15: Antidepressants.

In this final episode dedicated to understanding pain we draw on what we have learnt so far to understand how a deeper understanding of the processes that contribute to chronic pain can help us to discover new strategies for dealing with pain. If pain is produced by neural networks in the brain what can we do about it? We explore ways of rewiring these neural networks to reduce pain. To get the most out of this episode I would really recommend listening to the previous episodes on pain first, or at the very least doing the homework from episode 23 and watching Professor Moseley’s 20 min TED talk. You can find the link for this on my website, Facebook and twitter. www.cambridgeprogressivemedicine.com

In this second episode about pain, we pick up where we left off in part 1 to further explore the neuroscience and philosophy behind pain production, and introduce the concept of neural networks and neuroplasticity, which may provide us with new ways of addressing chronic pain. Although all pain is real, there are different categories of pain. Identifying these different categories is important as it may inform us of the most appropriate and effective treatments. www.cambridgeprogressivemedicine.com

It is some time ago that I promised we would be doing some work on pain and so I figured it's about time we got started on the advanced class. This is the first of three episodes all about pain.  Pain is complex and incredibly difficult to manage, and many of the medications we use to treat pain are ineffective or have harmful side effects. However, I believe that through a deeper understanding of the mechanism that produce pain it is possible to find fresh approaches to addressing pain, even when the medications are not cutting it.  In this first episode we take a broad approach to explore what pain is, drawing on emerging neuroscience, as well as considering evolutionary and philosophical perspectives. http://cambridgeprogressivemedicine.com/episode-22-pain-part-1/ 

There is a perception in society that people are prone to malingering. But in my experience, we are far more likely to commit the error of continuing to battle through at work, when we really need to be focusing on looking after ourselves. There comes a point where the right thing to do is to look after yourself. And this point comes much sooner than you think. When you find yourself in this situation take the time. Don’t beat yourself up about it, don’t debate it, don’t feel shame, just take the time. We live in a society where we look after people because it is the right thing to do. But this is also a blessing and a gift. Out of respect for that gift, and out of respect for yourself, use your time wisely. www.cambridgeprogressivemedicine.com

Within the health space there are a lot of different terms floating about. Western medicine, holistic medicine, alternative medicine, functional medicine, and now I have added progressive medicine into the mix. What’s more these words may mean different things to different people. This can be confusing, but by understanding the relationship between these different ways of approaching health, where they overlap and how they differ, we can gain a better understanding of what we need to be healthy. www.cambridgeprogressivemedicine.com.

There are many scientific studies demonstrating the multiple benefits of exercise on our health. But these are not why I recommend regular exercise to my patients. Humans are designed to move, and if we don’t, our bodies and minds don’t run as well as if we do. If you can find some time in your day to get your heart rate up a bit you will feel happier, enjoy your food more, be more in touch with your spirituality, have less aches and pains, feel more alert and energetic, be more productive, and sleep better. In short, your life will be better. Looking more attractive, not getting diabetes and living a bit longer are merely favourable side effects. They are not the goal. The exercise is its own reward. You don’t need a scientific study to convince you, all you need to do is take a walk on the beach, in the woods, or down by the river, and observe how you feel. www.cambridgeprogressivemedicine.com

If you’ve listened to this series from the beginning, you will have frequently heard me saying that this or that “isn’t a moral issue.” What do I mean by this, and how do we know what is or isn’t a moral issue? Moralising is a risky thing to do, and puts your own happiness, as well as that of others, in serious jeopardy. By making something into an ethical issue you are inadvertently transferring power over your wellbeing to somebody else. If we are wise, we will keep our moralising to an absolute minimum. In general, most of us overshoot by a mile, making moral issues far more often than is necessary or helpful. www.cambridgeprogressivemedicine.com

Poor sleep is a sure sign, a common early warning, that we have lost balance in our lives. It is also a key area that can be responsible for lack of balance. It is a vicious circle. If we don’t sleep well, we will feel anxious and bad, but feeling anxious and bad can stop us from sleeping. Even if you don’t think that sleep is an issue for you, I would still recommend having a think about your sleeping habits, as invariably all of us have room for improvement across many aspects of our lives. Even if you don’t sleep badly, it is possible that you might be able to sleep better! www.cambridgeprogressivemedicine.com

The key to improving our health lies in making sustained small changes across multiple aspects of our day to day lives. Whilst this always starts with our thoughts, with managing our minds, we must translate this into action if we are to regain our balance. www.cambridgeprogressivemedicine.com

In 2017 there were 67 million prescriptions for antidepressant medication in England. Despite the widespread availability of a medication which has been clinically proven to treat depression, there still seems to be a lot of depression and anxiety about. If antidepressants were the whole story, surely, we should all be feeling a whole lot happier by now? Whilst I am sure that antidepressants can have a role to play in the treatment of depression and anxiety, it is important that we understand how and why we use these medications, otherwise I think there is potential for them to become part of the problem, rather than part of the solution. www.cambridgeprogressivemedicine.com