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Thursday 21 November 2013 07.00 GMT
The Guardian asked readers of five newspapers in the UK, Germany, France, Spain and Italy to talk about being on antidepressants. There were more than 3,000 responses.
Elsie, from Belgium, was prescribed Effexor, among others: ‘I got all the side-effects except the one that I needed, namely sleep.’
Some said they were a lifesaver; others dismissed them as unremarkable; still others said they just made things worse.
When the Guardian asked readers of five European newspapers to share their experiences of antidepressants for our series, we were unsure what we’d get. More than 3,000 responses later, the feedback from the UK, Germany, France, Spain and Italy was illuminating and moving.
And although statistically it is hard to draw conclusions from such a self-selecting group of Europeans, the overwhelming sense was that respondents felt that antidepressants had helped them – particularly when twinned with some kind of talking therapy. A smaller but not insignificant number of respondents reported no effect at all with others describing very negative experiences.
If there’s one thing we can be certain of from our survey it’s that people are keen to share their story, but on the condition that we didn’t reveal their identity.
Megan described how after seeking help from her childhood doctor, the antidepressant fluoxetine “gave a break from the relentless and oppressive darkness. It didn’t make me happy, it gave me perspective, which was the most valuable thing I could have had. I’d previously suffered lows, but this one was different. I was miserable in my job and working for a horrible boss and just couldn’t climb out as I had previously. My mum has suffered with anxiety and depression and it was a call with her, in the middle of the day, in public that I burst into tears and asked how she knew she was ill.”
Lou also described her positive experience of taking citalopram after being diagnosed with depression and body dysmorphic disorder. “I was offered cognitive behavioural therapy, but didn’t think it would help me. I was astounded that something so small and innocuous as a little white tablet could affect me so much. I felt like a new person. I finally felt like myself again; although it’s a cliche, I genuinely felt like a cloud had been lifted.
“I still have what I call ‘wobbles’, but only once every four or five months. Since I have been taking medication, people comment on how much happier, calmer and more confident I am. I have stopped self-harming, I no longer miss work or university due to depression, and I can get to sleep easily at night. I honestly think I would be dead if it hadn’t been for antidepressants.”
But Lou realises that she was incredibly lucky to have had such a positive reaction: “I know several people who have been prescribed antidepressants and have suffered very negative side-effects. I was also lucky that the first one I was prescribed worked so well for me, and that I didn’t have to endure months of trial and error with other drugs.”
“I can’t imagine why doctors don’t try patients on different brands more regularly,” said Andrew who tried two types of antidepressant before finding relief in fluoxetine. “With citalopram there was no difference whatsoever and I stayed on them for two years at the maximum dose. The doctor convinced me I’d feel worse off them, but I didn’t. I found some stabilisation of mood with escitalopram but fluoxetine was absolutely life-changing. I wish I didn’t have to take them, but I know they stop me spiralling into a low. ”
Andrea, who lives in Germany, was one of those who had a very negative reaction to Effexor, which he started to take after suffering a breakdown. “I sought out therapy on my own, but I felt the medication wasn’t good for me. My dosage was eventually upped to 300mg. But the side-effects were severe. They eased the depression, but only for a time. I experienced profuse sweating, restless legs, tremors, forgetting words, a weird chill rushing up my legs, back and arms, dizziness, and more. I gained over 20kg in a year, which has devastated my self-esteem. I am jogging to try to lose the weight, but the medication has changed my metabolism, it seems. None of my clothes fit, and I refuse to buy a new wardrobe. I am free of medication now, but it feels like it will be many months until my body recovers. I feel damaged, to tell the truth.”
Like Andrea, a significant percentage of people described how access to talking therapies had aided their recovery. Some 51% of respondents in Germany, the highest percentage of the six countries surveyed, said they were offered alternative therapies. But in Spain just 34% reported that they were offered alternative treatments with 35% in France, 45% in the UK and 50% in Italy.
Jon believes that the 20mg of fluoxetine that he took for four years helped him to benefit from therapy. “They helped me to a sense of reality. In other words, they prevented me from getting too negative when talking about really sensitive childhood abuse. Initially antidepressants took control of the really low emotions and prevented them getting the better of me. From my experience, I would never suggest someone takes them without considerable therapeutic support.”
