Adam Morris: Mental health statistics make depressing reading

IT IS one of the great health curses of the 21st century. While breakthroughs in medical science and greater awareness of the importance of good diet have led to dramatic improvements in our physical health, never before have so many people been diagnosed with depression.

Some estimates suggest as many as one in four Scots will suffer from a mental health problem in any given year, with anxiety and depression the most common combination of disorders.

The increase has been accompanied by soaring levels of prescriptions for anti-depressant drugs, with – for the first time – more than 500,000 a year now being signed by medics in the Lothians.

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The growing numbers being treated by their GPs has in turn fuelled concerns about an "epidemic".

Questions are being asked – "Why are so many people declaring themselves depressed?" and "Are doctors failing to tackle the root problem by dishing out so many pills?"

As with any mass phenomenon, we are now seeing the first signs of a backlash against such widespread diagnosis of depression.

Writer and broadcaster Janet Street Porter has described it as "an epidemic of middle-class breast- beating" – pointing out that poor folk in the favaelas don't get treated for depression – and a "tidal wave of analysis".

The founder of Grazia magazine Fiona McIntosh dismissed the "trend" as the "new black".

In Edinburgh, the Priory – famous for its treatment of drug-addicted stars – has had to extend the opening hours of its new clinic to cope with rising mental health referrals.

The uncertainty and financial pressures caused by the economic downturn are said to be one reason for the most recent surge.

But Dr Helen Anderson, a consultant psychiatrist for the Priory and NHS Scotland, says the causes are far more complex.

"Of course when there is more awareness there will be people who confuse distress with depression, but that can be spotted at a very early stage," she says.

"People don't tolerate illness the way they used to, physical and mental, and are therefore happier to admit when something is wrong and seek help.

"This is a good thing undoubtedly, and for many, particularly those with more serious depression, anti-depressants are the best solution. They do make people feel better.

"The problem is for many the solution is counselling or other methods like that, and there is a shortage of those services in some areas, so the only alternative is a pill."

Another reason for the surging number of diagnoses, though, is less reassuring – the fact that GPs can't, and don't, always get it right.

A study in England, which was published in the Lancet medical journal, found that up to 16 in every 100 depression patients were misdiagnosed by their GPs, who mistook the symptoms of a physical ailment for mental health problems.

The report blamed the problem on questions focusng on very recent moods and behaviour, with the pressure on GPs restricting the time they spent with the patients said to be a likely contributory factor.

The study also found other patients who were genuinely suffering from depression but were not diagnosed.

One of the problems with identifying the illness and treating it is that there are broadly several types of depression, ranging from mild post-natal depression to bipolar disorder, which used to be called manic depression.

Symptoms can vary dramatically, but include weight loss and poor sleeping, as well as more widely recognised signs such as low self-esteem.

Lothians Conservative MSP Gavin Brown fears that in too many cases doctors are taking a "sticking plaster" approach without tackling the real problem.

"The fact is that since May 2007, the use of anti-depressants has increased by 11.5 per cent in NHS Lothian," he says.

"It is known that early intervention can prevent mental health conditions becoming chronic and long-lasting."

Mr Brown adds: "Patients need the support and treatment from professionals, rather than another prescription.

"The Scottish Government must ensure that anti-depressants are not allowed to become a quick fix for depression."

There are a wide range of treatments prescribed in the Lothians, including exercise sessions and coaching CDs which encourage positive mental habits, using similar techniques to peak sports performance systems.

However, there are doubts about how widely available some of these alternative approaches are being made to patients.

The Scottish Association for Mental Health (SAMH) believe more research needs to be carried out into the reasons behind the latest surge in prescriptions in the Lothians, but the charity does harbour some concerns about whether drugs are always the right solution.

Chief executive Billy Watson says: "There is nothing wrong with people being prescribed anti-depressants when this is the best treatment option.

"However, people should be given a choice of treatments: official government guidance says that anti- depressants should be prescribed for people with a history of moderate to severe depression or when other approaches have not helped.

"We want to see equal access to other approaches, such as talking therapies, exercise and guided self-help."

Number of prescriptions of anti-depressants in the Lothians:

2006 – 440,587

2007 – 467,947

2008 – 489,897

2009 – 521,944