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Turkey is marching toward a record in antidepressants

HDN | 8/19/2011 12:00:00 AM | Metin Münir

Sales of antidepressant medication in Turkey have increased by 70 percent in the past six years.

Sales of antidepressant medication in Turkey have increased by 70 percent in the past six years.

According to data from the pharmaceutical industry, sales between 2005 and 2010 have increased from 20 million odd boxes to 34 million boxes.

This is twice the increase recorded in total drug sales in the same period.

What is happening? Is there an epidemic of mental health disorders?

The answer depends on who you are asking.

According to the pharmaceutical industry, because of the health reforms of the past years, more people gained access to medication and medical services. Service was provided to those mental patients who were otherwise unable to see a doctor or take medication.

This is not a very convincing explanation.

If drug users are increasing, then cured patients should also increase, thus drug usage should decrease in years. But, just the opposite happens.

There are two reasons for the increase. First, it is the expansion of the definition of such diseases as anxiety, depression and several psychological states. Second, drugs which should be considered the last line in the treatment of neurological diseases have become the first remedy to be sought.

This is because of the promotions pharmaceutical companies are providing doctors.

But treatment only with pills is an outdated treatment method.

According to the latest views, medication is not sufficient in the treatment of psychological diseases. Some consider them completely useless. According to some others, they are completely harmful. The patient should be subject to psychoanalyses and has to be enabled to develop a new life perspective.

“If you do not do this, medication is no good,” said one experienced psychiatrist. “The moment you discontinue the medicine, the patients go back to their former states.”

Administrating medication suits the doctors’ book. “They diagnose in 10 minutes and say, ‘Take this pill.’ The more patients they treat, the more money they make. The more medication they administer, the bigger bonuses they receive from pharmaceutical companies.”

The correct way is that psychotherapy hands tools to the patients to overcome their problems. Psychotherapy is the art of finding the root of the patient’s problem and teaching them how to eliminate this problem. “Medication is the last stop,” said one psychologist I talked to.

But insurance companies do not cover psychotherapy. Many patients do not want to pay money or are unable to pay.

It is generally known that mental disorders and neurological diseases are a result of the distortion of the chemical balance in the brain. But there is no scientific evidence to prove it as such. None of the scientific research done up until this day has proved that mental disorders come from the deformation of brain chemicals.

It is the American Psychotherapy Association that determines what are mental disorders and neurological diseases.

This institution in every couple of years issues a handbook called the Diagnostic and Statistical Manual of Mental Disorders, or DSM. The manual contains a list of all mental health disorders and how they are diagnosed. “Diseases” are determined not based on scientific data but based on symptoms and observations.

In every new edition, there are new diseases. While in 1970, there were 182 “mental health disorders,” in 2000 this figure was 365. In the new edition soon to be published, several new diseases will appear; it is said. According to what I have read, shyness is being considered as a mental health disorder.

Turkish doctors have had this list translated. They make their diagnosis and treatments according to it.

So, we not only import the drugs. We also import diseases.

Psychiatry in Turkey, to a great extent, follows the tracks of the American Psychotherapy Association and foreign pharmaceutical companies.

Who will save the patients from pills and them from this burden?

*Metin Münir is a columnist for Daily Milliyet in which this piece appeared on Friday. It was translated into English by the Daily News staff. He can be reached at mmunir@milliyet.com.tr.

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