Humor over prescription: Patients who use stand-up to combat depression

Depression costs tens of billions of pounds a year and nine million sufferers are on medication.

Now a trial is inspired by the adage that laughter is the best medicine, by hiring professional comedians to teach patients how to perform stand-up routines.

This month, seven women gave live performances at the Royal Albert Hall in front of an audience of friends, family and supporters. The “Comedy About Prescription” program aims to increase confidence and reduce dependence on antidepressants.

Claudia Merlich, 77, signed up for the course after struggling with her husband’s onset of dementia and the death of her mother, while weighing the possibility of downsizing their home. “The course gave me a sense of fun and helped me connect with different women that I wouldn’t normally meet,” she said.

Tracey, a 42-year-old homeless woman who previously found that antidepressants didn’t work for her, said her key worker had recommended the course.

“It’s unbelievable how much it has helped my self-confidence,” she said. “I wouldn’t have even imagined being able to perform on a stage six weeks ago but I got a lot out of it and the techniques they taught us have helped me in my everyday life.”

Her key insights include trying to be more optimistic and positive. “Even when things are bad, there’s always a bright light,” she said. “From here I feel like I can reach for the stars.”

The scheme was founded by Louisa Jackson, Head of Comedy Body Crack Health, because of her concerns that there were not enough non-medical treatments available to GPs.

NHS-endorsed “social prescription” measures designed to reduce dependence on antidepressants include dog walking, community gardening and museum tours, and Jackson is on a mission to add comedy to the list.

The pilot scheme was developed to prove to NHS bosses that laughter can be a valuable tool in healthcare. Previous studies have shown that laughter can provide significant mental health benefits and act as a natural way to combat stress, anxiety, and depression.

Although some of those waiting to perform at the historic London landmark appeared nervous, their pride was palpable after they overcame their fears and performed their routine. The episode featured six “comics” struggling to cope with issues including homelessness, grief and malnutrition before the program began six weeks ago.

“At the moment, people are given antidepressants after an eight-minute GP visit, so there’s a big move towards intervention and prevention,” Jackson said. “You can be offered museum trips, gardening or going to the gym, but comedy is considered a joke. We want the NHS to integrate comedy into social prescribing so that GPs can safely refer their patients to comedy to prescribing providers.”

Jackson received a grant from community charity One Westminster and set up a series of ‘stand up and shine’ workshops for women facing a range of issues. She befriended Carly Smallman, a comedian, who held sessions at The Passage, a homelessness charity. There the group was encouraged to share funny stories about their lives and learned how to write jokes. They also participated in voluntary laughter exercises to increase happiness and reduce inhibitions.

Time photographer Richard Pohl

Subjects were asked to fill out a form to measure their well-being after each session to assess whether their mental health had improved.

Jackson is now trying to convince other bodies, including the Ministry of Justice, to fund more pilots to build enough evidence to convince NHS bosses to add comedy to the social prescription package. He wants to expand the trials to include veterans suffering from PTSD, victims of severe trauma and desperate youth at risk of toxic infiltrators.

“Men don’t have access to traditional services like counseling, so comedy is a great way to improve their confidence,” she said.

Smallman said the results he saw were overwhelmingly positive. “A lot of groups come in because they’re lonely or want a social connection,” she said. “The group’s confidence has definitely improved. The aim was to help them feel a bit better about themselves and now by performing at the Royal Albert Hall they feel like complete bad asses. I feel like a proud clay.”

Simon Offer, a doctor and Labor representative for Stroud, which supports Crack Health, said: “With around 8.9 million people in the UK prescribed antidepressants, non-medical interventions such as ‘prescription humor’ should be taken seriously as an alternative to prescriptions.

“After more than 30 years as a GP, I have seen first-hand the power of social offering – from charity and art classes to running football. Comedy is an innovative addition that creates a space for people to connect, reflect on their experiences, and build trust through laughter. Seeing the first cohort graduate at Westminster is a powerful hope to see the same approach and powerful concept from local authorities.”