Experiences of antidepressants

Antidepressant use and hospital care

We talked to some people who had been treated in hospital, either being admitted or attending as a day patient. Some accessed private hospitals or clinics through medical insurance schemes. Being referred to the ‘Crisis Team’, which is part of the Community Mental Health Service (CAMS), had sometimes averted the need for a hospital admission.
 
In hospital prescribing medicines is the responsibility of a psychiatrist. A psychiatrist might make a new diagnosis such as psychotic depression, bipolar disorder or personality disorder.
 
There were mixed experiences of hospital treatment depending on circumstances. Roisin admitted herself to a private hospital through a workplace insurance scheme because she felt desperate for help and that over several years she had not been taken seriously by GPs, and not been given the help she needed. Others had wanted to avoid being admitted to hospital. It could be a relief for some people to be looked after in hospital, and to have an opportunity to be let go of responsibilities at home or work for a time. In hospital some said they had benefited from a range of treatments including being prescribed antidepressants or other medicines or talking therapies, it could also be helpful to be with others’ who were going through similar experiences (see also Experiences with health professionals – ‘Psychiatrist’ and ‘Community Mental Health Teams’).
When Flora attended a psychiatric hospital as a day patient it helped her ‘to feel connected again’ as she had felt isolated at home on her own. On another occasion she became more unwell and was admitted to hospital, which she described as ‘sometimes disturbing’, but she also felt ‘safe and contained’ and it provided an opportunity for her medicines to be reviewed and changed. In hospital Flora was able to start taking tranylcypromine, a MAOI antidepressant, which turned out to be the medicine that has helped most in her recovery (see also ‘Using antidepressants: SNRIs, Mirtazapine and MAOIs’, ‘Changing antidepressants’, ‘Antidepressant use and recovery from depression’ and Feelings about using an antidepressant’). Being in hospital whilst she started to take this antidepressant meant she could be monitored and looked after during the initial stages whilst she adjusted to it. Max was admitted to a private hospital because he had medical insurance. He found it difficult to remember exactly what medication he was given whilst he was there.
Whilst some people had been admitted to hospital voluntarily, a few had been ‘sectioned’ under the Mental Health Act. This can happen if someone is considered to be very ill, or a danger to themselves. The Mental Health Act 1983 is the law in England and Wales that allows people with a ‘mental disorder’ to be admitted to hospital, detained and treated without their consent – either for their own health and safety, or for the protection of other people. People can be admitted under different sections of the Mental Health Act, depending on the circumstances, which is why the term ‘sectioned’ is used to describe a compulsory admission to hospital.
 
Olivia X (below) did not agree with the psychiatrist’s diagnosis and refused to take the mood stabilising medicines he prescribed, which set of a chain of events that led to her being ‘sectioned’ for assessment. This affected her family life to the extent that her ex-husband gained custody of their children, and she was ordered by a judge to take Seroquel (quetiapine) for almost a year before they could return to live with her. When Thomas (below) became increasingly unwell a psychiatrist suggested that he could be ‘sectioned’ and he feared the effect this could have on his life as he was studying for a PhD at the time. ‘I was very, very worried at the time, that if my functioning got any worse that my studentship would be withdrawn and I would lose my income. I’d lose my means to live.’ He avoided being admitted to hospital but was treated as a day patient in a psychiatric hospital and was prescribed antipsychotic medicines as well as antidepressants. However, after a time he stopped taking them without telling his doctor. Hannah (below) was admitted to hospital because of serious concerns about her safety. ‘The Crisis Team were worried that I was at risk of taking my life’. Sonia’s psychiatrist was ready to admit her under section ‘the reason he admitted me to hospital was the paracetamol overdoses because I think I’d probably overdosed every night in a week... and he said, “You either go voluntarily or I force you”’.
Being taken into hospital under section can be a frightening experience. People felt fear, shock, panic and anger at having their liberty taken away and some said that their choices and decisions about treatment had been removed. Dina felt strongly that in these circumstances ‘there’s a lot of talk about ‘choice’ and all that stuff… but when you’re sectioned under the mental health act you haven’t got a choice and you haven’t got any rights basically’. Dina, Hannah and Olivia X were critical about the care they received in NHS hospitals. After Dina was sectioned she spent three months in a psychiatric hospital but said the only treatment she received was medication, and that there was little interaction between staff and patients. Olivia felt very angry about the NHS Acute hospital she was originally admitted to ‘this was not therapeutic, it was prison; I was in prison as far as I’m concerned’. Later she moved to a private hospital where she said things felt more structured, and that people had a more positive outlook about the possibility of recovery. Hannah said she felt the hospital she was taken to ‘wasn’t a suitable environment to get better… it felt like I was being punished’.
When people take an overdose they are sometimes taken to A & E for emergency treatment. Hannah was worried when she went to A & E after an overdose that staff would see it as ‘self- inflicted’ and be unsympathetic but she was surprised to find this wasn’t the case. But some felt hospital staff lacked empathy or were indifferent towards people who had overdosed. Dina recalled a nurse in A & E had been dismissive about questions she had about fluoxetine and whether it can increase suicidal thoughts, ‘He didn’t really listen to what I said’.
Mixing with other people who have similar problems in a hospital setting can provide opportunities for people to compare their treatment and talk about the medicines they are taking, although not everyone finds this useful. Max described how there was ‘a sort of ‘cold war’ between the patients... comparing what drug you’re on... it’s like the ‘arms race’, who’s taken the most drugs kind of thing and what they’re taking’. Similarly Thomas said people at the day hospital he attended would ‘swap stories’, ‘this was a staple of conversation for people in contact with mental health services. “What medication are you on?” That would be one of the first questions that you would be asked. “How much are you taking?” “What side effects are you getting?”
 
Being in hospital for another medical condition

Some people were admitted to hospital because of other health conditions. They said they would take in their own supplies of the antidepressant they were taking although if other medicines were needed they would be given on the ward. Emma has a neurological condition and has been in hospital several times. She takes her antidepressant in with her but said having to hand it in to a member of staff makes her feel she isn’t trusted. Jenny has a very severe form of asthma, and takes nineteen medicines each day including an antidepressant. She has such a complex medical history that she takes a folder of information about her drug regime in with her each time she’s admitted.


Last reviewed June 2016.
​Last updated June 2016.

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