DR MARTIN SCURR: Why this apparent ‘epidemic’ of depression is so worrying

Have we become a nation of depressives? It appears so, according to shocking figures released yesterday showing that as many as one in seven in England are taking antidepressants.

Imagine the queue in a high street coffee shop – at least two people there will be on these drugs.

When I first started out as a GP I might have prescribed this kind of medication to just one new patient a month.

This new, apparent ‘epidemic’ of depression is deeply worrying, on two levels.

First, there is the effect of the medications themselves. Untreated, depression can have serious and sometimes catastrophic effects including suicide, and these drugs really are lifesaving for people in severe mental crisis.

But they have potential side- effects, including brain fog and sexual dysfunction. A small number of people can develop suicidal thoughts when starting anti- depressants or changing their dose. The drugs can also be very difficult to wean off.

And this matters if you’re being given these medicines for the wrong reason.

It used to be that people found it hard to accept they were depressed – seeing it as a shameful problem, ‘all in the mind’.

We now know that depression is a whole-body condition, and can cause a host of symptoms, including fatigue, unexplained weight loss, relationship and sexual problems.

But I think the pendulum has swung too far – with more people than ever seeking help for problems that aren’t mental health issues but a reaction to life circumstances and sadness.

For instance – social media doesn’t help, with its images of other people’s seemingly ‘happy’ lives holding out the illusion that we all deserve to be joyous all the time. And if the world seems to be going all wrong (let’s face it, there’s been little to cheer about in recent years), it’s no wonder more of us feel low.

But I question if medication is the answer.

Ideally, people with mild to moderate depression would be offered a talking therapy, such as cognitive behavioural therapy (CBT), which helps patients identify their negative ways of thinking and teaches them coping skills to overcome them.

In my view CBT provides a better long-term solution than medication, not least because it puts control back in the hands of the patient.

But there is a huge shortage of trained therapists. And with the lack of GP continuity of care – GPs used to be able to provide a more personal level of care and spend more time with a depressed patient, to good effect – doctors are having to hand out prescriptions instead (and often after only a telephone or online consultation).

I fear this problem of prescribing as a shortcut for treating depression isn’t going to improve very soon.