Doctor"s Diary: are medical professionals dependent on Prozac?

At 1 time, psychiatrists produced a distinction between two kinds of depressive sickness: melancholia, a significant, protracted, often lifelong gloominess of the spirit and the a lot more widespread “reactive” depression, whose comparable but less severe symptoms are normally in response to an adverse daily life occasion, such as unemployment, marital breakdown or bereavement. Back in 1980, the American Psychiatric Association abolished this distinction in favour of seeing depression on a continuum, more significant in some than other individuals, but usually responsive to medicine.

Subsequent, Prof Shorter argues that psychiatrists were also readily seduced by claims that Prozac-like medicines have a particular mechanism of action, bettering mood by boosting the ranges of serotonin in the brain. In reality, scientific understanding of the role of transmitters in mental sickness was, and remains, “trivial”.

“The complete Prozac story is a cautionary tale,” says Prof Shorter. “When it comes to both diagnosis and treatment, the early approaches are very typically far better.”

Dizzy at springtime

The conundrum featured in this column of the lady whose mild vertigo when lying down or turning in excess of in bed is exacerbated close to the spring equinox has prompted the notion that this have to be due to adjustments in strain in the middle ear – for which there are two attainable explanations.

The very first would be a hayfever-variety allergy, the place sensitivity to pollens in late March brings about narrowing of the Eustachian tube at the back of the throat, stopping fluid draining from the middle ear and adversely affecting balance.

Up coming, readers level out that the climate is typically unsettled at this time of year (therefore March “coming in like a lion and going out like a lamb”). The fall in barometric pressure in the days prior to a storm, for illustration, would result in the fluid in the middle ear to increase, with comparable consequences.

Mystery abdomen discomfort

This week’s health-related query comes courtesy of Mr HJ from Leeds, creating on behalf of his 12-12 months-old grandson, who has Sort 1 diabetes. This is effectively-managed on his present insulin regime, but for months he has been troubled by a consistent abdominal ache of this kind of severity as to wake him at evening, affecting his schooling due to exhaustion.

The typical scans and X-rays have failed to determine a cause and he has been labelled as possessing “chronic non-natural abdominal pain”, with the implications that the difficulty is psychological rather than physical. This obviously can not be the case. Does any person, he wonders, have a suggestion as to what may well be amiss?

E-mail healthcare concerns confidentially to Dr James LeFanu at drjames@telegraph.co.uk. Answers will be published every Friday, at telegraph.co.united kingdom/overall health

Doctor"s Diary: are medical professionals dependent on Prozac?

Iain Duncan Smith says I am dependent. But my benefits are a lifeline, not a trap

‘Dependency sounds like people are addicted to rewards. If that is the prevailing perspective, then no wonder people who need to have help come to feel picked on and ashamed.’ Photograph: Christopher Thomond for the Guardian

Iain Duncan Smith’s speech last week on jobseekers possessing to search for perform just before they can sign on, talked about “dependency” 14 occasions. He didn’t mention individuals created redundant, or staying at house to care for loved ones or, like me, who are also sick to operate. I uncover that deeply disturbing and I compose in the hope that the operate and pensions secretary thinks about the consequences of what he says and changes how he speaks in the potential.

I’m 52 and live in Newcastle with my wife and two young children. Six many years in the past I was diagnosed with a uncommon and incurable form of leukaemia (cancer of the blood). My objective is to live long sufficient to see my young children grow up.

I left college at sixteen and have worked all my life due to the fact that is all I wished to do. I come from a loved ones which was hardworking and was brought up to understand that you got a task and worked all your existence. I’ve worked in retail, the motor business, in insurance coverage and, for 12 years I worked at the Department for Operate and Pensions. It truly is been a good daily life. Not rich, not bad, but I’ve loved every little thing we have worked hard for.

For 4 years right after my diagnosis, I worked complete time but I was extremely tired, in ache and choosing up every cold and flu going due to the fact of my weakened immune technique. I retired due to ill health at the finish of 2012 and given that then have claimed the advantages I am entitled to and that I have contributed to all my existence so that we can proceed to pay the mortgage loan and place food on the table.

You could say that me and my family are dependent on rewards. In the exact same way we had been dependent on my salary and we are still dependent on my pension and the income my wife earns. Unless of course we are born rich, we all depend on the funds coming in every single month. But Iain Duncan Smith makes use of dependent in a way I reject. Dependency sounds like folks are addicted to positive aspects. If which is the prevailing attitude, then no wonder folks who need to have help come to feel picked on and ashamed.

I’m not unusual. Other folks who have had help from benefits have essential that assist because they were operating in reduced-paid jobs, looking for work or, like me, unable to function. Perhaps we are an inconvenient reminder that becoming unable to pay the expenses with no aid is not a straightforward moral failing – it truly is anything that so several of us are only a diagnosis or a redundancy letter away from. If I can not persuade men and women in electrical power to stop speaking about dependency, possibly they would agree that, for each and every time they do, they match it with a reference to the millions of us for whom help from rewards is a lifeline, not a trap.

Iain Duncan Smith says I am dependent. But my benefits are a lifeline, not a trap