Do you live in an antidepressant hotspot?

Given the amount of anti-depressants prescribed by his GP, Sunderland must be the most depressing place in England.

In May this year, NHS Sunderland Clinical Commissioning Group (CCG) doctors prescribed 71,306 antidepressants to 286,855 patients on their books. That works out to 248 items per 1,000 patients — by far the highest rate recommended nationwide.

And that’s just the overall average for the region: One practice — Bridgeview Medical Group — dispensed 378 antidepressant items per 1,000 patients, the highest rate in the region with the highest rate in the entire country.

And, as Good Health discovered, there’s a huge postcode lottery in prescribing antidepressants – which means that in some areas of the UK (table to find your area’s prescribing rate in May, right (see), you’re more likely to end up on a drug that some research suggests may be no better than a placebo for mild or moderate depression, even though its Side effects may occur.

Antidepressant use is on the rise in the UK – it was revealed earlier this month that the number prescribed in England is set to rise by more than 5% by May 2022.

Charlotte Brighton, 36, A Nail Technician, Lives In Gosport, Hants, With Her Husband Gary, 36, And Their Children, Aged Ten And Five.  She Says: When I Was Diagnosed With Depression I Was Told I Had To Go On Anti-Depressants - There Was No Other Option.  My Gp Said, 'This Is The Best And Quickest Procedure.  The Wait For Counseling Was Months.

Charlotte Brighton, 36, a nail technician, lives in Gosport, Hants, with her husband Gary, 36, and their children, aged ten and five. She says: When I was diagnosed with depression I was told I had to go on anti-depressants – there was no other option. My GP said, ‘This is the best and quickest procedure. The wait for counseling was months.

According to the British Journal of General Practice, women are more than twice as likely as men to be prescribed, including antidepressants for anxiety.

Some of the increase in antidepressants is due to the impact of the epidemic on mental health. But it was the sixth annual increase in a row: the number of prescriptions for antidepressants in England rose by a staggering 34 per cent in six years, to more than 83 million a year in 2021/22.

And yet research published last week has raised questions about the use of antidepressants on this scale. He suggested that the idea that depression is caused by an ‘imbalance’ of the brain chemical serotonin is a myth.

Serotonin is a chemical messenger that transmits messages between nerve cells and its deficiency has been implicated in depression.

Joanna Moncrieff, professor of psychology at University College London, was the lead researcher on the project, which looked at the results of studies involving 300,000 patients.

‘We can safely say that, after extensive research over decades, there is no convincing evidence that depression is caused by serotonin abnormalities,’ she says.

This undermines the decades-old basis for prescribing the most commonly prescribed antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs). According to the NHS, shaky or agitated, feeling or being sick, indigestion and diarrhea or constipation.

Coming out of them can also be a problem. Mental health charity Mind says withdrawal can cause dizziness or lightheadedness, feeling electric shocks, problems with movement or involuntary movement, sensory disturbances, such as strange dreams or smelling something that isn’t there.

Antidepressant Use Is On The Rise In The Uk - It Was Revealed Earlier This Month That The Number Prescribed In England Is Set To Rise By More Than 5% By May 2022.

Antidepressant Use Is On The Rise In The Uk - It Was Revealed Earlier This Month That The Number Prescribed In England Is Set To Rise By More Than 5% By May 2022.

Antidepressant use is on the rise in the UK – it was revealed earlier this month that the number prescribed in England is set to rise by more than 5% by May 2022.

A review by Public Health England, published in 2019, found that 20% of people who stopped taking antidepressants after just one month would suffer such a ‘withdrawal tendency’. .

Meanwhile, statistics show that women are more likely to take pills.

Professor Moncrieff says: ‘One theory is that women internalize their problems, while men externalize them – meaning women become depressed. That is, they “blame” themselves, and men get angry and blame other people or things.’

Research published earlier this year in the British Journal of General Practice found that women were more than twice as likely to be diagnosed with anxiety and to be prescribed antidepressants, and to have ‘mental health problems’ compared to men. were more comfortable seeking help for their conditions’, who were more affected by it. Stigma associated with poor mental health’.

Professor Moncrieff added that women also often have family responsibilities and often lack the clear public rewards associated with their careers.

But if it helps explain the difference between the sexes, when it comes to that you’re more likely to end up on SSRIs if you live in Hampshire than if you live in Frimley, Surrey. — The picture is more complicated.

Take the region with the highest prescribing rate, NHS Sunderland CCG, with 286,855 patients (with 248 antidepressant items per 1,000 patients in May).

By contrast, North West London, with a total of 2.7 million patients on GPs’ books, has the lowest rate, just 53 items for every 1,000 patients.

Apparently, people in London are generally less depressed — the North West London Commissioning Group told Good Health that the capital ‘has the lowest prevalence of depression in the UK’.

