It’s been a really long time since I was last inspired to put my thoughts into writing. For me, Instagram captions have replaced longer form blog writing, which is a reflection of my inability to hold concentration on just one topic for an extended period of time.
But today feels different.
On my morning scroll I was met with a BBC article that reads:
NHS could give therapy before anti-depressants, under new guidelines
In theory I feel as though I should be ecstatic about this. This is, after all, what I’ve been advocating for this entire time through Run Talk Run, right?
Before I delve into my current thoughts on the article and the complete overhaul of how depression is possibly now to be approached I think it is worthwhile exploring my very first interaction with the “medication debate” and my own personal shift in perspective.
Let’s talk about Johann Hari. Mr “anti-anti-depressants”.
In 2017 I was doing an absolute tonne of self development and self-help reading. I was in a depressed state for a number of months and was reading anything I could on the topic of depression to try and better understand why I found myself in a state of permanent melancholy.
I read Johann Hari’s book, Lost Connections, and had my eyes pried open. It was the first time I had ever been introduced to the notion that my anti-depressants had been too readily prescribed, and that during my visits to the GP all other life circumstances had been ignored. Johann describes the symptoms of depression as being a natural reaction to our circumstances. It is to be expected, essentially, if we are not maintaining connection with ourselves, with others, with our work, our environment, and so on.
I soon realised that there was far more work that I needed to do to improve my sense of connection with “the self” if I was ever to move closer to escaping the heaviness that I felt on my chest. I also realised that connection with other people was also going to be a critical part of my recovery, and it largely inspired the development of Run Talk Run’s early days too.
I immediately took myself off the anti-depressants I was taking (note: bad move, not recommended at all, please do so gradually with the help of a doctor if you’re considering this) and I threw myself into developing my life into one that was centred around that one word: Connection.
So what’s happening now?
The new draft guidelines say: "Do not routinely offer antidepressant medication as first-line treatment for less severe depression, unless that is the person's preference."
In place of anti-depressants being the immediate response, there is a push towards group CBT and outdoor activities, such as exercise. If I’m going to have a moment of complete honesty, I feel as though GP practices have already moved slightly towards this way of thinking. I can only speak on behalf of my current state of depression and interaction with my East London GP, but I have been offered ‘Group Mindfulness CBT’ and medication hasn’t arisen once in my conversation about treatment.
Why I think it’s great
Reliance on medication alone can be harmful. If a person is to make a full recovery from mental ill health, it is likely that they will need to develop wellbeing tools outside of their medication to support their recovery. Talking therapy, exercise, and time outdoors are all great tools to improving a persons physical and mental wellbeing. There is a risk with the prescription of an anti-depressant, that the person feeling unwell doesn’t seek to look after their wellbeing in these other ways too.
Another reason why this is a really positive move is that for some people, medication quite simply does not work. We really have reached a point where it is ignorant and dangerous to brush aside the other ways in which someone might be able to recover from mental ill health.
Why I’m feeling quite uneasy about it all
Medication does have it’s place in treating mental ill health. Despite my own personal revelation on the back of reading Johann’s book in 2017, I still wholeheartedly believe that medication is an effective tool for taking someone from -3 to zero. They might not get them to +3 but at least it can help someone feel on a more even keel. This then might just be the lift that someone needs to engage in all of the other activities like therapy, exercise, etc, that will also support their wellbeing. Some people truly do need the support of medication to feel like they are even in a place where they can attempt things like CBT.
My second concern with this move, is that the NHS will not be ready to cope with the increase in demand of therapy, in place of medication. There is already a waiting list that is far too long, and I am concerned that people will be put to the side to “wait” for treatment which will result in devastating and preventable consequences.
As the founder of a Peer Support non profit that 100% ticks the boxes of what a GP would want to prescribe someone to, I am concerned about the increased demand on grassroots organisations like my own. There is a significant need for more funding in the non-profit sector, if we are to carry the weight of a nation that is very much in a mental health crisis. There are, of course, pots of money in the forms of grants and funding but it is competitive beyond belief, and I draw on my own experience here when I say that they make it incredibly hard for someone relatively inexperienced (like myself) to make a successful application. The various loopholes that you have to jump through to access these pots of money is both unfair and anxiety-provoking - ironically.
What are my thoughts overall
At the end of the day, I think that a more holistic approach to supporting people with their mental health has been LONG awaited. The question is, are we actually ready to provide that support?
Link to the BBC article can be found here - https://www.bbc.co.uk/news/health-59383722