Most of the people we spoke to had taken a range of different medications to try to address their mental health problems over the years. Although people had tried a wide variety of medications over their lifetime, the three main types of medications people spoke about were: antidepressants, antipsychotics, and minor tranquilisers e.g. for anxiety and sleeping.
Antidepressants are thought to work by either increasing the production of brain chemicals like serotonin, or prolonging their effect. Although they work for many people, they don’t help everyone. When they do work, it can take many weeks for them to be effective, and people may have to try several before they find one that works for them, further delaying any benefit. The people we spoke to had often been offered ECT when their antidepressants hadn’t led to an improvement in their well-being and they had then become very unwell.
Antipsychotics are prescribed when people have been experiencing psychosis, including seeing or hearing things or holding unusual beliefs that other people don’t share. Although antipsychotics aren’t a cure for psychosis, they can help lessen some distressing experiences associated with psychosis. Most antipsychotics are taken by mouth although some are given by a slow release (depot) injection. Antipsychotics are sometimes known as ‘major tranquilisers. They are different to what people normally call tranquilisers (minor tranquilisers) used for anxiety and insomnia.
Although frequently used over the short term to good effect, some people who were on medication for their mental health became concerned about being on it for too long, or even for the rest of their lives. Yvonne says in the past she tried to ‘fight against the medication,’ and didn’t want to be on it. But she accepted life-long medication use after someone said her situation was similar to a diabetic taking insulin. Suzanne had been taken off medication a few times, but had found she always needed to go back on it eventually. But Beattie said she was given too many drugs when she was manic, and they made her depressed. Antidepressants gave her some relief but she thinks some other drugs (antipsychotic drugs) caused her friend’s diabetes and her husband to get symptoms like Parkinsons. She has now joined local user group and sits on service user committees and thinks people are given too many drugs for too long.
Effectiveness of medication
Medication often took time to work and most people tried a number of different medications before they found one that worked for them. Enid is now taking an antidepressant that regulates the melatonin cycle (a substance that helps the body respond to night and day), which helps her sleep at night and this, she feels, keeps her well. You can read more about medication here: ‘Managing mental illness and recovery‘.
Helen was diagnosed with manic depression and kept going high on antidepressants. However, quetiapine was brilliant because it allowed her to wind down and sleep at night.
When Sunil was given antidepressants as a student in 1980 he improved quite rapidly. Later in life he was prescribed carbamazepine (for mood instability) that he felt kept him well for 18 years.
While Jane couldn’t see how antidepressants had benefitted her, antipsychotics had balanced [her] out. However they did also make her put on weight, which she said isn’t good for your mental health.
Sunil had good and bad experiences with medication. In 1988 he was in and out of hospital for eighteen months and was prescribed thyroxine for an underactive thyroid and lithium for bipolar disorder, which he felt shouldn’t have been given because it interferes with the thyroid gland. He felt his treatment was mismanaged. He has since heard that a depressive episode that is untreated usually lasts about eighteen months anyway, so he was not sure if it was the medication that helped him or just the episode coming to a natural end (for more see ‘Diagnosis‘ and ‘Staying in hospital‘).
For others, medication gave temporary or partial relief, or had no impact at all, and yet some still experienced side effects. When Tania was first depressed she tried lots of different medicines and ‘nothing worked’. Tranquilisers helped her feel calmer ‘for a few moments’ and sleeping pills helped her sleep a little but she got steadily worse and was eventually admitted to hospital.
Side effects vary according to the type of drug and the individual, and are too many to list here. But common side effects include things like weight gain, dry mouth, anxiety, tremor, feeling constantly sleepy or tired (sedation and lethargy), lack of sex drive.
People we spoke to varied hugely in the way they responded to medication and the side effects they experienced from taking medication, and, sometimes, when they stopped taking them. Some reported no side effects or very mild or hardly noticeable side effects. Enid said she ‘is one of these people who [doesn’t] suffer side effects very readily.’ Others reported noticeable or disturbing side effects.
Catherine Y experienced a significant amount of weight gain on antidepressant medication. Kathleen gained up to twenty seven kilograms in weight as a result of various medications she had been on, as well as the experience of being inactive on an inpatient ward over 2-3 years. Suzanne felt that she had gained weight whilst on antipsychotics even though she was barely eating and thinks it was fluid building up. Tristan felt that antidepressants led to his wife’s weight gain. Although he felt they lessened her depression, he also felt they took away some of her ability to enjoy life.
Suzanne was given highly sedative medication whilst she was an inpatient. She remembers she didn’t have dreams for a long time and did not feel well rested.
Some people took additional medication to reduce their side effects. Catherine Z said haloperidol made her shake and she was given procyclidine to counteract it, which made her mumble and dribble.
When Catherine Z’s son had depression she was very concerned about the high doses of drugs he was given. He had ECT when the drugs did not work.
For a few people the side effects were very serious and badly affected their health (such as causing osteoporosis, or damaging the liver), and some medication seemed to contribute to their mental illness.
After her husband left her, Cathy was coping extremely well, but after a change of medication became incredibly anxious. She eventually took an overdose. She has slowly recovered and still takes medication.
Although ECT has side effects, Sunil said medication can also have serious adverse effects. He experienced side effects from the mood stabilisers Depakote and carbamazepine, such as osteoporosis.
Catherine Y heard from some doctors that the development of fibromyalgia (a condition which causes pain all over the body) might have been a response to taking antidepressants. Beattie, Suzanne and Helen had experienced strong psychological and sedative side effects of an old antipsychotic medication called chlorpromazine (brand name Largactil). Helen remembered feeling so sedated she could barely get out of bed.