I watched the BBC Panorama programme Antidepressants: A Prescription for Murder last week with my psychologist boyfriend, but it’s fair to say that you didn’t need a Phd to spot the holes in data analysis, reputable studies presented or objective reporting. While side-effects can of course be severe and serious for a small number of patients, and merit investigating particularly owing to the fact that more of us are taking antidepressants in the UK than ever, linking SSRI antidepressants (more on these below) to mass murder (in this case mass killings by James Holmes in Colorado in 2012) by way of a felt-tip pen flowchart while ignoring all of the proven, evidence-based benefits that antidepressants bring was seen as a step backwards by many where mental health awareness, understanding and treatment is concerned. Sue Baker OBE, Director of mental health charity Time To Change , expressed her frustration regarding the reporting bias in the programme in a recent statement:
"Media portrayals of mental health problems are very powerful in shaping attitudes and informing people. This is why it's so important to get it right by ensuring coverage is balanced and provides context. People with a mental illness are more likely to be a victim of violence than a perpetrator so we are concerned that the Panorama broadcast about medication causing homicidal behaviour feeds into outdated, negative stereotypes and fuels stigma.”
With high profile figures such as Prince Harry, Lena Dunham and Adele speaking out about mental health issues, plus positive campaigning by charities and media organisations and today’s announcement by Health Secretary Jeremy Hunt that he aims to put an end to the ‘historic imbalance’ between mental and physical health services by 2021, the future is starting to look bright where mental health diagnosis and care is concerned. Let’s not let one programme take our impression of mental health treatment back to the dark ages. Here’s why Bupa GP Dr Petra Simic doesn’t want you to panic if you are prescribed antidepressants, and why you most definitely shouldn’t go cold turkey out of panic if you’re already taking them...
Why you might be prescribed antidepressants
“Your GP might suggest that you start taking antidepressants if you have moderate to severe depression and it’s starting to impact your daily life. For example, if you’re struggling to go to work as you normally would, or if you’ve stopped enjoying everyday things like reading or socialising, your GP may suggest antidepressants as a form of treatment. Sometimes, they may also suggest that you start complementary treatment such as a talking therapy.”
“If you have mild depression, your GP may recommend that you attend a self-help group or increase the amount you exercise to see if that has an impact before prescribing medication. Antidepressants are sometimes used to treat conditions like anxiety , OCD , PTSD, insomnia , pain, headaches or even if someone is struggling to quit smoking – but this is something that should be discussed with your GP.”
Different types of antidepressants prescribed and how they work
“There are many different types of antidepressant. These include:
Tricyclic antidepressants (TCAs), such as amitriptyline, lofepramine and imipramine.
Serotonin and noradrenaline reuptake inhibitors (SNRIs), such as venlafaxine and duloxetine.
Noradrenergic and specific serotonergic antidepressants such as mirtazapine.
Melatonin agonist and specific serotonin antagonists such as agomelatine.
Monoamine oxidase inhibitors (MAOIs), such as phenelzine.
These all work gradually over time to treat depression and affect chemicals in the brain which can improve mood, quality of sleep and concentration levels.”
Questions to ask if you're prescribed an antidepressant
“It’s a good idea to ask about any potential side effects and how long you might need to take them for initially (usually this is around six months to start with).”
“I’d also recommend speaking to your GP about any additional therapies that may help, particularly talking therapies such as Cognitive Behavioural Therapy (CBT) .”
How you might feel, and how long they could take to work
“You won’t notice the effects immediately as antidepressants can take up to two weeks to start working, and often it takes as long as four to six weeks for them to work fully. That’s why it’s important to keep taking the medication, even if you don’t immediately feel better.
“When you first start taking them, your GP is likely to want to catch up with you every couple of weeks – as it can take a while to find the right medicine for you and you might need to try a few different options. Make sure that you speak to your GP if your symptoms don’t improve or if they worsen, or if you are worried about the medicines you’re taking. It’s really important that you don’t suddenly stop taking and follow the GP’s guidance.”
Why you shouldn’t be scared of taking them
“It’s totally normal to be a bit worried about starting new medication – and I’d recommend that you talk through all your concerns with your GP before you start. If you can, talk to a close friend or family member, who can support you throughout the first few weeks while you get used to everything. There’s also plenty of really great information on the internet- for example on the Bupa blog , or from charities like Mind or the Samaritans .
“Something that I always tell my patients is to make sure to also look after, and be kind, to yourself. Arrange to spend time with loved ones, go for a walk or watch your favourite movie - just prioritise whatever makes you feel better and focus on you as much as you can.”
The most common side-effects of taking anti-depressants
“All antidepressants have side-effects and feeling sick or dizzy, having headaches and even experiencing increased anxiousness are common, but not everyone who takes them will experience side-effects, and almost all of these wear off after one or two weeks. It’s important to remember that even if you’re getting unpleasant side-effects, you mustn't stop taking your medicine without speaking to your GP first.”
Coming off antidepressants
“It’s important to speak to your GP if you feel ready to come off your antidepressant, as they’ll be best placed to advise on your situation. For example, under guidance of your GP it might be that you slowly reduce your dose over time - suddenly stopping taking them is rarely advisable.”
Alternative treatments to antidepressants
“There are plenty of alternatives, and it’s important to try many different treatments to work out what’s best for you, after all, everyone is different. Counselling and other talking therapies such as CBT can be really effective too, either with or without medication."
Find out more about treating depression here
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