Sunday, April 21, 2013

Antidepressant medication and stigma

I read this today, which I've read before but found really useful to read again. 

Ten Supportive Things I'm Glad Somebody Said To Me


The previous post, 'Ten things not to say to a depressed person', is great too, but I'm glad there is a positive version as well. So many people have been incredibly supportive and accepting lately - members of my sports club who don't necessarily have knowledge about these things who have treated me as someone who is ill, rather than as someone alien or self obsessed or lazy or all the negative things I imagine that other people see in me. This is especially wonderful when you are unable to see past this image of yourself.

But out in the real world there's a lot of belittling and invalidating and blaming behavior which can be really insidious and is easy to internalise (although the situation is definitely improving, attitudes have transformed even in my lifetime and organisations like Rethink and Mind are doing exciting work). One of my bug bears recently is the stigma around antidepressants, that they make you 'numb' and the idea that taking them is somehow cowardly or avoiding the issue - the 'prozac nation' view. Antidepressants do sometimes make you feel numb - I certainly don't deny that - but depression can have exactly the same effect. I do object to relatively throwaway comments around the idea that people are numbing themselves against the cruelty of the modern world, or that we are coddled and cosseted so much we create the problems for ourselves. Beyond whether this is in some way true or not, it is irrelevant - if you can make life less painful for yourself then you do. 

A feeling of total emotional flatness is not the desired response to antidepressants and is also a depressive symptom in itself. Medication that helps to make negative symptoms less overwhelming is not a cowardly or cheat's way out. (There are other psychiatric medications which may attack symptoms with more of a sedative/sledgehammer effect, but that's for another blogger).

  Thankfully it's been a long time since I've experienced an extreme degree of emotional flatness, which is an awful thing to go through - and at the moment I would welcome some respite from overwhelming and quite deeply felt negative emotions and reactions to everyday life. 'Fully experiencing' those negative symptoms without any intervention is not particularly helpful either - although catharsis certainly has a place in recovery, it can be a very small and specific part depending on your particular issues, and chemical intervention can also play a part. Often there's a choice between functioning in everyday life and catharsis; you can't do both, and its hard to say whether your current suffering is a helpful part of your journey or whether you are just stuck. Most of the time we need to choose 'functioning' over 'pain that might be healing in the long run', if at all possible - that's what society demands of us - so society cannot also demand that we both function in our jobs and daily lives AND magically fix ourselves, pull our socks up, think positive - all completely without drugs or help - using some spectacular strength of will - when strength of will is precisely what is lacking in the case of a depressive episode. 


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