A new study has shown patients prescribed anti-depressants are ambivalent about them even if they work as part of their treatment because of social stigmas attached to the prescribed drugs.
The study conducted by Monash University and the University of Westminster compared data on 103 patient experiences of anti-depressants in the UK and Australia.
It found that before people take their first antidepressant they can be influenced by the controversial publicity surrounding the medication -- including the opinions of friends and relatives and fears of addiction.
Antidepressants are not known to be physically addictive, however discontinuation can bring on distressing symptoms.
The University of Westminster’s Professor Damien Ridge said it was particularly concerning that people experiencing severe depression think twice about using the potentially life-saving treatment.
“People experiencing depression – no matter how positive about antidepressants – are still forced to engage at some level with a range of underlying moral concerns about antidepressants,” he said.
— Monash Public Health (@Monash_SPHPM) October 16, 2015
A UK man in interviewed for one of the studies described his relationship with his medication as feeling "sordid...my dirty little habit, a dirty little stash".
The research also showed a number of patients remained defiant about taking the prescribed drugs, with one describing it as "a bit like Berocca, it’s you on a good day", while another said, "I challenge anyone to live my life… without antidepressants".
Monash University’s Associate Professor Renata Kokanovic said some of the study’s subjects -- collected from three data sets in the UK and Australia -- expressed ambivalence in their relationship with anti-depressants, even when they experienced them as being helpful.
“There is still a lot of stigma attached to the use of anti-depressants,” Prof Kokanovic told The Huffington Post Australia.
“Particularly in relation (to) people (feeling) judged, as not being able to cope or not being strong enough to cope with life's challenges.”
While increased media attention on depression in recent years has allowed more open discussion about it, people are still not keen for those outside their immediate circle or family to know about their mental illness.
Prof. Kokanovic said a social debate is needed about the potential root causes of depression -- such as the impacts of working long hours on our social networks, or being in fear of losing your job or professional status.
“I don’t think there is enough out there to really reflect on the way contemporary life is lived,” she said.
“As a society we don’t really have that broader debate on depression as a response to problems in everyday life.”
While doctors will usually tell their patients that it can take many weeks for antidepressants to work, the study found some of the participants believed they were feeling the effects -- and even high -- after only a few hours or days.
“Careful explaining, considering all the positives and also all potential side effects, should be carefully described,” Prof. Kakonovic said.
“People feel those discussions should be revisited and those concerns addressed and people should have access to continuous contact with health professionals.”
It’s a view shared by the Royal Australian and New Zealand College of Psychiatrists.
RANZCP President Professor Malcolm Hopwood said anti-depressants are an important part of treatment for moderate to severe depression, and they sit along-side treatments such as psychotherapy as well as social and physical well-being.
He said the college was aware the use of anti-depressants is hotly debated -- but it should be a logical debate.
“We acknowledge that they are often shrouded in some mystery and some anxiety for some people in the public,” he said.
“Currently available anti-depressants are generally safe, but are not side-effect free for everyone -- so they need to be used in an informed, logical manner and their use reviewed regularly.”
He said it is important any prescription is followed by a clear discussion about the risks versus benefits of any treatment, including medication; and that conversation should include the risks of not taking treatment.