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Antidepressants

Antidepressants: talking to family and friends

People who experience depression often find it difficult to talk openly to others and worry about what others would think. Many said it had taken a long time, and a lot of courage to talk to their doctor for the first time, and that they hadn’t always told friends or family. Often when people said they had told others that they had depression, they were surprised to find people were sympathetic and supportive. The people we spoke to seemed to be more inclined to talk about depression itself, rather than disclose they were taking an antidepressant to others. Catherine said, ‘It’s not a question you’re ever asked, it never really comes up at all’. Sometimes friends and family found out because they saw the packet of medicine in the house and asked about it.
 
Family relationships 
Lucy X had been prescribed Prozac (fluoxetine) as a teenager but hadn’t wanted her parents to know. In hindsight though she felt it would have been better if they had known ‘I should have told my parents because it meant they couldn’t give me any support... and I think they felt very rejected that I’d made this decision to like, to lie to them... to sort of deceive them’ as an adult she is more open with them and understands more how they feel. ‘I think they’d like me to not take the medication... because they want me to be better... my medication implies there’s an illness and I think they just don’t want me to have the illness.’ Greg’s parents think he is right to take them if they help him feel happy and healthy. ‘They’ve supported me in whatever I do… they would rather me take pills than me cut myself’. Some people said they would talk about it if it came up in conversation but wouldn’t make a point of doing so. 
 

Andrew recalled ‘Someone saw that there was citalopram...

Andrew recalled ‘Someone saw that there was citalopram...

Age at interview: 50
Sex: Male
Age at diagnosis: 49
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Some family members know I didn’t tell them but I wouldn’t not tell them. Someone saw that I had, there’s a, there was citalopram sitting on the shelf and she’d had it herself and she said to my wife ‘Oh who’s on citalopram?’ and she said ‘They’re Andrew’s.’ So my wife’s family know, they’re the family I see more often we don’t really see my family that often so they know, fine I don’t mind them knowing at all.
 
Well I haven’t, you see I haven’t avoided telling her, and I would tell her but we pop down there for half a day and really, you know, there’s not really discussion, there’s discussion about the kids and stuff but never that, sit down and have half an hour to say how are you getting on...
 
And well I mean if, I don’t mind people knowing and I would tell them but then I don’t know I feel there’s a bit of weakness there. I did tell someone at work and I work very closely with one of the professors, he’s enormously busy and I take on a lot of his load. And I spoke to the administrative worker at work and said did she think I should tell him that I’m depressed and that I’m on this treatment. Particularly as I wasn’t sure how the treatment was going to make me feel and I was at work the first few weeks and I was feeling bloody awful, you know. And she said I don’t know whether you should tell him or not, what do you want to do? And I said I don’t know because I don’t know what I want out of telling people at work, do I want them to treat me differently? Do I want them to take into account some odd behaviour they might have... they had noticed, or do I want them to think that I might not be as productive as I normally am? And I couldn’t answer that question in my head, I didn’t, I couldn’t think through what it is I might want from them. You know if you’ve got a broken leg you can say well I can only.... I need a taxi to work.
 
You can work out what are your limitations.
 
Well yes if I’d been diagnosed with cancer – well, there would be three days a week I can’t come in because I’m on my treatment but I’ll try and get in for the other two but I would appreciate it if people knew. But perhaps I don’t want them to keep asking me about it when they see me in the coffee room really, you know, I mean there are different ways people want to handle it. And I don’t want the ‘Oh’ that ‘Oh.’
 
Yes that sympathy thing.
 
Yes. Nonetheless I do think it would be useful if they knew that somebody like me has been unwell with depression and has also had the treatment so I do feel as it’s a bit of a copout but I didn’t tell my boss and I just kind of tried to handle it as best I could myself.
Some people had shared experiences about using antidepressants with relatives who they knew had taken them themselves. Stephen had found it reassuring knowing his father had taken them and they compared notes. ’He was on a different one; I’m not sure which one he was on. He was on it for a very, very short time about... we sort of compared side effects’. But Emily said although she knew some of her relatives had taken them, it wasn’t spoken about. ‘One of the interesting things is I’ve found out... over a year after I started the medication... after I’d come off it, the same year - my father and my sister were both on anti-depressant medication’. Reasons for not telling others about being on antidepressants varied for example Emily said her father was ‘a very private person’ and others hadn’t wanted to worry their families. People said others associated taking antidepressants with ‘craziness’ or ‘that you were ‘mental’. Clare’s husband jokingly referred to her antidepressants as her ‘mad pills’.
 
