It took over an hour for me to swallow my first antidepressant, after popping it out of its little metallic jacket. I’d spent the previous hour sitting across from my therapist, trapped in a cycle of faulty logic, rolling the pill between my right thumb and forefinger. Couldn’t I just be brave and soldier on? Why was I so weak? Did I really need to take medication? If I really set my mind to it, surely I could just push through unassisted? Other, “normal” people didn’t need medication, so why did I?
Even getting to this stage had been an achievement. It followed years of denying myself the help I so desperately needed in the pursuit of bravery! Stoicism! And strength! Looking back, I can’t believe the time I wasted feeling shit when I could have been on the road to recovery. Why refuse help when I so clearly needed it? And once I had accepted that I needed help, why did I discriminate against certain avenues towards it?Medical intervention to treat mental illness began in the 1950s. Since then, social acceptance and media coverage of the broad spectrum of mental health issues and those who suffer from them has come a long way. For some people though, medication still seems a step too far. In recent times especially, talking therapies, meditation, exercise and other practices that fall beneath the banner of ‘self care’ have become more and more talked about as forms of mental health management, which is fantastic progress.
In 2019 however, misinformation about a lot of things to do with mental health is rife. Instagram influencers can (and do!) publish posts under mental health hashtags telling followers about teas that will cure their anxiety. Or that taking a cold shower will loosen you from the grip of depression. Or that buying a squatty potty (yes you read that right) will make everything better. But despite the fact that prescriptions for antidepressants almost doubled in the 10 years leading up to 2018, suggesting that many people find them to be useful, it is still uncommon for a public figure to admit to taking medication to manage their mental health, unless, like Caroline Flack, or Chance The Rapper’smanager Pat Corcoran*, they are decrying their value.
Can we really say that as a society we are breaking down stigma for people with mental health issues, when we avoid speaking publicly about an effective and common form of treatment that has helped so many? Especially as a chronically underfunded NHS struggles to meet increased demand for psychotherapy.
“Unfortunately, stigma surrounding medication unnecessarily limits treatment choices, including those that have the potential to significantly improve one’s health and quality of life,” Dr Lisa Orban, a clinical psychologist, tells me. In combination with changes in diet, lifestyle and talking therapy, Dr Orban says she has seen “many patients benefit tremendously from medication.” She’s quick to caveat this by saying that prescription drugs are not for everyone and should only be taken in close consultation with a medical professional. In some cases, medication is vital, including with chronic conditions such as bipolar disorder where, she says, “medication is a critical part of staying healthy.” Of course, there are many women who have tried medication (especially for anxiety and depression) and not got on with it. And that is fine. Mental health does not have a one-size-fits-all cure and many may find relief in other avenues. However, it is time to open up the conversation around mental illness to include honest discussions about medical intervention. As Dr Orban says: “No one should have to suffer unnecessarily due to stigma and misinformation.”Ahead, I interviewed a range of women suffering from different mental health issues who take prescribed medication as part of their treatment. What are the main side effects that they have experienced? What other tips and tricks do they have for managing mental health? Did they struggle with the stigma themselves? And what would their advice be for other people looking into different psychiatric medications?
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PHOTO COURTESY OF BILLIE. Billie Dee Gianfrancesco, 29, Head of PR at a law firm
What was your diagnosis?
Borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD).
What is/was your prescription?
Mirtazapine 30mg originally, now sertraline 50mg.
How long have you been taking it?
Was it your first prescription or did you swap?
It was my first prescription, but I’m currently transitioning to sertraline, a selective serotonin reuptake inhibitor (SSRI) to help with some of the side effects I’ve experienced.
Did you feel hesitant about taking medication?
Yes. It took me almost 10 years of suffering before I eventually tried medication. There was so much stigma around it – I thought it was a ‘cop-out’ or ‘cheating’. My parents were hugely critical of meds. My dad worked in mental health and would tell me people became dependent on them and ended up as ‘zombies’. Because of this I thought taking them might change my personality – and that fear meant that I didn’t get help when I should have done.
How long before you started to feel better?
Two weeks into trying mirtazapine for the first time I felt calm for the first time in my life. I kicked myself for buying into all that bullshit for so long.
Were there any other side effects?
The main thing for me has been weight gain. It’s tough because when it comes to putting on weight and being happier, obviously the latter will always win, but it’s a delicate balance. My doctor recently suggested that I try sertraline to improve this, but it’s too early to say if it’s helped.
Do you have any other treatment?
I’ve had regular therapy for three years (a mix of CBT, psychotherapy, psychodynamic therapy) and attend regular drug and alcohol recovery meetings.
What happens if you miss a dose?
It’s fine! I just take it the next day.
Can you drink on them?
I could but I choose not to. I self-medicated a lot before I began taking prescription drugs, and I find that alcohol and recreational drugs make things so much worse for me.
Do you have any other tricks for managing your mental health?
Learning the art of self-love has been lifesaving. I never realised how much I had neglected myself before. So now when I am in pain, instead of trying to fight it or block it out, I try to accept it and treat myself with kindness instead. I have long hot baths with salts, I make sure I eat well, I set aside lots of time to relax and I enforce strong boundaries with others to protect myself. I also have a cat, Lillie, and having her around has helped to give me comfort and ease the sense of isolation.
What would you say to someone who is considering medication?
If you broke your leg or picked up an infection, would you refuse medication? Sometimes we simply just need a little help to get better, there’s no shame in that. I feel like I have lost years of my life to mental illness and if I could go back I would have tried medication much sooner. If it doesn’t work, it doesn’t work – but what do you have to lose from trying?
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