Robert makes the case for the life-saving effects of psychiatric medication and why we need research to find new drugs and improve how we prescribe them.
Drugs get a bad name: taking pills will only ‘mask’ the symptoms; pills aren’t ‘the answer’. Big Pharma, nasty drug companies.
I find this frustrating. I’m not sure I’d be alive without them, or certainly life wouldn’t be much worth living. Two months ago, I started a new anti-psychotic medication, which has helped transform my life.
I was diagnosed with bipolar disorder, aged 18. I’ve had 27 years of hit and miss prescribing, more miss than hit. I’ve taken literally dozens of different medications. Some have helped control the symptoms to an extent. Lithium made a big difference and really helped with the depressive phases of my bipolar disorder.
But nothing had ever stopped the rapid cycling. It was relentless. Up for 10 days, down for 10 days – and then all over again, without variation. A rollercoaster journey that has punctuated most of my adult life, with only a few periods without cycling.
This meant weekends in bed, when I was depressed, unable to care for my children properly. When down, one of my symptoms was social anxiety. It was so severe even socialising with my parents, brothers and their families could cause me paralysing fear and anxiety, let alone the social terrors of a week in the office.
There’d be no joy, no hope, until the 10 days of very mild mania (largely suppressed by the medication) got underway. Some extra energy, some fun, but also agitation and sleeplessness, and then back down again and onto 10 days of depression. And then all over again. Groundhog Day. Again, again and again.
This new ‘atypical’ antipsychotic has blown my socks off. No cycling, no social anxiety. My wife barely recognises me (I’d already fallen ill when we got married 13 years ago). Life almost feels, well, normal.
But how did I find this new drug? I have relentlessly hunted for treatments that might work. This one was was suggested by a professor of psychiatry I know and pestered for tips. This medication was licensed for use in the US in 2010 and in the UK in 2014. It is recognised as highly effective for depressisve episodes (yes, that’s me) in bipolar disorder, I’ve since discovered. It wasn’t suggested by my own psychiatrist. In fact, my psychiatrist has not suggested either of the drugs that’s worked (I asked to be put on lithium).
So, what’s going on there? Why does it take such a long time for new effective treatments to trickle down into NHS practice? In my view, psychiatry is far more backward and good practice far less well established than in other branches of medicine, like oncology. It feels to me like your average psychiatrist isn’t going to go that extra mile, won’t know about emerging treatments and you’ll get bog standard treatment.
How many people are there out there, like me, but not being prescribed this drug because they’re not pushy patients and don’t know a professor of psychiatry? A lot, I’d guess. I’m only enjoying the benefits because I obsessively searched out treatments that might help – any treatments – and struck lucky. What happens to those who are less involved with their care, unable to advocate for themselves? In fact, statistically only one in three psychiatric patients get the best practice treatment they so desperately need.
So there are two messages. Psychiatry needs to catch up with the rest of medicine, so everyone gets the most effective treatment for them and it’s not pharmaceutical pot luck anymore. Only training and investment will do that. And more life-changing drugs like the one I’m taking need to be discovered. We must fund scientists to design more targeted drugs that can save and transform lives like mine. These drugs - and the wider research agenda MQ supports - are critical to improving the lives of the millions of people whose lives are blighted by mental illness worldwide.
Last updated: 23 March 2018