Australia and depression

[paulv]

Why is the Lucky Country prescribing so many anti depressants?

And why have prescriptions of these drugs doubled in the last 10 years?

 

http://www.abc.net.au/news/2013-11-22/australia-second-in-world-in-anti-depressant-prescriptions/5110084

[jac2011]

 

 

I am currently writing a my dissertation around this subject and I find it very interesting...

 

Drug companies... profit???

[caramac]

All the reasons mentioned in the article and I'm sure what jac2011 says plays a part too, but I think there's some over/misdiagnosis too.

 

http://www.theguardian.com/society/2013/nov/20/antidepressant-use-rise-world-oecd

[stevie ellis]

easy fix for docs noo adays , IMO:eek:

[NicF]

My a OH started on anti-depressants in the UK. Rightly so I must add. He still takes them now because they work and keeping taking them is easier than doing the therapy and dealing with things. I suspect there are a few others in a similar position.

 

There are a number of ads in the TV from beyond blue over here highlighting depression and encouraging people to get help. I don't remember seeing anything quite like it in the UK (please correct me if I'm wrong). Maybe the ads contribute to people seeing doctors for mental health issues but then the drs don't know what to do other than prescribe the drugs.

[caramac]

My a OH started on anti-depressants in the UK. Rightly so I must add. He still takes them now because they work and keeping taking them is easier than doing the therapy and dealing with things. I suspect there are a few others in a similar position.

 

There are a number of ads in the TV from beyond blue over here highlighting depression and encouraging people to get help. I don't remember seeing anything quite like it in the UK (please correct me if I'm wrong). Maybe the ads contribute to people seeing doctors for mental health issues but then the drs don't know what to do other than prescribe the drugs.

 

 

Anti depressants definitely have their place, but they are over prescribed. Places like Beyond Blue generally aren't the problem, but GPs who either don't have time to do anything else, or don't know what else is available. They also prescribe inappropriately where the diagnosis shouldn't be one of depression at all.

[Guest]

I haven't read the article but as an ex-psychologist and someone who has personally been prescribed anti-depressants these are my thoughts....

 

There are a high number of migrants in Australia....

 

....moving house, let alone moving country is a major life event and major life events can lead to depression

....less family support means small problems are more difficult to deal with

....ditto established friendship circles

.....less social cohesion with a transient population

 

Plus factors that effect migrants and non-migrants alike

 

The 'no worries' mentality makes it harder to offload your problems to friends

 

The 'lucky country' mentality results in anyone down on their luck to feel let down 'cheated'

 

Most peoples basic needs are met so they have the 'luxury' of focussing on higher needs (true of all developed countries) - certain depression I believe is a true 'illness' in the sense that it has a physical cause but most I believe is a psychological state (and certain people may have a physical pre-disposition to that state) and your environment has a lot to do with it.

 

And definitely misdiagnosis and over-prescription, I went to the Dr. complaining of a raft of symptoms and various tests were done that came back negative, so 'stress' was concluded (& it's true to say I was stressed), I was never even diagnosed as 'depressed' but given anti-depressants. Eventually it got to the point where I could barely walk as I was in so much pain and they finally diagnosed me with RA, all the other symptoms were consistent with that! I do believe the stress was a contributory factor to the RA and RA causes depression too, so it's complex but anti-depressants were not the right treatment that's for sure.

[NicF]

Anti depressants definitely have their place, but they are over prescribed. Places like Beyond Blue generally aren't the problem, but GPs who either don't have time to do anything else, or don't know what else is available. They also prescribe inappropriately where the diagnosis shouldn't be one of depression at all.

 

Agreed. I think that's the point I was trying to make. Beyond Blue do a great job at raising awareness of mental illness and it encourages people to go to the Drs to get help, but then once people get to the GP the GP doesn't know enough and just prescribes the pills. Then, like my OH, you get stuck on them and don't bother trying anything else.

[flag of convenience]

This has been a rapid area of growth in the past couple of decades in Australia. Over medication has been around awhile and I was surprised how many drugs were given to children to control behaviour patterns a decade and a half back.

