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Antidepressants

Antidepressant use and recovery from depression

‘Recovery’ means different things to people. Some said it was about ‘feeling normal while others saw stopping taking antidepressants as a marker of their recovery. Emma felt just starting to take an antidepressant was a step on the ‘road to recovery... just the fact that you’re getting medication’.
 
Max said being discharged from hospital marked the beginning of ‘being recovered, for want of a better expression’ and that he continued to take antidepressants but as ‘a functioning depressive.... being able to exist and contribute in your own little way, leading a sort ‘normal’ lifestyle’. Recovery was often described as a gradual process. Some said they had reached a kind of ‘recovery’ whilst continuing to take an antidepressant. Flora had tried various different antidepressants before finding one that helps her to feel well again. ‘Before I always somehow felt that it wasn’t normal to be continually on the medication and I think now I’ve kind of made my peace with it and in fact it’s less of a difficultly than I thought it would be so I’m happy to stay on it as long as it’s not giving me any problems’. Sharon had experienced recurrent episodes of depression over many years and had accepted she may be on them ‘for life’. ‘I don’t think I’d be too concerned if I had to stay on them for the rest of my life if that’s what it needs because I know the benefits and it gives a lift [to my mood]’. Others said they had come to terms with themselves to the extent that they acknowledged their own potential for depression, and saw taking an antidepressant as a means of keeping things stable, or managing their moods. Stuart decided to continue taking an antidepressant as a preventative measure as he feels taking it keeps his mood steady but still experiences depression sometimes. ‘They haven’t cured me and they never will’.  
 

Clare reflected ‘I genuinely hope there will be a day when...

Clare reflected ‘I genuinely hope there will be a day when...

Age at interview: 59
Sex: Female
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If I need to be on that until the day I die I’ll be on it because the ‘me’ on it is much, a much nicer more stable person than the me not on it. but then the other side of me goes ‘how lovely would it be to be the you that you are on the medication without it and it’s that how do I get to that, how do I get to that place? And again that’s about I know that I don’t, I’m not just the person I am today I need to keep developing and working on who I am and working on my coping strategies and, you know, lifelong learning about my mental health and I, I genuinely hope there will be a day when I can say’ no, you know, I’m okay I can deal with things’. But I don’t know if that will happen and so I’m not downing myself because of that because I kind of have this duel carriage way that I’m going down and I could be in either lane.
 

‘Taking antidepressants is just something I do now...

‘Taking antidepressants is just something I do now...

Age at interview: 52
Sex: Male
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So basically I’m now on antidepressants really as a long term preventative measure so the GP’s that I’ve spoken to have said well if you’re happy to be on them given that you’ve had depression all your life you, and you’ve got a drug now that doesn’t have serious side effects you might as well stay on it. And so taking antidepressants is just something I do now.
 
Over the years my depressive episodes have got shorter so in the past they could last months even years just being on average in a very, very low mood.
 
For me depression is about, it’s almost like a switch in my brain I can feel it when it, when it happens it’s shutting down, it almost feels like my brain is working in a different way you just want to, want to withdraw, you want to be away from the world, you want, and nothing seems to matter so, you know, technically I understand it’s called allodynia but it’s basically the feeling that there is no pleasure there is no point in things even things that you supposedly enjoy, you just feel you end up doing things because you know you should do them rather than because of any pleasure in things. And so that, that feeling of lack of pleasure and just wanting to be shut away and be left alone and it’s for a large, at times it almost feels like a living death you sort of don’t feel that you’re really alive which is where the suicidal thoughts come in for me which I still get although they’re easier to manage now you know I’ve never actually got to the point of doing anything but and so it’s now, now at the point where it’s, it’s pretty manageable and I’ve also changed, changed jobs so I’ve moved I’ve moved away from the fairly high powered job that I had before in industry and I now teach three days a week which I really enjoy despite all of the hassles there are with the bureaucracy of teaching. and I’ve now got to the point where I’m sort of getting, I’ve got quite involved in various trying to help other people who are struggling with depression, mental health and trying to do, I recently did a charity walk around England two and a half thousand miles which was basically a campaigning walk tied in with the campaigns that all of the mental health charities are running at the moment to try and reduce the stigma associated with mental health problems. Because a lot of my issues are worse than they needed to have been because if I’d been diagnosed as a teenager and treated earlier then you know, things would have been very different. 
Those who were taking an antidepressant for the first time hoped that it would help them to begin to ‘feel better’ or ‘get back to normal’ at some point, and often talked about taking an antidepressant as a short term measure. Gerry had discussed, with his consultant, how long he should take the antidepressant ‘he thinks until about March or April next year so that’s going to be about nine months I’ll have been on antidepressants. Touch wood hopefully, you know, I’ll be OK by then and I won’t have a reoccurrence of the depression’.
 