People in long term relationships said their husband, wife or partner were usually supportive and understanding. Lou’s husband seemed relieved that she had found an antidepressant that works for her and that they helped her feel more able to cope. ‘He’s not the kind of person that’s hugely into sharing and talking and things like that but... he clearly doesn’t think it’s a bad idea because he never said oh no you don’t want to take antidepressants’. 
 

Clare and her husband have different views about taking...

Clare and her husband have different views about taking...

Age at interview: 59
Sex: Female
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No well if I tell you that this is a man who last winter fractured his ankle so badly that his foot was facing the wrong way and didn’t want to have a plaster cast.
 
Oh gosh.
 
And in fact insisted that they took the plaster cast off and he just stood up kind of thing and thought he could go back to work. He doesn’t do medication, he doesn’t do doctors, he doesn’t do, all of that with [husband] is a sign of weakness, and it’s a sign of frailty that doesn’t feature in his being. so again I think, interesting I wonder if I dare ask him, not dare ask him but would I bother.
 
Would you have the conversation?
 
What did he think about me still being on tablets? I don’t think I’ve ever asked him no I don’t know, I don’t know.
 
Is it something that you very much keep for yourself?
 
Well it’s just, it’s just ‘me’.
 
You know that
 
He would pick them up from the doctors for me if he was going past, he would say to me, you know, next week when we are packing to go to [European city] he’d say, you know, have you remembered your tablets, you know. It’s not a bone of contention between us it’s not something that causes problems or it’s just.
 
That’s his way.
 
That’s his view of life, that’s his, that’s what makes him, him and I accept that and I don’t, I don’t have that as something that gets in the way because I accept that that’s his view and I, who am I to say that he’s wrong to think like that you know because he supports me.
Knowing when or whether to tell a new partner can be difficult. Gerry is open about it ‘It was very important to me with my current girlfriend to be honest and open about that because it basically defines me in a relationship now’. Olivia X’s told her boyfriend she was taking them when he came across the packet of tablets ‘He said ‘what are these?’ and it was just after we’d started dating. So I actually told him, I told him what they were and I explained why, he was cool with it he was fine’. 
 

It can be difficult to know when to tell a new boyfriend that...

It can be difficult to know when to tell a new boyfriend that...

Age at interview: 23
Sex: Female
Age at diagnosis: 18
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So yeah, we’ve, we’ve been together since April and he knew before we started going out that I had problems with depression and I took medication for it and he’s, he’s been, he’s been really great about that stuff.
 
So was that easy or difficult to tell somebody that you barely knew to begin with then.
 
So we were friends before we started going out so I kind of got to know and trust him like that and we talked about it in that context and then got together later and it was actually, it was, so I when I’d, you know, started dating people before there was always the oh God when I am supposed to tell you moment and I, I’ve never been able, good at being that forthcoming with strangers especially so, you know, I’d think oh God well three dates, is it six dates is it when we’re going out a couple of months or you, yes because, you know, at some point you do, I feel almost, you know, it gets to a point when it’s lying by omission, if it’s still a part of your life then you sort of owe it to that person if you’re dating them to be clean about it. But also you don’t want to drop it in on the first date, by the way [inaudible speech]. I do remember with, with one guy that I’d started seeing I decided the easiest thing to do would be to just, you know, take my medication in front of him and he said is that the pill and I said it’s a pill and that was the end of the conversation.
 
Have you had any kind of bad reactions to you telling people that’s what you do?
 
Probably the worst reaction was from my parents.
 
Right.
 
Yeah, I said, mentioned it, I think when I was first prescribed fluoxetine my dad said is that really necessary.
 
Did you talk to him about it?
 
No because it was much, much easier not to really, yeah we just don’t talk about it.
 
Actually some people say that when they do tell other people that they’re taking them they can be quite surprised to hear other people say oh I do to or I know someone who is.
 
