A man and a woman sitting face to face engaged in a conversation.

Combating psychiatric drug stigma: 7 common myths about antidepressants

A man and a woman sitting face to face engaged in a conversation. It’s gearing up towards exam time. Stress level tends to be high around this time and affects each student in their own individual way. For some, the effect of stress is higher on them due to existing mental health conditions or illnesses. The percentage of students who fall into this category is not necessarily large, but exactly because they are a minority, there are less people to speak for and to relate to them. As a member of the mental health team from HealthyU as well as someone who has recovered from clinical depression and anxiety, I want to take this chance to talk about something that they may be thinking about or even confronting: psychiatric drug stigma. There is a lot of misconception and judgemental attitude toward psychiatric drugs out there. It makes those who are medicating constantly needing to defend their treatment, and it dissuades those who may benefit from medication from starting treatment. I’m bringing up this topic now because the end of semester tends to be when negative mental health downward spirals snowball into a big crunch, and there may be some of you who are in distress, realizing that your coping skills are not enough and may need more help. No one will ever force you to take medication; it is ALWAYS a personal decision. But if it is only stigma and misconception holding you back, I hope to change that here. I have the most experience with antidepressants (which are to a degree also used to treat anxiety), so I will be talking about that here. However, many of them translate to other psychiatric drugs. Here are 7 common myths about antidepressants. Myth 1: Psychiatrists don’t care about your actual problems and will just push drugs Depression has had many decades of research, and all of them point to the same finding: pharmaceutical treatment is as effective as talk therapy, BUT the combination of both is MORE effective than either of them alone. Depending on the setting, the psychiatrist may provide talk therapy themselves, or they may refer you to therapy sites. For example, the psychiatrist I saw at UofT Health and Wellness last year provides 1-hour-long talk therapy every time I saw her. When I transferred to the outpatient clinic at CAMH, the psychiatrist does not provide talk therapy but signed me up on a waitlist to see a (OHIP-covered!) therapist the first time we met. Psychiatrists do care. Myth 2: Antidepressants only creates fake artificial happiness as an easy way out This myth is accompanied by the mental image of a person who seems happy for no reason, overly-excited, and dismissive of negativities. This does exist, but not in the way you think. It exists as a symptom of another illness, namely, the mania or hypomania state of bipolar disorder, and is treated. That is to say, psychiatrists don’t want you “artificially happy” either. Mania is associated with impulsivity, risk-taking behaviour, overconfidence in one’s ability, shortened attention span, and racing thoughts. Antidepressants are NOT meant to put you into manic states. I had a brief period when I experienced this during the optimization stage of my medication regime. Both my psychiatrist and I knew that this is not a good thing, and we worked on eliminating it. Myth 3: We should not be giving out antidepressants when we have no objective measure for depression This is usually a follow-up retort when I make comparisons of treating depression with antidepressants the same way we treat other illnesses like diabetes with insulin, asthma with inhalers, and anemia with iron. There’s a stigma associated with depression and not the other illness because some people don’t believe in depression or because they think diagnostic tools are flawed or insufficient. As a scientist, I can agree with the fact that, while we have a wealth of indirect measures for depression and mood disorders, we do not have an objective definitive measure. However, to form the conclusion that antidepressants should not be prescribed from that fact is to also dismiss many other classes of prescription doctors regularly give out: painkillers, antinausea drugs, or hydrocortisone creams. We treat physical ailments with no objective measures like pain, nausea, or skin irritation (all of which can be chronic and life-long). There’s no reason not to treat mental ailments as well. Myth 4: You are weak-minded if you have to take medication This is a very black-and-white sentiment. It’s implying that, whatever we experience as part of our mental illness, we just need to work through it ourselves. Can we work through some of the issues ourselves? For sure. Maybe we’re working through a breakup, a failure, or a bad habit. Medication will not magically fix those. On the other hand, never feeling rested no matter how much I sleep, being unable to experience joy in anything (anhedonia), or a constant state of scattered and unfocused thought are examples of depression symptoms that I have much less control over. Even if my medication relieves some of these symptoms, I still have to decide what to do with my day when I feel rested, actively pursue hobbies I would enjoy, and use my concentration to do something productive. I hardly see that as being weak-minded. Myth 5: You are changing who you are fundamentally by taking medication The most succinct response I have to this is, “Medication makes me normal.” It doesn’t change me. I know who I am. If anything, I was finally able to be the kind of person I’ve always wanted to be. Myth 6: Taking a pill to be happy whenever you experience negative emotions is avoiding confronting the real problems This myth differs slightly from number 4 in that they have the misconception that we can just pop a pill like taking Tylenol, caffeine, or alcohol, and suddenly we’re happy. Antidepressants do not work like that. Their effects are always gradual, with the standard time being 2-4 weeks before having an effect. They are not used to treat sudden life-changing events. Those experiences is just part of being human. Antidepressants are used when you have been experiencing negative moods on a consistent or prolonged basis. They’re there to bring your mood baseline up, not give you a spike. Myth 7: You will be addicted to the drug and rely on it the rest of your life This myth is fueled by an incorrect association of antidepressants with classes of abusable drugs like opioids and stimulants, as well as an overblown impression the withdrawal symptoms that come with discontinuing antidepressants. Antidepressants are not abusable. They do not give you any “high” whatsoever. How long someone wants to stay on antidepressants tends to be a combination of changes in their life, progresses they’ve made in therapy, and their experience from slow gradual decrease of the antidepressant dosage. Withdrawal symptoms like sleep disturbance, nausea, or mood swings may occur; no one will dispute that. But, even if they come up, they can be managed by decreasing the dosage slowly. At no point will you experience addictive tendencies (an itch) to keep taking your antidepressant. And that’s all from me for now. Wishing you all the best.

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