And more "depressing" statistics

[robinturner]

I wasn't intending this statistics abuse thing to turn into a series, but I can't help commenting on an article from The Daily Telegraph, "Women and depression: a modern malaise?"

The figures would appear to be rising further, as there has been a 43 per cent rise in the number of antidepressant prescriptions issued by GPs over the past four years, with the current total now standing at 41 million.

This increase in female depressive disorders is believed to be due to the stresses of balancing home and work, caring for sick relatives and feelings of loneliness brought about by childlessness, broken relationships or teenage children leaving home.

An increase in the number of prescriptions is the same as an increase in the number of people getting ill? So when some charity go and hand out, say, medicines to treat malaria, they're actually increasing the number of malaria cases?

Incidentally, depression (and in particular female depression) has been touted as a "modern malady" for as long as I can remember (and I remember that Rolling Stones song, "Mother's Little Helper"). Of course the word "modern" is suitably vague, but I assume they're not talking about "modern history" (i.e. any time after the French Revolution) or "modern" as opposed to "post-modern"; they mean "kind of now". In fact, later on, they point to an increase noted since 1993, which is a lot more precise, though those figures just talk about experiencing "some kind of mental disorder," which again is annoyingly vague. Since I'm neither a doctor nor a statistician, I have to describe my attitude as confusion with a streak of skepticism. Maybe that counts as experiencing a mental disorder too.

Comments

[miss-next.livejournal.com]

As an ex-depressive myself, I too am sceptical, possibly more so than you. People have always had to cope with the sort of stressors that the article mentions. (Admittedly the home/work balance has mainly been an issue since the Industrial Revolution, since before that time most people either worked from their homes or had a home-from-home in someone else's. Even so, there was still balancing to do, especially if you worked away from home as a domestic servant and very rarely got away from your work environment.)

To point to this or that external circumstance as a cause of depression is, in my opinion, misleading and unhelpful. Sometimes depression does have a recognisable external cause, and there's even a medical name for that: "reactive depression". The last bout of depression I ever had - ten years ago - was in that category. The others weren't. It's true that they probably weren't helped by the external circumstances at the time, but the circumstances can't have caused the depression, otherwise I wouldn't have weathered similar (and on some occasions much worse) circumstances in the last ten years without getting depressed. The fact that I got depression rather than sailing robustly through a sea of troubles (sorry, Shakespeare, but that does work slightly better against seas than taking arms against them) meant that, at the time, something in my brain wasn't working properly. It works just fine now.

So, if depression is on the increase - and that is quite difficult to tell, because depressed people do have an inconvenient tendency to go very quiet and unsociable and therefore not leave much trace on the historical record - then we need to be looking for something in our food or the environment that is upsetting the normal working of people's brains. I'd start looking at food first, if I had to, simply from my own experience: my diet has changed significantly since I last suffered from depression. But good luck to any scientists out there who are doing this, because there are an awful lot of candidates... and don't forget that the problem could be negative. In other words, it may not be a question of eating something we shouldn't, but of not eating enough of something we should.

There are an awful lot of ifs and buts here.

[solri.livejournal.com]

I agree with most of this, especially the last sentence! They may have a point about social factors, but then, as you point out, none of these are very new (as though infertility were a modern problem!). Of course it is always possible to jump to the opposite conclusion and assume a disorder to be universal when it's found much more in some cultures and times than others, hysteria being a case in point.

[solri.livejournal.com]

Bingo—a high fat and sugar diet contributes massively to depression: Akbaraly, Tasnime N., Brunner, Eric J., Ferrie, Jane E., Marmot, Michael G., Kivimaki, Mika, Singh-Manoux, Archana. Dietary pattern and depressive symptoms in middle age. The British Journal of Psychiatry 2009 195: 408-413 (http://bjp.rcpsych.org/cgi/content/full/195/5/408)

[miss-next.livejournal.com]

Oh, interesting! Though I've never had a diet very high in either fat or sugar (I can't eat a lot of either at once). The big change in my diet once my ex-husband walked out was that it got much more varied, because he was no longer there to drink the money.

Though I do say it myself, I'm absolutely brilliant at arranging a basically healthy diet on minimal resources. It was just so nice to be able to afford things like tomatoes all of a sudden.

[alsoname.livejournal.com]

To the writer's credit, s/he did say "would appear to be." Though I agree with you, and have the same reaction when people claim that autism rates are rising.

I take greater offense to the second paragraph, though!

[vret.livejournal.com]

You are right to be dubious. As far as can be determined so far, the increase is not down to an increased number of patients, but to a small number of patients being given a small increase in prescriptions over a long period.

Details from Ben Goldacre