Written by Stephanie Kleanthous
Illustrated by Jon Edgley
As the conversation around mental health continues to widen, medication for mental illness still holds a large amount of stigma and misconceptions. Meanwhile, medication for our physical ailments, which can sometimes be linked to mental illness, remains commonly accepted.
Due to Covid-19 and the drastic changes to our lives, many of us have either developed mental health issues or have had pre-existing ones worsened. In August, it was noted that in Australia there’s been over 1,200 suicides since March, compared to just over 200 deaths from the virus.
For England and Wales, ONS stated: “In 2019, there were 5,691 suicides registered. The male suicide rate of 16.9 deaths per 100,000 is the highest since 2000; for females, the rate was 5.3 deaths per 100,000 and the highest since 2004.”
During lockdown this year, there has been a delay in inquests, “as a result of this delay, we cannot yet be sure of the number of suicides that occurred during the coronavirus pandemic.” While statistics for this year are currently inconclusive, it is fairly obvious that mental health issues are continuing to rise.
Now, being in lockdown for the second time, it’s more important than ever to keep conversations open and to reach out for help when needed. Sometimes simply talking to friends and family isn’t enough and we need to look to professionals for counselling, therapy and even medication. While there is a stigma, The Royal College of Psychiatrists estimates that 50 to 65% of people treated with an antidepressant for depression will see an improvement.
If you are suffering and considering contacting your GP, I sat down with 19 year old Scarlett who tells of her own three year experience on SSRI’s, psychiatrists, counselling and therapy. In our interview we discuss what led her to taking antidepressants, how she fought against the stigma, if she would ever take them again and more.
Q: When did you first develop depression?
S: I feel like I’ve been struggling with low mood for quite a lot of my life. I realised that I had developed clinical depression in the Autumn of 2016. I had just started a new year at a relatively new school but I was dealing with a lot of environmental stuff – my dad was really ill at the end of the summer. He’d got ill in Hong Kong and so I had to leave him to go back to school and I said goodbye to him in hospital not knowing if I’d see him again. He’s really good now but that was kind of what started it.
Then I was struggling in my dorm with two other girls with sleep, anxiety… we got involved with this older girl who was like, “oh, I’ll give you some pills for that but it’s nothing serious, it’s this stuff called Xanax”. Which at the time I was like oh, I’ve heard of that, it’s a generic drug. I didn’t think it was anything illegal. I ended up getting almost expelled from school and it was a very unsettled time. Ended up being all fine and I went back to school but I couldn’t really forgive myself for the stupid thing I’d done and the dangerous situation I’d put myself in. When I really realised I wasn’t doing well was November 2016. I was fifteen.
Q: Do you or did you suffer from any other mental illnesses?
S: I suffer from anxiety which is something that I will always struggle with, I just know. A little bit of OCD (diagnosed) but nothing that’s been really serious.
Q: What led up to the decision to begin taking antidepressants?
S: So I think because the school was already involved when I got suspended, it was very much an open dialogue about how I was doing after that happened, and also with my dad. I had a very good support system there and I also have a really good relationship with my mum so I never felt like it was something I couldn’t talk to anybody about. I’d done counselling and therapy in the past and I’d even been suggested going on antidepressants two years earlier.
About November time, I went to see a few different counsellors and therapists. Whenever you go to see a new counsellor they always ask you “have you had any feelings of suicide or self-harm?”, and whenever I would fill those forms out they would say, “well I can see that it’s quite severe” so they would always float medication as an idea. Eventually a psychiatrist said I think this is something that needs to happen soon.
“Therapy is what saved my life.”
Q: Which SSRI did you take? Did you have a journey of finding the right one for you?
S: I first started on Prozac. It wasn’t actually too difficult to find the right one. Obviously it wasn’t the first. I had the Christmas holidays, it was clear I wasn’t doing very well. When I came home I immediately had an appointment with my psychiatrist and I said that things were not any better and my anxiety was a bit worse. That’s when she said to go on Citalopram ’cause that’s something that they commonly prescribe to people who deal with depression and anxiety as well. That’s the one I settled on for the rest of the time.
Q: You mentioned attending therapy and counselling, do you think it’s important to do this alongside medication?
