The drugs don’t work (and other mental health myths)
Our attitudes to mental health are changing but much of the stigma that surrounds conditions such as schizophrenia remains – along with some enduring and often damaging untruthshere can be little doubt that public attitudes to mental health have already turned a corner. Just consider the sheer number of public figures – from Robbie Williams and Lady Gaga to Baroness Davidson – who have opened up about their struggles.
Despite this progress, some myths about mental illnesses are still widely shared, including false claims about the efficacy of treatments. Here are six of the most prevalent beliefs, and the truth behind them.
In reality, there is very little hard evidence that overdiagnosis is the serious problem that some claim. Surveys of depression in western countries, for instance, have failed to reveal a large uptick in diagnoses as people jump on the “mental health bandwagon”. “The evidence points at stability,” says Prof Johan “Hans” Ormel of the University of Groningen in the Netherlands. He suggests that doctors are just as likely to miss real cases as they are to wrongly diagnose someone who is simply experiencing transient distress.
Related to the claim that doctors are medicalising everyday distress, there is the suggestion that many people who think they have depression should show more resilience and simply wait for time to heal their woes. If they are simply suffering transient sadness, after all, then the problem should surely go away on its own?
To find out if this were really the case, researchers in Australia examined the data from 16 clinical trials, in which a control group of patients had been placed on a “waiting list” before being given a treatment. They found that just, while the rest continued to show symptoms during the three-month period.
It’s not just the diagnostic process that has inspired medical myths; the treatments used to help patients are often the subject of misinformation.
One common belief is that , and work no better than a placebo. The idea recently attracted widespread attention following the publication of a paper that raises some serious questions about the proposed mechanism of these pills.
SSRIs, which include Prozac, were thought to address a “chemical imbalance” in the brain, by correcting levels of the neurotransmitter serotonin that is thought to be involved in mood regulation, among other functions. The recent paper, however, examined the evidence to date and concluded that there was .
Other myths concern side-effects. You will see many articles, for example, claiming that antidepressant pills “blunt” people’s emotions. There is a seemingly good basis for this idea: many patients do report concerns that their medications have muted life’s ups as well as its downs, resulting in numbed feelings.
Until recently, however, few studies had interrogated the causes of the emotional blunting, and it now seems that the . It makes sense: depression is often accompanied by apathy and an inability to feel pleasure. The SSRIs have taken away the more salient 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 recent study: “The feeling of emotional blunting is real, but it isn’t caused by the drugs.”
Perhaps the most persistent myth has been the idea that mental suffering is a source of artistic genius – from Virginia Woolf to Kanye West. But any is extremely tenuous, says Prof James C Kaufman at the University of Connecticut.
“Historiometric” analyses, for example, have plumbed the biographies of notable artists. While these studies seem to suggest that mental illness is more prevalent in creative personalities, any post-hoc diagnoses, based purely on a text, have to be treated with great caution. “They are not super objective,” says Kaufman. “Very few creativity researchers believe there is a strong connection.” And the idea that mental anguish may inspire great art certainly shouldn’t be grounds for avoiding treatment for a serious conditions, he says.
One big misconception is that schizophrenia is simply “untreatable”. With the right medications and talking therapies, however, , while 35% show mixed patterns of remission and relapse. The belief that there is no chance of recovery can be a cause of great despair for people who have been diagnosed with the disease, and their families. (The campaigner and film-maker Jonny Benjamin famously described the diagnosis as feeling like a life sentence.)
In general, earlier interventions are more effective. But a chronic lack of resources in the health service means that many people with schizophrenia fail to get help in the first stages of a crisis, says Wallace, which reduces their chance of recovery. They may be turned away from hospitals or psychiatric facilities, and often it will be police officers who end up dealing with the patient. The escalation of their condition in these cases only adds to the perception that it is impossible to treat, yet the person may have fared far better if they’d had earlier access to treatment.