helen-louise (baratron) wrote,
helen-louise
baratron

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Popular myths about antidepressants.

I accidentally saw 5 minutes of the Panorama programme about The Evils of Seroxat, and now I'm pacing round the flat with teeth clenched and swearing a lot. I had to stop watching the programme because I was so goddamned angry. This wasn't even the original Evils of Seroxat programme - it was the followup!

I would just like to repeat what I've said before: that taking antidepressants is like hitting your head with a sledgehammer.

Myth number 1: Antidepressants are a magic cure-all. Er, nope. If your life is a mess, it's not going to suddenly improve because you're on an antidepressant. The best that can happen is that with a combination of the right drug, support from friends and/or family, and support and therapy from mental health professionals, you can get to a point where you're strong enough to rebuild your life into less of a mess. It might take a long time to get you to the point of being strong enough, even if you get the right drug first time, and it might take several attempts of rebuilding before things look any better. (This of course can lead to a dangerous situation whereby your first attempt to sort things out has failed horribly and you end up more depressed than before.)

Myth number 2: Antidepressants make you happy. Definitely not the case. If you get the wrong drug, it can can make you manic, which feels like happiness but is actually more like a dangerous over-excited state; it can make you numb, dampening down all your emotions so although you don't feel so depressed any more, you don't feel happy either; or it can make you violently stressed out and agitated. If you get the right drug, it does not make you happy, it just takes the "edge" off the depression, helps you to concentrate for longer periods, and stops you completely falling apart.

Myth number 3: There's a perfect antidepressant which is the right drug for everyone. No way! Drugs need to be matched to the patient. This is one of the few things that I think alternative medicine has right - the idea that you tailor the remedy to the person taking it. Different
people react in different ways even to a simple drug like aspirin, which has a mechanism that is well-known. (There's a theory being tested at the moment that male-bodied and female-bodied people feel pain differently, and thus should use different painkillers). The brain is such a complex organ that it is nowhere near properly understood yet, and things like the relationship of brain chemical/neurotransmitter levels to emotions of the patient are just not really known. The mechanism of the majority of antidepressants is not known at all - there are only broad theories with lots of handwaving.

What makes me really fucking mad: 1) Doctors who try to "sell" antidepressants as a magic cure-all. They're not. See above. 2) Doctors who don't at least try to match the antidepressant they prescribe to the patient's symptoms. Not all SSRIs are the same, and not all modern drugs are SSRIs. People who are agitated need something different from people who are crying all the time who need something different from people who stare at the wall all day. Even two people who are agitated might be behaving in very different ways. This implies that a different approach is needed. 3) Doctors who don't realise that antidepressants are the chemical equivalent of hitting the patient's head with a sledgehammer. Hello, if I know that with no medical training, why don't you? They might make things better, or they might make things a hundred times worse. Even people with mild depression can become suicidal on the wrong drug or on too-high a dose of the right drug. Patients should be given proper supervision, and doctors should take patients' concerns and reported side-effects seriously, not fob them off with an "I'm the doctor, I know best" approach. But hey, that would mean actually listening to their patients.

Having said all this, I'm not against antidepressants. They can be a literal life-saver in some cases and a metaphorical one in many others. I take some myself and have no plans to come off any time in the forseeable future, because the difference to my brain with and without them is unbelievable. Handled well, they really do help. But something like 9 out of 10 GPs really don't understand them well enough to be prescribing them, and I've met so-called mental health professionals who are no better. Then when patients complain about horrendous side-effects throughout six months of taking the drug, they do nothing, and patients are left permanently damaged. And then the patients try to sue the drug's manufacturers - when the side-effects were documented in a way that said "when a patient complains of symptom X, that means they need to come off the drug"!

I do think it's wrong when a drug manufacturer lies about the number of people who have had a side-effect, or the severity of a side-effect: that's definitely a very bad thing and they should be hauled over the coals for it. But in a lot of cases that are turning up on Panorama (or on the Efexor is Evil website I found some time ago), people were complaining of things that are in all the information that is available to doctors. If the doctors fail to listen and patients get damaged as a result, they're the ones that should be sued - not the manufacturers, whose product is helpful and safe for some percentage of all the depressed people who take it.

I remain, very grateful to the handful of genuine health professionals I know, and cursing the huge numbers of fucking awful ones.
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