5 Myths of Antidepressants and Why I Needed to Bust Them

Source: Matteo Badini / Unsplash

We’ve all heard of them, or at least some of them: Paxil, Zoloft, Effexor. And the most suspect culprit of them all: Prozac. Like a roll call of lieutenants on a starship, they file into our minds carrying a string of preconceived, and often inaccurate, ideas of what antidepressant means.

Ramifications of Shame and Stigma of Psychiatric Medication

When I was first diagnosed with bipolar disorder and generalized anxiety disorder, medication was the last thing I wanted to take. The major reason was the stigma that accompanied (and still accompanies) it. Choosing not to take psychiatric medication for me, and a lot of other people, was based on misunderstandings that never got explored or corrected. Not until very late in the game. Once those erroneous ideas were addressed, I was willing to try them.

A doctor glibly explained when I was refusing (bad patient!) to take my prescribed antidepressant that "It’s just like taking insulin for diabetes." Uh. No, it’s not. We don’t think insulin is a crutch for diabetes. But we think medication for a psychiatric condition is.

Psychiatrist Ron Remick, medical director at the Mood Disorders Association of BC, describes what’s called "pharmacological Calvinism": the disapproving attitude that taking medication is a moral issue, not a medical one. “Some people,” he explains, “incorrectly believe psychiatric medications are an easy way out. Instead of pills, they believe people should get to the root of the problem. Meaning uprooting a personality problem or weak temperament.”

I’d never heard of pharmacological Calvinism, but I was a classic example of its impact. For five years, I didn’t take meds. Why? I believed I needed to work harder, do better. I needed to do more therapy, find the origin of my depression. Then the depression would disappear. But it doesn’t matter how much trauma work I do; my system still needs the support of meds. I have other management strategies to be sure, and they are equally important. It’s not an either/or situation.

For years, the shame I felt with regard to not only having a mental illness but also associated with the medication for it prevented me from accepting a pharmacological treatment.

Countless times, I berated myself: "If I only tried a little harder, I wouldn’t need medication." The following are my top five misunderstandings that prevented me from taking antidepressants. Maybe they are stopping you or a loved one, too.

Top 5 Myth-Conceptions

Antidepressants are

1. addictive
2. medications that change the personality or create a "high" and artificial happiness
3. for people who can’t cope and are weak-willed
4. to be taken only until the depression lifts, and shouldn’t have to be taken for life
5. not natural and therefore "bad"

1. Are anti-depressants addictive? No, this family of medication is not addictive. But this needs caution, qualification and clarification. Anyone who has had bad experiences with antidepressants knows this. According to The Centre for Addiction and Mental Health's (CAMH) definition "drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect. Antidepressants do not have these effects."¹

However CAMH continues to explain "antidepressants do have one thing in common with some addictive drugs—they can cause withdrawal effects when you stop taking them." CAMH states because your body gets used to the antidepressants, especially if you've taken the medication for months or years, if you stop taking them, particularly if you do so abruptly, you can experience symptoms of withdrawal. Understandably, this could be seen as a sign that antidepressants are addictive.

Myself, I've never felt any 'high' taking them, nor have I had cravings for them, or the need to have more in order to experience the same effect. Others may disagree with me on this point. But for me, I've not experienced antidepressants as addictive. Nor have I seen others experience addiction with antidepressants. I'm talking about addiction, not experiences of withdrawal.

This does not mean antidepressants don't come with risks. The potential risks and benefits of taking them need to be thoroughly discussed with a trained medical professional before choosing to take them or not. They need to be administered or decreased in cooperation with a competent physician. Please refer to my citation (1) for further information.

SSRIs Essential Reads

Antidepressant Discontinuation Syndrome: Just the Beginning

The Brain Effects of Therapy, Antidepressants, and Psychedelics

2. Nor do antidepressants create a high or an unnatural happiness. They help rebalance a neurochemical deficiency in the brain, restoring and stabilizing natural mood.A new personality isn’t eerily created. But, with appropriate medication, the already existing personality, previously painfully submerged under the illness, returns. That’s been my experience.

A particular set of antidepressants—SSRIs (selective serotonin reuptake inhibitors)—the kind I'm on, prevents certain neurons in the brain from reabsorbing the neurotransmitter serotonin so quickly, permitting healthy mood regulation.

3. Are antidepressants for those who can’t cope? This is no truer than saying a person with diabetes should forgo insulin and control their blood-sugar level with sheer willpower and a positive attitude. PET scans—"photo shoots" of the living brain—show marked decreases in activity in the depressed brain.² When the right medication is taken, the brain returns to healthy activity and "normal" levels of mood result.

People fail to understand that major clinical depression is a physical illness as well as a psychological one. It is a condition needing medical attention, which can, depending on its’ severity, include treatment with medication. A person living with severe depression can benefit from learning better stress management skills, going to counseling, regular exercise, and good sleep habits, but it’s not always enough to eliminate the depression completely. That’s what I've found. My wellness tools include all the aforementioned (and more) as well as medication.

4. People mistakenly believe once a depression lifts, medication can be discontinued. Not always. As with diabetes, insulin is needed daily to manage the condition. So, too, in cases of chronic clinical depression. Once a person starts feeling better, this doesn’t necessarily mean the course of treatment should stop. On the contrary, it means the medication is working and the individual is managing the illness well.

Only you and your doctor can decide what's the best choice. Depression varies in both type and intensity, with an individual’s history playing a pivotal factor, all of which influences the direction of treatment. For some, staying on an antidepressant long-term is the wisest choice. I will be on my unique dosage and combination for the rest of my life. I wasn't always OK with that, but I am now.

5. "I want a natural approach," people diagnosed with depression often say, including myself. I spent years in therapy, trying different kinds of herbal medicines and alternative therapies prior to accepting traditional antidepressant medication.

With mild depression, an herbal remedy such as St. John’s Wort may help. Counseling combined with exercise is also a good form of treatment. But in most cases of severe depression, like mine, medication in combination with therapy is needed.

Taking a prescription for any condition can never replace the benefits of healthy lifestyle choices and good psychotherapy. In fact, antidepressants combined with these other two approaches statistically produce the most effective treatment.³

The more educated we are about antidepressants, the more we remove their disabling shame. Accurate information means more objective decisions about treatment.

Medication should never be mandatory, but up-to-date information and a stigma-free option should be.

© Victoria Maxwell