Guest Blogger, Vogue writer Sydney Lima had hoped antidepressants would relieve her anxiety, but the reality was somewhat different. Here, she tells of her experience, and why so many people struggle both on and coming off antidepressants.
It was at 4pm somewhere along the Holloway Road that I called my dad telling him I wanted to die. Convulsing through panic attacks, he found me hiding down the back of an alley, trying to keep out of sight. I hadn’t felt “good” in a long time and had hit the peak of a snowballing problem with anxiety. I was drinking a lot, unable to hold down any job due to a sporadic approach to attendance, the only consistency in my life being a maxed-out overdraft.
When I no longer felt I could laugh off the devastation around me, I tried to explain the all-encompassing fear I had been experiencing to a friend, responding to a “Wubu2” with a “TBH bit anxious ATM”. She replied: “Just go to the doctor, I had exam anxiety and they gave me some Citalopram. It really helps.”
Citalopram is one of a group of relatively new forms of antidepressant, collectively known as SSRIs or selective serotonin re-uptake inhibitors. They are most commonly prescribed to treat depression and anxiety disorders and work by increasing levels of the brain chemical serotonin, which is thought to affect mood and social behaviour.
The ease in which my friend had received SSRIs for short-term exam anxiety shocked me. Five years previously, after having my depression assessed, answering yes or no to a flimsy list of questions, my GP concluded I suffered from moderate depression, but no drugs were offered.
Spurred on by the notion of a miracle cure, I booked an appointment with a different doctor for the next day. I explained how I had been feeling; unable to get out of bed, over emotional and out of control, and just liked that I had a subscription for a three-month supply of the SSRI Sertraline in my hands. It’s hardly surprising; one in 10 people in the UK are now taking antidepressants and last year and the number of NHS prescriptions has increased by 108.5 per cent since 2006.
For the next few months, I felt numb. Emotionally charged since birth, this sudden cease in emotions was unnerving. Great, you’d think, to stop the excessive lows, though this worked both ways. I could no longer laugh. Life seemed to just pass me by, untouched; I felt absolutely nothing. Apparently, I’m not the only one. One survey by the University of Oxford found that 46 per cent of patients receiving antidepressant medication for depression can experience what’s known as “emotional blunting”, a condition of reduced emotional reactivity.
After the second visit to my doctor, I switched to Bupropion, a multi-purpose antidepressant which can be used as a smoking cessation aid as well as an add-on medication when a patient doesn’t respond to an SSRI. However, despite the sudden relief on my respiratory system, the pills brought on increased bouts of rage. I lost all concept of cause and effect and felt as though I were in a video game, albeit one where the protagonist was a 21-year-old woman, unable to complete any level due to recurrent panic attacks.
The internet provided little comfort; there was no mention of rage as a possible side effect of the drugs on any of the healthcare websites. Only on patient forums did I begin to find stories that resonated with my experience.
When I next saw my doctor I couldn’t speak through tears. He pulled the plug on the whole thing, prescribing me five days’ worth of a Valium-like substance to come off the combination of pills. I bypassed the predicted withdrawal symptoms in a dopey haze. Speaking to others, I found this is rarely an option. Withdrawing from antidepressants can be tough; a friend who had been prescribed Citalopram for anxiety two years ago is still taking them through fear of coming off.
Many find the rates at which their doses are reduced are too fast – and in some cases people are taking matters into their own hands. In 2010, Cinderella Therapeutics, a Dutch non-profit organisation, began selling “tapering strips”; kits designed so that patients can hack their doses and wean themselves off the drugs over a more extended period; with the goal of dramatically reducing withdrawal symptoms.
It is true that more and more people are suffering from indications of diagnosable mental disorders. But there are varying degrees of anxiety and depression, and the one-size-fits-all “pill for every ill” approach to treatment could be more indicative of a health system in crisis than a comprehensive cure and understanding of mental health disorders. With psychotherapy waiting lists over a year in some parts of the UK, drugs are often the first port of call for anyone suffering from mental health issues.
Of course, many people have had their lives transformed for the better through antidepressants, and this shouldn’t go unnoticed. For me, however, antidepressants were not the quick fix I had envisioned; what I needed was clarity, which I eventually found through therapy, and the antidepressants had clouded my judgement and the little rationality I had.