Typically people saw taking an antidepressant as a means to help them ‘get back on track’, to feel more able to engage with problems or help ‘get some perspective’ but many felt that just taking an antidepressant without having therapy or finding other ways to deal with problems would not lead to a lasting recovery. Although an antidepressant had helped, it was rarely seen as a solution in its own right. Several people reflected that it was like ‘plastering over the cracks’ which might alleviate symptoms, but real ‘recovery’ involved confronting the ‘root causes’ of depression.
People described their own sense of recovery in terms of gaining new insights; developing a greater sense of self- awareness; learning to cope better with life’s ups and downs; finding new ways to think about situations and life events, and identifying strategies that helped keep them buoyant such as exercise, talking to others and eating healthy food. Being able to return to work, feeling on top of things at work, getting pleasure from everyday activities and taking up new hobbies were recognised as signs of recovery. 
 

Lou sees taking an antidepressant as a stepping stone on the...

Lou sees taking an antidepressant as a stepping stone on the...

Age at interview: 39
Sex: Female
Age at diagnosis: 22
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I don’t feel that I’m anyone different just that I’m unburdened really.
 
And coping.
 
And coping and, you know, and then able to kind of do the other things that I need to do, you know in order to then maybe stop taking the antidepressants, you know to put the other structures in place so that I don’t need them anymore but without the crutch if you like of the antidepressants you’re never going to get to the point at which you can... not take them anymore.
 
So it sounds like they’re a stepping stone to help you through and get you to another place?
 
Yes.
 
Where you can.
 
Yes or, you know, I mean I guess like I’d say to people it’s like, it’s a bit like you know if you have really bad migraines all the time it would be like having pain relief to give you enough time to then not have this dominant headache while you try and work out what’s triggering you migraines. You know, it’s a lot harder to do something if you’re in a lot of pain; well psychological pain’s the same
Roisin felt venlafaxine helped alleviate symptoms, but she still had other issues to contend with ‘it wasn’t an overnight thing, you know that it changed because even though venlaflaxine helped with the depression and I found myself feeling better in terms of that, I still had a serious alcohol dependency that I’d developed’. Melanie felt it was impossible to put a timescale on her own potential recovery; her doctor had told her ‘it’s a personal thing’ and that she might need to take antidepressants for six to eight months, but it could be one or two years. ‘It’s open ended... I think I would be concerned if anybody did say, well we would expect you to have results within six months because I’m not sure that you could’. 
 

Emily took an antidepressant for a year and gradually began...

Emily took an antidepressant for a year and gradually began...

Age at interview: 28
Sex: Female
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Because I was on medication for a year and I think, because I kept thinking I was better and I don’t know if that’s the right word really, better.
 
Improving?
 
Yes improving and oh everything’s fine and dandy now, brilliant. And so a couple of times I tried to go back to work full time and just, you know, be normal I suppose and then that would set me back because I was trying to do too much, I was trying to take too much on. And I think I was just expecting because I felt like there was no event or nothing wrong in my life, I kept feeling like I wasn’t entitled to feel the way I felt even though I was being told, you know, sometimes it can be a chemical imbalance it just, you know, it can be something long buried form a long time ago and there’s various reasons for it I still kept thinking well I’m not entitled to feel this bad. So it took me, and so yes I kept assuming right I’m better now, I’m better now, I’m over it, I’m over it. So I was very up and down and then I would get as far as to say it did, it was obviously more gradual than this but it almost just clicked and I actually chose to stop taking the medication myself a year later by that point I was down to twenty again and I just stopped taking it and I haven’t actually been, I haven’t, I didn’t go back to the doctor and discuss it I just stopped taking it and I haven’t, I didn’t go back to see the doctor at all actually.
 
And since then I think I’m hyper aware of the potential of going back so I try to talk through the help of the therapist I was seeing at the time, the counsellor she really helped me to sort of understand coping mechanisms different ways of looking at things. And so it’s things like when I feel, because I still every now and then I do, it’s hard to judge whether it’s, you know, ‘normal’ or something else because.
 
A low mood, or actually depression?
 
