The Drugs Don’t Work (And Other Myths About Mental Health) | Mental health

TThere is little doubt that public attitudes towards mental health have already undergone a reversal. Just think of the sheer number of public figures – from Robbie Williams and Lady Gaga to Baroness Davidson – who have been open about their struggles.

According to an analysis of English newspapers, the number of articles stigmatizing mental illness roughly halved between 2008 and 2016, while articles challenging that stigma roughly doubled over the same period. And that seems to be having a positive impact on everyday experiences of prejudice—people with mental illness now report significantly less discrimination from family, friends, and co-workers than just a few years ago.

Despite these advances, some myths about mental illness continue to perpetuate, including false claims about the effectiveness of treatments. Here are six of the most common beliefs and the truth behind them.

Mental illnesses are overdiagnosed

Let’s start with the idea that people mistake everyday stress for a clinical disorder. The claim is a favorite of television personalities and newspaper columnists, who regularly claim that the increasing focus on mental health is reducing people’s autonomy, causing them to turn to medical interventions instead of addressing the issues in their lives.

In reality, there is very little hard evidence that overdiagnosis is the serious problem that some claim. For example, surveys of depression in Western countries have not shown a large increase in diagnoses as people jump on the “mental health bandwagon.” “The evidence points to stability,” says Prof. Johan “Hans” Ormel from the University of Groningen in the Netherlands. He suggests that doctors are just as likely to miss real cases as they are to misdiagnose someone who simply has a passing condition.

Time is a healer

Related to the claim that doctors are medicalizing everyday ailments, there is a suggestion that many people who believe they have depression should show more resilience and simply wait for time to heal their ailments. If they experience only temporary sadness, surely the problem should go away on its own?

To find out if this is really the case, researchers in Australia looked at data from 16 clinical trials in which a control group of patients were put on a ‘waiting list’ before treatment. They found that only one in eight of these patients went into remission while awaiting therapy, while the rest continued to show symptoms throughout the three-month period.

Antidepressants don’t work

It’s not just the diagnostic process that has inspired medical myths; The treatments that help patients are often the subject of misinformation.

A common belief is that a common class of antidepressants called SSRIs (selective serotonin reuptake inhibitors) are ineffective and work no better than a placebo. The idea garnered a lot of attention recently following the publication of a paper that raises some serious questions about the proposed mechanism of these pills.

SSRIs, which include Prozac, have been thought to correct a “chemical imbalance” in the brain by correcting levels of the neurotransmitter serotonin, which is thought to be involved in mood regulation, among other things. However, the most recent study examined the evidence to date and concluded that there is no clear link between serotonin levels and depression.

But there are many other ways they can help relieve symptoms — like reducing inflammation, which is another potential contributor to depression. An up-to-date meta-analysis is important lancet, considering several clinical studies, confirmed that SSRIs are effective in relieving depression. Although they don’t work for everyone, they are about 50% more likely to cause a reaction than placebo pills. According to Professor Cathryn Lewis of King’s College London and Professor Andrew M. McIntosh of the University of Edinburgh, the clinical benefits are now ‘above any doubt’.

“Happiness pills” simply numb people’s feelings

Other myths concern side effects. For example, you will see many articles claiming that antidepressants “blunt” people’s emotions. There’s seemingly good foundation for this idea: Many patients report concerns that their medications have dulled the ups and downs of life, leading to numb feelings.

However, until recently, few studies had investigated the causes of emotional numbing, and it now appears that numbness may be a residual symptom of depression. It makes sense: depression is often accompanied by apathy and an inability to feel joy. The SSRIs eliminated the more pronounced feelings of hopelessness – but they don’t necessarily increase positive emotions and motivation, says Prof Guy Goodwin of the University of Oxford, who conducted the current study: “The feeling of emotional deadening is real, but it doesn’t get through the drugs caused.”

Mental illness makes people more creative

Perhaps the most persistent myth has been the notion that mental illness is a source of artistic genius – from Virginia Woolf to Kanye West. But any evidence to support the link between creativity and mental illness is extremely tenuous, says University of Connecticut professor James C. Kaufman.

“Historiometric” analyzes have fathomed the biographies of well-known artists, for example. While these studies suggest that mental illness is more common among creative personalities, post hoc diagnoses based on text alone must be treated with great caution. “They’re not super objective,” says Kaufman. “Very few creativity researchers believe there is a strong connection.” And the idea that mental anguish could inspire great art certainly shouldn’t be a reason to avoid treating a serious medical condition, he says.

Schizophrenia is not treatable

Despite changing attitudes toward other mental illnesses, schizophrenia still carries heavy stigma, says Marjorie Wallace, founder and executive director of mental health charity SANE. “Schizophrenia is still a ‘forgotten disease’ because it’s been pushed out of all these anti-stigma campaigns that have emphasized stress, depression and anxiety.” This means that most people only have a vague idea of ​​the condition, although lifetime prevalence in the UK is around 1.5%.

A big misconception is that schizophrenia is simply “incurable.” However, with the right medication and talk therapy, 45% of people with schizophrenia go into remission after one or more psychotic episodes, while 35% experience mixed patterns of remission and relapse. The belief that there is no chance of a cure can cause great despair for people diagnosed with the disease and their families. (Activist and filmmaker Jonny Benjamin famously described the diagnosis as a life sentence.)

In general, earlier interventions are more effective. But a chronic lack of health care resources means many people with schizophrenia don’t get help in the early stages of a crisis, Wallace says, reducing their chances of recovery. They can be turned away from hospitals or mental health facilities, and it is often the police who eventually attend to the patient. The escalation of their condition in these cases only adds to the perception that treatment is impossible, but the person might have fared much better if they had access to treatment sooner.

  • The Expectation Effect: How Your Mindset Can Change Your Life by David Robson is published by Canongate (£18.99). In support of Guardian and observer Order your copy at guardianbookshop.com. Shipping costs may apply

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