S: It’s different for everybody, I don’t want to say that everybody should do one thing or another but I would say that taking medication without talking therapy would feel strange for me. I feel like, depression, although it can just be a chemical problem, even if it isn’t rooted in the things in your life, it’ll definitely effect it. So I feel like learning to talk about it is important, even if it is getting it off your chest, ranting. Whether it’s CBT or psychotherapy, I don’t know all of the different types. But it can just be ranting about something or it can be talking about strategies to help you deal with negative thoughts, feelings, whatever. I just think it’s imperative to anybody who’s struggling. Therapy is what saved my life.
“Explore and consider every option if you’re in a difficult situation. If you’re struggling then there’s no wrong answer as to what might help.”
Q: Would you consider taking antidepressants again if you found yourself depressed or anxious in the future?
S: I think having had such a long journey on them, and my mum specifically she was always really worried, it’s not an addictive drug but there’s questions as to whether you become dependent. I’d be weary. I know I make a big show to myself, to my friends, that recovery is not linear and that relapse is inevitable but I feel like it would be hard for me to go back on them. I definitely would if it was necessary because I wouldn’t want to risk anything. I know that they helped me in the past so I know that they might help me in the future, and they might have to, but I feel like I would be careful about it.
Q: What would you say to someone who was considering taking antidepressants but felt unsure?
S: Explore and consider every option if you’re in a difficult situation. If you’re struggling then there’s no wrong answer as to what might help or what might be necessary even for just a period of time. I mean, people who don’t like meds in terms of mental illness say “it shouldn’t be used as a placeholder” and I don’t think it should. But if you’re in the worst place then it can be used to lift you up a little bit and then you can get to that point of talking and working through the other causes of the issues. Nothing’s final but it’s an important option to consider.
Q: Did the stigma surrounding antidepressants put you off?
S: A little bit with my mum. It took a long time to convince her. She had been on them herself when I was younger and reacted quite badly. I think she only tried one and they didn’t work for her or they made her feel worse. So she kind of just had that judgment about all of them in general. She’s also really into spiritual healing and natural methods. So staying away from the meds has always been a big thing for her but she realised eventually that it was a path that we should at least explore. Eventually we saw that it was working for me so then she was like, whatever will help.
It’s weird though that I never felt uncomfortable telling people that I was on them or meeting new people and discussing it. It just never seemed like an issue to me, maybe because I wasn’t even old enough to encounter that stigma. Also, being in a boarding house, you go get your meds from a specific person and you realise that a lot of other people are taking them as well. It felt not ‘normal’ but more normalised.
Q: What side effects did you encounter and how did you manage them?
S: I never had anything that I could really control. Random tiredness, fatigue, I would get shaky, sometimes have a raised heartbeat and feel very anxious but I don’t know if that was just my anxiety. In terms of dealing with them, I found it really hard. I would just try and do all the stuff that doctors tell you to do like get enough exercise, eat a balanced diet, drink enough water. Be very careful to mix them with alcohol because it does reduce your tolerance but also alcohol is such a depressant. So if you’re in a bad way and you’re taking meds as well, alcohol is absolutely not going to help.
Q: What are some common misconceptions that you’d like to clear up or eradicate?
That it’s not the be all and end all that you’re on them. That’s the kind of thoughts that I feel like my mum had when she was like, “I don’t want you going on them because this is going to be the rest of your life”, but absolutely not. Or that it’s a simple solution because it’s definitely not. It should not just be like, you take pills and you think you’re going to get better. It helps chemically but if there’s still stuff in your life that’s impacting you in a negative way then you need to address those head on. Not just the dialogue but the awareness about them should be greater because people don’t realise that they can actually have different effects on you.
Q: Finally, what advice would you give to people who know someone going through mental health issues?
S: Be there for them. I never wanted for me and I don’t think in general that it should ever be used as an excuse if someone is acting sh*tty. But I do think sometimes you have to be accommodating.
If you’re struggling with your mental health, I’ve listed some resources below and I would urge you to book an appointment with your GP and/or refer yourself to therapy. The waiting lists may be long and the NHS is underfunded but it’ll be worth it when you eventually get seen. Any time is better than never.