Now to me this is a no s**t Sherlock story but I think its good to raise awareness. I know many members, myself included, have been accused of being depressed, anxious and offered antidepressants, which is easily explained if you see the story on the struck off GP. Even when we are absolutely certain its a physical problem.
However many doctors are getting it wrong and blaming physical health issues on MH, whereas the research in this article seems to indicate the reverse is true.
That having long term, chronic physical health conditions negatively impact the brain and can lead to low mood, anxiety, cognitive decline and even Alzheimers.
It seems like a no brainer ( excuse the pun) to anyone who is dealing with such a condition, but its good to have it down in black and white and we can then tell our hard of understanding GP's and other healthcare professionals that if they tackled the physical problems first then any accompanying MH issues would be rectified or at least reduced.
if they tackled the physical problems first then any accompanying MH issues would be rectified or at least reduced.
One thing that always annoys me is that doctors don't take nutrient levels seriously.
These days NICE says that a ferritin level below 30 is evidence of iron deficiency. But GPs think a level of 30 is fine.
Some years ago, before NICE declared that a ferritin level below 30 indicated iron deficiency, I had a ferritin result of 20 or 21, which at the time was in range. It turned out later that my serum iron and my saturation were below range, but I only found this out when I bought a copy of my medical records. I felt terrible at the time and I pleaded for a prescription for iron supplements (I didn't know then that I didn't need a prescription).
I still remember the doctor scowling at me ferociously and slamming the prescription on her desk in front of me. It was enough for two months. It was the last iron prescription I ever got from a doctor (because I stopped asking for help with my iron after I found I could buy my own prescription-strength supplements).
When I started treating my own low iron it eventually ended up taking me nearly two years to get my ferritin level up to mid-range and another five years of a maintenance dose to get it to stay at a good level and for my serum iron to go up a bit (it has never reached mid-range). My doctor would probably have declared my mid-range ferritin was completely over-the-top and unnecessary but compared to how I felt at the time of the last GP prescription for iron I feel a hundred times better.
These days I have vowed that, unless I was suffering from something life-threatening and/or visible, I won't go to a GP again. I would probably end up being told that my problem was functional, all in my head, caused by depression or anxiety, or I'm just a hypochondriac. I know this is what the NHS and the medical profession wanted to achieve, so they can pat themselves on the back because they have done a good job of keeping me away. But it is also proof, as far as I'm concerned, that I have needed much less medical attention since I dealt with my own nutrient levels.
Well said. This is something totally absent in General Practice, hospitals and MH care; in a society where ‘food’ is cheap and plentiful, ‘nutrition’ is overlooked except in cases of dire deprivation .
GPs are however ‘generalists’ - something I bear in mind at every meeting.
My daughter is 46 and has a severe and enduring mental illness. Last year she was sectioned for 10 weeks - entirely through dangerous neglect of MH team and their lack of response to her GP team . She was discharged on weekly antipsychotic injections, though she has never been psychotic.
It took me 6 months after discharge to get her to see a community psychiatrist whose view was “I don’t know why you were put on this drug”. The side effects were horrendous. When I raised them with the nurses giving the injections, their answer was “we’re not medical”.
When I raised her physical symptoms/side effects with her GP (who we like v much) he said “let me scratch my head a min” - and made several diagnostic referrals. The ensuing investigations revealed nothing - BUT her blood tests showed severe vit D deficiency, bottom of the range levels of B12, et cetera,
When I raised this at her consultation, he was totally dismissive of any relevance to my daughter’s physical or mental wellbeing🤷♂️ He’s a relatively young GP, and a product of current medical training and NHS standards.
They are definitely missing a trick. Good diagnosis is about elimination.
PS my daughter is now off the injections : the side effects are slowly diminishing, and she declined further meds.
PPS my daughter eats at my house and I buy her supplements. We still like her GP 😊
Just a thought, triggered by your post - I don't know what MH condition your daughter has but I was amazed to read a while ago that sufferers of schizophrenia have found their condition has been improved by improving their nutrient levels. There are many articles on the subject on the web, and in PubMed and Google Scholar.
