How we do (and don’t but should) treat depression
Isabel Hardman

Firstly thank you for the incredibly honest and well-written account of depression; and actually talking about it as being “unwell”, “sick” and other medical terms. That might sound silly, but it’s only when you frame it like that people really begin to appreciate that it is a serious illness. It also helped me work through the suicide of a brilliant friend; he didn’t leave us behind or let us down, he wasn’t being selfish. He was very, very poorly. Sadly the experience took me out of the Mental Health Promotion scene for a long time, as he and I had worked on a lot of projects together. I can also entirely relate to blowing my bank balance on different things like gym memberships, and all sorts of gadgets to get me motivated for exercise and getting out doing things… With maybe 10–20% of those purchases ending up being used regularly…

I suggest you have a read of a book called “The Emporer’s New Drugs” by Irving Kirsh. I attended a brilliant lecture by him at Lincoln University years ago, where he explains why anti-depressants potentially have no effect beyond placebo, and that any “positive” effect is less than even the error rate usually given in medicine studies.

I’m not about to be some kind of no-meds evangelists- I happen to be on the heavyweights Venlafaxine and Quetiapine, and have been for about a decade. I also believe they are by far best used as a temporary stop-gap before and during some other intervention (at least SSRI’s and the like); indeed, if I remember correctly, a lot of studies don’t factor in additional things people may be doing (or not doing) like exercise and the like.

However, I do find it alarming how fast such tablets are dished out to people, sometimes with no additional therapy or even support. I also find it alarming how little psychiastrists and pharmacists really know what effect tablets have on the brain. Notice phrasing even in some medicine information inserts such as “it is believed serotonin has an effect on mood” (paraphrased). After seeing his lecture, I came to realise meds are an incredibly blunt tool, without a complete understanding of how and why they work. As well as the long-term effects, especially in the newer SSRIs.

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