“Sometimes it feels like we’re all living in a Prozac nation. The United States of Depression.” – Elizabeth Wurtzel, Prozac Nation
An estimated one in 10 Americans takes some form of antidepressant medication: a figure increasing all the time. Some surmise this is because depression is on the increase; others that this is because people are increasingly seeking help for their depression. But do they work, and how, and for whom? Is our reliance on them really healthy?
I’ve been on and off – mostly off – antidepressants since the age of 14. Prozac, Seroxat and Citalopram: all the most commonly prescribed SSRI (Serotonin Reuptake Inhibitors) on the market here in the UK. Like many users, not only have I found they do little to numb my pain, but I’ve had terrible side effects–including increased anger and frustration, nightmares, a bigger helping than normal of insomnia, deeper-than-usual self-harm cutting, inability to orgasm and even a suicide attempt (using a pack of Citalopram – oh the irony). Yet, more often than not, over the years, my doctor has insisted I try them one more time (often without suggesting any other method of controlling my depression). And–crazier still–many, many other people I have talked to claim these drugs have saved their lives. Even during periods of abstinence from alcohol – something I can rely on a little too heavily and which can affect how antidepressants work – the side effects have always continued.
Elaine, 29, is a primary school teacher. She’s a “sherry-at-Christmas kind of girl” who rarely drinks, but she finds antidepressants give her the same side effects. “I’ve always done everything right when taking them,” she says. “But like you,” she tells me, “I found myself with even darker thoughts whilst on medication.” Elaine reports “a suicide attempt, self-harm, indescribable night terrors and nightmares.” Eventually, after four years of perseverance, she’s resorted to “talking therapies, exercise and mindfulness” and is slowly finding she can at least manage her illness most of the time, even if “defeating it is a long way off.”
Hollie, 26, is a journalist. Her experience with antidepressants has been quite different from mine and Elaine’s. “I’ve been on quite a few different anti-depressants over the past decade or so, mainly to combat depression and anxiety,” she told Loner. “I’d stop taking the pills suddenly, because I didn’t like feeling I was being controlled, but then I’d get the crippling side effects that come with going cold turkey and I felt I could never win.” Antidepressant users are advised to taper down their dose slowly if they intend to stop the medication, as side effects from “cold turkey” include increased risk of suicide, insomnia, self harm and nightmares. Which, in my case, the drug induces anyway.
“The turning point came around four years ago. I gave Citalopram a go for the second time in my life, when I was going through bad anxiety whilst at University and it has 100% changed my life,” Hollie continues. “Without Citalopram, I wouldn’t be able to hold down a job I love, a great relationship and have the confidence to have fun and live my life. It’s part of my evening routine now and I take it before bed. When it comes to doctors prescribing pills, I do think we need to be a little more cautious and see if there are other ways issues can be resolved, but as long as the patient is happy and healthy, that’s all that matters.”
So why do drugs work for some people and not for others? SSRI antidepressants are intended to work by increasing the activity of chemicals called neurotransmitters in the brain. But some studies – including this one, which is rigorously researched using data from the Food and Drug Administration – suggest that antidepressants produce little more than a placebo effect. This study, conducted in response to the previous study, concludes that we should give them a chance.
However, on a personal note, I’ve noticed that one of my doctors resolutely refuses to prescribe me antidepressants, even when I wearily sigh and offer to give them one more chance. I have a suspicion it’s because he’s heard everything I’ve had to say and he agrees: they can’t help everyone. Why, is something of a mystery. It seems clear, though–pushing pills at everyone isn’t the answer. They are just one part of a possible jigsaw of solutions.