Trust me – treating depression is a terrifying lottery

What is shocking is that vulnerable patients are treated like guinea pigs

Not so long ago in these pages, I urged “Feeble Britain” to buck up its ideas and stop wallowing in an imaginary mental health malaise.

I was inundated with emails from readers endorsing a tough-love approach to “snowflakes” who lacked the resilience to cope with the minor bumps and potholes on life’s journey.

A lost bank card does not warrant a duvet day and counselling. Functioning adults shouldn’t need pet bereavement leave (as discussed on Good Morning

Britain this week). Fear of Missing Out is not an affliction recognised by the World Health Organisation (WHO).

Work stress is normal. Loneliness is normal. Sadness, anxiety, and the rest: all completely normal responses to given situations.

By catastrophising stress and medicalising perfectly understandable, if unfortunate, episodes of low mood, as a society, we do a grave disservice to those who are genuinely ill.

People caught in the merciless vice of depression rarely speak out – because they can’t. When getting out of bed or washing takes such a supreme effort, who has the energy to get aerated about a distant in-law’s selfie-promotion on Instagram?

Meanwhile, Britain has become one of the biggest consumers of antidepressants in Western Europe. But our use – overuse – of pills has not had the required effect. Otherwise, we wouldn’t need them; that’s if the “worried well” ever needed them in the first place.

Now the Royal College of Psychiatrists has admitted that antidepressants can do more harm than good, with unpleasant side effects such as anxiety and insomnia that last for months. Coming off them must be a slow, tapered process, monitored by a GP so as not to trigger further side effects. Quick-fix prescriptions may not be quick or even a fix.

I have struggled with depression since I was 14 but only admitted it when I was 36 and was diagnosed with what I felt was its far more socially acceptable allotrope: postnatal depression. Since then, any number of public figures in sport, entertainment and even the Royal family have spoken out about their mental health to reduce the stigma and get a conversation going. But for me, a talking cure has never been what’s needed. I suffer from a chemical imbalance. Medication is the only thing that can work.

The fact that leading psychiatrists have come clean on the potential negative effects of antidepressants is no revelation. I’ve lived through them, and this announcement is merely a public acknowledgement of my experience.

The difficulty lies in the binary nature of the outcome. By way of a parallel, let’s say I had a dreadful, scary birth at my local hospital (which I did). My friend, who went into labour the same day, had a sublime birth. I report that the hospital is awful. She praises it

to the hilt. Both judgments are true, but the variables differ so dramatically, there’s no way of generalising.

No two mental health patients are the same. While treatment protocols for a fractured wrist may be much the same, with depression it’s a matter of trial and error – and what is really shocking is that vulnerable patients are treated like guinea pigs.

Antidepressants make you feel far worse before they make you feel better. That is, if they make you feel better. In fact, you might end up suicidal.

The real outrage here is that the human genome was mapped in 2003, yet there’s not even a blood test to discern which of the 27 or so different brands of antidepressants could be the right one for the patient.

Last year, a King’s College Londonled international team of 200 scientists mapped the 44 gene variants that increase the risk of depression. Since this debilitating condition is the leading cause of disability globally, according to the WHO, where is the cutting-edge research into antidepressants that use this knowledge? The big pharmaceuticals are very quiet on the subject. For now, scandalously, depression treatments amount to a health lottery; the GP takes a guess.

The first time I was prescribed Citalopram, I felt numb and sad. I reckoned at least it was preferable to hysterical and sad. I’m not sure it ever worked, and, eventually, I unilaterally stopped taking it. I had no side effects, apart from the hysteria that returned. After the birth of my second daughter six years later, I again had postnatal depression and was prescribed Sertraline. Day One: I felt so anguished I wanted to die. Day Two: I handed my newborn baby to a neighbour, went home and lay on the floor, howling in misery. Day Three: Paranoia seized me, and I was terrified that social services would take my daughter. My hyper-vigilance and a searing headache kept me awake all night. Day Four: Not exactly calmness, but I no longer clenched my jaws, and the headache was receding.

Fast forward a decade, and I am still on medication, not “happy pills” because there’s no surge of artificial elation, just no random misery.

I get stressed, I feel down but can trace the cause and either reason those feelings away or focus on solutions.

That’s great – for me. Now imagine another new mother taking the same pills, enduring the same terror and morbid thoughts. For her, the clouds do not lift. Six weeks later, she goes back to her GP and is told to take a different medication, endure another 40-odd days of strung-out hell, and quite possibly that one won’t work either.

Advising GPS to inform patients better about side effects might put off doctor-bothering snowflakes, but genuinely depressed people are rarely in a fit state to make such a decision.

All they – we – need is to know that the pill they take will work for them. Is that really too much to ask?