Depression and anxiety are endemic in Britain, a survey commissioned by the British Association for Counselling and Psychotherapy (BACP) reveals today. Two thirds of us told the Mintel/YouGov poll that we experience bouts of depression or anxiety, while almost nine people out of ten have had more than one period of depression.
The social and human costs of this are enormous. Depression alone takes more than £10 billion out of the economy every year. Most of us, it seems, can find our own remedies (or we grin and bear it), but nearly one person in five feels that their distress is severe enough to visit a doctor. One in ten has consulted a therapist.
Modern life has brought us all mod cons, unprecedented safety, longer lifespans and a wealth of entertainment opportunities. So why is Britain so glum and anxious? For 44 per cent of us, relationship problems are mainly to blame. About the same proportion cite overwork. More than a third of the people who had consulted their GP about depression were suffering a bereavement. A further third mentioned financial problems. London life is, perhaps unsurprisingly, the most pressured: people of all ages living in the capital had more pronounced problems stemming from money and redundancy.
For young people, the biggest problem is exams. Youthful optimism is a thing of the past, according to the survey findings. More young people report debilitating bouts of depression or anxiety than their elders. Suicide, we know, is now the commonest cause of death among men under 35 and this almost certainly reflects the fact that life today is more demanding and complex for the younger generation. Many jobs are short-term; house prices are often beyond reach. Not only are the under-35s bombarded with images of success that leave many feeling inadequate, but this generation is at the forefront of the 24/7 lifestyle — they, and their technology, never switch off.
People in their late thirties and early forties likewise appear to be under pressure, possibly struggling to balance demanding work patterns with raising a family. Many at this stage may additionally be forced to care for their ageing parents. In fact, those aged 35 to 44 were the most likely (72 per cent) to admit having suffered from either depression or anxiety. If youth is a risk factor, then so is gender: women are more likely to report suffering depression and anxiety: 73 per cent have seen their GP about it, compared with 59 per cent of men.
The BACP commissioned Mintel and YouGov to survey a nationally representative sample of 2,032 adults to determine the incidence of depression and anxiety among the general population. A second and more detailed investigation was then carried out among those 513 respondents who suffer from depression or anxiety and have a condition severe enough to see their GP or a therapist.
Overall, most sufferers report having faced more than one bout of depression or anxiety, while a third of those who suffered from depression indicated that their condition was chronic. Women are more likely than men to have had multiple episodes of depression. Most respondents reported having multiple symptoms, with women generally experiencing more symptoms than men.
All previous surveys have shown that women suffer more depression than men, usually by about two to one. The BACP survey suggests that the gap is narrowing. In early middle age, work-related issues are more likely to trigger depression in men, whereas relationship issues are more likely to trigger it in women. Regardless of age or gender, the most common treatment we receive for depression comes in a pill. Three quarters of people who sought help from a GP were given medication. But a large number of depression and anxiety sufferers take treatment into their own hands. The sale of self-help books rose by an astonishing 40 per cent last year, with five of Amazon’s overall bestsellers falling into this category.
The internet also plays an important role. We are still reticent, however, about discussing the condition with friends and family, as 55 per cent claimed never to have done so. That’s not to say that we don’t find talking useful. The vast majority of people who had received therapy, a huge 94 per cent, indicated that they would recommend therapy to others. They felt that their therapy had been beneficial, with a third indicating that it had helped a lot and about half indicating that it had helped them a little.
The biggest plus for people who have benefited from specialist therapy for the treatment of depression or anxiety was the “opportunity to talk through their problems” with someone who has “time to listen, wouldn’t be judgmental and had experience in helping people in a similar predicament”. While the first port of call should always be the GP, most doctors may not have the time, even if they have adequate training, to help people through these most complex experiences.
It’s clear, then, that the medical response to depression is slipping in popularity. Patients are inevitably influenced by remarks such as those of Dr Allen Roses, the vice-president of genetics at GlaxoSmithKline, who in 2003 admitted: “The vast majority of drugs — more than 90 per cent — work in only 30 to 50 per cent of the people.”
We already possess evidence from Professor Michael King’s research, published in the British Medical Journal, in December 2000, that the best and most cost-effective treatment for most depressions is psychotherapy and not only in its simpler cognitive behavioural therapy forms. This BACP survey suggests that patients would like a more holistic approach to mental health treatments, with less dependence on drugs.
When stricken with despair, the public wants to talk. If the Department of Health is wise, it will listen. If the politicians want our votes, likewise. And that approach needs to be nationwide. There are now significantly more therapists in London NW3 than in Devon and Cornwall. Future governments must ensure that other postcodes nationwide have as many resources.
Phillip Hodson is a Fellow of the British Association for Counselling and Psychotherapy
Finding the best treatment
Therapy A trial published in the British Medical Journal in 2000 found that in the short term non-directive counselling and cognitive behaviour therapy (CBT) were more successful at relieving depression than alternatives such as drugs. CBT may especially benefit people with moderate to severe depression. One person in ten being treated for “neurotic disorders” such as depression is having therapy.
Drugs The Government no longer recommends the use of antidepressants for mild depression. The risks of taking them outweigh the benefits. However, they can be of genuine help to people with severe depression. About one fifth of people being treated for a condition such as depression are taking medication.
Drugs and therapy With severe depression, the Government recommends a combination of drugs and CBT because studies indicate that this is the most effective approach. About 4 per cent of people being treated for conditions such as depression are receiving both drugs and therapy.
Exercise A report last year from the Mental Health Foundation said that exercise could be just as effective as antidepressant drugs. Just 10-15 minutes’ exercise can improve mood. The Government recommends it as a first line of self help.
St John’s wort This herbal remedy can help with mild to moderate depression. But it can cause unpleasant side-effects.