The rapid changes to Aussie life and a great deal more avenues of stress abound today than just a decade back even. A lot of folk are not managing and all predictions are that this is to worsen. It's been around for sometime now, that Depression is going to be the illness of the 21st century.

 

Not hard to see why. Now they're telling folk they'll be likely to be required to work until their 70 in order to get a pension. We mostly all know this is only sounding out the reaction but a continuation of lack of security in age, workplace pressure which looks only to increase in time, competition culture fostered on folk instead of co operation, the pressures of needing constantly more money to live, pressure to spend, the ongoing breakdown of meaningful human contact in many areas all lead to unhealthy mental health outcomes.

The system plays a big part on our detachment from what is important and the cause of many negative mental health outcomes.

[Melb3000]

I think society is starting to discover that anti depressants aren't all that great to be honest.

 

People I know who have been on them have reported a very uncomfortable feeling akin to a 'zombie' like state unable to feel a normal range of emotions.

 

They have their purpose when it comes to people who are suicidal or completely unable to function and carry out necessary day to day activities, but when it comes to most cases of depression they do nothing to tackle the underlying causes, i.e. the distorted thinking patterns, self defeating attitudes, excessive sensitivity to rejection from others etc. that lead to ultimate feelings of helplessness and hopelessness.

 

The most effective treatments, scientifically proven over more than half a century, are the 'talking' therapies, eg. Cognitive Behavioural therapy and Rational Emotive Behavioural therapy. Psychologists and Psychiatrists that are trained in these therapies are widespread in the community however I can imagine GPs not referring patients to these therapists.

 

It seems a trip to the GP rarely results in an outcome not invoving some sort of drug being prescribed.

[MARYROSE02]

Perhaps Australia is so much more advanced in its acceptance (and corresponding decrease in 'stigma) of mental illness as a 'real' illness, as 'real' as any other disease. As people come to realize that perhaps they really ARE ill, so they seek medical help, rather than copping the old bullshit about 'pulling yourself together' (which perhaps is still more in vogue in the UK?)

 

Doctors prescribe medication for every illness from A to Z, but because of the prejudice towards mental illness, many people are put off taking medication, though they will happily take it when prescribed for other conditions. I wonder how many people on PIO would be happy to admit to taking medication to control cholesterol, blood pressure, chronic pain, even premature ejaculation, but would die before admitting to taking Prozac?

 

I think I saw a post on here the other week in which someone was joking about having an OCD, and I was going to say something about it. I would take a bet that someone, somewhere, has made a similar joke about having a phobia. I probably joke about them myself sometimes; we all do, but that is part of the problem. If you suffer from OCD, or a phobia, perhaps both, and allied with depression/anxiety, and you hear people making fun of it, how likely are you to talk to someone about it?

 

I certainly wouldn't want to talk to some of the people who have already commented on this post about any mental problems. "Suffering from claustrophobia? I'll put you in this ****ing lift and lock you in. That will cure you!"

[MARYROSE02]

PS I forgot to admit I DO take an anti-depressant - 'Citalapram' - for anxiety, rather than depression, about time to take it too, thanks for reminding me!

[HappyHeart]

Interesting topic and I agree that drugs are handed out too freely by GPs without a thorough assessment and monitoring. My daughter was prescribed fluoxetine aged 16 and went on to misuse the drug further adding to her troubles. What she needs is ongoing psychological input not drugs. Drugs have their place and as a nurse dealing with people in the advanced stages of illness, often anti depressants can be helpful. The important distinction however is are you sad, low in mood as a consequence of your circumstances or clinically depressed? Theres a big difference and being 'appropriately sad' is overtreated imo. Its ok to be low, sad and down its part of the human condition...so much emphasis on being continually satisfied and happy when its not a realistic aim.

[MARYROSE02]

I guess that, perhaps, a feeling of sadness would go away after a short while, but depression, and other similar problems, linger. I had some therapy for a number of years, not just the medication.