For years the poor patients with schizophrenia have been given more and more powerful anti-psychotic drugs that have ghastly side effects, and it turns out that vitamins do the job a whole lot better.
It's possible that if their mothers' nutrient levels had been optimised before and during pregnancy that their children might not have become schizophrenic at all, or they would have a much less severe MH condition.
In my own case I have a family history of people who suffer from severe depression and anxiety. They also frequently have anaemia. When I treated my own iron, and kept supplementing until my levels were as optimised as I could get them, my anxiety disappeared and my depression was reduced to a minor, occasional problem. The two months of iron pills I used to get prescribed by doctors never achieved anything. It took me seven years - and I was using prescription-strength iron pills.
Thank you v much for replying , and for the article links - and I am not surprised at this. My daughter does not have schizophrenia, but diagnoses include Borderline Personality Disorder/Emotionally Unstable PD - both of which are controversial and always accompany other comorbidities. Latest dx is Bipolar - which she is not. There is a big discussion that women get dx’d with a Personality Disorder and men with PTSD. In our case her illness relates to severe trauma at age 11. There is no gendered treatment or facilities for traumatised women.
I agree 100% that the most obvious options for improving physical and mental health are missed/ignored.
In my opinion, MH services have rarely been therapeutic and more often extremely harmful - I know because I have had to pick up the pieces.
There is a big discussion that women get dx’d with a Personality Disorder and men with PTSD.
Why am I not surprised? I've noticed that my husband usually gets taken seriously and treated for his medical problems, while I am usually treated as a drug-seeking hypochondriac with mental health problems.
It is becoming talked about at least - there is some recognition of failure to recognise the need for gendered treatment. And also treatment for different ethnicities.
I still have a letter from about 12 years ago from the Head of Clinical Psychiatry of the Trust in reply to my request to seek gendered treatment in which he said my request was “a waste of everybody’s time and would only lead to disappointment”.
And this was after a voluntary inpatient stay during which she was sexually assaulted by another patient. Police attended and charged him and it took about 18 months to go to Crown Court where be pleaded guilty minutes before we were about to go into trial.
No action against the Trust. You couldn’t make it up.
My biggest beef with them is their use of inexperienced, arrogant, unmonitored staff. Very dangerous. I’m so tired of reading every week of vulnerable people losing their lives in hospital settings - it’s becoming the norm in MH hospitals . I know they can’t all be bad - but too many managers counting beans and devising unfathomable ‘pathways’ and not enough brains and hands at the coal face. It’s getting worse it seems. They listen to neither the patient nor their relatives.
Can’t tell you how many reports and emails I have sent to the CQC - and had many phone calls. My daughter had never been sectioned before last year and it only happened as consequence of the Trust’s failure to treat. I am pursuing answers but the whole process is inadequate.
But we do have to keep challenging - it’s really important not to be bullied into submission. Keep speaking up.
I thought the article pertinent to us thyroid sufferers as MH is a symptom, not a cause of both hyper and hypo. I've lost count of the number of posts I've read on the forum where the poster mentions depression, anxiety and has got either undiagnosed or undertreated thyroid conditions.
And obviously its not confined to thyroid. My late mum struggled with her mental health as she had severe Rheumatoid Arthritis and was in pain all the time. Its patently obvious that poor physical health hugely impacts our emotional wellbeing, so why dont doctors get it?
Indeed it's not confined to thyroid disease, but here, my focus was on just that.
When patients reel off the issues that trouble them, aka symptoms, then it beats me why medics can fail to join up the evidence dots, and see the thyroid picture.
It's a straight forward process
If trained medics are not the experts, then where can we turn....
Exactly what part of losing your health - for some of us confused and declining for YEARs - wouldn’t make one feel [insert negative feelings here - low, sad, angry, irritable, hopeless.]
I try to make the distinction with doctors between situational depression and clinical depression. And yet they throw ADs out like candy for situational (not clinical blood chemistry).
Find the root cause (for us hypo), treat the root cause, and voila ! my whack-a-mole symptom list all but disappeared.
