Editorial: This post comes from a Belgian colleague. Belgium’s best-selling pop singer Stromae has been talking about his drug-induced illness all over the media since last year. He claims the anti-malaria drug Lariam (mefloquine) made him instantly psychotic and caused long-term anxiety problems which have already persisted for 3 years after stopping the drug, and still counting. See this account in the Guardian and this elsewhere. It is not that I don’t believe him – we should give him the benefit of the doubt in matters like these – but in a country such as Belgium, which has the highest prescription rates for benzodiazepines in the world, and also very high antidepressant and antipsychotic use, not a single person has ever been allowed to blame his symptoms on a prescribed drug. Ever. There are literally ZERO confirmed and officially recognized cases of benzodiazepine withdrawal syndrome in Belgium. Certainly my protracted withdrawal syndrome has never been validated, and I was on 7 different benzos, all on prescription and taken as prescribed, for nothing more than plain insomnia. I was also taken off the tablets abruptly no less than 6 times, by the best psychiatrists of the country.
So what’s the deal with Stromae then? His doctors believed him instantly, and his diagnosis “sick as a result of the pills” is doubted by no one. He can talk about his illness freely without anyone stopping him. If ordinary mortals like myself say the drugs made us ill they treat us as attention-seeking loons. It’s also interesting to note that the singer openly admits he was already on the verge of a nervous breakdown prior to taking Lariam. I looked up the frequency of serious complications with this medication and all sources say it is only 1 in 10.000. I assume this is an underestimate but still the actual percentage would never be as high as 15% of users, which is how many benzo users get into serious trouble with also long-term damage after quitting (as in YEARS). Roche by the way are responsible for both Lariam and the benzodiazepines. I’ve already told our Minister of Health that I don’t have to take this. Millions of Belgians are with 100% certainty sick because they take prescription drugs, and none of them is ever believed. But now a celebrity says he was damaged by medication he took for a couple of days 3 years ago and he gets away with it. I have not received a reply from our Minister of Public Health yet regarding the Stromae case versus the total neglect of benzo victims. But I know she reads my e-mails, or at least her staff does, because in the past I have received replies on different matters. Also in my letter of complaint to the minister was this: in January, a leading Belgian child psychiatrist denied on live TV that we prescribe too many antidepressants to children.
To fight a rising tide of depression and suicide, psychiatrists need to do more than just fill patients up with pills
The New York Times recently published an important investigative report shining a long-overdue light on the painful, sometimes disabling experience of withdrawing from antidepressants – drugs that millions of Americans have been taking, sometimes for decades
The recent deaths of Kate Spade and Anthony Bourdain threw into stark relief the human toll that depression can take. But the problem is complex, with multiple factors. We are seeing a striking increase in the number of Americans diagnosed with depression, and an accompanying increase in suicides. This is coupled with the promiscuous and sharply increasing prescription of antidepressants to 34.4 million Americans in 2013-2014, up from 13.4 million just 15 years earlier. And this pervasive prescribing continues despite the lack of proof of the drugs’ long-term effectiveness; their mixed results even with short-term treatment; the frequent side-effects – weight gain, gastrointestinal problems and sexual dysfunction – that are themselves depressing. Meanwhile, we are paying the prohibitive financial costs of depression – an estimated annual average of $210.5bn in treatment and lost productivity.
These numbers raise critical questions: why are so many Americans becoming depressed? Why do rates of suicide, depression’s dire and irreversible consequence, continue to increase – by 25% since 1999 according to a recent Centers for Disease Control and Prevention report? Why are we treating vast numbers of these depressed and suicidal people with drugs that are of limited effectiveness? How can we do better?
Depression is characterized by low energy and despondency, negative self-esteem, pervasive pessimism, difficulties with eating, sleeping and sexual functioning, and helplessness and hopelessness. It is caused by biological, psychological, social and economic and spiritual challenges which are increasing in number and severity and often compound one another. These include decreases in social support and the loneliness that follows; high levels of stress about the economy, and the future; the hyper-competitiveness and hypercritical self-assessments of youth; sedentary lifestyles and poor diet; and our addiction to our digital devices.
The prevailing psychopharmacological treatment is based on the theory that depression is a neurotransmitter disorder. Pharmaceutical manufacturers and physicians are fond of making an analogy between depression and type-1 diabetes. The bodies of type 1 diabetics do not produce enough insulin, so diabetics receive insulin by injection. Depressed people, the analogy goes, are incapable of producing adequate amounts of neurotransmitters and must be prescribed drugs to increase them.
This is incomplete and misleading. Some depressed people may have lower levels of serotonin or norepinephrine. But no one knows how many, and doctors rarely measure these levels before prescribing drugs. A variety of emotional, social, nutritional and environmental factors affect a person’s fluctuating neurotransmitter levels, which in turn affect how a person functions. In other words, low levels are likely to be the symptoms, not the cause, of depression. Unfortunately, the prevalent view of depression as a “Prozac deficiency disease” prevents many Americans from seeking out a more comprehensive, safe and effective approach, grounded in self-care and group support.
Meditation is fundamental to this approach. Slow, deep breathing relaxes our body, quiets our mind, and lowers the stress which often precipitates depression. It quiets activity in the amygdala, a portion of the emotional brain responsible for fear and anger, and enhances activity in the hippocampus, which mediates stress and memory and is damaged by depression. Meditation thereby promotes functioning and increases tissue mass in the frontal part of the cerebral cortex, where depression has inhibited judgment, self-awareness and compassion. Meditation also makes it easier for us to connect with others who may provide comfort, intimacy and support. It gives us perspective – helping us see that what seemed insurmountable is manageable. It promotes compassion, and facilitates finding mood- and life-enhancing meaning and purpose.
Physical activity complements meditation. As a depressed person moves, she overcomes her inertia, releases tension and reclaims and enjoys a body that seemed alien, even hostile. Jogging, tai chi, yoga and dance all lower stress and stress hormones, may help rebuild the hippocampus and enhance activity in the frontal cortex. Exercise by itself can be at least as effective as drugs in relieving depression.
These self-care tools enhance the production of the neurotransmitters that drugs are aimed at – serotonin, dopamine and norepinephrine – without damaging side-effects. And the active engagement that self-care requires may itself be the most effective antidote to depression’s hallmark symptoms of hopelessness and helplessness.
Rates in Wales are the second highest among the regions of the UK, according to official data.
Suicide rates in Wales are the second highest among the regions of the UK, official figures have revealed.
Rates among men are significantly higher than among women in Wales, according to the data from the Office of National Statistics.
The figures show that Wales is only just behind Scotland in terms of suicide rates, with a rate of 11.8 per 100,000 people, compared to Scotland’s rate of 15.
Key trends from the Samaritans Suicide Statistics Report 2017
In 2015 there were 6,639 suicides in the UK and Republic of Ireland.
6,188 suicides were registered in the UK and 451 in the Republic of Ireland.
The highest suicide rate in the UK was for men aged 40–44.
The highest suicide rate in the Republic of Ireland was for men aged 25–34 (with an almost identical rate for men aged 45–54).
In England and the UK, female suicide rates are at their highest in a decade. Rates have increased in the UK (by 3.8%), England (by 2%), Wales (61.8%) and Northern Ireland (18.5%) since 2014 – however increases in Wales and Northern Ireland may be explained by inconsistencies in the processes for recording suicides in these countries.
Female suicide rates have decreased in Scotland (by 1.4%) and the Republic of Ireland (by 13.1%) since 2014.
Male rates remain consistently higher than female suicide rates across the UK and Republic of Ireland – most notably 5 times higher in Republic of Ireland and around 3 times in the UK.