The Continuing Rise of Anti-Depressant Prescriptions:

The BBC reported recently about the increase in the number of anti-depressant prescriptions dispensed in England in 2018. In fact, the number of prescriptions for anti-depressants in England has nearly doubled in the last decade (2008-18).

NHS Digital figures showed that the number of prescriptions for these medicines, which are a common medicinal treatment for anxiety and depression issues, had jumped from 67.5 million in 2017 to 70.9 million in 2018.

Based upon these figures, it seems the continuing rise in prescribing anti-depressants is likely to continue to grow and grow.

Putting aside the cost upon the NHS, should we be worried by this continuing upward trend in prescriptions?

Anti-Depressants For Anxiety and Depression

Before we start looking at the figures I think we need to add some wider social and cultural aspects to any discussion around anti-depressants, anxiety and depression.

There has probably never been greater mental health awareness amongst society as a whole here in the UK. Pop stars, film stars and other celebrities are now more likely than ever to open up about their struggles publicly and there have sadly been some who took the step to end their struggles. Mental health appears on social media, in the news, on TV and in the workplace and classroom.

In the context of this greater awareness of anxiety and depression, certainly a proportion of the rise in anti-depressant prescriptions may be attributable to more people seeking help for mental health. In a way, some of these prescriptions can be a positive sign in so far as more people seeking help is concerned.

It always saddens me when I read comments about people accusing doctors of handing out pills like they don't care about their patients. Sure, we all know that other therapeutic approaches, such as CBT, aren't always funded as we would like them to be and there can be long delays in accessing help in some areas of the country. In these situations, what's the doctor to do? Send someone struggling with their mental health away to carry on with their anxiety and depression with no help or support at all? 

In my experience, doctors tend to have their patient's best interests in mind in any prescription decisions they make (even despite the huge pressures many are under). I struggle to think that there are hundreds of GPs out there handing our prescriptions willy-nilly without considering what is in the best interests of the person in front of them. Sometimes anti-depressants are the best option for that person then and there. Let's not forget we are talking about real people and real lives here because it's too easy to forget that and just focus on the numbers.

anti depressants depression anxiety hypnotherapy

I'd love it if we lived in a country where someone could go to their doctor about a mental health issue and then walk out and immediately see a mental health specialist. Yet with increasing demand and limited supply we aren't anywhere near that.

Sadly the people who seem to be most against anti-depressants are some elements of the hypnotherapy and therapeutic community. Since the NHS Digital figures were published, I've seen many, many comments on my social media feeds about how 'drugs don't work' and how it's all down to evil pharma companies with millions of pounds at their disposal forcing drugs on hapless doctors and how hypnotherapy/CBT/mindfulness (or whichever form of therapy they do) is so much better than any of that rubbish.

This is different to an individual deciding that anti-depressants or medication are not the approach they want to pursue to deal with their anxiety or depression. I work with many clients like that, and I also work with many who are taking anti-depressants and want to address their thinking patterns and other thoughts, feelings and behaviours that will help them to recover, come off the medication when they are ready (and in agreement with their GP) and have the coping skills they need for the future (so they don't need me or anti-depressants).

There is an underlying thread of them (doctors and medicine) versus us (therapists) in some quarters of the hypnotherapy profession. I don't agree and I don't even think it's helpful. For some people, therapy alone can help them to overcome anxiety and depression issues. For others, anti-depressants help them to be in a mental space where they can benefit from their hypnotherapy. There is no one size fits all individuals here.

Even worse, it suggests that most of these 'anti-medicine' practitioners are putting their own beliefs and values above the person they are helping. That can't be right can it? I mean, how is a client of theirs supposed to feel if they are already using anti-depressants: a bit of a failure? And what of the dilemma for those who have also seen their GP and have been advised to start taking them?

It also implies they are oblivious to the ever growing volumes of research that show the benefits of hypnotherapy for many issues (including depression and anxiety) that actually place hypnotherapy slap bang in the mainstream of evidence based treatment. 

Which is where hypnotherapy should be. Not on the periphery of mental health treatment because of false battle lines imagined up by some therapists to try and encourage people to ditch doctors and work with them. Hypnotherapy has a pretty impressive (and growing) evidence base that we should all be using to place us at the heart of anxiety and depression treatment, alongside doctors. 

Yes, we need more mental health funding. Yes, we need more mental health awareness. And yes, we need to teach people of all ages how to manage their thoughts, feelings, decisions and challenges to support their ongoing better mental health throughout life. And yes, hypnotherapy can and does help with anxiety and depression.

However, perhaps the last thing I have to say on this subject is about whether anti-depressants do in fact work (that is, that they have a demonstrable effect greater than placebo or expectation). And we know the answer to this because it's been researched and I've written about the results in a 2018 blog (you can read the full article here: Depression, Anti-Depressants & Mental Health - Do The Tablets Actually Work?). If you don't want to read that then the answer is that research shows that anti-depressants do have an effect (and some are more effective at reducing depression symptoms than others).

Anti-depressants can have side-effects, can be difficult to come off and are not beneficial or suitable for everyone. However, for some they are the thing that helps them to feel better and function in their life and for others they help them to get into a place where they can make the changes and receive the therapeutic help they need to reduce depression and anxiety symptoms. And hypnotherapy can certainly form part of achieving positive therapeutic outcomes.

Above all I think we need to remember amongst the prescription numbers that every one of those prescriptions for anti-depressants was made to an individual, an individual facing mental health issues who took the brave step to go and seek help and talk to their GP. For many that is a huge step. Each of these people will have their own beliefs, values, decisions, ways of life, people, challenges and circumstances that don't get reflected in the numbers. The main thing though has always got to be that if you are struggling with your mental health then please, please talk to someone or go and see someone who can help you and support you.  

To your success,

Dan Regan

Hypnotherapy in Ely & Newmarket

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