Patient perspective: mild depression must not be ignored

Dowrick and Frances express concern that two weeks is too soon to diagnose depression after a major bereavement.1 Most patients would probably agree with this. They are also troubled by recent increases in antidepressant prescriptions and relate this to changes in the criteria for diagnosis. Most of this increase is actually the result of patients being advised to continue with antidepressants after symptoms have disappeared to reduce the chance of relapse, rather than a large increase in new diagnoses.2

However, the biggest worry, from a patient’s perspective, is the authors’ apparent dismissal of the benefits of the placebo effect. Antidepressants do provide benefits to mildly depressed patients; the issue is that those benefits are much the same as those produced by a placebo pill.3 But …