 

I was prescribed fluoxetine I think, in the UK, a few years back, but I was in a terrible state then. My GP did not 'force' it upon me either. I went back to see him twice after the initial appointment, and he ran a few tests to make sure there was nothing else wrong.

 

The problem with many of these drugs are that they often take a long time before they 'kick in' and you also often have to take them for an even longer time. Of course, you have to be careful when you stop taking them too. Stopping abruptly (cold turkey?) is definitely not to be recommended.

[Cubic]

I've been working here as a GP for a month having moved from the UK. Society here seems much more medicalised here generally. Everyone seems to be on a tablet for something, whether that's fish oils, vitamins, statins, antidepressants, diet pills or "something from the naturopath". There is a greater expectation from the patient to come out of the consultation with a prescription than I ever felt in the UK. I'm sure the reasons for this are multifactorial.

 

It's actually much easier to refer for psychology here than in the UK. If I do a care plan with the patient I can refer them directly to a named psychologist of their or my choice and they will often be seen within a few weeks. This is available under medicare. In the UK I would refer a patient to the "single point of access psychological team" and a nurse or social worker would triage it to whatever service they felt appropriate, which was often not a psychologist but someone with brief training in counselling, and the patient would wait 6-12 months to be seen.

[Quoll]

As a (now ex) psychologist I blame the plethora of psychologists and the need to pathologise normal responses into something requiring medical intervention TBH. Part of it, too, is the media expectation of perfect lives (especially amongst the young who take soaps to be real lives and then get upset when their lives aren't as peachy). It starts young in Aus too with high levels of self harm and high youth suicide rates. Even among my Aus friends (as opposed to clients) the number on anti depressants/anxiety meds far and away exceeds those of my UK friends (and for some reason, they need to talk about their medications far more too!). Mental health plans in Aus are good but there are still psychs out there who are milking the gullible and keeping them coming back week after week for months on end (ethically I have huge difficulties with that!) and paying through the nose for the privilege.

 

Im not saying that mental health isn't a real issue, of course it is, but it worries me that Australian society is losing its resilience.

[Que Sera Sera]

I think anyone who has been depressed , genuinely in a place where death seems like a blessed release knows the difference from feeling depressed & really miserable. Anti depressants definitely have a place and so does cognitive therapy and many other treatments. There are many people dealing with depression on a day to day basis many self prescribe with their own forms of medication ( booze etc!) So the number globally could well be a lot higher.

[jac2011]

Melb that is exactly my line of thinking, Irving Kirsch in my article did a Randomised control trial covering all the research ever done on anti-depressants and it shows that whilst people think that they work they are no more effective than a placebo. The drug culture in the US is huge and the drug profits are behind the majority of the research that we use as professionals. Anything that does not agree with the effectiveness is shelved and never released to the public. However, the side effects are huge the effect these drugs have on people is immense and as you say does nothing to solve their problem. I have taken anti-depressants and at the time I believed they worked however, reading the evidence I am certainly doubting whether they worked for the reason I thought they did.

 

Stories such as children on Clozapine in the US is shocking, some of the most lethal drugs for adults being given to primary school children.

 

Children with ADHD being given drugs as soon as they are diagnosed rather than other alternatives.

 

http://edition.cnn.com/2011/HEALTH/05/23/kids.overmedicated/

 

Joanna Moncrieff does an excellent overview of it all in her book 'The Myth of the Chemical Cure' a leading Psychiatrist herself from University College London. The more you look at the information we have been fed the more shocked you become.

 

I am sure you all read about the dangers of 'Prozac' well a quick research of its history shows it was only ever used as an anti-depressant because it didn't work for the reason it was created. It was only ever tested on 5 mildly depressed subjects and then advertised to the world by Eli Lilly as a 'miracle' and made $10bn in revenue for the company. Many research studies even show the link between Prozac and increased risk of suicide. In 2004 it was found in the UK's drinking water due to its over subscription, so everyone was taking it (albeit in small amounts). When Prozac started receiving bad press and effectively lost its patent Eli Lilly repackaged it as 'Cymbalta' and it was prescribed unknowingly to the public as a completely new drug despite its known side effects.

