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 of ‘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…

Age at interview 59

Gender Female

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Taking antidepressants is just something I do now…

Age at interview 52

Gender Male

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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 9 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…

Age at interview 39

Gender Female

Age at diagnosis 22

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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 6 to 8 months, but it could be 1 or 2 years. “It’s open-ended… I think I would be concerned if anybody did say, well we would expect you to have results within 6 months, because I’m not sure that you could.”

Emily took an antidepressant for a year and gradually began…

Age at interview 28

Gender Female

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“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 3 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 full-time, 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…

Age at interview 71

Gender Female

Age at diagnosis 28

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(See also Expectations about taking antidepressants, Other strategies for dealing with depression, Talking therapies and antidepressants).