Six tips to help you avoid taking taking long term medication.

Why is this important? Because in a 2013 report in the BMJ, professors Christopher Dowrick and Allen Francis drew attention to the evidence that depression is over diagnosed and over treated at the expense of ‘medicalising’ a normal human experience such as sadness or distress. This can lower the threshold for treatment with antidepressants and once started, stopping them may become a problem.

In the UK, prescriptions for antidepressants doubled between 1998 and 2010 and this seemed to be mainly due to long term prescription. In the US, 11 per cent of the population over 11 years of age are taking antidepressants including nearly a quarter of women in their 40s and 50s.

In a report published by the Nuffield Trust and the Health Foundation in 2014, not only was there evidence that the amount of antidepressants dispensed in the UK had increased by sixty percent between 1998 and 2012, but nearly half the increase occurred between 2008 and 2012 when financial and employment stresses may have been at their highest.

Labelling grief, anxiety, sadness or emotional distress as depression is not uncommon. In one US study published in 2013, when a clinician applied label of depression was reviewed using a structured interview tool, only 38 per cent of people, most of whom were already on drug treatment, met the clinical criteria for the diagnosis of depression. This fell to only 9 per cent of those aged 65 and over. It would appear that grief and stress induced symptoms are often inappropriately labelled and treated as depression, particularly as we get older.

How do you recognize the difference between mild and the more severe forms of depression? First with mild depression there is usually a definite and recent life event, or sometimes a series of stressors, which predate the onset of symptoms. Secondly sadness, loss of interest, guilt and unworthiness tend to be milder and less troublesome in the morning; this is in contrast to the melancholia and a deeper sense of gloominess and hopelessness in moderate to severe depression. In addition the capacity to feel pleasure is retained in the ‘milder’ group.

So what is the best treatment? Prognosis for the milder group is good and watchful waiting or following some of the suggestions below may be of benefit. As far as antidepressants are concerned, placebo controlled trials have shown they have little or no effect in mild depression. This includes those with a recent bereavement or even complicated grief reactions.

6 Tips to get back on track:

Don’t be harsh on yourself. Human emotion and response, particularly to a significant loss in your life, is a normal and understandable reaction. Practice being a compassionate ‘coach’ to change what may be negative self-talk into something more helpful.
Do something. Anything that engages you in a distracting activity or helps to re-establish routine. This could be something as mundane as tidying up around the house. Even if you don’t feel like doing it, do it anyway.
Talk to someone. Anyone who is willing to give you time and has good listening skills. You may have to take the first step to make this happen, particularly if you are establishing a new relationship. Some people, including acquaintances, may appear to be avoiding you, most likely because they don’t know what to say. Sometimes talking to a professional councillor or GP is the most helpful option.
Get active. Even if this takes effort the value of exercise is enormous. Make an attempt to enjoy the process, whether this is during a walk down the street, or going for a swim or whatever generates a significant increase in physical activity.
Write a list of things to do. Make sure they are achievable within a reasonable time-scale. As you cross them off recognize the benefit of the achievement and give yourself some positive feedback…even if you don’t do this normally.
Trust yourself. These feelings are not who you are. You will get through this and get back on track because the human spirit, your human spirit, is naturally buoyant and resilient. Make a commitment to yourself to do this. Remind yourself as often as you need to that this natural reaction will pass and you will be ready to begin a new section of your life. Your life and destiny is in your hands.