Yes, yeah. Now I haven’t, haven’t had a lot of that but what I have had is friends who I’ve, who’ve you know, if I haven’t had long conversations with them about it they’ve at least been aware that that’s my situation and then if they’ve encountered problems themselves later or if they’ve got other close friends that are having those troubles that they come to me to talk about it which I really, really like. I feel like, you know, at least it’s doing other people some good that I’ve had these bad experiences, that you know, and that I’ve had long and extensive enough experience of, you know, treatment and whatever to be able to say look here’s my advice, here’s what I think you should do.
 
I suppose it also encourages you to be able to talk a bit more as well.
 
Yeah, yeah it really does and I, I sort of quite, I really like the fact that people feel that they can talk to me about that, that they can, that they have come up to me and said look I’m feeling like this or I’ve got a friend who’s just started taking this and I know you’ve taken this so what would you, what would you recommend to her, that kind of thing.
Taking an antidepressant can affect one’s sex life, with side effects such as loss of libido, or inability to climax which can be difficult to talk about with a partner. Stuart had spoken about it with his wife, but it can be a difficult topic to discuss. Sharon said that most antidepressants she had tried had ‘shut off’ her sexual feelings which had caused problems, but that feeling well was more important to her. ‘I wasn't too upset because I knew that was a side effect... I think for my husband it was probably quite frustrating and I did spend time explaining to him that it wasn't him, it was the medication you know, it's part and parcel of having that and the higher the dosage the worse it got’. Steve told his new boyfriend he was taking an antidepressant and would have liked him to have asked more about the reasons, but was glad he hadn’t got a negative reaction, ‘It was just that easy, there was nothing like, it was nothing tough. If I’m really honest though when I talk about it he is quite blasé about it, he’s quite good at getting on with life’.
 
Friends and social life 
Lucy Y is open about taking an antidepressant with close friends and they sometimes ask her for advice. People sometimes worry that others might be critical or make judgements about them. Lou feels it’s important to be open. ‘I don’t feel any particular shame, in fact I that the more people talk about antidepressants as a positive thing the better’. Charlotte’s close friends know she takes antidepressants. ‘Some said... oh you don’t need to take them you just, you know, pull your finger out there’s nothing wrong with you, [but] most people were really understanding about it, didn’t judge me whatsoever.’ Sonia has a friend who also suffers from depression who she can talk to, but doesn’t tell most friends. ‘I don’t want them to think of me in that way’. Olivia Y said she was careful about who she told. ‘I was embarrassed and I thought I would be stigmatised, absolutely. My close friends knew I was taking them but it’s not something I would shout about’. 
 

Greg feels that there are lots of pressures on GP’s. One doctor he saw was ‘amazing’ and spent time talking things through, but another one ‘just dished out pills’.

Greg feels that there are lots of pressures on GP’s. One doctor he saw was ‘amazing’ and spent time talking things through, but another one ‘just dished out pills’.

Age at interview: 34
Sex: Male
Age at diagnosis: 34
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I’m realistic enough to know that people who don’t have that much time, doctors don’t have that much time to sit down and speak to every patient and I was very lucky with one that he was an amazing doctor, he would always take his time over me whether that was personally, I think he was like that with everyone he would just take his time and he was amazing doctor and I’ve had another doctor who just dishes it out straight away and maybe he was under a lot more pressure, he had a lot more patients, so it’s hard to judge.
 
Yeah in an ideal world we should sit down with someone and talk to them for half an hour and find out why they want to take them and what the history is, whether that’s feasible, I can understand there’s probably pressures to see all these patients get these patients through the door . Yeah I think, you know, a conversation is the best thing for mental health issues alongside pharmaceuticals as well. I think pharmaceuticals alone are probably not great, and I think conversation alone possibly is not great as well. So it’s just whether there’s time for people to be able to converse with someone about their issues.
 

Gerry explained, I’m completely fine...

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Gerry explained, I’m completely fine...

Age at interview: 31
Sex: Male
Age at diagnosis: 29
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People just see it as you’re a bit crazy if you’re on antidepressants, you know, it’s usually, I mean I’ll be completely honest it’s especially from the kind of place I come from sort of my friends it’s, I’d just be... emotional girls should we say... going on antidepressants you know, maybe they should just pull themselves together. Yes.
 