 

Now do you really trust these drug companies who prey on the unbeknown public?

Edited November 23, 2013 by jac2011

[caramac]

"but there are still psychs out there who are milking the gullible"

 

 

 

That's exactly what my oh said years ago when he was being pressurised into taking the Aus exams. The training was geared to private practice which had the patient coming back far too regularly without ever making much progress with the illness. He said his conscience wouldn't let him work that way.

 

There are good and bad services everywhere - the best ones are the ones set up as multi disciplinary teams where GPs can refer their patient for assessment, then the right care package can be arranged. That may be psychology, social service input, nursing or psychiatrist, or a combination of several services.

Anti depressants should be used with caution. People tend not to go to their GP when they're feeling happy or full of energy, but when they're feeling down. The GP makes a diagnosis of depression and prescribes antidepressants when the person may have a bipolar disorder instead. In these cases the antidepressants can cause mania or rapid cycling which can result in the patient having to be hospitalised under the mental health act, as happened to a friend of ours last year. It also increases suicidality. They're not drugs which should just be handed out as a quick fix.

[MARYROSE02]

So, if I understand correctly, if you are depressed, living in Australia, and have a British passport, go back to the UK ASAP and your problems will disappear?

[MARYROSE02]

Melb that is exactly my line of thinking, Irving Kirsch in my article did a Randomised control trial covering all the research ever done on anti-depressants and it shows that whilst people think that they work they are no more effective than a placebo. The drug culture in the US is huge and the drug profits are behind the majority of the research that we use as professionals. Anything that does not agree with the effectiveness is shelved and never released to the public. However, the side effects are huge the effect these drugs have on people is immense and as you say does nothing to solve their problem. I have taken anti-depressants and at the time I believed they worked however, reading the evidence I am certainly doubting whether they worked for the reason I thought they did.

 

Stories such as children on Clozapine in the US is shocking, some of the most lethal drugs for adults being given to primary school children.

 

Children with ADHD being given drugs as soon as they are diagnosed rather than other alternatives.

 

http://edition.cnn.com/2011/HEALTH/05/23/kids.overmedicated/

 

Joanna Moncrieff does an excellent overview of it all in her book 'The Myth of the Chemical Cure' a leading Psychiatrist herself from University College London. The more you look at the information we have been fed the more shocked you become.

 

I am sure you all read about the dangers of 'Prozac' well a quick research of its history shows it was only ever used as an anti-depressant because it didn't work for the reason it was created. It was only ever tested on 5 mildly depressed subjects and then advertised to the world by Eli Lilly as a 'miracle' and made $10bn in revenue for the company. Many research studies even show the link between Prozac and increased risk of suicide. In 2004 it was found in the UK's drinking water due to its over subscription, so everyone was taking it (albeit in small amounts). When Prozac started receiving bad press and effectively lost its patent Eli Lilly repackaged it as 'Cymbalta' and it was prescribed unknowingly to the public as a completely new drug despite its known side effects.

 

Now do you really trust these drug companies who prey on the unbeknown public?

 

My God, you will be going on about the Illuminati next.

[jac2011]

Well I do have to write 6000 words on the subject so I have been doing a lot of background reading... Just opening peoples eyes to information!

[MARYROSE02]

As a (now ex) psychologist I blame the plethora of psychologists and the need to pathologise normal responses into something requiring medical intervention TBH. Part of it, too, is the media expectation of perfect lives (especially amongst the young who take soaps to be real lives and then get upset when their lives aren't as peachy). It starts young in Aus too with high levels of self harm and high youth suicide rates. Even among my Aus friends (as opposed to clients) the number on anti depressants/anxiety meds far and away exceeds those of my UK friends (and for some reason, they need to talk about their medications far more too!). Mental health plans in Aus are good but there are still psychs out there who are milking the gullible and keeping them coming back week after week for months on end (ethically I have huge difficulties with that!) and paying through the nose for the privilege.

 

Im not saying that mental health isn't a real issue, of course it is, but it worries me that Australian society is losing its resilience.

