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Antidepressants

Antidepressants: Messages for health professionals

We asked people if they had any messages they would like to convey to health professionals who prescribe antidepressants.
 
Most people we talked to had been prescribed antidepressants by a GP. Some had also been under the care of a psychiatrist, either through community mental health services, or in hospital. A key message they wanted to pass on was how important it was for people to feel they could trust the health professionals they were seeing and to be treated as an individual. They wanted to be involved in decisions about their treatment. People appreciated having a good relationship with the GP or psychiatrist so that they felt well supported, and they said it helped if they could build up a relationship with staff and ideally see the same person each time. Andrew, Clare and Emily (below) describe the care they received from their doctors, and the importance of feeling listened to, and cared about.
 

‘I really valued feeling cared for and that someone took an...

‘I really valued feeling cared for and that someone took an...

Age at interview: 50
Sex: Male
Age at diagnosis: 49
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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.
 

Claire describes her doctor as ‘amazing’. ‘She was positive...

Claire describes her doctor as ‘amazing’. ‘She was positive...

Age at interview: 59
Sex: Female
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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.
 

Emily thinks she may not have coped if she hadn’t felt able...

Emily thinks she may not have coped if she hadn’t felt able...

Age at interview: 28
Sex: Female
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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.
People stressed how important it is for doctors to listen to their patients and treat them as individuals, so that they can feel confident about the diagnosis and be offered the right treatment. Depression often leaves people feeling disempowered, negative and without hope, so working in a way that can help people regain a sense of control can be very powerful.
 
Some people were surprised at how quickly they had been diagnosed with depression and given a prescription for an antidepressant, simply by filling out a questionnaire and talking to a doctor for a few minutes, and they felt that doctors should spend more time talking to people before reaching for the prescription pad. They felt it was important for the doctor to explain about the options for other treatments, especially psychological ‘talking’ therapies. 
 

Thomas feels it’s important for doctors to ‘see the bigger picture...

Thomas feels it’s important for doctors to ‘see the bigger picture...

Age at interview: 34
Sex: Male
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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.
 
When an antidepressant is prescribed, people want their doctor to keep a close eye on them and to provide on-going support, and to be given, or pointed in the direction of reliable and trustworthy information. They also emphasised how important it is that health professionals shouldn’t give people false hopes, or give the impression that an antidepressant can solve all their problems. Emily explained how it was important for doctors to guide people to have realistic expectations ‘They need to communicate with their patients, they need to explain to their patient... they shouldn’t tell people it’s a miracle cure because it’s not a miracle cure you’re not going to get better overnight’. Collette felt her doctor hadn’t taken her seriously when she experienced problems that she thought were caused by the antidepressant she was taking ‘they need to listen to the patient and not just say ‘oh it will be okay it will go away’ because it might not go away. Support them through it, give the person some time’.
 
Catherine recommends that doctors should understand that some people hold strong views or beliefs about antidepressants and may not want to take them, and that they should respect individual choices. Many people stressed how ‘pills treat symptoms, not causes’. They felt that it wasn’t enough to just be given a prescription, and that doctors should be able to offer their patients time to talk things through, as well as to help them find other ways to deal with depression.

People expressed wider concerns about the limited availability of psychological help and said that although the provision of these services may not be in the hands of individual doctors, they felt it was important that health professionals and policy makers should act to try to increase the availability of talking therapies and other psychological help. Melanie waited many weeks for an appointment with a counsellor, during which time she felt that nobody cared.
 
‘Try and motivate people to have some kind of talking therapy as well because I think otherwise you are just treating the symptoms and not helping people really move on’. Lou
 
‘I think they need to question their motivation and say ‘right what am I, am I ticking the box or helping this person but then I’m just shoving them out the door because I don’t have that much time?’ Max
 
‘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’. Stephen
 
‘It shouldn’t be seen as a panacea to the problem of depression, you know that’s very important that they offer talk therapy as well’. Gerry
 
‘There’s a whole world of support out there and GP’s and the medical profession could act as a sort of gateway to not just the drugs but all the other places that people can get help’. Stuart
 
‘Double check that the person does really need it and there’s not another condition that’s underlying … just really listen to your patient and talk to them other over a period of time rather than just in one consultation’. Olivia Y 
 

‘Have a two way conversation with the person... it’s...

‘Have a two way conversation with the person... it’s...

Age at interview: 31
Sex: Female
Age at diagnosis: 17
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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 as much about talking...

‘It’s as much about talking...

Age at interview: 48
Sex: Male
Age at diagnosis: 44
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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.
 

Michael’s message is for doctors to provide information...

Michael’s message is for doctors to provide information...

Age at interview: 72
Sex: Male
Age at diagnosis: 26
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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”.
 

Hannah wishes doctors could ‘prescribe’ exercise classes...

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Hannah wishes doctors could ‘prescribe’ exercise classes...

Age at interview: 28
Sex: Female
Age at diagnosis: 23
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I think there should be more options without like because when I when I first went to my GP it felt like that was the only, that was like the only option really because there was such a long wait for counselling it didn’t feel like there was anything else. But even like I don’t know if there is any kind of sort of exercise schemes or some sort of therapy courses, I think definitely the more options the better but also you do need that because, you know, sometimes when you feel like you just don’t know what to do or what’s the best approach.


Last reviewed June 2016.
​Last updated June 2016.
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