By John Bowron
Mental health is, quite rightly, widely talked about in these times. But there are still many niche facets of this profoundly broad topic that the public, in particular the youth, don’t have sufficient knowledge on. This article won’t be a medical publication on the science of antidepressants, as you can get all this information from your GP. But, what I can and will talk about is a 19 year-old's experience on SSRIs (Selective Serotonin Reuptake Inhibitors) and the implications it has had on my life, in conjunction with why I think there is a stigma around taking them and why it should be dropped.
SSRIs are the most prescribed antidepressant in the UK. A lot of what I am going to talk about will still apply to other antidepressants, but my personal experience and knowledge concerns SSRIs. I started taking sertraline 3 years ago, after a long battle with mental health after losing my dad and my sister at a young age. The way antidepressants were described to me by my GP at the time was that the medication is like plugging a hole in your boat, but what is actually going to get that boat moving is counselling and talking to friends and family. My interpretation of this now is that they aren't ‘happy’ pills, you don’t start taking them and suddenly you’re happy and your low mood is eradicated. However, for some people antidepressants are a very helpful and sometimes necessary step to facilitate other actions to make you feel better. It doesn’t mean you’re never going to have bad days, but for me it meant that I had a stable platform to push on with counselling, helping myself and ultimately start being myself again. Once I did this, I was able to realise the extent to which I hadn’t been myself.
Sertraline didn't work out for me - the side effects ended up being long-term, meaning I really struggled to sleep, I couldn’t concentrate in school and in general it just made me feel worse. This was clearly not the desired effect but I really wanted to get better so I talked it through with my GP and other people who had taken sertraline and I found out that this was a relatively common reaction. But it really is worth not just writing it off at this point, because different SSRIs suit different people and I know there have been many people that have hugely benefitted from sertraline. I have now been on fluoxetine for 2 years which has given me all the benefits I spoke about in the previous paragraph with no long standing side effects.
Understandably, side effects of these medicines are a big concern for many people. Why would a pill that supposedly gives you insomnia, lowers your libido and makes you nauseous to make you feel better? My answer would be that once you find the SSRI that agrees with you, then you are free of this. One of the reasons this is so widely advertised is that when you first start your course it is common to have 2-3 weeks of feeling worse, namely with these sorts of side effects. For my first 2 weeks of fluoxetine, for example, I started having panic attacks which felt terrible at the time. But this was 2 weeks of my body adjusting out of 2 years where I have felt considerably better. Honestly, the first 2 weeks wasn’t pleasant, but once I adjusted to it the side effects calmed down quickly. For me there is no question that these were worthwhile, but you can make a judgement on that yourselves.
Another concern for taking antidepressants, often from teenagers and uni students, is the consumption of alcohol in tandem with antidepressants. It is a common belief that you can’t drink alcohol on antidepressants at all, and that not only will it stop the medicine from working, but it will actually make you feel worse. I have drunk almost the whole of my way through my fluoxetine course and it has had very limited influence on the effectiveness of the fluoxetine. I think that what you have to be prepared for is that if you go out drinking, alcohol is obviously a depressant so you may feel a bit wistful and experience a low mood the day after, but I don’t think it's all that different to what a person who doesn’t take SSRIs would experience after a night of heavy drinking. What I did, and I know many others have done, is not drink when I initially came onto the SSRI. Just while you're getting used to them it is important to judge things yourself or talk them through with your GP until you start to feel at a good level of stability. Having said this, in the first lockdown I completely stopped drinking for 2 months and did feel great, however now things are back to normal the benefits of not drinking are massively outweighed by the benefits I receive from going out with friends every now and then.
There are without a doubt more people in this boat than you realise. It is difficult to gauge because we have made so much progress with talking about mental health, but there is certainly still a stigma around taking antidepressants and talking about them, which perhaps explains the root from which feeling alone in this experience stems from. But I firmly believe that there is good reason for this stigma to be dropped now - especially for young adults and teenagers. My mental health difficulties were related to bereavement, but many other SSRI takers that I know have been helped out with issues that span across the whole board of situations, from ones similar to myself to things such as exam stress. You shouldn’t take my case as gospel as there will be thousands of people who have a slightly different opinion on this, but there is definitely information worth knowing here and I think it would have been extremely valuable to know for me before I made those first steps. As is always said, it's just about reaching out and making that first move. Whether antidepressants are the answer for you or not, there will be a solution.