Thursday, 29 October 2009

Is depression increasing, and what is the best way to treat it?

It seems as though NICE is in the process of making itself about as popular with the pharmaceutical industry as a fart in a spacesuit (again):

Is depression increasing, and what is the best way to treat it?

This business of drugs really only being suited to severe depression, and counselling being the best option, otherwise, is something that NICE has said, before, but it's reiterated it, just now. Incidentally, Alan Johnson, when he was Health Secretary (also in charge of the success of the pharmaceutical industry), promised that, through investment and training, more CBT counsellors would be available on the NHS (the current waitlist, I believe is 3 months for a 6-week course).

Mr Johnson now has another ministry, and I don't recall hearing word of improvements in this area. What's the betting that, were I to ask my useless cunt of a MP, he'd ignore me? I don't know why they bother even pretending to give a shit - lies are just a way of life to these people... "Yes, yes, just fob them off with some announcement, with a delivery date years down the line, and if they haven't forgotten about it by then, somebody else will be in charge, and it won't be my problem." What a bunch of wankers.


I have just shared an email exchange with Kate Goodridge, Customer Service Centre, Department of Health... She had this to say, amongst other things:

"...the Department of Health is not responsible for the ‘success’ of the pharmaceutical -or any other- industry..."

So that's that settled. She was responding to a couple of emails I wrote to Andrew Burnham, Secretary of State for Health, mostly concerning Eli (Lilly). Kate didn't mention Eli, in her reply. Eli is, of course, a drug pedlar, according to CIA docs.


Ana said...

Good that they are at least saying that psych-drugs are for major depression.
But even for major depression SSRIs are not of any help as those who are bloging are trying hard to explain.
CBT? A six-week professional?
No. Not good.
Psychiatry has also put an end in good therapy using many tactics like taking away the concept of "neurosis" from the public.
CBT is not the right approach for depression and it depends on many factors who is the appropriate therapy for a person.
CBT might work for phobias.
This is my two cents.

Radagast said...

[shrug] I think it depends what "depression" means to the individual, to be honest. If depression is a matter of the way that people think, as some believe, then teaching a person to think differently, or organize their thoughts differently, or gifting them alternative viewpoints, will have a benefit.

Let's say (purely for the sake of the argument), that you perceive that your belief that CBT is only good for phobias is a "disempowering belief" that you're keen to be rid of, and is an obstacle to you dealing with your depression - it might even be representative or an element of your depression. I guess the job of a counsellor would be to try to have you accept the possibility that depression could be helped with CBT, before going any further, because without that acceptance, you would be looking constantly for ways of disproving what the counsellor was saying. Note, incidentally, that I don't believe any counsellor should try to overwrite your belief in the ineffectiveness of CBT with his own belief that CBT was absolutely the thing for you (if (s)he had such a belief) - that approach rarely works, because both parties end up retreating into their corners and defending their independent realities, and there is no winner in that scenario.

I dunno, to be honest... I'm not a counsellor, and I'm unlikely to be permitted access to somebody who is depressed and is willing to stand and answer questions, even if the stated objective were to have them be not depressed, whatever form that "not depression" might take. As such, I'm unlikely to be able to refine my approach, for best effect.


Marian said...

I think, disregarded what the problem is, if it's anxiety, depression or whatever ("psychosis" included), it's the client not the therapist who has the answers. Some people find their answers with the help of CBT, others with that of analysis, or art therapy, or whatever. It doesn't really matter, IMO. What matters is that the therapist allows and encourages the client's own answers. CBT with its almost exclusive focus on thoughts, and how to change a person's thinking, unfortunately has an enormous potential to brainwash people. More than any other kind of therapy. So, of course, it attracts people as therapists who can't accept anything but their own truths. And of course these therapists make CBT extremely attractive to a society that can't accept anything but its own truths...

That we're talking the brainwashing version of CBT here becomes obvious looking at the 6 weeks. A 6-week course hardly leaves any room for people to find their own answers. CBT, or whatever kind of therapy. But it's time enough to brainwash someone at least superficially, if you have appropriate tools like the techniques of CBT at hand.

Radagast said...

Marian: You make a whole bunch of very interesting points.

First, I would say that all communication is capable of being classed as NLP, or waking hypnosis; certainly so, if a conversation runs for any period of time - each participant has to accept the suggestions of the other on some level for a discussion to proceed. If a person is concerned about their own thought patterns (perhaps a person is suicidal, for example), then they may be keen to change them. They do not understand how to change them - if they did, they'd do it themselves. These two factors (and probably others that I haven't brought to mind, just now), leave a patient very vulnerable to a therapist, who must, at least to some extent, have an understanding of the power of words, and may understand how to misuse them, as well as how to use them to genuine therapeutic effect.

Words represent thought - a person hears or reads words and a corresponding mental process occurs, almost simultaneously, usually in picture form, I understand (I think in pictures, anyway). If a person has already had pretty much every shred of trust in his fellow man stripped away, it's going to take an enormous leap of faith for him/her to say to a therapist "hey, I need some new thoughts - I don't know you from Adam, but I'm trusting that you're both skilled and scrupulous enough to do the job as if you were counselling yourself." It's a terrible thing when a person is so damaged that they daren't ask for help, fearing that they will be either rejected, or exploited, or even deliberately damaged even further.

Second, the business of allowing a person to find their own solutions has to be the best one, I think: implementing somebody else's idea of what is a good idea has any number of risk factors involved, not least the question of whether the idea was understood as it was meant. Also, integrating somebody else's ideas into one's own belief system is a tricky business, with repercussions way beyond the "presenting issue".

Anyway, the waitlist and the ticking clock don't contribute to the efficacy of the thing, in my view, and for the reason stated - they have enormous potential to just add to a person's already vulnerable state of mind - they need a fix, right now, not in three months' time. I'm as cold-bloodedly angry as it is possible for a person to be about the way I have been treated, but because it appears that I am not permitted to complain and have my complaints resolved, I will be angry for others in a similar position... It's how I repair myself!


Herrad said...

Hi Matt,
Good post.
Came by to say hello and wish you a good Halloween weekend.