Stop Looking Down on Antidepressants — We Need Them to Function
“You don’t want to be on them forever though, do you?”
Ask anybody who has used antidepressants, and almost certainly they will have had a well-meaning relative or acquaintance drop this old chestnut. There’s a tweet from Chance The Rapper’s manager, Pat Corcoran, currently doing the rounds on social media which recommends that people suffering with depression try such activities as ‘make ur bed’ and ‘give thanks’ before ‘using mental illness drugs’. Thanks Pat — if only I’d have made my bed a tad more often, I might not need the medication keeping me alive.
After battling depression and anxiety throughout my teenage years, I was finally prescribed medication last year after hitting rock bottom. I started on 20mg of fluoxetine a day, and I am currently taking 60mg. The side effects weren’t the most enjoyable at first — increased anxiety and upset stomachs seldom are — but they were well worth it. Although I still have bad days, my mood is generally a lot more stable than it was in that summer, and I have no doubt that if it wasn’t for the fluoxetine I’ve been taking since August, I would not be here to write this.
Mental health, particularly in young people, is constantly belittled and played down. ‘Puberty’. ‘Teenage hormones’. ‘Exam stress’. These comments are often made by well-meaning people, the sort that would offer utmost sympathy if you were to break your arm, or have your appendix removed. It’s just that mental health issues are, often unwittingly, minimalised. Hence, I had to struggle all through my teenage years, my GCSEs and A Levels, and it could have cost me my life. I’m not suggesting that I should have been placed on antidepressants as a younger teenager, as that is seldom recommended, but it has to be noted that since being placed on medication, I feel far more frequently that there is a light at the end of the tunnel.
We are in the midst of a mental health crisis. In England alone, four million people are long-term users of antidepressants, and in the UK the amount of young people reporting mental health issues has increased sixfold since 1995. It’s no surprise that antidepressant use is on the increase — as the stigma against mental health issues decreases, and people are more likely to seek help, it makes sense that more are being prescribed. Likewise, it’s hardly shocking that young people in particular are more depressed now than in 1995, when we take into consideration cuts to youth services. 600 youth centres closed from 2012 to 2016 alone, and over eight out of ten teachers have said that mental health amongst pupils in England has deteriorated. How are young people meant to feel when their illnesses get written off and undermined by the very people they are supposed to trust?
Antidepressants, and their effectiveness, is a topic that is hotly debated. Many people swear by them, while others, Corcoran amongst them, believe in such miracles as positive thinking and exercise. According to the NHS, “it’s not known exactly how antidepressants work”. They explain that it is believed they work by increasing levels of neurotransmitters — e.g. serotonin — in the brain, and that they are often used in conjunction with therapy. The most common antidepressants are selective serotonin reuptake inhibitors — or SSRIs — and they include fluoxetine and sertraline. It’s not an area of science where there’s a comparatively great deal of knowledge, but fluoxetine was introduced in 1987, and over the last 30 years it appears that the benefits outweigh any potential risks.
Yes, there are of course potential issues and side-effects with the use of SSRIs, as there is with any medical treatment from paracetamol to chemotherapy. The psychiatrist David Healy wrote in his book The Antidepressant Era that fluoxetine, or Prozac, might increase the risk of suicide in a small number of people liable to that particular side effect, even though it decreases the risk of suicide across the board. It’s understandable that GPs would be hesitant to hand them out willy-nilly, but once a patient has jumped through all the hoops required to actually get put on medication, others should respect that.
Whereas we rightly vilify the likes of antivaxxers, for example, for being ‘anti-science’, it’s appears socially acceptable to deny the potential scientific benefits of SSRIs. This is despite a 2018 study showing that they work better than placebos. They aren’t perfect, but there’s no harm in giving them a go if other options have been exhausted. They aren’t being prescribed for a laugh. Doctors aren’t just handing them out for something to do. The ignorance surrounding them is astounding. ‘What if you just came off them?’ asked a family member. First of all, the decision to stop taking antidepressants is not one to be made on a whim and should always result from a discussion with medical professionals. And more to the point, there’s a possibility that — in my case at least — it may even put my life at risk.
It’s time to let people live their lives, whether that involves them taking antidepressants or not. Because essentially, it’s not really anyone else’s business. And if antidepressants aren’t for you, there’s always ketamine, right?
