Mental illness is not a disease and therefore cannot be an epidemic but unless we challenge the curr
Marjorie Wallace, CEO of mental health charity Sane wrote in a recent article; ‘In time the disease will pass, but, there will be aftershocks: we’re all concentrating on the physical sides of coronavirus, but actually we’re facing a mental-health epidemic.’ [1]
She warns of ‘unknowable side-effects of the draconian measures’ and compares her feelings during Coronavirus to her time in Entebbe, Uganda, and ‘Idi Amin, opaque-eyed soldiers, blackouts, restrictions of movement and association, suppressed panic, tight knots in the stomach, unfreedom, helplessness, hopelessness, unpredictability’.
Marjorie Wallace continues, ‘I woke up at 4am, safe in my bed. But the disquiet lingers on. Memories of times past speak to the present and project on to the unknown future.’
I was recently reminded by Psychotherapist Marion Brown’s letter, published in the British Journal of General Practitioners, that ‘LANGUAGE MATTERS’ and never more than during the Coronavirus Pandemic is this true.[2] - The future mental health of a generation could now be dependent on the language we use during this time. ‘Never more are memories of times past speaking to the present and projecting an unknown future.’
Let me explain…
Between 1992 and 1996, the ‘Defeat Depression Campaign’ run by the Royal College of Psychiatrists and the Royal College of General Practitioners used very specific language to educate general practitioners to recognise and manage depression. The campaign wished to assess public attitudes to know which public attitudes towards depression 'needed' to be changed and to measure the effectiveness of the campaign in promoting those changes. Surveys reported that ‘the lay public seemed to be sympathetic to those with depression but reluctant to consult. 85% believed counselling to be effective but were against antidepressants. 78% regarded antidepressants as addictive.’ At this time most patients treated with antidepressants in primary care abandoned taking them prematurely as fear of dependence was one likely explanation.
Conclusions were made that ‘Doctors have an important role in educating the public about depression and the rationale for antidepressant treatment. In particular, 'patients should know that dependence is not a problem with antidepressants.’
So what changed? Prozac and the language that came with it changed everything. The ‘Defeat Depression Campaign’ became one of the most influential marketing campaigns of our era. Mental health became a mental ‘illness’ and the solution was to be found in a psychotropic drug branded ‘Prozac’.
Prozac was first introduced in1988 and Eli Lilly marketed it ‘as happiness in a blister pack’. Prozac (Fluoxetine) was quickly handed to Interbrand, the world's leading branding company (Sony, Microsoft, Nikon, Nintendo) and given its identity. National campaigns (supported by Eli Lilly) alerted GPs and the public to the dangers of depression. Eli Lilly funded 8 million brochures (Depression: What you need to know) and 200,000 posters. Prozac was pushed as a wonder drug; entirely safe, an easy answer, an instant up, a neurological panacea. When launch day dawned, patients were already asking for it by name.
The public were brainwashed into believing depression was a biological disease, that chemical imbalances needed balancing, that GPs were missing and undiagnosing depression and suddenly our vocabulary grew with terms to explain every aspect of our ‘mental state’ which needed medicating. The language of psychiatric disorders grew with psychiatry’s ever expanding DSM and the growing powers of the pharmaceutical and psychiatry ‘industries’ which influenced our GP’s prescribing habits. The medical model of mental health took over.
There has never been any sound evidence for an 'epidemic' of depression or any other psychiatric disorder yet a 'pseudo mental health epidemic' has been created in the Western World and the case of an epidemic of antidepressant prescribing is now solid. The surge in antidepressant prescribing has always been a cultural trend as a well as a medical one. It reflects the rise of our medicalisation of everyday life. It is a rise which comes at a cost to individuals and society. It is now widely acknowledged that antidepressants can put us at risk of dangerous adverse effects, most notably they can raise the risk of suicide.
Life before Coronavirus was a constant loud drip of mental health messages from governments and charities. Some people have always found life harder than others and that hasn’t changed now, but the language being used is starting to.
When talking about the potential mental health ‘epidemic’ Marjorie Wallace uses powerful words; ‘restrictions of movement, suppressed panic, tight knots in the stomach, unfreedom, helplessness, hopelessness, unpredictability, draconian measures, being driven to distraction, dark caves, crying or pleading for mercy, months of pain, savage control, being driven to suicide, going mad, self-harming, chaos, crises, terrors of the mind, anxieties spreading across the nation, fragility and the perilousness of human existence, being scared, worried, and learning to confront mortality, intense, exhausting, unending churn.’
Dr Lucy Johnson, clinical psychologist, also wakes in the night but takes a somewhat different approach to her understandable anxiety about Coronavirus. She asks, ‘Have I suddenly developed a “mental health problem,” unfortunately timed to coincide with the COVID-19 pandemic? No, of course not. I’m having an entirely rational response to a major threat to our whole way of life.'
