Let’s talk about depression.
Last week, The Lancet published research into the effectiveness of antidepressants. The study was vast, taking in 21 drugs prescribed to nearly 120,000 patients in more than 500 trials across almost four decades.
And the results? Every single medication was more effective than a placebo in treating adults with major depressive disorder, though some prescriptions were more beneficial than others.
Dr Andrea Cipriani, who headed the study, concluded: ‘Antidepressants are an effective tool for depression. Untreated depression is a huge problem because of the burden to society.’
The findings are not without controversy. Some see antidepressants as a modern snake oil; while others claim they are a money-making scheme for Big Pharma. Even clinical opinion has been divided, with some doctors wanting more evidence of their value.
This study is the evidence. The drugs do work. I know because I wouldn’t be here without them. This column is brought to you in association with Venlafaxine 75mg, twice daily. Always read the label.
I have never been one for doctors. Best to get on with things and not to dwell on problems. But when you’re served a cocktail of clinical depression and anxiety disorder by the bartender of life, you learn to get over that working-class male pride. I have come to embrace John Lennon’s philosophy: ‘Whatever gets you through the night/ It’s all right, it’s all right.’ I have my nights and antidepressants more or less get me through them.
Depression is my dark companion, Gil-Martin to my Robert. It lurks in the shadows for the most part; but every now and then, without warning, it comes out to play.
I can be perched in the press gallery at Holyrood, peering over my helpless prey below, waiting to pounce on some slip or tic or foible. God, Adam Tomkins looks bored out of his box. Imagine having a brain the size of Pluto and having to sit through Mike Russell speeches for weeks on end. Which is, after all, how long the average Mike Russell speech lasts… Wait, is Michael Matheson picking his nose? He has to be good at picking something, I suppose. It’s certainly not chief constables… I wonder where Humza gets his suits. And if he asks Barry Manilow’s permission before borrowing them…
All of a sudden, my companion is back. It feels like the air has been sucked out of the room and everything has somehow flattened. Everyone experiences depression differently; for me it comes, not as an excess of melancholy, but a hollowing out. I become numb, withdrawn, desolate. At the lowest points, life seems pointless and bleak thoughts beckon. There are bridges of steel and bridges of the mind.
Antidepressants don’t work for everyone and shouldn’t be seen as a cure-all. For me, they help, albeit haphazardly. At least they do for now. My medical history reads like lyrics from the Billy Joel song ‘We Didn’t Start the Fire’: Fluoxetine, Citalopram, Mirtazapine, Diazepam. South Pacific, Walter Winchell, Joe DiMaggio. Blue pills, pink pills, orange pills – my bedside cabinet looks like an explosion in a Skittles factory.
The years go by and the milligram count goes up. Depression is chasing me and I pelt it with capsules and tablets and manage to slip away but I dread the day the pills no longer repel it. The day I run out of road.
I was aware from an early age that something was wrong. Of course, it’s difficult to tell these things because you have no point of reference. But my peers at school appeared outwardly more content and the people on TV didn’t seem as maudlin. Not even on EastEnders.
Knowing didn’t make it easy to do something about it. Growing up in Coatbridge, feelings were soft and weak and, well, gay. It took years to work up the pluck to go to a GP. I knocked on the door with trepidation, struggled to get the words out and asked for help. He told me to get some mates and go for a curry. It was a long time before I found the courage to seek a second opinion.
Things are slowly getting better but we are still really bad at this. The Scottish Government says 90 per cent of children and young people reporting mental health problems should be seen within 18 weeks. Last year, we managed 73 per cent – a decrease on the year before. NHS Lothian scraped a dismal 57 per cent, Grampian a scandalous 33 per cent.
The situation is scarcely better for adults. Three-quarters begin treatment within four months but only two health boards are meeting the target.
We need to be more open about mental health, even if that’s hard because we’re Scottish and would sooner run down the Royal Mile starkers than talk about our feelings. One in every four of us experiences mental ill-health annually. Almost 900,000 Scots are prescribed antidepressants, including nearly 6,000 under the age of 18.
I know politicians, journalists and public figures who live with depression but do not speak about it for fear of the stigma that still attaches. Yet, while it’s not quite right to call depression a disease, it is a health condition like any other. It’s caused by a stressful event, a bout of physical illness or an early trauma. For others, it’s a matter of genetics or nerve circuits not communicating the way they’re supposed to.
As Professor John Geddes, co-author of the study and head of psychiatry at Oxford University, says: ‘This isn’t just a bit of common unhappiness, this is a major mental health problem that really is devastating for an awful lot of human lives. Poor access to available treatment would not be tolerated if it related to high blood pressure or cancer.’
Sometimes drugs can manage it. Sometimes therapy works better. We still have much to learn about how to treat it and even more about how to prevent it. We’ll do neither unless we stop running away and confront it.
Let’s talk about depression.
We head Down Under, where our Antipodean cousins are in the middle of a very Aussie political scandal.
Deputy Prime Minister Barnaby Joyce is the archetypal bushie larrikin, with Akubra hat and Queensland drawl. (Imagine Crocodile Dundee went into politics instead of wrangling muggers in New York).
The past few months have been somewhat eventful for him. He found out he was actually a New Zealander, was removed from office by the High Court, cost the government its majority, surrendered his Kiwi citizenship, won his seat back, was reappointed Deputy PM, got exposed as a love rat, fathered a child with an aide 17 years his junior, and was forced to stand down all over again today. Strewth!
Until now, his career highlight was a spat with Johnny Depp over Australian quarantine laws. He threatened to have the star’s dogs put down; Depp said his ruddy-jowled adversary had been ‘inbred with a tomato’.
This Brexit business seems pretty tame by comparison.
My hearty congratulations to Scotland on its 25-13 victory over England in the Six Nations rugby over the weekend. Or, as Nationalist MP Angus MacNeil put it in a typically graceless tweet, ‘Scotland 25… Them 13’. Some people have passwords on their mobile phones; others thumbprint recognition. Mr MacNeil’s should come with an IQ test.
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Originally published in the Scottish Daily Mail. Contact Stephen at firstname.lastname@example.org.