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Why is there still stigma around antidepressants?
Thanks to more of us talking openly about mental illness and the impact it has on so many lives, an increasing number of people are reaching out for help and treatment. Yet despite this, there is still stigma surrounding the use of medication to treat mental health problems.
Last year, Claire*, 26, was prescribed fluoxetine - a type of antidepressant known as an SSRI - for OCD and anxiety.
"I went from having a mind that was having ten thoughts at once to being able to organise it all a bit more. I feel like joy is a little easier to find now, my compulsions are easier to control and my panic attacks are much less violent than they were," she says.
Although the medication helped her, Claire says her mum was still unsure.
"She felt like it should be something I can manage on my own, that with positive thinking and exercise that I could cope with it," she explains. "But I've been open with her about how I feel and she's generally more supportive now."
Another friend also told her she would benefit more from 'being outside' than taking medication.
"This is the stigma," Claire adds. "It's embarrassing to insist that you need medication to feel normal. It's humiliating to have to fight for the right to take something that you don't want to have to take."
A common myth is that medication is a 'quick fix' for mental health issues. In reality, finding the right medication is not always an easy process and it can take time before the effects are felt. In many cases, your GP may advise talking therapies or counselling alongside medication too.
"I think the biggest myth around medication for me is that people often see it as a failure or a weakness," says Becky Barnes, 38, who has bipolar disorder.
"Friends and family will ask 'how long do you have to take those for then?', as if suddenly after a couple of months the chemical imbalance in your brain is going to miraculously get better."
"For someone like me with bipolar, my antidepressants are my lifeline. They enable me to get to up in a morning, get dressed and function."
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Another myth is that taking medication means you are lazy and haven’t tried to help yourself by exercising, eating healthily or trying meditation. While lifestyle changes can help improve your mental well-being, some people find it difficult to do these things without medication and other treatments, such as therapy.
"People seem to think that taking a pill is lazy or that you're taking it because you can't be bothered to go for a run, or manage your diet, or think positively. That you're taking a pill so that you don't have to do things," Claire says.
"I love exercising; I love cooking and eating healthy food that makes my body and mind feel good," she adds. "But my compulsions make it impossible to eat; I'm convinced that everything I eat is contaminated. My medication helps me manage those obsessive thoughts so that I can eat the food and look after myself better."
Perhaps one of the most common myths is that antidepressants are simply 'happy pills' - a term which is hugely stigmatising for those who take medication.
"Antidepressants don’t work in that way. It is a myth," says Isabella Goldie, a trained mental health nurse and director of the Mental Health Foundation. "They help free the brain up from negative thinking and help people develop other coping skills, maybe start to get out and regain an interest in life, or get more motivation to do stuff to make you happy."
Rather than triggering feelings of euphoria, antidepressants are believed to treat the symptoms of depression and anxiety by increasing levels of chemicals called neurotransmitters in the brain, such as serotonin and noradrenaline, which can help improve mood.
Calling them happy pills isn't just inaccurate, says Nia Charpentier from Rethink Mental Illness, but it is also 'dismissive and reductive' - and makes what can be a lifesaving treatment for some 'seem frivolous and unnecessary'.
Why does stigma still exist?
Stigma around mental health still exists, which is part of the reason why stigma surrounding medication is still pervasive.
Like all drugs, different antidepressants can have side-effects, but these may improve over time as the body gets used to the medication. If you don't get on with a certain drug, your GP can advise others.
"We need to understand that medication is there to help people, we have invested over the years and medications are better than they ever were before," says Goldie. "People can still experience side-effects and that is trial and error - there are different types of medication people can try."
People often worry that mental health medication will turn them into a 'zombie' or dramatically alter their personality so they won’t be themselves anymore. For many people who benefit from medication, though, the relief from intrusive thoughts and obsessions can help improve energy, motivation and focus. In turn, this allows them to be more like themselves and find enjoyment in things again.
Impact of stigma
"Unfortunately there is still a lot of stigma and misconceptions around medication for mental illness and this can have serious negative consequences," says Charpentier. "The knock-on impact of this is people might want to stop taking medication or not want to approach it altogether. Medication isn't for everyone, but it's concerning when people are put off a treatment that could help them, by misunderstanding and fear."
Not only does this stop people from going to their GP for help, but it may encourage people to come off medication too early.
"Often, people who are benefiting from medication and who have done well on it, are ashamed of it and come off it," Goldie explains. "We have a major issue with relapse around depression and a lot of that it coming off medication too soon."
If you are struggling with your mental health, seeking support is often the first step towards getting better. Your GP can advise the best course of action for you and point you in the direction of local support groups. Organisations such as Mind can offer advice and information.
Speaking to friends and family can help them understand what you are going through and they may be able to help you access the right professional support.
*Names have been changed.