Antidepressants are not ‘happy pills’


I am sick and tired of the way the press portrays depression as unhappiness and antidepressants as ‘happy pills’.

Over and over and over and over and over again they tell us that we’re medicalising our normal emotions and that resorting to tablets simply encourages our own helplessness.

The professional equivalent of cutting and pasting, the same article seems to keep coming back like a bad penny. For problems in other areas of health we’d only trust the experts to comment, but when it comes to mental health it seems like anyone can cast judgement. Every author seems to think they’ve discovered something amazing, when all they’re actually doing is repeatedly insulting a huge group of people with their ignorance.

‘Normal Unhappiness’

Depression is not normal unhappiness, it is not something everyone goes through at some point. Only someone who has not been depressed would say that. It is not a bad day at the office or a row with your partner. Depression feels like someone has reached inside your chest and torn out your soul with a rusty spoon. And is laughing at you about it.

You can’t just choose to instantly recover from depression. It is not a case of willpower or a lifestyle choice. Why would anyone choose to be depressed? Unsurprisingly, ‘snapping out of it’ or ‘pulling yourself together’ have already occurred to people who are depressed, because they aren’t stupid.

I agree, the causes and biological markers of depression are still murky to us. We don’t have a blood test or a scan for it and we realised that the ‘serotonin hypothesis’ was too simplistic decades ago. But this does not make depression any less of an illness, because the symptoms are still there. Just like migraines, we know very little, but we shouldn’t bizarrely stop calling it an illness just because of that.

‘Happy Pills’

Antidepressants are not ‘happy pills’. They do not make you happy. If you’re lucky they take the edge off the searing, crushingly hopelessness and allow you to focus your thoughts in reality just long enough to find a solid foundation for recovery. Taking them is not an admission of defeat or weakness, it is accepting help for a problem which can lead to devastating consequences.

Nor is taking antidepressants an admission that you have a brain disease instead of a complicated illness with psychological and social factors. Antidepressants can be the crutch people use to make it to talking therapy, just like pain killers can be the crutch people use to do physiotherapy. If they help it should be lauded, not chastised on ideological grounds (‘I know you feel better on tablets but I don’t think it’s right for you to be taking them’).

However complex the cause of depression is, we know that antidepressants can help. Even staunch antidepressant-hater Joanna Moncrieff has done a meta-analysis which suggests it, and the largest critical meta-analysis suggests they still work in severe depression.

They don’t work for everyone, but no drug does. In fact, antidepressants work at least as well, if not better, than drugs from the rest of medicine. They have side effects, but every drug does. Some say ‘they only numb you’, as if being numb sounds like a bad thing to someone who feels so gut-wrenchingly low.

The real issues

The real issues are that so many people feel so low that a doctor thinks they might benefit from antidepressants, and that there isn’t enough provision of alternatives in these situations. The first choice treatment for mild to moderate depression, as every reasonable GP knows, is actually talking therapy. But the waiting lists are horrendous and GPs feel they need to do something.

The press desperately need to take a more nuanced view of these genuine issues or they’ll continue to trample over the thousands of people who genuinely need antidepressants to continue living their lives.

For the final time:

Depression is not normal unhappiness and antidepressants are not ‘happy pills’.

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