A Hard Pill to Swallow: The Stigma around Anti-depressants

I quite like to buck a trend, I’m proud to say I never read 50 Shades and I have never bought anything with the ‘Keep Calm and Carry On’ phrase plastered all over it (quite apt really), and my belief that anti-depressants can work just as well at treating mental health issues as counselling also seems to go against the grain. I mean, just imagine if I said that anti-depressants are better at treating depression and anxiety than therapy is? That would be outrageous, right? Could a drug with endless side effects that poisons your body actually be of more help than having a chat? Well that is the case with me and, yes, I’m ashamed to admit that. The stigma around anti-depressants is such that despite the medication working the treatment cannot work to its full potential as society has made anyone who needs drugs to tackle their mental health issues feel a failure, reinforcing the low self-esteem the sufferer is struggling to overcome. Not only that, medication is often considered a short-term solution for people suffering with clinical depression or generalized anxiety disorder. This can exacerbate feelings of uncertainty as there is the continual fear of being told you have to come off your tablets which makes you worry about how you will cope with this. But why aren’t anti-depressants a long-term solution? Why should I have to stop taking a medication that treats an illness I have? Should diabetics come off their insulin?

The best treatment for anxiety and depression differs from person to person and although I don’t want to criticise using counselling or CBT (Cognitive Behavioural Therapy) as a means of treating anxiety I do want to draw attention to the stigma around anti-depressants, a stigma that piggybacks on the stigma of having a mental illness in the first place. There is a glut of articles claiming that counselling is much more effective in treating depression than medication, but few, if any, offer the opposing view. This can make people like me, who take anti-depressants, feel weak and insignificant. Counselling reigns supreme in the eyes of many and even David Cameron, when recently tackled by Jeremy Corbyn on the need for improvement in mental health services, heralded CBT, but would he have been as comfortable singing the praises of Prozac?

Medication is NOT the easy way out

As an anxiety sufferer who uses anti-depressants to treat my illness I not only feel embarrassed about having mental health issues but also about how I cope with them. There’s no praise for me recognising I have a problem, seeking help for it and then treating it. Oh no, medication is the easy way out. If I’d solved my illness by talking about it I could shout it from the roof tops and everyone would be extremely proud of me. But no, I chose medication as that’s what works for me. This was by no means an easy decision. I have taken three different kinds of medication, with very different effects. The first anti-depressant worked well for me after the initial ‘it’ll make you feel worse before you feel better’ stage. But after a health scare about that particular drug I was changed onto a ‘safer’ one, which again worked well – so much so that I decided to slowly withdraw from it. I managed about a month off the medication before I started to slip. Nothing had happened in my life to cause this decline but I felt myself beginning to struggle again. My doctor advised going back on anti-depressants and she put me on another different kind. The next couple of days were the worst of my life. I tried to persevere and get through the initial stage which I knew from past experience was hard. But after having severe panic attacks which culminated in me fainting then coming round to a place I didn’t recognise (which wasn’t surprising as I didn’t know who I was let alone my own bathroom), I immediately stopped taking that drug and went back to the doctor. This clearly wasn’t the right anti-depressant for me.

Sometimes it can take a while to find the right anti-depressant but luckily my doctor realised what a bad experience I had had and instead of trying another different kind she put me back on the anti-depressant I had first started with nearly ten years previously, as we knew it had worked and would probably do so again. Thankfully there was no longer a scare about it – just as red wine can be good for you one day and bad the next, it seems anti-depressants are also subject to change. I am still on this anti-depressant now and I am stable, well and feel like me. I don’t feel completely at ease though, as I don’t have the security of knowing that for as long as I need this medication I can have it. There’s always that niggling worry that I will be told I can no longer take it and recently the issue has surfaced as I’m getting closer to wanting children and would need to consider whether to stop taking it, change to a ‘safer’ drug, or keep taking it and risk harm to the baby. So, yeah, medication is NOT the easy way out.

Being able to function again

Taking an anti-depressant is not ‘taking a happy pill’. They don’t make you happy – they make you able to function again. Which after having been so anxious it was a struggle for me to leave the house, I pretty much consider anti-depressants my life-safer.

Imagine having a panic attack one day out of the blue – actually scratch that. If you’ve never had one you can’t imagine the absolute horror of experiencing one, especially your first one when you are suddenly in a kind of hell you never imagined and have no idea what this thing is or how it happened. Then suddenly it’s not out of the blue, it’s every time you’re in the same environment you were in when the first one struck. For me that was a lecture theatre – trapped, unable to leave without everyone seeing. Next it’s cinemas and theatres. Oh and then it’s trains, buses, any place you can’t suddenly exit. So I don’t like being trapped. So why did it start happening when I was walking to the shops. I wasn’t trapped there – I was out in the open, out in the fresh air. But I was stranded, marooned. Unable to get to the safety of home in a minute or two. So I didn’t leave the house, I stayed where I was safe. But I was now trapped in the worst possible way, trapped in a fake existence where the only company was a mind that didn’t even feel like it belonged to me anymore.

Now try treating this by talking about it to a person you have never met, and actually don’t get to meet until a few months down the line when you get to the top of the waiting list. They tell you to draw a circle on a piece of paper connecting the words ‘thoughts’ ‘feelings’ and ‘behaviour’. Then you see how your anxiety is a vicious circle where your thoughts ‘Oh God, what if I panic on this train, I can’t get off’, affect your feelings – you start getting panicky and hot because you are thinking about it – result in your behaviour, for example getting off the train before the doors shut and it sets off. Then you’ve failed and you feel bad and you’re back to square one. For me I understood all that – I still understand it. I know how anxiety works and how it feeds my depression which then feeds my anxiety … etc. etc. Another cycle. But understanding it didn’t make any difference, I still panicked, I still felt down, I still couldn’t lead a normal life.

Taking anti-depressants means I can function normally, I still have the odd panic, I still feel miserable sometimes but I can hold down a job, have a social life and actually participate in this world. My thinking has changed, and I do use CBT alongside my medication. I know that my recovery is not all due to medication, my ability to understand anxiety and depression and try and change my thinking has also contributed. But without medication I’m not sure I would have been well enough to take these ideas on board and work with them.

Do we need chemicals or counselling?

What if depression and anxiety is in your biological or genetic make-up? Can it then be solved with counselling? The causes for depression are still not fully understood but some experts believe it can be genetically inherited. So how can talking and using different ways of thinking compete with your genes? My grandfather and uncle both suffered from depression, therefore my depression could be caused by genetics. Scientific research has also shown that certain activity in different parts of the brain can determine whether someone reacts better to treatment from therapy or medication. Could brain scans be the way forward in identifying the type of treatment that would suit the patient? Despite the theory of depression as a chemical imbalance in the brain being considered inaccurate by many scientists today, research is continuing to prove that depression is a very complex and multifaceted illness which may result just as easily from malfunctioning circuits in the brain as environmental factors. So just as the cause for depression can be different in different people, so can the right treatment method. If you are taking anti-depressants don’t feel ashamed. You have acknowledged your mental illness and sought treatment for it, which, in itself, should make you feel proud, not weak.