UK mental health funding needs to change

Antidepressant prescription is at an all time high in the UK but funding for the support that should be provided alongside this form of treatment is far from suitable. Many people are being given antidepressants when it is not entirely necessary and alternatives such as therapy or self help guides could potentially be more effective.

Antidote 2 Antidepressant spoke to writer for Samedan LTD pharmaceutical publishers, Louis Goss, about the problems with over prescription. ‘It seems that antidepressants are effective in some cases, particularly in combination with other forms of therapy. Recent studies seem to suggest that antidepressants are more effective than placebo. However in many cases antidepressants are only somewhat effective. It seems that antidepressants may be more effective in more severe cases of depression.’ Goss said in reference to a 2018 study.

With the knowledge that the extent of depression may determine the suitability of antidepressants, there is indication that treatment needs to be more personalised in order to tackle the problem rather than causing others. The severity of withdrawal and side effects is becoming a huge talking point but with current funding and research it feels like there is no easy way around it.

‘The area of mental health has suffered from significant under funding since the so-called golden era of SSRIs. There has been little investment in new drugs for mental health treatments and the area is seen as somewhat of a ‘black hole’.’ said Goss. Despite depression affecting 1 in 10 people in the UK in their lifetime, it seems like we are miles behind where we should be when treating and even preventing the mental health condition. When people already feel burdensome asking for support when suffering with depression, it often feels like the better option for everyone is to quickly accept medication and deal with the effects of it on their own.

47688978_1148052418686812_3259983166684790784_n

Photo by Kirsty Bird

Goss said: ‘Antidepressants come with risks and patients should be aware of potential side effects. For people with mild depression, CBT and other forms of treatment should be the first choice.’ Cognitive therapies have been found to be highly effective for conditions such as depression and anxiety and ‘CBT treatments have the lowest relapse rates of any psychological treatments.’ Therefore, there should be more focus on providing people with talking therapies rather than churning out more and more of the same SSRIs.

Goss told us that there has been a 70% drop in the number of research programmes into drugs for mental health conditions since the 1990s. Only 5.8% of the health research budget is spent on mental health research. ‘This represents just £9.75 per person living with a mental health condition.’ he said. This is simply not enough support.

Fortunately, online therapies are becoming more accessible possibly following rising awareness around mental health conditions. Though sites like BetterHelp are still incredibly expensive and not an option for many people, leaving them with little other options. Money seems to be a common theme when it comes to what is stopping people from getting better and it should not be this way.

There is hope in the concept of personalised medicine which is undeniably a step in the right direction for treating mental health. In the future, artificial intelligence tools may give doctors the ability to predict which people will respond best to different forms of treatment. ‘As of now, it seems for most people a combination is most effective. Nevertheless mental health is still poorly understood and doctors have trouble in predicting who responds to what treatment.’ Goss said.

Goss told us that on the whole, ‘around 60% of patients respond to medication.’ He said: ‘With greater research and a deeper understanding of the root causes of mental health problems we may be able to predict with greater accuracy.’ The general consensus when treating depression is that we do not have the funding and tools we need to perfect it right now. But seeing decreases in funding is incredibly disheartening and it’s time to make a change.

You can sign our petition for increased mental health funding here.

 

Advertisements

Interview with MMU Medicinal and Pharmaceutical Chemistry lecturer Vittorio Caprio

Vittorio-Caprio-crop-145x145-577b7b52d5086

Photo by MMU

Selective serotonin re-uptake inhibitors or SSRIs are commonly used antidepressants used mainly used to treat depression alongside other mental health conditions such as generalized anxiety disorder. Serotonin is a neurotransmitter, a messenger chemical that carries signals between nerve cells in the brain, which is thought to have a positive influence on mood. SSRIs work by blocking serotonin from being reabsorbed by nerve cells, also known as ‘re-uptake’. This means more serotonin is available to send messages to nerve cells, altering a person’s mood.

