Antidepressants

Because I had a good experience with the doctors; I think that they levelled with me. They......being told I was depressed, you know, clearly being told that was the case and all these other things that were going through my mind were a symptom and not a cause felt good to me. I think the doctors spent time with me I never felt rushed at all and we talked about me and my emotions and how I felt and I really valued that. I really valued feeling cared for and someone took an interest in me more than anything else. And I think I may not have taken the tablets if I’d come out of there thinking ‘Oh it’s just another patient to be given drugs to shut up,’ or whatever.
 
The doctor who prescribed the treatment said think about it, you’re not under pressure but from where he was sitting he thought it would be a good idea, but he didn’t want me to do it unless I thought that it would help me. And yes I just felt looked after, I felt that they took an interest in me and I felt if it all went pear shaped they would be there to help me out.
 
You felt well supported.
 
And if it went well - fantastic. So I had a really good experience from the general practice I should say.

I would have to say here and now that the GP that I’ve had is one of, in the practice it’s a woman, she has seen me through this whole episode and she has been amazing, absolutely amazing and this is in a GP practice that as kind of got a policy of not prescribing anything, you know, they don’t give you anything for anything unless you’re kind of dying. but she’s been supportive she has been listening, she has been positive about my participating if you like in, in my getting well, you know so it’s been very much a collaborative, a collaborative thing.

I think the way my doctor went about it was very good. Just open discussions, you know, providing the options but asking how you felt. He asked me how I felt about each option, he took the time and he was, I was in there a long time, I dread to think how long I pushed back the appointments that day but he took the time to explain the different options and asked me how I felt about each one and so we could actually discuss openly. And it just, and I think because it was so important that, it was the first time I’d met him and he became such an important part of my life so quickly I don’t know how well I would have coped without knowing that I had that support and I could go in each session each appointment and not feel judged but literally give the facts this is how I’m doing and trusting the response.

Consider alternatives first. Look at the bigger picture. Look at what else is going on. I don’t think depression myself, despite all the evidence that there is in literature is caused by chemical imbalance in the mind. It’s caused by what’s going on in someone’s life. It’s caused by not having enough money to live on, not having a decent place to live, not having enough friends. So if you can address those problems, begin to address them, I think that’s what’s going to solve things in the longer term.
 
Because one of the things they often say is, well we’ll put you on these and they’ll kind of stabilise you and then you can deal with that other stuff.
 
And that’s what they said to me.
 
Yes.
 
But I think, I think they’re not quite upfront about that. I think they need to be; well it might improve your mood. It might help you. But rarely do GP’s actually say that in my experience, they’ll just say ‘look here it is, take it. Have antidepressants, they will help with your mood.’ And they don’t, again they don’t look at the bigger picture.
 

Have a conversation with your patient, I understand that there are times where actually that’s not possible and where you need to be making the decision and certainly I’ve been in positions where all I’ve wanted them to do is say you knew what just to make a decision just give me something I don’t care what it is but as a general rule you need to be actually having a conversation having a two way conversation and saying ‘this is what I think, what do you think’, because, especially if a patient has been on more than one medication before, they know what works for them they know what doesn’t work for them , they know what side effects they can tolerate and they know what they can’t tolerate. I just, you, I can’t stress it enough it’s just so important to talk to them instead of talking at them.

It’s not just ‘I feel a bit sad’ there are usually deeper reasons. It might take you a while to get to the reason as I say it took myself and my doctor just chatting for a while to actually work out how far back the symptoms, the cause of the illness as I say ...I’d probably been depressed for many years before I realised or we realised. So the first thing is be empathetic with the person, understanding, and then start to talk about the way forward. Whatever you do don’t just sit and say ‘oh I think this person’s got depression here’s a prescription’ you actually have to get them to understand what’s wrong with them so they understand why you’ve given them the tablets. If I hadn’t admitted I was depressed I don’t think a tablet would help me because it's as much in the mind as it is in the body, the chemicals you have to, so you have to be able to talk to the people as much as prescribe things to them.

I think, first of all I think you ought to tell them about the side effects and I can realise why they don’t because some people wouldn’t take it if they knew the side effects. I think they should tell them side effects, I think that’s important and also, I know why they don’t because it might psychologically bring on the side effects, people might talk themselves into having side effects and some people wouldn’t take it, they’ll say oh yes I’ll take it and stop it, there’s quite a lot it’s quite a lot of reasons people don’t take the medication, they get home and read the side effects and they don’t take it but they don’t always tell the psychiatrist or the doctor. So I can understand why they don't do it but I think they should do it and I should also think, like I said, they should tell you what this is going to do for you, I’m going to give you this and this will make, and this will have the same psychological, this will make you feel better this will enable you to get up early in the morning, go out more, do things feel a bit lively, if they said, if they said they would do this it would be a good message. This will help you get better this will help you do so and so and they don’t do it, they just say, “Take this”.