 

Are Australians really losiing their resilience compared to similar societies? Maybe more people are diagnosed in Australia because Australia takes mental health more seriously? Maybe there is less stigma in Australia, so people are far less embarrassed to talk about taking anti-depressants? Maybe there are far more hidden cases in the UK?

 

Speaking personally, I have exactly the same problems, whether I live in the UK or Australia. It was a UK doctor who first prescribed my anti-depressants, and my Aussie doctors have continued to prescribe them. Should I stop taking them. I have asked my GP from time to time but he has recommended I keep taking them. Should I trust in his forty years of experience, or assume that he is corruptly in league with 'the evil drug companies? Then again, are anti-depressants any worse than than alcohol, tobacco, caffeine, and all the illegal drugs, with which so many people self-medicate themselves?

[MARYROSE02]

Here we are, with my very first 'Google' searching for 'depression in Western societies' - pretty well what I would have expected to find. Wherever you live in the West, life is much the same.

 

[h=1]Anxiety More Common in the Western World, Depression in East[/h]By Traci PedersenAssociate News Editor

Reviewed by John M. Grohol, Psy.D. on July 26, 2012

Depression and anxiety affects every country and society in the world, according to what is believed to be the world’s most comprehensive study of these mental disorders, conducted by researchers from the University of Queensland, Australia.

The researchers carried out two separate studies that focused on anxiety disorders and major depressive disorder (also called clinical depression). Researchers analyzed surveys of clinical anxiety and depression that had been conducted across 91 countries, involving more than 480,000 people.

In Western societies, anxiety disorders were more commonly reported than in non-Western societies, including countries that are currently experiencing conflict.

About 10 percent of people in North America, Western Europe, Australia and New Zealand were experiencing clinical anxiety compared to approximately eight percent in the Middle East and six percent in Asia.

The opposite was true for depression, with those in Western countries least likely to feel depressed. Researchers found that depression was the lowest in North America and highest in certain areas of Asia and the Middle East.

Approximately nine percent of people experience major depression in Asian and Middle Eastern countries, such as India and Afghanistan, compared with about four percent in North and South America, Australia, New Zealand and East Asian countries including China, Thailand and Indonesia.

Study co-author Alize Ferrari said that the findings suggest that depression may be more common in parts of the world where conflict is occurring. However, she emphasizes that it can be a difficult task to get hold of good quality data from low and middle income countries.

Amanda Baxter, who led the study, also added that researchers should use caution when comparing mental disorders across different societies and countries.

“Measuring mental disorders across different cultures is challenging because many factors can influence the reported prevalence of anxiety disorders,” said Baxter.

Source: The University of Queensland

[MARYROSE02]

People who are genetically inclined towards depression are more likely to become depressed in western societies and they are better off in East Asian cultures where there is greater tolerance and support for the condition.

 

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Scientists from Northwestern University in Evanston, Illinois found in a cross-cultural study of mental health that depression -- which they say is both genetically and environmentally determined -- is more likely to manifest itself in more individualist western societies but that the more collectivist, eastern cultures provide more understanding and social support.

"Such support seems to buffer vulnerable individuals from the environmental risks or stressors that serve as triggers to depressive episodes," said Joan Chiao, lead author of the study, in a statement. "Western cultures are more likely to value uniqueness over harmony, expression over agreement and to define themselves as unique or different from the group."

Researchers studied the genetic data (the variants of the serotonin transporter gene associatedwith depression) of populations from 29 countries and found more prevalence of depression in western populations even though in East Asia, nearly 80 percent of the population has been found to be genetically susceptible to depression.

Actual depression in East Asian countries like China and Korea, as well as in Singapore, was significantly lower than in individualistic nations, such as the United States and Western Europe, the study said.

The findings could have implications on understanding the causes of depression as well as developing culture-based treatments.

"We need to move away from quick and dirty methods of treatment for depression, especially for those genetically susceptible to developing mental illnesses, " Chiao said.

The study was published online Oct. 28 in the journal Proceedings of the Royal Society B: Biological Sciences.