Dr Johnstone is somewhat more realistic; ’Surviving the pandemic, as most of us will, is only the start of it. However, we must not be tempted back into a medical narrative, even though the aftermath will probably be as bad, if not worse. Healthcare staff may be deeply shaken by the suffering they saw, but we don’t have to call it an outbreak of “PTSD.” People who have lost their jobs are likely to feel desperate, but we don’t have to describe this as “clinical depression” and prescribe drugs for it. The economic recession that will follow the pandemic may lead to as many suicides as austerity measures did, but we don’t have to say that “mental illness” caused these deaths.’[3]
The pharmaceutical Industry and psychiatry supported by governments and mental health charities have for years propagated the unsubstantiated basis on which mental health has grown to be a huge industry.
When talking about the potential mental health ‘epidemic’, Marjorie Wallace is right that ‘This time will pass’ and it is my sincere hope that the government and mental health charities begin to communicate the message that when it does, eventually, for most, so will the way they are feeling. Marjorie Wallace says ‘Without crisis funding, emotionally devastated individuals, families and communities will never recover’. I disagree. Most of us, in time, will 'recover'.
What is certain is like with the campaign in the 1990s, the drug companies will no doubt seize the potential the Coronavirus presents as an opportunity to capture new 'patients' and expand their existing mental health market. In the 1990s, Eli Lilly and psychiatry created an incredibly successful 'pseudo epidemic of depression'; by 2001, Prozac, had 40 million users and accounted for a quarter of Lilly's $10.8 billion in sales and more than a third of its $3 billion profit.
Today’s language in the media serves only to assist the pharmaceutical industry to further boost its profits in the aftermath of the Coronavirus crisis. To help us understand the success of the campaign in the 1990s; we have gone from from 85% population believing they were against antidepressants and they were addictive, to a Mental health drug business today worth an estimated £63 billion a year worldwide!
The Coronavirus crisis is an incredibly difficult time for everyone, and ‘language’ now matters more than ever. The constant ‘mental health’ messages we are receiving could become a dangerous precursor to increased prescribing of drugs we know cause incredible harm and dependence. The messages of 'seeking help’ threaten to bombard our GPs with patients seeking help for Coronavirus related ‘mental health’ issues and it is now time to realise our over medicalising of normal life events just doesn’t make sense and is in many ways unsustainable.
I suggest that unless we listen to professionals like Dr Lucy Johnstone and less to self-serving charities like Sane, the Coronavirus legacy will be one of a new generation of young people dependent on antidepressants and other drugs used in mental health.
Language matters and so do facts. There are no known biological causes for any mental health disorders apart from dementia and some rare chromosomal disorders. Consequently, there are no biological tests such as blood tests or brain scans that can be used to provide independent objective data in support of any psychiatric diagnosis. Nevertheless, the ‘Defeat Depression Campaign’ led to the unsubstantiated medicating of our mental health and to millions today being dependent on and harmed by antidepressants, including those who have died by antidepressant-induced suicide.
Marjorie Wallace says ‘past times speak of present’ and we should let that be a warning this is the time we need to realise a ‘psychosocial’ rather than ‘medical’ approach to dealing with this unprecedented difficult life event is the only sustainable one.
Thirty years on, let’s not be duped and fall for the subtle but well-orchestrated ‘Defeat Coronaviras Mental Illness Campaign’ which will no doubt be just around the corner. The future mental health of a generation really could now be dependent on the powerful language we use at this time.
Mental illness is not a disease and therefore cannot be an epidemic….it never was and never will be, but unless we challenge the current mental health narrative, ‘Memories of times past ‘definitely’ will speak to the present and project on to the unknown future.”
Please remember
There are no known biological causes for any of the mental health disorders apart from dementia and some rare chromosomal disorders
No chemical imbalances have been proven to exist in relation to any mental health disorder.
Antidepressants do not ‘cure’ diseases, and in many cases their mechanism of action is not properly understood
Studies have found that antidepressants have no clinically significant benefit over placebo pills in the treatment of mild to moderate depression
There has been little research on the long-term outcomes of people taking antidepressants and they can have effects including mental disturbance, suicide, violence, and withdrawal syndromes
Withdrawal from antidepressants can be disabling and cause severe physical and psychological effects which often last for months and sometimes years, sometimes leading to suicide
It is now widely acknowledged that prescription drugs can put us at risk of dangerous adverse effects, most notably that antidepressants and some other medication can raise the risk of suicide.
[1] https://www.msn.com/en-gb/health/familyhealth/coronavirus-we-are-facing-not-just-a-disease-but-a-mental-health-epidemic-too/ar-BB11DYfs
[2] https://bjgp.org/content/70/693/167.2
[3] https://www.theguardian.com/world/2020/mar/25/why-its-healthy-to-be-afraid-in-a-crisis