Is it a bit of a macho thing?
 
Yes a bit of a macho thing yes. You know I’m, I’m completely, I’m completely fine with being on antidepressants and suffering from depression but I don’t really feel the need to go and bang the drum and try and change everyone’s perceptions and attitudes about it I’m just glad that I sought help and I feel better really and I don’t know maybe that’s not the best idea, I’ve got a lot of respect for people that are out there trying to raise awareness of it because it is very important but I don’t know I think that once you, the big thing for me is acknowledging you’ve got depression and getting help yourself.
Very often socialising with friends involves going to the pub or places where it’s customary to drink alcohol. People had different attitudes about whether or not they drank alcohol when they were taking an antidepressant. The guidance generally is that it’s safest to avoid drinking alcohol because some antidepressants can interact with it. Alcohol increases the sedative effects of tricycles and may also increase the sedative effects of SSRIs. With MAOIs, you should completely avoid certain alcoholic and non-alcoholic drinks that contain tyramine.
 
Not drinking alcohol had triggered awkward questions in some situations. Lucy X’s friends asked her why she wasn’t drinking ‘I couldn’t drink and so I think that’s why it came up was they asked why and I said, ‘I can’t drink it because I’m taking medication’ and then obviously being my close friends they wanted to know what and what was happening’. Lucy Y said it was relatively easy to make excuses about not drinking when she was at university because often people were more careful if they had an essay to write or an exam coming up. 
 

Peter felt that ‘It’s really tricky socially not to drink... it must...

Peter felt that ‘It’s really tricky socially not to drink... it must...

Age at interview: 28
Sex: Male
Age at diagnosis: 22
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I think it’s really tricky socially not to drink I think it’s really tricky socially not to drink I think, you know, it’s tricky not to get into a conversation when someone says, because I went off alcohol for quite a long time actually I went off, I said to people I was going off it for Lent but really I was going of it to stabilise myself around the time of my last sort of big episode and I just completely went off alcohol for a good sort of six or seven weeks. Now I don’t drink a lot now but I might drink once a week and I don’t drink to get drunk but I mean last night for example I’d a friend in town from America and we went out and I maybe had four pints or something like that so, you know, that’s not crazy but obviously I’m not going to drive or anything after that. so I think if you try to limit yourself to once a week or special occasions and if someone offers you a glass of wine with a meal or something I’d say take it but just be careful. And it is, it must be up to the individual person, I mean it’s going to affect different people in different ways, people are going to obviously be bigger physically or not but I, I find I can handle a couple of drinks and it not adversely affect me in terms of my antidepressants.
 
Do you tell other people that you take antidepressants?
 
No.
 
Can I ask why, why would you not?
 
I do sometimes I wouldn’t volunteer the information but if, if it came up in conversation I might mention it but it will depend on people, certainly I mean I have to declare to my employers what medication I’m on which I’ve done but I wouldn’t ever say to the person sitting beside me oh yes I’m on antidepressants and I think, I still think there’s a stigma with mental illness.
Several people had continued to drink alcohol whilst they were taking an antidepressant because it was a part of their social life. Greg felt it was unrealistic to stop drinking completely especially if you have to take an antidepressant for a long period of time. He felt that avoiding going out drinking would isolate him from his friends, and make him more depressed. ‘You want to go out and have a drink with your friends ... I want to live my life normally - and ‘normally’ means going to the pub’. Not everyone noticed adverse effects from alcohol, but Victoria found it affected her. ‘I was absolutely all over the place after one drink’. Greg said, ‘One drink felt like ten drinks’ and that he had blacked out on a couple of occasions. Steve had continued drinking alcohol, and said if his doctor had suggested stopping ‘I would have ignored him’. Charlotte had not been given any advice about it by her doctor but recalled the patient leaflet had advised caution. ‘I’ve always ignored that and carried on going out with friends or whatever drinking... fortunately it’s never had a negative effect on me. (See also 'Antidepressants and work', ‘Coping with antidepressant side effects’ and ‘The Patient Information leaflet’).

Last reviewed June 2016.
​Last updated June 2016.
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