Now… root cause analysis for how to fix these doctors - do they not care. Lazy. Are they THAT dumb. Did they never learn critical thinking skills.
I think lately I am most incredulously angry at the ones who do not care. Who dehumanize and treat people (PATIENTS!) worse than objects.
This issue seems to stem from the fact that you’re treated as a collection of body parts rather than a whole person.
Take MRIs for example, I've had 3 done, one of which was pointless as the source of my pain was lower down and obvious, but that's never been investigated. They won’t do the whole region though, they’ll do lots of individual parts and waste months because that’s how the siloed system works.
Yes there doesnt seem a single dept in the NHS for general medical care, its all orthopeadics, gynae, neurology, rheumatology etc. And I've also noticed they are very reluctant to step out of their comfort zone or tread on each other toes. " not my dept" they say.
I have Ehlers Danlos which causes me a lot of jip as I get older. I have functional/ structural issues with my joints and muscles. I recently saw an advanced NHS physio because I have foot and knee issues related to my EDS and I wanted some exercises to do that could reverse the fact my knees point inwards, which puts stress on my lower body.
As soon as he heard I was under the Podiatry dept and seeing someone in the next month he basically couldnt get rid of me quickly enough. Saying he didnt want to interfere with anything podiatry might do. It was a waste of time and buck passing, which happens all the time.
Nonetheless, I am disdainful of those who suggest that thyroidies should never worship at the altar of happy pills. Bit of a misnomer, that; happiness is not a right, not a 'normal' way of being, but a precious though fleeting emotion.
I have taken ADs for the best part of 30 years and they do undoubtedly help. I have tried on several occasions to wean myself off them, resulting in a transmogrification to a hateful shouty old mare who pisses me and my family off to an unacceptable degree. I prefer the somewhat more zen person resulting when I swallow the meds, away from my thyroid meds, of course.
Sure, thyroid ill health can make such issues worse; it remains the case that some thyroidies should also take ADs with impunity. Please stop the smug 'when your thyroid issues are resolved there'll be no need for ADs'. I'm living proof that they are sometimes necessary and I'm buggered if I'm going to apologise for it, or feel in any way a failure or deemed diminished by others who don't respond to ADs. 😁
Falls into the category of “just because you’re hypo doesn’t mean you don’t have other things that need treating.”
The distinction is that there is a category of people whose doctors decide step 1 is give ADs DESPITE low Ts. Because low thyroid does CAUSE depressive symptoms, it makes sense for newbies who have not had their thyroid treated optimally to see how far they can get with optimizing thyroid.
Then what’s left becomes more clear. Depression, anxiety, heart issues, cholesterol drugs, rosacea treatment, etc.
If I didn’t have this forum I would be on medications for all of those for the last couple years. Now, 2 years later I am not sad the vast majority of days, my hypo-induced-anxiety is rare, my cholesterol is back down, I almost never need my rosacea cream.
I am still mad at my GP who left me on 50 mcgs for a year and at the first meeting waved his hand dismissively at my symptom tracker, tried to convince me I was depressed, and told me to just take a walk every day.
On my report that day he wrote “Denies depression.” in his assessment. So passive aggressive.
Circling back to the point of my post - I don’t and I don’t think anyone on this forum would “judge” anyone for taking ADs.
Not to mention your posts are always a bright spot here 😎
I certainly have no judgement on anyone taking AD's, whatever it takes to help. unfortunately I'm someone who just cant tolerate them. I've never taken them for depression but Fibro, migraine prevention and insomnia. I must admit I dread the day I'm struggling with MH as I simply cant tolerate them, and not through want of trying.
In the right circumstance they are life savers, literally. But I do think they are prescribed too freely and inappropriately. I mentioned earlier that the scientific evidence for their widespread use for chronic pain is simply not justified on the grounds that they dont work or at best give very modest relief.
And yet GP's are still dishing them out for Fibro, migraines, chronic back pain, neuropathy. They arent the solution for all ailments despite what doctors think.
well said. I’ve tried AD’s many times and can’t tolerate the side effects. I know many people who take and don’t have any problems so I am not against them.
