Many mental health awareness campaigns focus on how the experience of mental health problems affects so many people that we should try and remove the stigma around it. The campaign message is that mental health problems could affect any of us at any time, and that these are no respecter of who we are, our background or economic circumstances. It can affect the wealthiest or the poorest, anywhere in the country. It’s a powerful message. So how do we square that view with some recent research that doctors in Blackpool prescribe more anti-depressants per person than anywhere else in England? Shouldn’t our mental health awareness campaigns focus on Blackpool (and other northern seaside towns who also prescribed higher than average levels of anti-depressants)? I think the way to explain this apparent contradiction is to think about causes of depression.
Let’s think of why Blackpool is at the top of this league table. I worked in a mental health team in Blackpool some time ago and I know what some of the issues were then. In common with many coastal resorts, the changing pattern of holidays means there’s a lot of multi-occupancy rented accommodation and not a lot of secure employment. So financial pressures, lack of opportunities and misuse of alcohol perhaps as a way of managing anxiety are all present factors that can provoke depression. Of course, depression is not just about feeling bad sometimes because of your circumstances, this is a persistent mental health problem with disabling symptoms of sadness and low mood.
Deprivation as a risk factor is not just an issue in identifying the causes of depression, it’s also an issue in recovery following treatment. A report by the providers of the Improving Access to Psychological Therapies service last year showed that rates of recovery from depression following their intervention was worse in areas of high deprivation than in other areas.
Other risk factors
So if indicators of deprivation are the cause of depression what happens to the argument that depression can hit all of us? I think the answer is because there are many other risk factors that might cause depression, or increase the likelihood of someone developing depression.
- If there is a family history this might mean increased chances of developing depression
- Biological or hormonal causes such as in post-natal depression
- Chronic physical illness
- Major life events such as a sudden bereavement
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