Getting a depression diagnosis – or not
Diagnosing depression can be difficult as it can manifest very differently in different people, and at different times. Diagnosis may be delayed because 'symptoms' are...
Antidepressive medication can be an effective treatment for depression and is also used for young people. Particular types of antidepressants are used for those under the age of 18. Most people who take an antidepressant after 2–3 weeks of starting the medication will experience an improvement in symptoms of depression. Like any medicines, antidepressants can have side effects which can vary greatly between individuals and types of medicines.
The decisions about medicine taking should always be made together with the doctor and it is important never to stop taking an antidepressant without talking with the doctor first.
Several young people we spoke with had been on antidepressants. Their experiences varied hugely; some said it had been the ‘best thing’ they’d ever done, some found them of no help at all or had suffered bad side effects and a few said they had made no difference either way.
Many people told us that beforehand they’d had a lot of reservations about taking antidepressants. Some had heard about negative experiences from their friends, or family members. They worried about becoming reliant on medicine and not being able to live without it once started.
A few people had refused the option of antidepressants, either because they again worried about becoming ‘addicted’ to them, or because they just didn’t want a medical intervention.
Some found it easy to decide to start taking an antidepressant and had pushed for it themselves. These people said they wanted to try anything to help them get better. They also felt that being prescribed medication acknowledged their experience of depression and that they were taken seriously. Others said they’d been very ‘cynical’ about medication generally, and about starting on antidepressants, but that they’d been happy about the choice in the end.
Young people’s experiences of their doctors’ approach to prescribing medication varied a lot. Whereas some young people felt antidepressants were offered to them too easily, others had struggled to get a prescription. A couple of people said their doctors had been ‘reluctant’ or ‘unkeen’ to prescribe; one woman said without an official depression diagnosis she couldn’t get medication although she’d wanted to. A couple of young people had never been offered medication though they had wanted to try one.
Many also emphasised that antidepressants were never ‘a quick fix’ or ‘a magical cure’ that would work overnight, often finding the right antidepressant and the right dose took a long time. As one woman said, ‘I didn’t think of it [medication] as a magic overnight thing, but more a, ‘here’s the light at the end of the tunnel, and for once it’s not a freight train.’
Some people criticised what they described as a ‘random’ approach by doctors to choosing a particular type of antidepressant and said they wanted their doctor to view their life situation holistically when choosing medication. For example, young women with eating problems wanted to avoid antidepressants that could increase their appetite or make them put on weight. On the whole, people wanted to be included in the decision making process about their care, including medication.
Many people had very positive experiences of taking antidepressants. They described them as ‘the best thing I’ve ever done’, ‘really helpful’ and the thing which had helped ‘boost’ them over the worst. The benefits people described of antidepressants included helping to ‘take the edge off’ the biggest lows, to ‘function better’, giving ‘motivation’ to seek other help, especially talking treatments and ‘stabilising’ moods. Some also described how medication had helped suppress feelings of self-harm and suicidal thoughts and helped stop or ease off panic attacks.
Young people’s experiences of antidepressants were closely linked to their expectations of how the medication could help them. Those who saw medication as helping them to get back on their feet, get through the worst and enable them to function better, seemed more satisfied than those who hoped the medication would make them ‘feel happy’ or who perhaps struggled with often a long process of finding the right medication.
We also spoke to several people who had negative experiences of taking antidepressants. Some had felt worse off when taking antidepressants (see more below on side effects), particularly when their moods had got worse after taking them; others said medication had made no difference to how they felt or to their symptoms. A few people also questioned the logic and function of medication which made no sense to them. One woman asked, ‘Why would I take a tablet to control my thoughts?’
For some, the negative experience of medication was linked to their GP’s or consultant’s approach. One woman said the success of antidepressants as a treatment depends heavily on the doctor’s approach and knowledge level. One man said he’d be happy taking medication if he knew it was a carefully thought through decision in his specific situation, not just ‘the easy’ option. A couple of women felt that prescribing a medicine was a form of control by the doctor. Rather than involving young people in care decisions, their doctors had just told them what to do. Many said that antidepressants were the first and only form of help they were offered’ they had been refused counselling or put on long waiting lists for it.
Many found the combination of medication and counselling most successful. For them it had been the ‘double headed attack’ which had worked. One woman compared it to fixing a broken leg: ‘It’s like having a broken leg and just you know just wrapping it up so it doesn’t hurt, but not actually getting it fixed, you need both treatments.’
For some, it hadn’t been counselling but other coping strategies and ways of helping themselves that had helped alongside medication (see ‘Self-help & coping strategies‘).
Those young people who’d not been able to access talking treatments despite wanting to, felt that antidepressants were useless on their own because the underlying causes of depression weren’t addressed. One woman said that medication might help someone otherwise ‘unable to get out of bed’ to function but wouldn’t ‘solve’ the problem.
Like any medication, antidepressants can cause unpleasant side effects. These can vary from one person to another and between different antidepressants. Here we discuss the different types of cognitive, emotional, and physical side effects that young people had experienced from their medication overall, rather than focusing on the side effects of any one particular antidepressant.
The most common side effects that young people had experienced were tiredness, lacking energy and sleeping problems. Some said that their medication kept them up all night, whereas others had the opposite problem of always feeling sleepy, ‘drowsy’ or ‘sedated’. Many said that medication had completely messed up their sleeping pattern.
Antidepressants also affected some people’s appetite, either increasing or suppressing it. One woman lost her appetite completely, while a couple of people put on weight. Some people had felt ‘sick’ or ‘nauseous’ and one man had had ‘violent retching’.
In some, antidepressants had unwanted effects on moods. Some described feeling more ‘anxious’, ‘mad’ and ‘more suicidal’ after starting their medication. A couple of people described not feeling ‘in control’ or ‘real’ or not caring about what happened to them. One woman said that while an antidepressant helped her not to feel depressed, at the same time it also stopped her feeling anything at all.
Some had also experienced different kinds of pains, particularly headaches, but also stomach pains or generalised tremors. Rarer side effects included blackouts, dribbling, hallucinations and, in women, producing milk (lactating).
People also talked about the routine of taking their medicines. Some had become used to it as a straightforward routine, whereas others said they sometimes forgot to take it. It was also crucial to take the medicine at the right time of day.
Several people had tried two or more different types of antidepressants. Tapering off one antidepressant, and then gradually building up the dose for another was a long process. One woman said she was really ‘frustrated’ with ‘playing around’ with different types of antidepressants; settling on the medication she was currently on had taken years.
Many were keen to wean off antidepressants over time and a couple said that – against medical advice – they had stopped their medicine altogether of their own accord. One woman said about her plans to wean off medication, ‘I’m still on my anti-depressants but when I’m ready I will gradually come off them. But when I am ready, not when I think I am.’
Find out more about antidepressants experiences.
Diagnosing depression can be difficult as it can manifest very differently in different people, and at different times. Diagnosis may be delayed because 'symptoms' are...
Talking treatments are a common psychological method of processing distress, overcoming emotional difficulties, and changing negative or destructive patterns of thinking and behaving. It can...