Attitudes towards depression medication

Some of the people we talked with resisted taking antidepressants, and some stopped taking their medication, even after the medication seemed to be working. People knew others who suffered considerable side effects from antidepressants, and so felt negative about medication. One woman saw depression as a sign of weakness, and resisted taking antidepressants for some time because she thought ‘I’m better than this, I can do this, I can beat this.’ Others had no problems taking antidepressants. This was particularly true of people who felt well and suffered few if any side effects on the newer antidepressants (see ‘Newer anti-depressants medication: SSRI’s and SNRI’s’). One man said, ‘I’m certainly not one of those people who thinks ‘Oh God, there’s some kind of poison in my body.’ It’s like no, it makes me feel better’.

Is for various reasons reluctant to take an antidepressant; once started a course, but did not go…

Age at interview 39

Gender Male

Age at diagnosis 32

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I’ve been prescribed antidepressants in the past but I’ve always felt reluctant and apprehensive about taking it, largely because a) I feel that the effects are probably short-term, they’re not going to actually resolve the depression, b) because they do have side-effects and, c) I didn’t feel comfortable, myself, with taking some tablets.

There was one particular tablet I was prescribed, it wasn’t Prozac, but it was something that was on a lower scale which I started the course…. but I only took them for a few days and I feel that, looking back now, that I didn’t actually take them for long enough, anyway, to have any [pause] authority to say whether they would have helped me or not.

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Felt she was ignorant about depression and medication and was scared about taking medication,…

Age at interview 43

Gender Female

Age at diagnosis 39

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Because I was quite ignorant and na’ve as well, because I… I was scared. My mate says to me, “You’re depressed.” And I said, “I’m not.” She said, “You are” so, as I say, I went to the doctor and I, I expected some miracle cure and, but… so she put me on some tablets and I don’t know what they were, but she said to me, “See a counsellor as well.” And because I was scared going on the tablets, I took the tablets for a little while… but she never explained to me that, she said, “They’re not addictive anyway”, but I was still scared.

I can’t remember them off-hand, but they’re not addictive and they weren’t that strong, but they did make me feel more confident. I could walk up the street with a smile on my face. Yeah, they did help.

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Interestingly, not only did the newer antidepressants have less stigma than older drugs, but some people even thought them fashionable. Newer antidepressants like Prozac had had much press coverage in recent decades. While not all the press has been positive, as one woman said, her experience was of an horrendous depression and then the ‘amazing lifting power’ of Prozac. Needless to say, she did not believe the bad reports. Some were concerned that doctors prescribe antidepressants too readily, pointing out that antidepressants were serious and powerful drugs, and depression was not simply a sad mood (see ‘Experiencing depression‘).

In the mid-1990s, Prozac (fluoxetine) helped her to get ‘out of a rut’ and get on with life; it…

Age at interview 36

Gender Female

Age at diagnosis 34

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The actual antidepressants I can’t remember the first time I took those, probably, let me think, mid 1990s? I don’t know whether it was after, after college. And what was I. Prozac. Prozac worked really well actually for me.

In what sense?

I can’t remember it was that long ago. I know it worked at the time. No side-effects. Sort of kicked in within a week, and got me out of a rut. I think I was feeling very tearful, very depressed and it lifted my spirits. I don’t know how long, whether I was on it for six months or a year. But this enabled me to get on with life and. And I think see it wasn’t one of those nasty early depressants or heavy ones like, I don’t know I mean there were it’s quite fashionable.

Prozac is quite a fashionable antidepressant. And it was ok to say you were on Prozac, it’s like a happy pill isn’t it. I’m OK I’m taking Prozac and then of course I knew quite a few people who were taking it as well, so it was like ok like join the club. So it wasn’t. I didn’t feel too bad on that.

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Several people felt significant improvement through medication was evidence that a chemical imbalance in the brain had caused their depression. Just as some people had diabetes and so lacked insulin, some felt their brains lacked chemicals like serotonin. Nevertheless, even those who believed in the chemical imbalance theory felt that learned behaviours contributed to depression and so thought talking therapies were helpful.

The curative effect of Efexor (venlafaxine) was her proof she had a brain chemical imbalance,…

Age at interview 27

Gender Female

Age at diagnosis 16

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I was worried before I took them that I would become divorced from reality’ like you don’t care about anything. But I don’t think it really is like that. Perhaps if you took a high dose, but I don’t think it is. Despite the side-effects, for me it was the right thing to do. I actually felt happier that it worked, because it proved to me that what I had been suffering was a physical thing. Chemicals in my brain. And you spend years with people saying, “Oh, cheer up love, why are you so miserable?” And you’re thinking it is not my fault.

