Antidepressants Are Options


There is a constellation of facts and emotions swirling around antidepressants, always. And the big feelings around antidepressants are of suspicion, anger, judgement, pressure, guilt, and shame. And a lot of times, facts get misused or distorted, or completely invented.

I am pro-pharmaceutical.

I am also pro-meditation/mindfulness, pro-cognitive behaviour therapy, pro-eating right and exercising, pro-sunshine, and pro-vitamin B6. I am pro-GETTING BETTER.

A mood disorder (like anxiety or depression or bipolar) is a physical illness. Why? It takes place in a PHYSICAL body (where else?) and it is hurtful; it’s not conducive to thriving or living your life. It is body stress. And just like other kinds of stress or inflammation, it is accompanied by biochemical markers like increased cortisol and cytokines in your bloodstream [source].

Anxiety and depression disorders are excruciating. They are agonizing to go through and create alienation and isolation around a person. They create chaos in families. NO ONE chooses to be anxious or depressed any more than they want to hold their hand against a hot stove burner. In a culture of shame and judgement, most symptoms are covered up, hidden, and disguised as much as possible. What you see, if you see any signs at all, is usually just the tip of the iceberg.

The decision to treat your mood disorder is a painful one and it requires a lot of courage. More difficult, is when people battling their anxiety and depression get caught in a larger battle – Treat With Drugs vs. Without Drugs.

I roll my eyes when mental illness is called an ‘invisible illness’ – it is no more invisible than any other kind of injury on the inside of the body, as opposed to the outside. By that definition – a physical illness somewhere that isn’t on the skin’s surface – a knee injury is an ‘invisible’ illness. Heck, most soft tissue injuries are invisible. A GI disease like a hernia or ulcer that isn’t seen by the naked eye is an invisible illness. Just like with other physical illnesses that can’t be seen on the outside of the body, mental illness is initially diagnosed based on the patient’s reported symptoms, such as pain and impaired functioning. But are conditions like carpal tunnel or a pulled muscle as de-legitimized and stigmatized to the level that mental illnesses are?

Illnesses that happen in our most vulnerable organ – the brain – are the hardest to examine by doctors. So in the absence of information, comes a lot of opinion and judgement. Sadly, most of it is negative because the signs and symptoms of mental illness can resemble extremes of normal emotions in healthier people. And therein lies the key to understanding the stigma. Because we can’t open up the brain’s minute circuitry to look inside as easily as we can view somebody’s GI tract with a scope, people create assumptions about WHY people with mental illness are suffering. They make the mistake in thinking that victims of mental illness are not doing enough to cope on their own, when in reality their brain is creating a situation that is overriding their capacity to cope.

The brain is not inherently mysterious; we just don’t understand it well, and perhaps we won’t for a long long time. When something is beyond understanding, it is human nature to fall back on familiar points of reference – such as ourselves. In ancient times we thought lightning was caused by a human-like god throwing spears of fire. So when someone can’t come to grips with a loved one’s depression, their solution to the problem is like pouring a cup of water on an inferno. What works for them, won’t work for someone with depression.

This all seems pretty obvious, but it brings me to my next point.

If you have never needed a psychiatric medication, you cannot possibly begin to condemn someone for taking one.

Mental health medication gets a lot of bad press. It’s not surprising why. Psychiatry and medicine has a sad history of over-prescribing, chemical abuse and oversedation, calling normal human experiences ‘disorders’ that require pills when they don’t, making considerable profit by exploiting desperate people, creating addiction and causing permanent damage, and the list goes on.

BUT that doesn’t mean under the guidance of an ethical health care provider you cannot find a SAFE option for you and take it responsibly. It doesn’t mean that you should be judged or shamed for needing medication, or that medication is a bad thing when prescribed and taken responsibly. It doesn’t mean that you are copping out. Or taking a shortcut. Or not trying hard enough. Or have a weak or addictive personality. It doesn’t mean you are a pill-popper. Or a junkie. Or a bad mom or a bad husband.

I am SICK up to HERE with the subtle and not-so-subtle message towards people who take mental health medication. If you can take some vitamin B12 and a sniff of lavender essential oil before bed to manage your depression and anxiety, that’s awesome. But don’t go writing an unsourced airy fairy blog post about how the pharmaceutical industry is just trying to kill everybody and you should feel nothing but shame and guilt for relying on some sketchy chemical from a lab, that is little better than a placebo. Just ask anyone lucky to find an SSRI that worked for them – the effect is the complete opposite of placebo.

And for every industry worker for Big Pharma I swear is some alternative asshole trying to make money by selling you holistic oils and crystals, but I digress.

We need to remember that mental health should be treated the same way all other issues in the body are – with titration, and appropriateness. If someone comes to the ER with a hangnail you don’t just throw some hydromorphone on it. Or just as bad – if someone comes with their foot cut off you don’t ask if they tried icing it first.

So yes some things like meditation and sunshine and essential oils and vitamins and good nutrition and a sweaty workout and cognitive behaviour therapy  and a big old handful of cashews daily will manage some mood disorders. But not others. That is why antidepressant options remain just that, options. And non-invasive non-medical things should be continued as supportive therapy.

So are you failing if you need it? No way. You are trying your best. Haters can hate. You just keep on keepin’ on your healthy way. With your head up. And a middle finger in the air. If you need it.

– Jessica C., RN, BN