“Though the doctors treated him, let his blood, and gave him medications to drink, he nevertheless recovered.” ― Leo Tolstoy, War and Peace
I am unsure what I think about the recent study led by researchers in Oxford University and the subsequent criticisms of their findings around antidepressants and their efficiency.
I believe that there’s no one size fits all when it comes to mental health. How could there be? If a friend and I both catch the flu, chances are we’ll experience it differently despite having the same illness. One of us might feel worse. One of us might not throw it off as quickly. We might need different pain relief for different symptoms. People are very varied. That’s only one illness. Mental illnesses, just like physical ones, are numerous.
I do believe the adage about the question being more about “what’s happened to you?” than “what’s wrong with you?” when it comes to mental illness. That comes mostly from my experience and the people in my life who have mental health difficulties. Everyone has a story. Everyone is struggling to live with something. Everyone has tried to cope in so many different ways and some of us have nearly destroyed ourselves in the struggle to survive. Some of us are destroyed by the systems that are supposed to help us.
The sad fact is that it takes a long time for each of us to work out what’s going to help us, or rather what combination of things. For some it could be as simple as lifestyle changes. Some of us need medication. Some need therapy. Some need both. There are lots of therapies as well as medications out there. In therapy, the fit between therapist and client and mode of therapy needs to be right. It’s trial and error. The client needs to be in the right mindspace and ready to give it their all. Painstaking trial and error. Unfortunately there isn’t a budget for people to undertake these journeys in this country. For a public patient, often medication is prescribed because it’s the only option. By default it becomes the only option. The whole system is based on a medical model and everything else gets lost in the mix.
Having said the above, I was very lucky to receive DBT therapy through the HSE Adult Counselling Service. That was my “thing” that finally gave me the skills to start to understand and work through my issues. But there was a long, long wait for this as well as an an even longer one for the professionals I saw to realise that this was a service I needed. All in all, I waited years. In that time I struggled and medication helped me to cope. The first antidepressants that I took made no difference to me. I wasn’t sure what I was supposed to be waiting for but nothing seemed to happen. The next ones were the same. I started to think that the whole antidepressant thing was a myth. Then I was prescribed the third type, which I still take.
When I started the third antidepressant it was towards the end of a really tough year. I wasn’t eating or sleeping properly. All of my energy was going into getting through work and outside work I struggled to do anything meaningful. A few weeks after taking the new tablets I suddenly realised one day over Christmas that I had just spent an hour immersed in a book. This was something I had not been able to for a long time and reading was by far the worst thing that depression had stolen from me. Now I could read again. Then my interest in things around me picked up. I slept better. My appetite returned. In terms of my overall journey to get to today, it was just the beginning. Therapy was the thing that helped me move forwards but I still think that the antidepressants helped me when there was nothing else. They gave me the impetus to keep going and to engage in that therapy when the time came.
I still struggle. Neither therapy nor medication has cured me. Both still play their part. I think the therapy will be the long term measure that will give me my life back whereas I hope medication won’t always be necessary. Some days are hard. Some weeks are all uphill. But both things give me enough to work on to keep going. Medication can help with my concentration and motivation and therapy can help me check facts, realise what I need, ask for it and recognise what I need on a bad day. When your illness is complex and based upon a lifetime of certain ways of thinking and coping, you need a wide variety of things to draw on in order to recover. It’s dangerous (I believe) to become blinkered into thinking that it has to be one way or another. We are humans and humans are complicated creatures.
I am still sat on the fence. In a way, the study was interesting reading as well as quite validating but it told me nothing that I didn’t know already. The moment of looking up from my book and realising that I could read, that pages had turned without me glancing away and getting lost in my own head,that another world had allowed me to leave the darkness in my head and join in. That was enough to tell me that this medication was worth taking. At that time, anything that felt worth doing was a bonus. The media will insist on calling them “happy pills” – this they are not. Learning to feel again after the nothingness of depression can be excruciating. But it’s real, and messy, and alive.
I have BPD and given that I can be prone to black and white, either/or thinking, sitting on the fence is always a novelty.
I like seeing both sides.
“We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.”
Atul Gawande, Complications: A Surgeon’s Notes on an Imperfect Science
What is Dialectical Behavior Therapy (DBT)? (from Behavioural Tech)
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment developed by Marsha Linehan, PhD, ABPP. It emphasizes individual psychotherapy and group skills training classes to help people learn and use new skills and strategies to develop a life that they experience as worth living. DBT skills include skills for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
Help information
If you need help please talk to friends, family, a GP, therapist or one of the free confidential helpline services. For a full list of national mental health services see yourmentalhealth.ie.
- Samaritans on their free confidential 24/7 helpline on 116-123, by emailing jo@samaritans.ie
- Pieta House National Suicide Helpline 1800 247 247 or email mary@pieta.ie – (suicide prevention, self-harm, bereavement) or text HELP to 51444 (standard message rates apply)
- Aware 1800 80 48 48 (depression, anxiety)
If living in Ireland you can find accredited therapists in your area here:
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