Dr Max talks depression and BBC's Panorama programme
 As if those people with depression didn’t have enough to contend with, anyone who switched on BBC1’s Panorama this week will have been confronted by one of the most irresponsible and stigmatising pieces of television made in years.
A Prescription For Murder? looked at an alleged link between antidepressants and violence and mass killings.
My heart sank because these kinds of programmes are so unhelpful â€" sensationalising the subject matter as if it was a crime show. Yet they get commissioned because they claim to be doing a public service; airing an important concern.
Actually, all they end up doing is resonating with people’s prejudices about those with mental illness: that they are all axe-wielding maniacs. They do nothing except cause fear and worry for a vulnerable and misunderstood group of people who really don’t need this.
Now don’t get me wrong, it is absolutely the right of others to express their view. And even though I’m a doctor and I prescribe antidepressants every day, I don’t think they are the be-all and end-all.
Depression is complex, and an approach that tackles it from several angles is the most effective. This means psychotherapy is important, too.
But television programmes like this play on the idea that such medication is, by its very nature, dangerous; and on the insidious idea that those with mental illness should be feared. It then goes that if antidepressants are evil, those who take them are tainted by association.
The usually perspicacious, measured and penetrating Panorama lost all perspective and got sucked into perpetuating stigma and ‘pill shaming’.
What upsets me is that after these kinds of programmes, there are inevitably some people who stop taking their medication and, as a result, they deteriorate.
It’s not the producer or, indeed, anyone at the BBC who has to see the fallout. It is the GPs, psychiatrists and psychiatric nurses working on the front line who have to deal with patients who are suicidal as a result.
Of course, the pharmaceutical industry has not covered itself in glory, and this makes their products easy targets for spurious claims. We know that over the years they have cherry-picked the data they use so it ensured more favourable results.
This has made the job of clinicians very difficult because it means that truly evaluating how effective these drugs are is tricky. It’s problematic anyway, because the brain is such an incredibly complex organ that we don’t fully understand how it works â€" nor, indeed, fully the mechanism by which antidepressants work.
But the fact is there is no clear, definitive evidence to link antidepressants with violence. The programme relied entirely on anecdote and hearsay and the speculation of individuals who had experienced awful crimes and, understandably, wanted something to blame.
This is not evidence, though. Where was the empirical research demonstrating clear causation? There was not even a whiff.
And I worry about how all this affects those in desperate need of treatment. It is true that in some situations antidepressants are given out too readily. Harassed GPs faced with patients with complex social problems and eight minutes to sort them out reach too readily for the prescription pad.
There is no pill that is going to make your philandering husband change his ways, your screaming, ungrateful children better behaved or your bored wife love you. This isn’t an illness, it’s what is termed ‘rubbish life syndrome’.
But the flip side is that while antidepressants are in some quarters overprescribed, in others depression is woefully underdiagnosed and under-treated.
A horrifying study by the London School of Economics a few years ago showed that while mental illness accounts for nearly half of all ill health in the under-65s, only 25 per cent of those in need of treatment get it.
Further research by Aberdeen University showed that GPs failed to diagnose major depression in half their patients. Some of the highest rates of under-diagnosis occur in middle-aged and older men, who also have the highest rates of suicide.
A National Confidential Inquiry Into Suicide showed that fewer than 10 per cent of people who killed themselves had been referred to mental health services in the previous 12 months.
This is the true scandal about antidepressants that Panorama should be focusing on: the fact that we are failing to identify and treat people who have a crippling and life-threatening condition.
 Send luvvies into care homes!
 The arts aren’t there just to entertain â€" they can actually make us feel better, according to a report this week from the All Party Parliamentary Group On Arts, Health and Wellbeing.
It presented some astonishing research: 82 per cent of people enjoy greater wellbeing after engaging with the arts and 77per cent take mor e physical activity.
Even more striking, a project called Arts On Prescription resulted in a 37 per cent drop in visits to the GP and a 27 per cent reduction in hospital admissions. Furthermore, dementia patients’ medication rates drop and their levels of engagement with those around them increase.
Various prestigious organisations have taken part in projects, including Wigmore Hall, Bournemouth Symphony Orchestra and Liverpool Philharmonic.
As someone who’s spent years working in nursing homes, first as a care assistant and later as a doctor, I think anything that can do this has to be welcomed.
All too often, staff reach for the chemical cosh for ‘difficult’ behaviour, but the notable risks include stroke.
Given the benefits, why can’t GPs prescribe art programmes?
Part of the problem is that the NHS doesn’t view things holistically, and there is no mechanism whereby money saved from fewer consultations, say, is ploughed back into arts schemes. It’s all so woefully short-sighted.
I think we should encourage artists and performers to visit hospitals and care homes as a sort of community service.
The new report goes some way here, recommending that Arts Council England supports cultural organisations in making health integral to their work. Surely those in care homes deserve more than hours sat ossifying in front of daytime TV?
 How hallucinations can help heal the pain of grief
In a particularly poignant confession, the singer Celine Dion said this week that she still feels the presence of her beloved husband, even though he died in January 2016.
This i s incredibly common, with many people reporting actually seeing their partner after their death. This isn’t a ghost or anything scary, but something far more romantic and wonderful.
I first came across this as a junior doctor in A&E. I’d been asked to see Mr Simcock because he had pneumonia but was refusing to be admitted because he had to ‘get back to see his wife’. Perfectly reasonable, except that his wife had died six months before.
‘He says that he sees her every evening and wants to get back to her,’ I was told.
Mr Simcock, who was in his 70s, had been married for nearly 50 years ‘with no time off for good behaviour’, he chortled as I assessed him. When his wife died, suddenly, he didn’t know what to do with himself.
‘And then â€" she’d probably been buried a week â€" I saw her,’ he said. She visited him most evenings, he explained, just as he was dropping off, and sometimes they talked.
‘She was always a bit of a nag, so I suppose she feels she needs to keep her eye on me.’
He didn’t find the experience unsettling but, rather, a comfort. Such hallucinations are wish-fulfilment, the brain’s way of giving the bereaved what they so desperately want.
I asked Mr Simcock what his wife would say if she knew he was risking his health for her.
‘She wouldn’t be happy about it,’ he replied, slowly. ‘And if I’m honest, it would be nice to get away from the old battleaxe for a bit.’
With that settled, he was admitted.
These tricks of the mind in response to the pain of bereavement are testament to the power of love. They also show what an amazing organ the brain is.
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