I take so many tablets at the moment for hypothyroidism, atrial fibrillation and a hiatus hernia so definitely don’t want to take anymore.
There must be something else that would help with MH. I dread going to the doctors as they keep pushing me to go AD’s.
I've gotten to the stage that even if I was struggling with MH I'd be very reluctant to see a GP about it. I cant tolerate AD's and have tried several for various things over the years so they are off the table and I'm not willing to give them any more attempts.
Also my concern is that if you have a MH " label" then it follows you around and doctors are less likely to take you seriously. If you consult about anything they immediately assume its depression/ anxiety related and fob you off with that. I already experience this as a Fibro patient. Everything gets blamed on Fibro.
Oh dear! To me this study seems like an excuse for prescribing more psychotropics because the problem lies in the “brain”. The participants probably all have crappy thyroids leading to poor health outcomes across both physical and mental.
I still think each individual case has to be taken into consideration rather than blanket presumptions about causes. It is cause and effect, but those causes can be different. In my own case I strongly believe that mental/ emotional upheaval directly precipitated the decline of my physical health. I had always been a fit person, seldom ill until a period of extreme emotional upheaval and distress caused by external factors beyond my control. With my usual stoic attitude I just went on, until it seemed my body just decided enough was enough. I was diagnosed with thyroid and kidney problems, but it was counselling for the situation- based anxiety that had the most impact on me generally. (No drugs involved in that) It became clear that behavioural changes/ attitude adaptation were the key to controlling the physical effects. I believe that for me, if the external pressures were removed my physical state would greatly improve. When a young intern asked me if I had been under any kind of emotional stress it was a huge relief that I wasn’t imagining that as a cause of my physical decline. It felt insightful on his part. It would be a shame if such a holistic insight were to be condemned in an effort to focus solely on organic causes.
Its the old chicken and egg analogy, what comes first, mental trauma, emotional distress, prolonged stress leading to physical health problems, or worsening physical health causing social isolation, financial worries, pain, fatigue, which in turn leads to depression, anxiety and other MH issues. It just shows you cant seperate the two.
That said I do believe potential physical issues need to be either excluded or treated before doctors start handing out antidepressants.
That Guardian piece makes perfect sense to me and I believe I've been experiencing this over a long period of time.
I read this in an article, which shows how your brain can work against you:
'Alarm: The first reaction to stress recognises there’s a danger and prepares to deal with the threat. The hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system are activated. Primary stress hormones cortisol, adrenaline, and nonadrenaline are released
Alterations to the HPA axis can cause several conditions such as chronic pain, fibromyalgia, and insulin resistance.'
I think the chronic stress/anxiety and fear combo that can arise when a person has a chronic illness can be lethal if the brain/Autonomic Nervous System gets stuck in fight/fight mode.
Physical and mental wellbeing go hand in hand and yet there is no holistic whole person approach, its all piecemeal bits. That said not everyone who suffers from a physical illness, particularly invisible illnesses has been a victim of trauma, stress, abuse.
Functional Neurological Disorder or FND is another complaint being increasingly diagnosed, another wastebasket diagnosis of exclusion. Its allegedly somatoform in origin, or in other words doctors believe is psychological in origin.
Yet there are many sufferers who've now been labelled with FND " all in your head" who know there was no mental health issue, stress or anything else that precipitated it. It just happened. But as soon as doctors see FND on your notes they couldnt care less.
I totally agree with the points you raise and GPs are more willing to write patients off with "wastebasket" diagnoses like FND, a friend of mine being one of them but was actually relieved by that to my horror.
In my case, I don't think the origin of my illness was psychological, but my mental health has played its part in my downward spiral and impacted on my chances of recovery. My health journey has been a very complex one with other exacerbating factors involved.
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ME CFS unrelenting fatigue debate continues with letter in the Times and the best article I have read.
Full panel Thyroid results. Mental health issues and thyroid?
An article of interest re Thyroid issues and Fibromyalgia
