Antidepressants were a lifesaver, an emotional anaesthetic. But I’ve never managed to wean myself totally off them — and they didn’t fix my underlying issues

HAvING been something of a live topic in recent years, the over-prescription of antidepressants is an issue that has recently slipped beneath the radar.

Sadly, that’s not because the problem has gone away. On the contrary: if anything, things have got worse.

Over the past decade, prescriptions in England have almost doubled, from around 47 million a year in 2011 to 85.6 million in 2022/23, which is mind-blowing when you think about it, especially since the entire population of the British Isles is only about 70 million.

Attention was drawn to this yesterday in the form of an open letter to the British Medical Journal, published in the Mail, from the newly formed Beyond Pills All Party Parliamentary Group.

The letter called for an end to ‘a pill for every ill’ and the establishment of a national, 24- hour prescribed drug withdrawal helpline and website.

The group, co- chaired by the former chief executive of NHS England, Lord (Nigel) Crisp and backed by a number of eminent medical professionals, aims to reduce the number of people being prescribed antidepressants as a cure-all for a variety of issues, pointing out that ‘rising antidepressant prescribing is not associated with an improvement in mental health outcomes at the population level, which, according to some measures, have worsened as antidepressant prescribing has risen’.

The group argues that all too often these pills are being given to patients for minor conditions that could be treated just as effectively — perhaps even more so — with therapy or lifestyle changes.

‘The high rate of prescribing of antidepressants over recent years is a clear example of over-medicalisation,’ writes Lord Crisp, ‘ where patients are often prescribed unnecessary and potentially harmful drugs instead of tackling the root causes of their suffering’.

The other problem, which the letter also highlights, is the question of long-term dependency.

Most of these drugs — in fact, almost all of them — are extremely hard to stop taking.

While not technically addictive, many patients experience severe withdrawal symptoms if they try to quit, including disorientation, mood swings and other debilitating symptoms such as tinnitus, socalled ‘ brain zaps’, muscle pains and nasty flu-like sensations.

I know this to my own detriment. Having been prescribed antidepressants almost a decadeand-a-half ago, I have repeatedly tried — and failed — to wean myself off them. I’ve had some success, in that I have managed to greatly reduce my dosage — but every time I try to quit altogether,

I am assailed by all of the above.

And, as Lord Crisp’s letter highlights, there is very little help for people in my situation.

In particular, the drug companies don’t manufacture the pills in sufficiently small doses to be able to make tapering off possible, even though it’s the only way to do it.

The result is that people end up stuck on these drugs for years on end, often long after they really need them. What begins, as it did with me, as a chemical crutch to help overcome a difficult patch, it becomes a permanent fixture, impossible to escape.

But it’s not just patients for whom pills have become a crutch. The medical profession has become over-reliant on them, too — and that’s a big part of what’s driving this problem.

Antidepressants commonly represent a quick answer to a complex problem that GPs don’t have the time or the resources to properly address.

Accessing wider mental health services where this might be possible is very hard in these straitened times, and there are endless hoops to jump through. So much easier just to write a prescription and be done.

It also used to be the case that patients would have access to one family doctor pretty much their whole lives. Over time, they would develop a relationship with that person, who knew them not just as a set of symptoms but as a person.

Such relationships were crucial to helping people in times of personal crisis. A good doctor would know if Mrs Bloggs was simply having a bad day or something more serious was afoot.

That, sadly, is no longer the case. Many patients rarely see the same doctor twice in a row (assuming they see them at all), and when they do, they have only ten minutes to explain their symptoms.

How is a GP to know whether the person in front of them is clinically depressed, or just in need of a pep talk and a couple of days off work? Diagnosing mental health problems is not as simple as spotting a broken wrist or an infected cut.

There’s another important factor here. The destigmatisation of mental health problems has been a hugely positive development over the past few years.

Nowadays, it’s OK to say you’re not OK, and that’s all to the good. But there is a growing sense that the pendulum has perhaps swung a little too far the other way.

It’s important not to confuse the normal ups and downs of daily life, the inevitable highs and lows, with more serious mental health issues.

It’s up to medical professionals to spot the difference. But there does seem to be a growing expectation that happiness can be a permanent state of mind, which is impossible.

Again, as someone who has longterm experience of these drugs, I know first-hand what a doubleedged sword they can be.

In my case, there is no doubt that I needed them at first: they helped me through an extremely hard period in my life, one where a combination of serious emotional and physical challenges had left me struggling to function.

I could barely move, I couldn’t focus or concentrate, I was in constant physical pain — simply getting out of bed in the mornings felt like climbing Kilimanjaro.

My nerves were so frayed even performing the simplest of tasks seemed to present an impossible challenge, and no amount of yoga or reflexology — or, for that matter, chocolate (self-medication is often a feature of mental health problems, and my drug of choice was food) — seemed to help.

Things got so bad that my children, who were quite small at the time, just grew used to the idea I was an invalid. My son, now 19, even brought this up the other day. ‘I just used to think that’s how everyone’s mum was,’ he told me, ‘that it was normal for you to be ill all the time.’ Poor kid.

In the end, after much persuading, I sought help — and was diagnosed with anxiety as well as PTSD, both of which I struggled to accept, particularly the latter.

In my mind, PTSD is something that happens to soldiers — not middle-aged mums. What right had I to feel that way?

Anyway, despite my many misgivings, I agreed to start medication. Turned out the experts were right. I went from being befuddled, disorganised, forgetful and generally incapable to being so terrifyingly functional I almost scared myself.

The old me that I had feared lost for ever gradually returned, and with her some semblance of normality. It was like a raging storm that had finally passed.

Would it have been better if I had been able to take time off work and from my family obligations, to step back a bit from life and recover naturally?

Absolutely. But that was not an option to me, and I needed to keep functioning. The pills acted as a kind of emotional anaesthetic, dampening my anxieties, enabling me to carry on. And in that respect, they were a lifesaver.

But the problems that made me feel that way in the first place never went away. Indeed, if anything, they got worse, because now I was numb to them.

In the end, I had no choice but to deal with them.

By then, of course, they were much bigger and badder than they would have been if I had faced them down initially instead of relying on chemicals to keep going.

Depression is like tooth decay: if you don’t get the problem fixed at the root, long-term it only gets worse. What antidepressants do is make people feel better about the underlying causes that are affecting their mental health.

They can’t change those underlying causes per se. Only the individual can do that. The only way to do that is to work out what’s causing the depression in the first place, and deal with it. And that requires time, patience, perseverance and, in most cases, money — a luxury not many people have.

So while I’m all in favour of this initiative, I would just sound a cautionary note. By all means, yes, let’s put in place mechanisms to help people come off antidepressants and avoid unnecessary use in the first place. But let’s also be mindful of the fact that these drugs, when correctly used, do help an awful lot of people through some very tricky times.

And that mental health problems, while not always as common as we might think, are no less debilitating than other health conditions — and no less important to treat.

Most of these drugs are hard to stop taking

There is little help for those in my situation