Antidote 2 Antidepressant recently spoke to Senior Lecturer in Medicinal and Pharmaceutical Chemistry at Manchester Metropolitan University, Vittorio Caprio, about his thoughts on the rise in prescription of antidepressants and the problems surrounding this rise. Caprio is involved in the actual creation of drugs like antidepressants and has extensive knowledge in the area. We wanted to try and understand why people are having negative experiences with the drugs and suffering from such severe withdrawal without them.

‘Part of the problem is going to arise from the lack of understanding. The other issue is people expect a lot of medicine.’ Caprio said. As many of us consume medication on a daily basis, whether that be shop bought painkillers or prescription drugs, we tend not to second guess how effective it will be. So when antidepressants are causing a range of severe side effects and withdrawal symptoms, many people are left feeling misinformed about and let down by the treatment they have been provided by professionals.

Caprio spoke about these expectations of drugs often leading people to lose faith in certain medicines. We can often forget the intricacies of each individual human body and mind when we need help. He said: ‘It’s not always easy to predict how the body will react. We are all different and all metabolise at a different rate so it’s difficult for there to be a perfect remedy right now.’ Caprio spoke about ‘personalised medicine’ and the idea that, in an ideal future, each individual will be provided with medicine which is a perfect suit for their body. 

Sadly, we are very far off this point. Caprio said: ‘As long as we as a civilization are willing to take small molecule medicines, it’s virtually impossible for there not to be a side effect.’ The wide range of common side effects caused by SSRIs tend to be addressed before prescription however there is not always as much detail provided about withdrawal. Caprio suggested this could be partly due to the lack of investigation into withdrawal during clinical trials. 

Discussing the attitude changes around mental health in recent years Caprio said: ‘As a lecturer, I come across it [depression] a lot more now in the student population. When I was a student no one spoke about it.’ He questioned whether this is down to increased awareness in recent years or if times really are getting harder. Are young people facing more stress now than they were 20 years ago?

We also spoke about a recent article on The Guardian website which stated 38 children aged 10 and under were prescribed antidepressants in 2017.  ‘As a father it horrifies you that we’re in a situation where 10 year olds are being given antidepressants.’ Caprio said. He acknowledged that mindfulness is being taught in schools which is arguably an entirely new development. This could be an indication of a push towards cognitive therapies but with these alternatives being so underfunded and waiting lists being off putting, treating mental illness is often trial and error.

In October 2018, Transforming mental health through research shared findings from  interviews with 100 UK-based GPs that only ‘60% feel equipped to provide personalised treatments that can provide tangible benefits to a patient’s quality of life.’ They also found that ‘8 out of 10 GPs think it’s a process of trial and error to find a mental health treatment that works for patients.’ There are glaring problems with the lack of procedure and testing before prescribing antidepressants which need to be fixed. We can no longer be so general when it comes to mental health.

‘Comparing it to how it was treated decades ago, things have got better but are still not where they should be. Avoiding chemicals would be nice but it’s not easy to say that when someone needs help.’ Caprio said. Pharmacologists are constantly working on creating drugs as close to ‘magic bullets’ as financially possible. The world is not yet blessed with the perfect remedy to every individual’s mental health, but we can all continue to raise awareness and increase education until we get there. 

People need to be given more information about the wide range of possible side effects, withdrawal symptoms and long term effects before being prescribed these drugs. The trial and error approach when it comes to treating depression is proving to have negative effects on a huge amount of people. Particularly when treating the brain, it is near impossible to find a drug that will fix a health problem directly. Therefore there needs to be an alternative to making ourselves worse before eventually getting better. 

You can sign our petition for increased funding for mental health treatment here.

“I wish I had therapy instead of starting a body addicting drug.”

B929F5AF-E156-4A45-B699-0BAF7D46A714

Photo by Kirsty Bird

In November 2018, Antidote 2 Antidepressant spoke to 24 year old waitress and illustrator Chelsea Ford about her own experience with antidepressants. Chelsea was prescribed the antidepressant Sertraline in January 2016 along with a 500mg dose of Pregabalin around the same time to treat anxiety. She noticed the combination taking a toll on her mental and physical health only weeks into using them.