Diagnosed with clinical depression after a stressful period with work and private life, Emma was not directly offered counselling but was happy to be prescribed antidepressants. “I do think that talking therapies have a massive part to play in recovering from depression and encouraging positive mental health. When I encountered another period of low mood, I actively sought cognitive behavioural therapy before it got to the point where I felt I would need medication. I wouldn’t hesitate to take medication in the future if I felt I needed to, but would also try to address things with talking therapies.”
Katie was offered a combination of medication and therapy but initially chose just medication for the first few months as she felt unable to undertake therapy. “One thing I have experienced is that people assume that doctors just prescribe antidepressants without looking into alternatives. I’ve not found that to be the case at all during my experiences with the NHS. Doctors are trying their best to help a set of complicated illnesses, and there’s a huge amount of variation between how these illnesses affect different people. I chose antidepressants initially, because I felt that was the best option, but I felt in no way pressurised into making that decision.”
But there were reports of long waiting lists for cognitive behavioural therapy on the NHS in the UK, as Siobhan experienced, yet she was lucky enough to secure a short course of counselling sessions through her university. But this she says was only moderately helpful and may not have worked without the help of antidepressants “providing the necessary chemical jolt and support to get you back to a position where you can really address the root causes of your problems. They are not a long-term solution however, and GPs need to be mindful of such.”
Anabelle from France was also prescribed medication as “more of an ‘as well as’ than an alternative”. After three months, she decided to stop the prescription – 20mg of paroxetine. “It was helping a lot with the depression, but not with the anxiety. I felt like I had more energy, was more sociable, and had more motivation to do things. I felt an obvious lift in mood. But at times it felt like I had too much energy, and I felt very hyper. I was agitated, felt a constant need to move, and very anxious. At its worst it was difficult to hold a thought for more than a few seconds, and I felt almost paralysed in fear. Although this never lasted for more than a few days at a time, the last time this happened was so frightening that I decided to stop taking it.”
But that didn’t stop the negative side effects. “For about two weeks, I felt almost constantly dizzy. Every time I moved my eyes from side to side, I could hear a loud whooshing sound. I’ve never experienced dizziness to that degree before, and it would put me off of taking paroxetine in the future, even at a lower dose. There were a few moments when I thought about starting it again, just to get rid of the horrendous dizziness. I’d say they helped me, but not without consequences. I would consider taking a different type of antidepressants again to get me out of a severe depression, but I think talking therapies are better for the long term.”
John, who grew up in Germany, believes that neither medication nor therapy helped him but a change in circumstance. “I experienced high levels of social withdrawal at school and high levels of anxiety. I refused to attend school and was brought to the doctor by my parents. I was prescribed antidepressants by a psychiatrist with approximately 12 sessions of cognitive behavioural therapy. After three months, I felt much better with lower levels of depression and anxiety but I had extreme dizziness when standing up, ‘electric shock’ sensations going through my head when I moved it suddenly, and within the first week my mood worsened severely. I experienced very dark and disturbing thoughts, which had never been an aspect of my depression previously. I feel my progress had little to do with the prescribed antidepressants and was more the result of attending school again and feeling more self-assured.”
We received stories from people who feel they were given antidepressants unnecessarily. Elsie, from Belgium, visited her doctor in 2007 as she was unable to sleep. Her doctor prescribed trazodone, Lerivon, Remeron and Effexor over a period of time. “I was told I suffered from depression because I couldn’t sleep and that I needed to be drugged to get better. On top of the antidepressants, I was also given seven different benzodiazepines and four antipsychotics, usually in cocktails of two to four pills. I got all the side-effects except the one that I needed, namely sleep. I was constantly switched, lowered, raised and multiple times taken off all meds at once. I had pain everywhere, [an] endless list of physical and psychological symptoms that I most certainly did not have before being drugged. It was the worst experience of my life.”
People’s experiences of taking antidepressants vary from positive to extremely negative, and it’s hard to say who will and who won’t find them helpful.
But what is certain is that the use of antidepressants is on the rise with prescriptions in some countries having more than doubled in the last decade. Around one in 10 European adults are estimated to have taken pills, and in England alone more than 50 million antidepressant prescriptions were issued last year.