Sidney Bloch, October 2014

May I suggest that “depression” is more than Karen Hitchcock thinks it is; the same can be said about its treatment (September). Perhaps the principal lesson I have learned as a practising psychiatrist over four decades is that its features and causes are as diverse as the people who suffer from the malady.

Dr Hitchcock is correct in pointing out the massive over-prescribing by GPs of antidepressants and their negligible role in reducing the suicide rate, but she is wrong in averring that they are both ineffective and addictive. Well-conducted research studies have revealed repeatedly the benefits of medication combined with skilled psychotherapy (of which there are many forms).

The black dog “got hold of me” when I was in my 50s, to the extent that I felt utterly hopeless and helpless. Thankfully, I was treated by an empathic psychiatrist colleague who offered me much-needed emotional support as well as Imipramine (an antidepressant whose effectiveness in alleviating the sort of feelings that I experienced had been demonstrated in the early 1960s). I will always remain indebted to the pharmacologists who developed the drug and its successors, which have far less side effects and are not toxic in overdose.

Sidney Bloch
Emeritus Professor of Psychiatry
University of Melbourne, VIC