We live in a time of paradox. In the western world (indeed in almost all countries) life expectancy is increasing. Historically people had to worry about not having enough to eat and having shelter. In western countries, for the vast majority of people these are not day-to-day worries. Even those (not all) with little money have food and shelter.
Yet people seem to be more stressed than ever. We are told that mental health problems will exceed physical health problems this century. There seems to be an explosion of depression and anxiety in all age groups. The figures that get quoted about mental health problems are quite staggering. The claim that one in five people will experience depression during their life is never questioned. Neither is the need for an ever-increasing amount of money to be spent on medications or academic inspired “programs”.
In fact to question the “experts” who talk about mental health is to risk being portrayed as insensitive or not caring. This is a variation on the “ist “ and “phobe” method of shutting down a debate that some don’t want to have.
So with all the increased focus on mental health and the vast increase in funding and use of medications, how are we doing?
There are two answers to that question. The first is quite well but not for the official reasons. A large number of people who are labelled as having a “mental health illness” actually have no illness at all. They have life problems. These may be related to family, finances, relationships, or work. These problems are real and the people may need help to get through it. But there will of course be full recovery when the problem has passed or been solved.
This is despite the constant message that every time we feel a bit sad, worried or stressed that it is a sign of illness. This has contributed to 10% of Australians being on antidepressants.
As I have written many times before, human emotion whether it is “positive” (feeling happy about winning the lottery) or “negative” (relationship breakdown) is a normal part of being human. It is not a disease. In fact what we decide is positive or negative is necessarily relative. This is brilliantly described in the Taoist parable of the Horse which ran away. For those unfamiliar with the parable click the link and take the three minutes to read it.
So the reality is that our collective mental health is actually better than we are told. As usual there is no money in people who are well.
The second answer tells us more about our approach to mental health. Figures show that suicide is increasing in The USA and other countries. This is despite record rates of prescriptions of anti depressants and governments pouring money into suicide prevention programs.
In the USA rates are at 30-year highs. It has even impacted on average life expectancy, which has nudged down for the girls time in close to a hundred years.
The medical model for treating mental health problems is not working. Makers of psychiatric medications are amongst the highest spenders on educating doctors and payments to medical consultants. Yet all this prescribing of antidepressants is happening while suicide rates increase.
Whilst it has been shown that SSRI antidepressants increase the risk of suicide in teenagers, this has not been shown in adults so is not the cause. But is clearly not the answer. In many cases of mild and moderate depression they are no more effective than placebo.
Newer antipsychotic medications have been very profitable. Aripiprazole (Abilify) was the biggest selling drug in the USA in 2013 with sales of $US6.5 billion. Yet people using lithium, the oldest drug used for psychosis, have been shown to have the lowest rates of self-harm.
Meanwhile exercise and mindfulness have been shown to improve mental wellbeing but are largely ignored.
So we have the paradox. The number of people who can be diagnosed with mental health problems has been expanded to include many people who have no mental health illness. At the same time our “treatment” of those with mental health problems is not succeeding in many cases (to be fair some cannot be helped and some will not help themselves).
However, as is so often the case in medicine, there is a view that if what we are doing is not working then more of the same will. In reality it will not.
What we need is to demedicalize life so that those with life problems get out of the medical model. At the same time we need to re-examine our belief that medication is the best treatment when reality is telling us that (by itself) it is not.
Dr Joe Kosterich M.B.B.S is an author, speaker, media presenter and health industry consultant, who wants you to be healthy and get the most out of life. Dr Joe also gives practical, motivational health talks for the general public and organisations where he is known as “An independent doctor who talks about health”.
His latest book “60 minutes to Better Health” is available on Amazon.