Intended for healthcare professionals

Rapid response to:

Analysis Too Much Medicine

Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7140 (Published 09 December 2013) Cite this as: BMJ 2013;347:f7140

Rapid Response:

Re: Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit

I want to offer some hope here and invite you to be courageous.

I'm at the other end of all this. I'm a personal development coach in private practice, working in the field of Therapeutic Coaching and Auto Response Psychology. Many of my clients (we deliberately avoid the use of the word 'patient' because of its subservient associations) have already been to their GP and been offered some form of medication or CBT to alleviate their sadness and it hasn't worked. I also have GPs as clients, coming to see me because of the challenges they are facing, both personal and professional.

My contribution to this discussion is to say that there are now all sorts of very effective interventions available that sort out the causes of emotional damage due to life experiences. Some of the issues mentioned in the article can be addressed directly, have simple, clean and direct solutions, that literally 'rewire' the patient's thinking - and it can take as little as a few hours, perhaps just two 2-hour appointments to do that. (Typically a maximum of 4 sessions.)

Could it be that the main problem is that doctors are frightened to step beyond the current perceived options recommended by NICE? It takes courage to risk being regarded as lacking in judgement by their peers, and being reported by their patients for NOT prescribing, even though the GP knows they don't need that medication.

GPs who I deal with often cite their ethical problems in this field: Do they prescribe unnecessary medication 'on demand' when they know the side effects may be significant and potentially increase the life experience damage the patient has experienced? How can they do more within the minimal timeframe of the average consultation?

Hope? Yes, those of us putting the work in at this end can reassure our primary care colleagues that effective alternatives (and training) are available, but it needs your courage to explore them and use them in the face of sometimes overwhelming pressure not to.

Competing interests: Professional coach with GPs and their patients as clients.

17 December 2013
Andrew Sercombe
Coach
Powerchange
Thakeham, West Sussex, RH20 3NA