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Health Hell in a handcart

The drugs do work

The BBC reports that a new study, published in The Lancet, finds that anti-depressants really do work.

The study, which analysed data from 522 trials involving 116,477 people, found 21 common anti-depressants were all more effective at reducing symptoms of acute depression than dummy pills.

It’s timely given the massive and largely uncritical publicity recently given to admitted plagiarist Johann Hari, whose book Pull Your Socks Up You Miserable Bastards (I’m paraphrasing) argues that everything we – that is you, me and the medical establishment – know about depression is wrong.

Dean Burnett’s critique is worth your time; it’s a rare bit of common sense in a sea of credulous coverage. He debunks many of Hari’s key claims, such as the idea that anti-depressants are the only treatment offered for depression or that nobody but Hari has considered the link between life events and depression.

I’d always assumed the role of life events was widely accepted, and has been for decades. In psychiatry/medicine/psychology, this is often known as the Biopsychosocial model, and any decent professional will be very aware of it. Far from being a revelation of Hari’s, it was mooted back in the 70s, and has been part of standard teaching for at least 20 years.

Anti-depressants work. They work differently for different people, and some people respond differently to different antidepressants. Others develop a tolerance or intolerance. Regimes may need changed, or doses adjusted. Some people experience side-effects, or don’t get the outcomes they expect. But that’s medicine for you.

What anti-depressants don’t do is magically make everything okay, and nobody sensible claims that they do.

They’re medicine, not magic. If part of your depression is because your life is shit in every conceivable way, a course of Sertraline (or whatever drug) isn’t going to change that.

Think of it this way. Forget what you know about depression and just imagine being followed around all day by

WHACK

a man who

WHACK

for no reason

WHACK

keeps punching you

WHACK

in the face.

WHACK

It’ll take more than

WHACK

Nurofen to stop

WHACK

him from doing that

WHACK

but it’s impossible

WHACK

to think about what

WHACK

you need to

WHACK

do to make him

WHACK

stop when you’ve

WHACK

got a constant

WHACK

headache.

Anti-depressants don’t stop life from punching you in the face, but they can help you feel less punch-drunk. They can give you the clarity to see where the punches are coming from and to maybe dodge the next one, and the one after that.

I was on anti-depressants for a couple of years. I don’t need them any more. The drugs didn’t cure me, but they gave me the space I needed to see what had to change.