MENTAL HEALTH IS COMPLICATED.
Today, I was blocked on social media by someone who had been a friend. The reason? News had emerged that an antidepressant may be taken off the Pharmaceutical Benefits Scheme. This former friend claimed that antidepressants shouldn’t be used. This former friend also claimed that if you need medicine to stay alive, that you shouldn’t be alive. Also, that I was kicking psychologists to the curb.
Let’s take the second point first. A Type One Diabetic needs insulin to stay alive because their pancreas doesn’t produce any. The result of going without? Coma and death. A person has a heart attack and they have an a coronary angioplasty and upon their discharge from hospital, they are given a blood pressure medication or two, a statin and an anti-coagulant, which may be a low-dose aspirin. So, an anti-coagulant helps stop clots from forming and blocking an artery. Similarly, if a person needs a heart valve replacement, they will need to take anti-coagulants, especially if the valve is mechanical. And a transplant patient needs to take anti-rejection drugs. So, if you wouldn’t tell a diabetic not to use their insulin, why would you, unless you are ableist, tell someone not to take antidepressant medication?
Whether or not a person should be taking antidepressants has multiple facets. Just like you might be taking a certain medication off-label (for example, an alpha blocker can be used to lower blood pressure, but it can also be used to treat a benign enlarged prostate in a man), not everyone who takes an antidepressant is taking it for depression. They can be used for certain types of pain at lower does than can be used for depression.
And, yes, psychologists can’t prescribe antidepressants, but whether or not a person should take antidepressants needs to be broken down. Okay, a person shouldn’t go to the doctor and say, “Oh, I’m feeling a bit sad, Doc.” And the doctor reaches for their prescription pad and says, “Here, take this pill, and you’ll be dancing and singing in two weeks.” Sometimes, as I alluded to above, if a person is going to be put on a course of treatment that is likely to make them feel depressed, for example, interferon, the doctor may say, “Okay, I want to put you on antidepressants for two weeks and make sure you’re stable before I start you on interferon.” And, to establish whether or not the person is unipolar or bipolar, they need to be taken under supervision. If a person is bipolar, and only sees a doctor when they’re depressed, a doctor might prescribe an SSRI and sends them into mania.
Psychologists have a role to play in mental health for certain, as do antidepressants and as do lifestyle changes. Nobody, least of all me, is kicking psychologists to the curb. But antidepressants need to be prescribed by a doctor and a good GP works with the psychologist not against them. And, also, nobody who is depressed should sequester themselves away on a solitary quest to find answers, they may need to take some time out, and they may be encouraged to read, but they should be discussing what they read and what they learned with their psychologist, not claiming to have an undeniable truth that nobody else has backed.