Yes because obviously I can’t judge how other people feel, you know these experiences when they’re sad how sad is sad and what’s depression and what’s just sad. but I’ve got things were, you know, I go to the gym a lot regularly, structured and, you know, if I start to feel really down I do something and I make myself talk as well and make myself talk to my current boyfriend and make myself talk to my friends and my family and sometimes I find that very difficult because I still think it’s slightly in me to, to keep it inside and it does build up so I think it’s those coping mechanisms that the therapy gave me that have been a long term solution but the medication I guess I could say I needed straight away.
‘Recovery’, ‘getting better’ or ‘feeling well again’ was described as a gradual process of improvement in mood and feeling more able to cope with everyday life. Andrew said he gradually began to find pleasure and enjoyment in life and had started to feel like his old self. ‘Now I feel oh yes... this is the person I used to be’. Lucy X started to feel she was being herself again. ‘I felt like kind of my energy and kind of motivation started to come back, before I’d been very content to just sit around and not read anything... just feeling like I actually cared about stuff again and that I wanted to do things’. Some people said it was difficult to tell how much their recovery could be attributed to taking an antidepressant, because all kinds of other factors contributed to their new sense of wellbeing such as having undergone therapy, life events, or just the passing of time. Catherine had accessed a lot of support services over the years and also made efforts to modify her diet and take exercise. ‘I’m very intrigued at the placebo… does it… is it still working, and how do I know that… Do I really need it?’
 
Not everyone believed antidepressants would bring about a lasting recovery particularly if they had prolonged episodes or continuous depression over many years. Some of the people we talked to had experienced recurrent episodes of depression and had taken antidepressants at different times in their lives, When Thomas stopped taking antidepressants and began to rebuild aspects of his life he reflected that he had started to ‘redefine myself as a normal human being’ but later experienced a further episode. ‘It was a huge blow really. I thought it’s still there and it’s still in the cupboard’.
 
Rachel believed that antidepressants ‘shaved off’ a part of her personality and that she was wasting her life taking them. Greg had short periods of reactive depression usually precipitated by relationship breakdowns, and wasn’t convinced that antidepressants were the answer for him as a long term solution although he had felt they helped for a short time. ‘There are probably issues there that need... counselling rather than, than the antidepressants so maybe the antidepressants aren’t exactly right for me. But you know, I stand by those three months I really needed them at the beginning they were amazing.’ Max wasn’t convinced that any improvements he experienced would last. ‘I’m wise enough to know that it’s not gone... I would fully expect myself if I had a problem again to speak to my therapist or maybe go back on drugs, who knows?’
 
A few people we talked to felt that taking antidepressants had impeded their recovery and been detrimental to their wellbeing. Hannah had tried several, but found they made her feel worse rather than better, including inducing suicidal feelings. She felt that if she had been offered therapy instead of antidepressants when she first went to see the GP she would have been better off. She felt relieved that she had now stopped taking antidepressants and felt she had more control over her life without them. ‘I felt like I’d recovered when I was back at work fulltime, I felt like I was functioning, you know, the best that I could do at work, I wasn’t having any kind of dark thoughts of like suicidal thoughts.... I could see a future’. 
 

Janet has been taking antidepressants and other medicines...

Janet has been taking antidepressants and other medicines...

Age at interview: 71
Sex: Female
Age at diagnosis: 28
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On the whole it’s better to have them than not have them. I mean I may grumble about not feeling very bright and alert but I know that really they probably do me more good and I would be worse if I didn’t have them, if I came off the olanzapine I would probably be terrified again of everything so I think they are a good thing.
 
So they’re of benefit to you?
 
Yes I think so.
 
But it sounds like you’re not really in that kind of’ recovery mode’ where, you know you could get to a point that where you could maybe step it down or stop relying on them so much. Do you see that as a possibility for the future, I mean does recovery mean anything to you or do you just think that you’ll stay pretty similar to how you are?
 
Well I, I think I’ll stay more or less as I am which isn’t really very, very positive is it? It’s the fact that I am so much older.
 
Does that upset you?
 
Well it upsets me because I can’t do things as I used to do, you know, I couldn’t make a meal for anybody other than my family and I’m just so slow and so nervous and it doesn’t, as a family it doesn’t matter of it doesn’t go right as it would in other ways and I put that down to being older because people who are not on drugs like me would say ‘oh I can’t do what I used to do’. And yet on your website that I looked at last night, there were a number of, several older people who actually, in their 70’s and 60’s one in their 70’s and two in their 60’s who actually said that they had got better.
 
Right.
 
So that was quite encouraging.
(See also ‘Expectations about taking antidepressants’,'Other strategies for dealing with depression', ‘Talking therapies and antidepressants’).

Last reviewed June 2016.
 
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