Spiralling mental health medication is more dystopian than rational

Common Weal has argued for a while that one of the best indicators of our failure as a society is the mass medication of the public with literally mind-altering chemicals used to control mental wellbeing issues, particularly anxiety and depression. This is a strong indicator because it reflects both the way our society is creating this wellbeing crisis and the way we refuse to take it seriously.

And if it is such and indicator, it is another sign that things are not well in our society because we're now prescribing the best part of a million more antidepressants that we were five years ago. There are now 8.6 million antidepressant items prescribed a year for a population of 5.5 million people.

Obviously individual patients will receive more than one prescription in a year and some may be on more than one prescription, but the total is constantly rising. There are various narrative ways the government and some other stakeholders are trying to explain this, but they are not compelling.

The main argument is that people have become more comfortable talking about mental health and so the stigma of coming forward is lowered. This frankly seems like a fantastical version of the situation where presumably educated but proud people who were struggling a little but didn't like to say so are now coming forward for life-changing support they should have sought out years ago.

It is unlikely many working at the sharp end of mental health would recognise that rosey scenario. Seeking medical help with depression and anxiety is act of desperation and despair, not a lifestyle choice or a personal epiphany to share on Instagram.

But it does reflect what is becoming normalised – a medication industry which produces, supplies and campaigns for more pharmaceutical responses. Government likes the drugs because they are a comparatively inexpensive way of parking the problem out of sight. Manufacturers clearly like the drugs because they form a lucrative and growing global market.

And a generation of citizens are being trained to believe this is the best and most appropriate response to their problems and so are reinforcing the practice by seeing more and faster prescription as the solution.

What is lost in this is that the prescription of antidepressants is not a cure for depression and it is not even an effective long-term treatment for depression, it is a way of hiding and managing the problem.

But is it creating a problem instead? Antidepressants start to have some effect one or two weeks after a regime is started but it takes up to eight or 12 weeks to take effect fully. The median period of a bout of depression is 12 weeks. The most typical sufferer from depression will be recovering from their depression by the time the drugs are taking full effect.

Of course a patient will not be aware that the cycle of depression may have passed naturally and may credit the medication and therefore wish to remain on the medication much longer than necessary.

In reality a lot of depression has strong environmental factors, life stressors that combine with what may be a genetic or neurological predisposition to depression. The causes of anxiety are likely to be heavily environmental. No-one disputes that the proper solution is to deal with the environmental causes, not cover them over with drugs.

But that is expensive, time-consuming, means facing down powerful corporations and relies on something Scotland barely has – a functioning care service. It requires confronting corporations because there is a lot of evidence on what is causing this increase in poor mental health and key aspects are diet, an engineered information environment and financial instability.

The link between diets high in Ultra Processed Foods and mental health problems is very high indeed. We know that the impacts of social media's design is to create anxiety in users. Mental health issues cross class boundaries but poorer and working class people are significantly more likely to be affected.

Rather than tackle these causes by regulating the health-harming processed food industry, regulate the 'dopamine-engineering' of the social media algorithm and dealing with disrupted communities and poverty and inequality we are using the cause to solve the problem.

We literally buy pharmaceuticals from the same companies that make the food – for example, Nestlé makes some of the worst offending UPFs and also owns a series of pharmaceutical companies. We advertise mental health advice via the social media which plays a significant part in causing it. And we justify all this because there is 'no money' to do it properly.

This is most certainly not to say that antidepressants and antianxiety medication have no place. They absolutely do. While in the long term a care approach and not a pharmaceutical one is the correct solution for the vast majority of people, sometimes people need to be stabilised enough to get to that point. That is what we should be using antidepressants for.

Parking people on them indefinitely is about as close to a realisation of dystopia as it is currently possible to identify. Yet the public debate often sees the problem as the solution and no-one is really saying out loud what will actually work.

We need to regulate exploitative corporations happy to make us ill in exactly the same way we did with cigarettes. And we need a proper, functioning National Care Service equipped to address this real and increasing problem