Positive Health Online

The story is familiar. I hear it all the time from clients, friends and people featured in the media. Someone gets depressed for some perfectly good reason, feels more and more miserable, eventually some bodily symptoms are added to the emotional pain and the sufferer can't cope any more. He or she (more often a she) then goes to the doctor, tries to explain what's wrong, and gets a prescription for an antidepressant. From here the single storyline branches off into several possibilities. At worst, the patient may get suicidal or – in some dreadful cases – homicidal; she may get more depressed, suffering from panic attacks and violent mood swings; less starkly, there is the risk of addiction to the drug, producing severe withdrawal symptoms when it's time to stop taking it. At best, nothing much happens, but the repeat prescriptions act as a kind of talisman, stopping the condition from getting worse. (I know of one case where the patient was kept on an antidepressant for 15 years, although she no longer remembered the reason for her original depression). To my sincere regret, I've never heard of anyone who took the antidepressant for a short while, felt much better and was able to drop the drug without ill effects. But then good news rarely gets into the media.

This method, trying to subdue grief and despair with a drug, AKA a chemical cosh, is painfully inappropriate. People don't get depressed for the sheer heck of it. There's always a good reason for feeling crushed, over-burdened, lost or stuck (add your own definition), so that the usual controls break down and daily life feels like walking along an endless grey corridor that has neither windows nor exits. What is needed to break the deadlock is human contact, time spent with someone who not only listens but also hears what is being said, and is intuitive enough to sense what remains untold; someone who doesn't rush in with cheerful encouragement, but allows for the grief, the numbness or the rage to erupt and run its course. In other words, a trained counsellor or psychotherapist who is able to guide the sufferer to the cause of the depression. Without that, there can be no healing, no liberation.

What happens is the opposite. The cause is ignored, the symptom is clobbered with a drug after the usual seven-minute consultation with an overworked doctor who wasn't trained anyway to deal with psychological problems. Counsellors within the NHS are few and far between; a patient may have to wait six months for an appointment. No funds to employ more therapists, we are told – as if antidepressants were for free. And so the vicious circle spins on, while mental illness, including depression, costs the country some £9bn in lost productivity and benefits. At least part of that mountain of misery could be alleviated by psychotherapy, at a considerable saving of taxpayers' money.

There is a major issue here that needs spelling out. It is that silencing the symptom instead of exploring the cause suggests a lack of respect for the sufferer. "Take this and pull yourself together" is the message, whether spoken or only implied, which is cold comfort indeed – and all praise is due to doctors who act differently, who take a few minutes to ask questions or offer reassurance to the patient. It needn't take long to make a difference. The quality of listening matters more than its duration. I recall the case of a young woman who developed a severe pain in her neck. A series of tests found no physical cause for the distressing condition. Her doctor could only offer painkillers, so she 'went alternative' and experimented with Chiropractic, Reiki, Herbs, Kinesiology and Massage, all in vain. Finally she went to see a Homeopath, who listened to her carefully and then quietly asked, "Who is the pain in your neck?" She burst into tears, cried for a while and left without being given a remedy. The next morning, for the first time in over a year, she woke up free from pain, and ready to sort out her life.

My hope is that one day, perhaps under pressure from the newly emerging Expert Patient or out of fiscal necessity, medicine as a whole will abandon repressing symptoms in favour of tackling the causes of suffering. In our over-medicated and under-funded state of health care this may sound a foolhardy hope; there are too few holistic doctors who are aware of the problem, and too many vested interests which don't want to know about it. Yet without setting ourselves an ambitious target we'll never get anywhere. Who knows, we might even get deeply depressed about it all.