don't feel like you have to answer this, but you seemed like a person who might have a good response. I just recently started taking antidepressants, after being depressed for years, and I'm excited about the prospect of maybe not being exhausted and unable to feel anything all the time, but I also keep seeing these articles about how antidepressants are over prescribed and it's making me worry that I shouldn't be taking them, that I'm just not trying enough. any words of advice?
I cannot say this strongly enough: fuck those articles.
Antidepressants are a tool. They are extremely useful when applied correctly and can literally mean the fucking difference between life and death. And the person(s) who get to decide their correct application to your mental illness are first and foremost you, and secondly your prescribing physician.
There are potential valid discussions to be had about the problems of them being offered as the only option, or being offered without subsequent behavioural or situational support, or being offered and expecting that this is a Magic Pill That Will Fix All Everything (What Do You Mean You Still Have Health Concerns) or whatever. Those are population level questions of how we train docs and prescribing professionals, and in many ways on the lack of situational support for people suffering mental illness and the ways in which medication may not be sufficient, on its own, to actually solve quality of life issues.
Those are potential valid issues. They also have very little to do with whether or not you, suffering major depressive disorder, should use medication in order to relieve suffering. The only questions that are valid to your situation are as follows:
- does it work? does this med actually cause a relief from the symptoms it’s supposed to relieve that are making your life shit? if no, time to try a different one (there are lots for a reason!); if yes, move to next question.
- can you live with any side-effects it has? Are they worth the improvement of your symptoms and does the balance leave you in a situation where you can best-as-possible actually, you know, live a life worth living? For instance my Pristiq gives me dry mouth and occasional very mild bouts of vertigo; in exchange, it ameliorates all but one symptom of my chronic major depression to a point where behavioural strategies are actually possible. (The one it misses is an anhedonic lethargy, ie where I’m so Tired that my brain forgets how to respond positively to anything, ever; for that I take a small dose of dexedrine.) It removes my Crushing Grieving Sadness and tones down the gory suicidal-ideation in my head enough that I can ignore it and so forth and so on. That, for dry-mouth and occasional vertigo, is a fair exchange!
Conversely I was on Effexor before Pristiq and while Effexor also gave me the relief from symptoms, it added to the table “overheats like I’m in menopause except instead of random hot-flashes it’s just in response to any physical activity ever” to the point where I used to Stop Multiple Times during my morning routine in order to cool off and stop sweating so I wouldn’t get nauseated and stuff. So that became no longer tenable, especially while there were other options to try.
These are the two considerations, because one can generally assume that before you even started looking into meds you had already solidly hit “my life is Not Working, when I try to Get Myself Organized it still doesn’t work because I’m exhausted and sad and nothing seems to have any point” etc so you are already past “is there a problem that these meds are appropriate for”.
So otherwise you’re at: are they working without side-effects I can’t live with/that aren’t worth what they’re doing for me?
And everything else can just fuck the hell off. For reals.
Is my basic take.
And also good luck! I hope you get the effects you want without too much extra stress and fiddling around.
It's less that antidepressants are overprescribed than therapy is underfunded. There are a lot of people who would benefit from counselling, art therapy, or a bunch of other therapies, but cannot afford the quality and amount of therapy they need. But they can afford medication.
There are not enough sources of good, affordable therapy to meet current demand, so many people are on drugs when they could possibly be helped by non-pharmaceutical means. The major downside of that is that while antidepressants help, you might need a therapist's assistance to really nail down the habits, skills, and emotional and mental illness that will help you stay well in the future.
So some people end a course of antidepressants and find their depression is gone and they're fine again!
And others end their antidepressants and the depression is still there, same as always. And they need to go back on meds and do counselling before they're ready to take their brains on single-handed.