But she added that ‘the expansion of mental health services, including the Improving Access to Psychiatric Treatment (IAPT) programme, plays a role. [low antidepressant prescription rate]’

The IAPT program, a nationwide initiative launched in 2008, is designed to give patients with anxiety or depression access to talking therapies, such as counseling and cognitive behavioral therapy (CBT).

The NHS says it has ‘transformed the treatment of anxiety disorders and depression in adults in England’, but it is available on antidepressants to more than 8 million adults in England.

There were 1.6 million referrals for therapy in 2019/20, but only 1.46 million the following year.

Professor Martin Marshall, chair of the Royal College of GPs, told Good Health that while ‘antidepressants are often an effective treatment to help patients manage mental health conditions’, GPs report that ‘societies Access to appropriate, alternative therapies, such as talking therapy and CBT – which many mental health patients find beneficial – is complex across the country.

He suggests that the complex delivery of talking therapies is ‘a possible factor in why there are some regional differences in the number of antidepressant prescriptions’.

“We need to address this urgently to ensure patients can quickly access the treatment they need,” he told Good Health.

But lack of funding can leave GPs with no alternative to drugs – the cheapest, easiest option.

Yet this contradicts what experts see as the root cause of depression. ‘It’s not what happened to us but what happened to us,’ as Heather Sequeira, a consultant psychologist and NHS specialist in CBT, based in Milton Keynes, Buckinghamshire, explains.

Dr Mark Horowitz, clinical research fellow in psychiatry at University College London and North East London NHS Foundation Trust, and co-author of last week’s paper, agrees.

‘The link between depression and stressful life events, such as relationship break-ups, job loss and physical illness, is incredibly strong,’ he says.

According to an analysis by the NHS Business Services Authority in July 2021, there is a clear link between antidepressant use and deprivation. He compared prescription statistics with the Index of Multiple Deprivation (a measure of deprivation that takes into account factors such as income, housing, crime and health) and found strong evidence that most antidepressants were the most were proposed in deprived areas.

Professor Moncrieff says ‘prescription rates are strongly associated with social deprivation and particularly in areas where traditional industry has declined’. ‘It shows that we are treating the consequences of socio-economic change.’

Addressing the human health consequences of all this is Bridgeview GP practice in the Southwick area of ​​Sunderland city, just a stone’s throw from one of the most deprived areas of Tyne and Wear.

Half of the antidepressants prescribed in Sunderland in May were SSRIs. A spokesman for the North East and North Cumbria Integrated Care System, which covers Sunderland, said the Good Health Prescribing Rates were influenced by ‘a range of complex and social factors, including health inequalities’.

In order to wean patients off antidepressants, the Integrated Care Board has – a new – first of its kind in England – to support GP practices in ‘therapeutic discussions with patients about their long-term treatment’. Guidance on Depression’ has been issued.

This includes a ‘low mood plan and depression status check’ for every patient, which has led to a 3.2% reduction in the number of anti-depressants prescribed to patients in Sunderland.

However, the question remains: Are antidepressants really the answer for many others?

I really wish I had consulted sooner

Charlotte Brighton, 36, a nail technician, lives in Gosport, Hants, with her husband Gary, 36, and their children, aged ten and five. She says:

When I was diagnosed with depression I was told I would have to go on anti-depressants – there was no other choice.

My GP said, ‘This is the best and quickest procedure. The wait for counseling was months.

After nearly ten years of suffering, I realized I had no choice. But I spent 16 years on pills.

It all came from being bullied at school, every day, for five years. I started having severe stomach pain. I was diagnosed with irritable bowel syndrome (IBS) and was prescribed everything from relaxants to antispasmodics, but nothing worked. Looking back, it was bullying stress that caused all my problems.

After leaving school, I went back to my GP – by now he must have tried every stomach medicine in the book. When I told him I was feeling restless, not interested in anything, he said: ‘I think you have depression.’

So, at age 20, I was put on fluoxetine. [Prozac], then citalopram. I started at 20mg per day then increased to 40mg over four years. Within a month of taking citalopram, I was less anxious and more interested in the world. But it left me feeling numb and lacking in emotion. I was also tired, with a low sex drive.

Still, I saw it as a necessary evil to be free from depression. In 2019, I tried to inquire about counseling but was told that the waiting lists were even longer. Right after the pandemic, I was in a bit of a slump. I was hyperventilating and feeling panicked. One day I fell on the floor crying.

I decided to do private counselling. Six sessions would cost me £300 but I wanted to try talk therapy. I saw a psychotherapist who helped me open up.

There were a lot of tears but, through counseling, I’ve learned that emotions are normal. These emotions are what I should be feeling, instead of what I’ve been numb to for 16 years.

I feel much better now. I am slowly weaning myself off the pills down to 10mg. I wish I had gotten counseling sooner. It has changed my life.

Interview with Julie Cook