Imagine breaking your leg and not taking painkillers? Imagine contracting a chest infection and refusing antibiotics? Imagine suffering from cancer and not receiving chemotherapy? It seems crazy, doesn’t it? Why wouldn’t you take the medicine that has been specifically engineered to help you, to treat you, to relieve you?
There is an awful lot of judgement, stigma and debate around the topic of antidepressants, at the base of which seems to be a strong anti-medication-for-mental-illness sentiment. Even within the medical profession itself this seems to be the case, with a BMJ publication claiming a 59% increase in antidepressant prescriptions since 2006 is merely serving ‘as a distraction from the wider debate about why we are so unhappy in society.’ Evidently, antidepressants are enormously over-prescribed, and perhaps this can be pinned down as a contributor towards our anti-medication stance. Millions of patients across the country are going to their doctors, bravely admitting to feeling anxious or low in mood or having dark thoughts, and are leaving the surgery with nothing more than a slip of paper in their pockets. This is wrong on a fundamental level and, arguably, a direct consequence of the crisis within which our precious NHS finds itself. Antidepressants should never be used as a stand-alone treatment option, and it’s likely that many patients are actually in need of something else: talking therapies, CBT, DBT, nutritional advice, lifestyle changes, peer support groups, mindfulness classes, stress-reducing techniques. There are so many other effective ways to offer someone help aside from offering tablets, yet these are overlooked because, I suppose, it is faster and easier for overworked GPs to scribble out their signature and send us on our jolly ways.
The trouble is, antidepressants are thus seen as a cure-all. With doctors prescribing them alongside no conjunctive therapies, they are implicitly suggesting that they will magic away our troubles and save us from the gloom. But they aren’t happy pills, much to my inner child’s dismay. As far as my experience goes, antidepressants are like rubber rings. They lift you from the murky depths and give you something to hold onto whilst you drift to shore. They are not a lifeboat or a flashy coastguard speedboat; they aren’t able to whizz you to dry land and warm you up with tea and toast in the blink of the eye. They can act as stabilisers, lifting and regulating your mood to help you feel better able to tackle the ghosts of your past or the problems of your present. They can level out the unpredictable highs and lows, calm your racing heart or quieten those self-destructive thoughts. Sometimes this is all one needs in order to address what lies at the heart of their illness, and antidepressants can act as a life-saving stepping on the way to recovery.
Antidepressants are over-prescribed: that much is clear. Perhaps some people who take them really shouldn’t, and perhaps they aren’t right for everyone, and perhaps they do come with an unattainable expectation of instant joy, but they shouldn’t be stigmatised in their entirety. Doing so is only adding to the numerous barriers to seeking treatment for mental illness that already exist, when we should instead be striving to eradicate these obstacles. Antidepressants may have zero effect on one individual, a placebo effect on another, yet be life-changing to someone else. Like everything in our private lives, medication is a personal decision that should be left to that person alone. No stigma. No judgment. Just empathy.