Do anti-depressants really work?

I lay in bed looking up at the plain upper interior surface of the room. Everything stops. Walls seem to be closing in. I can’t move. I have nowhere to go. No escape.

Depression is seen as just feeling sad, unhappy, or down in the dumps but maybe there is more to it than that. Most of us feel this way at one time or another for short periods right? But does that mean we are all depressed?

True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time. Other than therapy or talking to someone about it, it seems as though anti-depressants are the go for ‘curing’ this illness.

Anti-depressants are medications prescribed to individuals to help treat depression. They fall into 4 basic categories; selective serotonin reuptake inhibitors (SSRIs), atypical anti-depressants, tricyclic anti-depressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

All of these medications work by altering the level of certain chemicals in the brain, particularly serotonin. Since they all work by slightly different mechanisms, patients will find that one type of anti-depressant may be more appropriate for their specific symptoms.

Doctors prescribe a lot of these as a treatment plan, but we’re an over-medicated society and it’s a lot easier to quickly pop a pill or prescribe than it is to explore the reasons for a person’s distress. The most recent annual data from NHS Digital shows prescriptions for 64.7 million items of anti-depressants – an all-time high – were dispensed in England in 2016. The average number of items prescribed for each person has gone up over that time from 14.8 to 20.

Annie Wade Smith, time out project worker for Healthy Minds, a non-profit holistic mental health organisation, told Artefact: “Anti-depressants are being given out too freely, especially by GPs as they are time restricted and it’s much quicker to give somebody a prescription than to ask them ‘how are you?’ For some people, it’s been really difficult to get to that appointment and admit they’re not ok and then they’re let down straight away/offered medication before the options are discussed.”

Annie believes anti-depressants are not a quick fix; there are side effects to these and also, how do we know they are actually working? “There are many side effects to anti-depressants, commonly: nausea, increased appetite and weight gain, loss of sexual desire and other sexual problems, such as erectile dysfunction and decreased orgasm, fatigue, and drowsiness. This often leads to individuals feeling far worse on them than not,” she told us.

Elizabeth, 21 shared her experience: “All I needed to do was tell the doctor how I felt then they prescribed me Sertraline (anti-depressants). He also suggested I do some counselling but that’s all done independently, with no help from the GP other than where to go.”

“Living with depression is a nightmare. You don’t want to do anything you have no motivation what so ever. To even do the simplest of tasks like self-care, to eat shower or see people is difficult you just don’t want to do it. it’s very negative. To other people, it doesn’t seem bad as its like oh yeah you are just staying in bed all day. You cant bring yourself to do anything its brutal nobody understands, they just think you’re being lazy but it’s a physical can’t but when you do have to do things everything just seems pointless,” Elizabeth told us.

Depression

Depression is often hidden [Flickr:MedOptions]

Data released by NHS England under the Freedom of Information Act showed that 64,765 under-18s, including 3,876 children aged 7-12, and 315 aged six or younger, were given medication typically used to treat depression and anxiety in the year to March 2016.

Annie is concerned about the use of anti-depressants in young people and children; “I definitely have seen an increase in young adults being diagnosed over the years, and not always correctly. For example, I was going through grief and this wasn’t recognised as a separate issue, my university told me they would only acknowledge my need for mitigating circumstances if I were diagnosed with depression. Depression also has a lot of co-morbidity with other disorders and these often get mixed up in a diagnosis,” she said.

“It could be really dangerous to come off anti-depressants. that’s why it’s a two-step thing. Mental illness is still not understood by doctors they treat anti-depressants are not a cure they are just to even out your mood until you have counselling that will fix your issues. But you have to wait months for therapy. The waiting list is very long.”

It’s been a difficult journey for Steph, 19: “I have been on them since school at first they were a bit skeptical about giving me them at such a young age. It was a struggle going to college, I got really behind due to depression and most lecturers were pretty good with me although some didn’t really understand. They were actually very patient with me and offered me extra help outside of lessons.”

The rise of young adults with mental health problems in the UK has increased especially in universities. More than a quarter of students (27 per cent) report having a mental health problem and more than half of students (52 per cent) know between one and five people that suffer from a mental illness, whereas just eight per cent know no one with mental health problems according to YouGov.

Research Fellow with the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) report that treatment with a tricyclic antidepressant was less effective compared to talking therapy.

The NHS is spending a record £780,000 a day on antidepressants as failing mental health services struggle to provide alternative therapies, new figures show. Prescriptions for drugs to treat depression have more than doubled from 29 million in 2005 to 61 million in 2016.

Are anti-depressants the best solution? Annie believes that people should consider all possibilities and use medication as a last resort because people see anti-depressants as a magic wand or a happy pill. Which certainly isn’t the case. A lot of people often struggle with feeling like a ‘zombie’ as the medication numbs them.

The Mental Health Advice Service at University of the Arts London provides information, advice, and guidance to students who have an existing mental health issue or who are worried about their mental health and well being.

To make an appointment with a mental health adviser, or for general enquiries, students should complete the Counseling and health advice request form. Telephone enquiries to 020 7514 6251, or emails to studenthealth@arts.ac.ukare also welcome.


Featured image: Sagun Tuli via Flickr CC.