‘Numbness’ was the first word she used to describe her experience. Like many people trialing antidepressants, there was a noticeable change in emotional response. The things that would usually upset, worry or even uplift her seemed to only elicit a lack of care. This mental shift began to impact her relationships and attitude towards the things that previously meant a lot to her.

The medication also had a negative effect on her creative ability. ‘Sertraline limited my creativity because it didn’t allow me to overthink to any extent.’ Chelsea says. With the medication that was meant to be making her better making it almost impossible to do the things she is best at, it left her wondering whether she was doing the right thing.

Alongside the emotional numbness, the drugs left her feeling constantly dizzy and struggling to do everyday things as simple as crossing a road. She described it as what felt like an out of body experience and felt completely disconnected both mentally and physically. On top of this, night sweats meant she was waking up ‘soaked’ most mornings and experiencing a whole range of other side effects while facing the day.

To her surprise, as she was figuring out how to cope with the negative side effects, Chelsea found the medication was treating a lot of her physical problems including acne and psoriasis. Due to her no longer experiencing stress in the same way as before, stress induced problems seemed to fade away. Despite this, her mental health was still not where she hoped it would be.

‘They threw the medication at me because they thought it was the cheaper option.’ Chelsea said when asked if she felt she was given enough information before being handed the medication. ‘They avoid spending more time than needed with patients because the NHS is so stretched. You become a number on medication rather than a human with problems.’

Chelsea attempted to come off the antidepressants a couple of times but found the withdrawal symptoms unbearable. These periods made her more prepared when she decided to stop her medication completely. Mood swings and ‘constant brain zaps’ made it hard for her to simply get through the day saying ‘the only way I could cope was to realise this wasn’t actually me flipping out it was the antidepressants and the chemicals in my brain.’

Two weeks after coming off the drugs, Chelsea began experiencing vertigo which she immediately labelled as the final with symptom of withdrawal as it had never happened to her before. ‘I was told to stay on them until a doctor told me but not one doctor had time for me coming of my antidepressants.’

The lack of supervision when attempting to come off the medication exacerbated the experience for Chelsea.  She told us: ‘I wish that I had therapy rather than starting a body addicting drug that made me basically non functional during the cold turkey days. The journey of withdrawal is too long.’

Chelsea stopped her medication completely in August 2018 and has since tried therapy. Drawing is beginning to feel natural to her again. You can find Chelsea’s artwork on her Instagram.

Over 70% of those on antidepressants felt uninformed before using them, our survey says

Antidepressant usage in the UK has been on the rise since the year 2000. In recent years, focus has been placed on the severity of withdrawal symptoms that occur when coming off the medication. 

Antidote 2 Antidepressant carried out a survey in October 2018 of people who have been prescribed antidepressants in the last two years. The aim was to gain a better insight into people’s experiences and understand where the problems lie. The findings showed that the overall experience differed for most individuals with 13% describing it as positive, 20% as negative and the rest ‘somewhere in between’.

The survey showed that all respondents experienced side effects when they started taking the drugs. Many respondents experienced side effects they were forewarned about but also dealt with some they did not expect. Most respondents described the side effects as ‘moderate’ and they included weight gain, lowered sex drive, emotional numbness, suicidal thoughts, headaches and difficulty sleeping.

66% of respondents have tried to come off the antidepressants and 46% of those experienced severe withdrawal symptoms when doing so. Some of the symptoms were stomach cramps, disorientation, suicidal thoughts and migraine and flu like symptoms. 

We also found that 73% of respondents felt they were not given enough information about possible side effects and withdrawal symptoms of antidepressants before they started taking them. 26% said they thought about remaining on the medication to avoid withdrawal and 20% said they followed through with this thought.

Antidote 2 Antidepressant wants to use this to make a step towards to preventing prescription with lack of education. Over the coming months we will be looking further into the problem from all angles and finding a way to reduce negative experiences with antidepressants.

The symptoms of depression

Graphic by Kirsty Bird