But you are made to feel it is your fault. The fact that these tablets helped me, I thought there was something going on with my serotonin. I felt vindicated. But after a while, I realised it sorted out my brain chemistry, but you have learnt all these negative ways of looking at things, and doing things’ you’ve learned this behaviour, from your parents at times.

And that is why I believe I need long term therapy as well. I felt better, but I still didn’t have ways of dealing with things. The tablet helps you to be more positive, but in other ways’ for example, I find it easier becoming friends with men, but I find it hard to make friends with women. But there is no tablet for that’ I still have a total inferiority complex. I think I am right, but I also think I am wrong. I hold myself back’ I know I am good at my work, but another part of me thinks I’m crap’

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People who considered they had chemical imbalances in the brain were sometimes reluctant to come off their medication. After all, medication was seen as balancing brain chemicals. Also, the fear and dread of depression was such that people did not want to come off medication if it risked another episode.

One man described ‘panic’ at the thought of coming off his medication. While some people had doctors (especially psychiatrists) who agreed they should be on medication for the rest of their lives, others felt that they had to persuade their doctor. Others worried more that long-term use of antidepressants could damage the brain, and were keen to work with their doctors to stop their medication.

When her GP suggested she come off Prozac (fluoxetine) after 2 years, she became depressed again….

Age at interview 44

Gender Female

Age at diagnosis 41

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So I try and make an appointment every three months or so to pop in and see him. And whenever he persuaded me or would suggest or advise probably rather than persuade. Advise that perhaps after being on the anti depressants for two years, that I should come off it. I was a bit unsure and he went on to say, ‘Well you know it’s worth giving it a try. Why don’t you? You’ll come and see me every two weeks and well see how you’re getting on and we can monitor it closely. And so I did.

I came off it fairly gradually, although I believe that’s actually not necessary. You can stop and start I’ve read elsewhere now without sort of tailing off, but I did sort of tail it off over the period of about a month. And then whenever I went back everything was reasonable, ok after the first few weeks, and then very slowly it began to sort of slide again. And so when I went back and suggested that perhaps I could go on to this medication again he said, ‘Well ok. He was happy enough with that.

The guidelines suggested that you know if you had sort of one depressive illness you should be on it for six months. The second occasion, on it for a minimum of two years, and the third occasion that you would be on it for five years. And so, I feel well, and for the next four and a half years from now I am quite safe. I can still continue taking that.

But in five years time do I have to go back and sort of plead my case again? Ask, as it were, if I can continue taking them, or do I have to go back through that misery of feeling that it’s all going pear shaped again and maybe existing for a number of months not feeling well?

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Several people had decided to take an antidepressant over long periods even though there could be longer-term problems later. They did this because ‘life is going by in the meantime’ and they wanted to live life more fully. One woman said ‘it is not in my nature to take tablets’, but took an antidepressant because she ‘could just see the rest of my life going ahead of me’ and medication ‘had given my life back’. Nevertheless, many long-term users believed that medication should go hand-hand with counselling.

Believes he has a chemical imbalance and that the benefits of antidepressants outweigh potential…

Age at interview 31

Gender Male

Age at diagnosis 17

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I mean in all my episodes it’s been drugs that have helped me, not just drugs, but drugs have been the safety net. I’ve no problem about taking drugs, never have. I’m still taking them. I can’t, I won’t, I don’t, I can’t imagine coming off them at the moment. I don’t feel safe enough to come off them, I don’t really worry about taking them.

I’m certainly not one of these people who thinks, “Oh God, some kind of poison in my body.” It’s like no, it makes me feel better. you know I’m quite, you know I’m quite happy to admit theres something screwed up about my brain chemistry, you know. But you know, some people are diabetic, they take drugs, you know.

And I’know people say, “Oh, it’s not the same.”But I’m afraid it bloody well is. It’s just, you know, you’re trying to undo several hundred years of cultural difference between the brain and every other organ. But you know, some people are just not built the same way, a lot of people actually. You know I wear glasses, I’m short sighted, I take anti depressants, I get depressed you know. [taking medication has] never been something that’s bothered me.

That might be partly family as well, my family has never been sort of anti taking things to make you feel better. And when people say to me, “Oh I’d be worried about the long term,” well alright let’s say Seroxat is more likely to make me. I don’t know. Let’s say, or even to take five years off the end of my life. I’d say well it’s better than feeling fucking awful now. Which is, you know, I can honestly say antidepressants work, work well.

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For more information on antidepressants see our website on ‘Experiences of antidepressants’.

Other medical treatments for depression

The older antidepressants medication tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are effective against certain kinds of depression, and are still sometimes prescribed if...