Through the wasteland: chronic depression
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d93 (Published 11 April 2011) Cite this as: BMJ 2011;342:d93
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Dear Editor,
It was interesting to read the paper of Hopson &
Holmes, Through the wasteland: chronic depression (1). During
my training I spent some time on the rotational scheme in Nottingham; one
of the Consultant Psychiatrists at Mapperley Hospital in Nottingham told
me that when he was appointed for the first time in
psychiatry during the 1950s/60s, they gave him a master key, and he used
to lock every door behind him! During my training in the late 1970s and
early '80s, the wards were overcrowded but the situation was more liberal.
I think nowadays, for example, we are using less ECT than before. We discuss the
treatment plan with the patients and have their agreement. They have many
assessments like risk assessment, capacity assessment, etc. Patients
receive copies of letters about them which have been sent to their GPs,
but still psychiatric illness carries a stigma. I think there is still
discrimination against people with mental illness. I heard a Mausdley
debate recently about Stigma and Discrimination; the lecturer gave an
example of when his mother had postpartum depression and she was off sick for
sometime. She was working as a charge nurse at that time and after discharge
he asked whether she was going to tell her employer after returning back
to work, she replied saying, definitely not, because they will sack me.
Is the situation different nowadays with the economic crisis? I don't
think so, although it is an offence to discriminate because of mental
illness.
References
1.Hopson J, Holmes J,A Patient's Journey: Through the wasteland:
chronic depression. BMJ 2011;342:doi:10.1136/bmj.d93 (Published 11 April 2011)
Competing interests: No competing interests
Depression is treatable condition: Lesson for physicians
The first-hand account by a patient with chronic depression has many
lessons to teach readers.
Firstly, there is a serious need to look
towards the pathetic state of mental hospitals throughout world.
Governments should wakeup and enhance their budgetary provisions for
improving infrastructure of these hospitals.
Secondly, despite efforts of
awareness and sensitization programmes, depression is under-diagnosed and
under-treated. Most physicians either do not pick up or treat
depression or consider it to be the job of psychiatrists.
Lastly, there is a wide
range of modalities available for treatment of depression, including
antidepressants and psychological treatments.
I highly appreciate that the BMJ has picked up the case of chronic depression, but it
may also lead to divergent messages to its readers. Success stories by an esteemed journal have a positive impact on doctors and
motivate them in picking up and treating depression.
Competing interests: No competing interests