with depression who would just prefer to be normal, so labelling them with a “faulty gene” does not help them at all. It makes them think they are stuck with it for life, when in fact most people can recover.
So I am not saying I am anti pharmaceuticals – without them I would probably have died of an asthma attack and had a lot more babies! I am just saying that there should be a great deal more care taken with who gives out drugs for mental health problems and when; after all many antidepressants have nasty side effects such as weight gain, sleep problems, anxiety attacks and addiction.Whereas therapy has no side effects at all!