Mental health: Pills mask not fix the cause of our problems – Dr Punam Krishan

I see on average 100 to 120 patients every week. The root causes of 80 to 90 per cent of the problems people present with are secondary to stress and anxiety. Mental health problems are on the rise and this is no coincidence when we consider that time is now viewed as a commodity, writes Dr Punam Krishan.

By Punam Krishan Thursday, 11th April 2019, 7:00 am Updated Thursday, 11th April 2019, 11:29 am

Many patients seen by Dr Punam Krishan have problems linked to stress and anxiety

The crux of many of our issues is that we are pushing ourselves faster than ever before, expecting to do more in shorter amounts of time. The younger generations are addicted to technology and success with a buzz to be the next big influencer. The older generations are struggling to keep up as they straddle the ever-widening social gaps. We are all stressed and this is manifesting in chronic and complex diseases like type 2 diabetes, heart disease, several cancers, strokes and mental health problems, costing people their lives way ahead of time.

The number of prescriptions for antidepressants has doubled over the past 10 years. We are so busy we are choosing to cure ourselves with pills instead of understanding the root causes of our mood imbalances. When we review the evidence from pharmaceutical companies, we can clearly see there is a very small number of benefits in improving low mood using antidepressants compared to people who are treated with a placebo pill. Why are we willing to take a leap of faith for the pharmaceutical companies but not take a leap of faith about our inner pharmacology which would have far more sustainable long-term effects if we put in the time and effort to heal ourselves.

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The long list of side-effects of antidepressants is enough to make anyone feel sick yet we trust and surrender to the thought that there is a pill for every ill.

The side-effects – or should I call them direct effects? – are very real as are the risks of dependence and withdrawal when weaning off them. Of course I prescribe drugs and there are conditions that warrant control with medication. Many people I see tell me they have no time to invest and therefore are willing to hope the drug will sort out the financial issues, the lifestyle-related medical issues, the domestic problems, the work bullying etc. I sensitively remind my patients, especially in the context of depression and anxiety, that no drug can cure the underlying trigger. It can help alleviate some of the pain but the cure requires deeper attention.

We need more resources in the community to narrow the gaps in the provision of health and social care. There needs to be a push not just from healthcare professionals – we need the Government to invest more in social prescribing.

The majority of my patients don’t need a pill; they need company, mental stimulation, hobbies, compassion and help on a social level. The pill will not help this, it will contribute to masking the problem for a short period but cause recurrent GP appointments, A&E attendances, more sick days off work and a collective loss of morale and sense of health and wellbeing.

The media has a role to play too to promote social prescribing more and the pharma agenda less, with an emphasis on self-help. When we take care of ourselves, we naturally want to help take care of others – it’s what social animals do. When we take care of others, it creates a ripple effect and this is the only way to start changing patterns in the community that can alter chronic disease trends. We also need to slow down, stop rushing from A to B and start enjoying the life that is happening for us, not to us.