IWAS 20 the first time I was prescribed antidepressants. I had gone to the doctors during a rainy, Manchester January due to the flu. Somehow, I came out having been diagnosed with depression and prescribed a course of SSRIs. But I didn't have a mood disorder, and I didn't need medication.

Over the past decade, antidepressant prescriptions have doubled in the UK. More people than ever are taking these drugs - a number equivalent to almost one in four adults. They're also doing so for longer - the average duration of time spent on antidepressants has doubled since the 2000s. While this may be in line with heightened awareness of mental health, the growing barrage of pills hasn't improved outcomes. "The evidence is overwhelming that the way we've gone about trying to understand and solve mental health problems for the last 30 years has failed," says associate professor of medical anthropology James Davies.

That's despite nearly a quarter of a trillion pounds being allocated to mental health over the last four decades. Recent research reveals that the cost to the NHS of 5.4m people in England being unnecessarily prescribed addiction-forming drugs including antidepressants is £560m a year. At the same time, the total cost of poor mental health was estimated at £300bn in England alone in 2022.

However, money, or rather money spent on drugs, is not necessarily the answer. The problem, according to Davies and the Beyond Pills APPG, is an overreliance on drugs in mental health care. "Mainstream biomedical thinking in mental health has broadly championed the chemical imbalance theories of depression," says Davies, even though this theory has "now been disproven". The 'chemical imbalance' theory has presided over Western healthcare since the 1980s when Big Pharma dreamt it up. At the time, firms such as Pfizer were looking to create a next generation of drugs after benzodiazepines (sedatives) fell out of favour. Having developed selective serotonin reuptake inhibitors (SSRIs), they needed to sell them to consumers and the medical community. Their idea - that low levels of serotonin caused depression and could be fixed with an SSRI - came to dominate the public imagination and medical establishment largely due to industry marketing, a UCL review states. Pfizer has since even accepted that the chemical imbalance theory was an "inappropriate" inclusion on medical leaflets for Sertraline. This is part of the "systematic entanglement of psychiatry with the pharmaceutical industry," Davies says. The UN agrees. In 2017, a report stated: "our collective knowledge about mental health [has] become tainted", directly blaming the industry for "corrupting research".

Multiple studies have shown antidepressants have no clinically meaningful benefit beyond the placebo effect, except for patients with the most severe depression. What's more, pills can have potentially life-altering side effects. These include headaches, nausea and sexual numbing or asexuality.

The tide, however, is shifting. A report by the Beyond Pills APPG released on Monday to coincide with Mental Health Awareness Week argues for a paradigm shift. Rather than an overreliance on medication, it wants a more holistic approach that addresses the social, economic and psychological determinants of mental health.

"We argue that a lot of the distress in contemporary society isn't a medical issue, it's a social issue, a political issue. It's poverty, inequality, discrimination, social injustices," Davies says. "For example, a single mum on a council estate during Covid was three times as likely to get depressed as a middle class mum with a garden. This has got nothing to do with biology. This has got everything to do with the social predicament you are subject to."

" A reformed approach understands that often mental health problems are symptoms of broader social issues. Investing infinancial, social and material support for families, schools and communities could help reduce the need for referrals later on.

Statistics show that most depressive episodes improve in a few months without medication. Whilst there is absolutely a place for pills, their potency has been overstated due to Big Pharma. But the truth is often we need help to change something within the orbit of our lives - form deeper connections, have more meaningful jobs, spend more time in nature. A pill can't be a substitute.

Lucy Kenningham is a feature writer at City A.M.

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