While very effective for some, many mental illness sufferers struggle with the effects of antidepressants, writes Amy Ryan.
Note: This article recounts one mental illness sufferer's experience with antidepressants. While she did not find them to have the desired effect, this does not mean that other sufferers should not keep up with their medication. If you are struggling with any of the issues raised in this article, please consult your GP or a mental health professional before making any changes to your medication.
 
“Depression is more than just sadness. People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide.” (American Psychological Association)
 
Depression is common. In fact, about one in ten people will experience depression at some point in their lives. However, the exact number of people with depression is hard to estimate because many people do not get help or are not formally diagnosed with the condition.
 
Do we understand depression and how to treat it here in Ireland? It doesn’t seem so; statistics show that our suicide rates are high in comparison to other countries. Depression that goes undiagnosed or isn’t treated properly may well be the reason for our high suicide rates.
 
Carol told me her story about dealing with depression since she was 17. I wanted to hear about her experience in dealing with a mental health issue in Ireland.  
 
“I didn’t know how I felt; I didn’t know what was wrong with me. I didn’t know how to cope with the erratic feelings I had.”
 
Carol went to see her family doctor, the GP that she had been attending since she was a child. She said that she felt patronised and felt that she didn’t listen to her. 
 
“She was doing all the talking whereas she should have been the one listening. She had no hesitations in writing me a prescription for antidepressants.
 
“She was more focused on getting me in and out of the room than actually listening to what I had to say.”
 
During her first visit, the doctor advised her to call a counsellor and handed the young girl a business card for a local service. She took the card, her hand was shaking. She knew that she wouldn’t go to a counsellor, it was hard enough for her to go to the GP.
 
Carol left the doctor’s surgery, unsure what to feel. There was a sense of relief that she knew what was causing her to feel this way; depression. She also had a prescription in her hand, for a pill that would ‘make her feel better’.
 
Yet, staring at the prescription for antidepressants, she still felt that she didn’t understand what was happening to her. She felt that she had no understanding about the emotional turmoil she was feeling and the doctor hadn’t helped to shed any light on the illness.
 
“My GP didn’t explain that it was a disease or how to deal with it. I didn’t know anything about antidepressants or how they affected you. She didn’t explain it to me; she just told me they’d make you feel better.”
 
Carol returned to the doctor every 6 months to renew her prescription and consult with her doctor. She said that she didn’t feel like the doctor ever questioned whether it was necessary to remain on medication. When Carol said that she felt fine, the doctor would say: “Let me write you another prescription, just in case.” 
 
Carol began feeling very lethargic while on the medication, she started falling asleep a lot in class. She also lost a lot of weight and began to suffer from mood swings. She said that she didn’t feel that it helped her feelings of depression.
 
“I didn’t feel any better and it wasn’t long after that that I started to cut myself. I did that for 10 years while I was on the tablets.
 
“The medication is meant to be helping you but it feels like its suppressing you. You can’t express your feelings. I was living, but not living at the same time. There is a numbing effect on your emotions.”
 
Carol came off the medication after 8 years with the help and support of her friends and family after she started to open up about her depression. Her emotions gradually began to become stronger, the ‘numbness’ eased away. She felt more emotional “in a positive way”.
 
“I was learning how to deal with my emotions finally, instead of just taking tablets to keep them at bay and hide them away from everybody.
 
“My personality came back. I was a lot happier, a lot more upbeat.”
 
She began to feel more positive and things became easier when she opened up to friends and family. The depression wasn’t gone; it will always be there, just below the surface. But she began to learn to manage it.
 
She began attending counselling through Pieta House and began to learn how to cope with the illness. I asked her how she would advise a friend who was struggling with anxiety, depression or self-harm.
 
“If a friend approached me for advice about antidepressants, I wouldn’t recommend them. Do not take them, no matter what they say. They’re not worth it.
 
“You don’t know how they are going to affect you. You don’t know if you’ll be the same person. I think you only feel better because of the placebo effect, I don’t think they do anything.”
 
The placebo effect usually refers to when a drug is being tested against a tablet that may be just made of sugar, for example. When testing the effectiveness of drugs, many patients report improvements in the symptoms of their illness, even when they are taking the placebo. This is due to the patient’s belief that the drug is helping them. Mind over matter.
 
“If you have anxiety or depression, you need to focus on counselling. It’s very hard to talk, I know I’ve been there. It was a taboo to talk about your feelings or mental health while I was growing up.”
 
Carol’s story is one of many. Antidepressants are commonplace in Ireland, although we don’t talk about it.
 
“Depression is the most common mental disorder. Fortunately, depression is treatable. A combination of therapy and antidepressant medication can help ensure recovery.”(American Psychological Association)
 
It’s naïve to believe that we can cure our thoughts with a pill. Medication may be necessary in some cases, but the placebo effect is much more effective than the drug itself. Especially when, here in Ireland, doctors are held in such high regard that many people take their doctor’s advice without hesitation or investigation. It’s not the doctor’s fault either; a patient needs to take control of their illness in order to overcome it.
 
The side effects of antidepressants are unnerving. Some common side effects of Lexapro, for example, include sexual dysfunction, loss in sexual ability, desire, drive, or performance, unusual drowsiness and trouble sleeping.
 
I find the latter baffling, since these are symptoms of depression.
 
“Antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs.
 
“Adult and pediatric patients receiving antidepressants for MDD, as well as for psychiatric and nonpsychiatric indications, have reported symptoms that may be precursors to emerging suicidality, including anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania. Causality has not been established.”     (Drugs.com)
 
What is the moral of Carol’s story?
 
We need to look a little further than what the doctor prescribes to overcome mental illnesses. They are much too complex to be treated solely with medication. Antidepressants may help you to put a lid on your emotions and deal with severe symptoms, but are they a long-term solution? 
 
 
Pieta House provide councelling free of charge
 
You can call Samaritans for immediate support on 116 123
 
My Mind provide discounted rates to students and those on social welfare
 
C-Saw provide councellors free of charge in Clonmel, Co. Tipperary 
052 6172477
 
 
Story courtesy of Amy Ryan's blog R.E.A.L.N.E.S.S, which you can read more of here.