Getting to the doctor: seeking help for depression
People may feel depressed for a long time before seeing a doctor. Often it's only looking back that they realise how long they had been...
The four main groups of antidepressant medicines are
These days an SSRI is most often prescribed first, but which antidepressant is prescribed varies. It can take a while to find one that works as antidepressants affect people differently.
People told us about their first and later prescriptions of an antidepressant, either by their GP, or by a psychiatrist.
Being offered a prescription for an antidepressant tells people that their symptoms are recognised as an illness. It can be a relief to know that it might help the person feel better and give them hope for the future. Sometimes just being given a prescription can help people feel more positive knowing that they are being proactive, acknowledging they are depressed, and beginning to “tackle the problem”. But some people feel differently about being prescribed medicines “for the mind” rather than for physical symptoms.
Talking to the doctor and asking questions is a good way to find out about how antidepressants might help and what to expect (see also Expectations about taking antidepressants). Feeling involved in the process can give people more confidence about what they are being prescribed, especially as they can worry about how it might affect them. Like Andrew (above), people value being listened to, and having time to discuss available options and any concerns.
It’s important for the doctor to know how a person feels about different types of treatment and that where possible decisions are made together about whether an antidepressant is the right thing. Booking a longer appointment than usual can allow enough time to talk things through. Sometimes appointment times are limited and some people we spoke to said they felt their doctor had prescribed an antidepressant too readily without much discussion, (see Antidepressants: finding information and Reviewing medicine use).
Many people valued being offered talking therapy as well as an antidepressant and saw it as a way to tackle the causes as well as the symptoms of depression. Unfortunately services were often limited with long waiting lists. This left some people feeling let down and unsupported. Some felt that a prescription for an antidepressant was all their doctor could offer them. Taking an antidepressant was sometimes seen as a first step to help improve mood so that they could engage with a talking therapy (see Feelings about using an antidepressant and Talking therapies and antidepressants).
It can feel frustrating to be given a prescription without the offer of other help. As Stuart reflected, “I think the biggest problem with going to a GP when you’re depressed is, you come out and you feel bereft, you feel that, okay he talked to me for, or she, she’s talked to me for 10 minutes, they’ve given me some drugs, but that’s it – what now if the drugs… the drugs might work, they might not.”
However, not everyone feels able or willing to talk openly to the GP and some people believe an antidepressant could provide “a quick fix”. The experience of depression itself often makes it hard for people to think or talk about how they are feeling, although those who have had positive experiences with taking an antidepressant sometimes said they found it helped their recovery to talk about depression, symptoms and treatment.
People who have already taken one or several different antidepressants before may already know what works for them, and ask for a specific prescription. Others may have had difficult experiences with antidepressants and feel anxious or reluctant when their doctor suggests a particular drug. Greg had taken Prozac (fluoxetine) when he was younger and hadn’t felt it had been effective. He also had side effects so when he had a second episode of depression he asked his GP to prescribe something different.
Sonia has tried a number of different antidepressant medicines over the years and says she knows what works for her and what doesn’t. If the doctor knows how the person feels and why, it can make it easier to prescribe the right antidepressant.
It’s important to talk openly with the doctor about the medicines they have prescribed, and to go back at regular intervals to review how things are going, (see also Reviewing antidepressants use).
People can find it difficult to challenge or disagree with what a doctor recommends, but need to remember that it’s a personal and individual choice. Some people worry about what other people will think, or fear being labelled and judged. People also worry that antidepressants may be addictive or that they will become reliant on them.
Melanie felt unsure about being prescribed an antidepressant: “they’ve got a kind of stigma and I didn’t want anything I could get addicted to.”
People may also be prescribed other medicines in addition to an antidepressant to cope with symptoms of depression such as anxiety or not being able to sleep (see also Taking other medicines with antidepressants).
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A wide range of feelings and beliefs influenced people we interviewed when deciding whether to begin taking an antidepressant. Some believed and trusted their doctor...