Opinion: The right prescription

  • 10/12/2015
Opinion: The right prescription

By Kyle MacDonald

Ask most people what the first thing someone should do if they’re depressed or anxious and most will likely say: see your GP. 

Likewise, most people would think the first treatment you're likely to get offered would be medication, specifically anti-depressants.  At least in New Zealand, you'd be right.  But you might be surprised to know not only is this not good practice, it may also be unhelpful.

The two big mental health research and good practice agencies in the world, the National Institute of Clinical Excellence in the UK (or NICE which is a great acronym), and the American Psychological Association in the USA (the APA) are clear that the first line of treatment for depression and anxiety, especially in the mild to moderate range, should be talk therapy.

Not only that, but there is also a lot of studies that show that most of the anti-depressant medications aren't very effective for mild to moderate range depression and anxiety, and certainly not as helpful as talking with a psychotherapist or clinical psychologist.  Not only that but when therapy is combined with medication for severe depression, both in combination are more effective than either on their own.

This is why people like me get so fired up about the lack of funded and affordable talk therapy options available in New Zealand right now.

It's great we're starting to break down the stigma so we can start to talk openly about how many people struggle with mental illness.  We now also need to be having a public conversation about what effective treatment looks like, and demanding it be appropriately funded, just like any other proven health treatment.

Kyle MacDonald is a psychotherapist at the Robert Street Clinic in Auckland and the Public Issues Spokesperson for the New Zealand Association of Psychotherapists.  You can see more about him, including his regular blog and podcast at www.psychotherapy.org.nz. 

This blog is part of Story's Mental Health Hub, a series documenting mental health and the work place.