Antidepressants; to pop or not?

Recently I was invited to speak to a few groups who train people in suicide prevention using a one day course. It’s a brilliant course, one that I completed last year and thoroughly recommend. I generally share my story of depression and having strong suicidal tendencies which led me to research deadly methods to end my life. In the course of conversation afterward the topic of anti-depressants arose and the fact that those under treatment are notorious for not taking their medication. For those of you who’ve cared for someone on medication I’m sure you’ve all asked the question “did you take your meds today?”

Asking that question is a bit like my uncle who as a boy climbed up onto the roof and as his father was passing underneath dropped a brick on him and asked “did that hurt?” It’s going to attract the same kind of response my grandfather had. He hauled the mischievous boy down, gave him a hiding and said “did that hurt?” Be prepared to don a flack jacket and helmet prior to asking the question.

So we got onto talking about why people go off them all the time and in the main it’s basically all about the downsides:

Firstly there’s the stigma. One bloke describe them as “old lady pills” – and even old ladies don’t want to take old lady pills, let alone the rest of us. For someone with depression whose self esteem is scraping rock bottom, the blow of having to take meds is yet another bitter pill to swallow (no pun intended). It took me months to fill the script I had while I struggled to accept that I needed them.

Second I had no feelings on antidepressants. I didn’t feel angry, frustrated, and irritable which was great – but nor did I feel any joy, hope, or happiness either. Interestingly I didn’t even feel fear when I should have (riding a mates Yamaha 450 dirt bike through the scrub at full tilt should have triggered some red lights in my head but it didn’t). I just felt totally calm. It was millpond still inside, but in an uncanny way.

Finally my performance in the sack took a big nose dive – one thing I like to think I was pretty good at (what guy doesn’t?). Now I sucked at that as well. My libido went on holidays and didn’t leave a forwarding address. This is the biggie and this is the one that was raised by the suicide prevention group leader. Everyone she knew who was medicated went off them frequently because they didn’t like having a non-existent sex life. I found that by going off them for 48 hours things worked again, but the crankiness returned pretty quickly and I was back on them again. Still, having my libido back even if it was just visiting was a good thing.

So do I recommend taking antidepressants? It depends. For severe depression it’s highly recommended. That in conjunction with therapy is a proven effective treatment. The meds are like floaties. They’re not the solution, but they do support you while you learn to swim. For moderate depression – maybe. But studies show that talking therapies (in particular CBT or Mindfulness Based CBT which I prefer) work at the same rate of effectiveness. For mild depression meds aren’t recommended. There’s a whole host of things that can help there from exercise to eating well, sleep, recreation etc. that will do wonders. For more on what works for depression, check out beyondblue’s comprehensive publication (clicking this link will download the pdf)

For us, medication was critical. Within 48 hours of starting, my wife said I was totally different and that she could talk to me again and have a normal conversation. Profound peace and calm returned to me and all the aggression and irritability totally dissipated. I was much better to be around. It was the pressure relief valve I needed to give me the breathing space to deal with the issues that had caused me to become so ill.

For you? That’s something that only you can and should work out for yourself.