QUOTE(Miss Ross @ Jun 29 2009, 08:26 PM)
Sorry to drag it on, but I just wanted to add to the anti-depressant conversation. Yes, they are undoubtedly over-prescribed. I don't personally think that they should be the first resort. Surely counselling or therapy would be a better idea first?
Not always - it depends on the individual in question and the severity of their condition. But, broadly, talking therapies should be used as a first line more than they are. Off the top of my head, the NICE guidelines recommend:
1) Mild depression: first call, refer for talking therapy; second call, medication. Rationale is that, give or take, at this stage people are still functioning well enough for a talking therapy to be effective.
2) Moderate depression - is a toss-up. Bias would be towards a rapid intervention with a talking therapy, though depending on the patient, they might not feel up to that or might not respond well to it, so medication has a role here too.
3) Severe depression - a combination of medication and talking therapy, with medication coming first virtually all the time to bringthe patient up to a point where talking to someone is feasible.
They're guidelines, so as I said, if anyone's personal preference would vary, that's to be expected. But, give or take, as you can see, talking therapies are very much recommended for mild/moderate depression, and these between them account for the majority of cases. The trouble, though, is that given the number of people who are currently being treated for depression, the NHS would require around 10,000 extra therapists to actually implement the guidelines - the facilities simply aren't there, so instead, we have waiting lists. For instance, if the most appropriate talking therapy is CBT, the waiting list is in excess of a year in 90% of NHS PCTs. Faced with this situation, anti-depressants end up being prescribed as the only option that might help any time soon.