Hooked on Happy Pills

‘Well I’m happy for you to stay on them…’ My GP peered thoughtfully at me over the rim of his glasses. ‘I’m also perfectly fine with you coming off them. I’ll set our review for a year’s time shall I?’

And thus passed the annual antidepressant prescription review, like so many of its predecessors, proving about as useful as a chocolate teapot – and that although it’s so very easy to start taking happy pills, getting off them is another story.

Happy pills. antidepressants, SSRI’s – whatever you call them – used to be the preserve of those teetering on the edge of psychosis. These days everyone’s on them. There’s no doubting that some people in the throes of serious clinical depression really need support from medication – and drugs like paroxetine, citalopram and zoloft provide a chemical lifeline to those nosediving into a serotonin-deprived abyss. However there seems to be a worrying trend towards over-prescription. Medication being handed out like smarties for the mildest cases of the blues – and patients consigning themselves to years of pill popping.

The NHS prescribed record numbers of antidepressants in the UK last year and a recent study by women’s campaign group Platform 51 found that nearly half of those using antidepressants have taken them for at least five years, while a quarter have used them for ten years or more. The statistics are frightening, but actually being part of these numbers scares me even more. I’m eight years and counting.

I have been on and off antidepressants three times now. Having never been able to tolerate more than the lowest possible dose of my particular brand of synaptic rocket fuel, I still have absolutely no idea if they help me at all. Literally none. However the emphatic explaining away of my anxiety, depression and fatigue symptoms with ‘serotonin deficiency’ has consistently led me back to a GP-endorsed SSRI prescription.

I do know that the first two weeks of cranium electrics, nausea, sandpaper mouth and night sweats feel like a grenade has been dropped into my soul. And that once these side effects have tapered off it’s impossible to benchmark what effect the antidepressants are really having. I’m just thankful to have survived. I’m told the ‘therapeutic benefits’ of my medication can be expected to kick in after six weeks or so – but at this point I’ve usually been working so hard at getting better through exercise, meditation, healthy diet and general avoidance of stress that any number of things could be bringing me back to wellness. Drugs have always been just one aspect of a very holistic treatment plan for me and I’ve never been sure of the part they’ve really played in my wider recovery story.

My uncertainty has always sat in stark contrast to the certainty with which medical professionals have recommended drug therapy to me. All roads lead back to chemical imbalance, it seems. That knowing nod in the GP room when it’s discovered that depression reared it’s ugly head again a year after ditching my medication, the inferred conclusion that being drug free was the chip in the metaphorical mental health windscreen that led to a whole world of shattered glass. Serotonin, you see. And my counter-argument that we’re all still utterly clueless around whether or not the pills actually help me? ‘Well they really can’t hurt…’

Except for some people it seems they can. Hurt, that is. Particularly for those on high dosage antidepressants, withdrawal can be vicious. Dizzy spells, migraines, aches and pains, insomnia. If you’ve watched Leo Di Caprio sweating and whimpering his way through heroine withdrawal in The Basketball Diaries think of SSRI comedown as a vanilla version. Pretty, it is not. Six months easily turns into six years on these pills when kicking the habit is this hard. Then there’s psychological dependency. Even if you’re not chemically hooked, mustering up the confidence to throw out the blister-pack-shaped safety net is terrifying.

At this stage I have no idea what to do and neither, it seems, does my doctor. It’s definitely the easier option to keep mindlessly slipping a small blue pill under my tongue after breakfast everyday. But time’s marching on and with it the ever decreasing likelihood of a chemically unaltered future. Do I really want to remain a slave to lab-manufactured serotonin? Can I put up with the tedium and inconvenience of monthly trips to the pharmacy coupled with the expense of prescription charges? It’s a sensitive subject – a decision worthy of careful, contemplative thought with due consideration for what support might be needed further down the road – and it’s going to take more than ‘come back and see me in a year’ to get there.


Antidepressants – why yours is the only vote that counts


My last GP appointment went something like this:


Me: ‘So…you asked me to come in for a review. To be honest I’m not really sure if the antidepressants do anything positive for me. There’s really no way of knowing… I’m pretty aware of all the side effects though.’

GP: ‘How do you feel?’

Me: ‘OK I guess. Pretty tired but getting on with things. I get stomach trouble, hypoglycemia and a lot of weirdness going on with my vision though…’

GP: ‘Those seem like reasonable side effects,’

Me: Awkward silence.

GP: ‘I think stay on them’. *writes prescription* ‘I’ve set your next review for January…’
January 2016.


Yep, just keep taking the pills and come back IN A YEAR.

It was at this point that I finally, truly realised, once and for all, that when it comes to making decisions about happy pills I really am on my own. My various doctors have always been very happy to dish out SSRI prescriptions for me, but I’ve generally been met with a wall of silence when it comes to proffering an opinion on whether or not they may be doing any good.

I get it. Coming off medication always presents risks – one of which being the patient slipping back into poor mental health and ending up at the bottom of a river. An extremely unlikely scenario for sure, but still one which must weigh heavily on the conscience of any medical professional dealing with those sick with depression. I can see why it’s easier to just keep writing prescriptions – and perhaps that’s why antidepressant use is sky-rocketing in this country.

In England more than 50 million prescriptions for antidepressants were issued in 2013 – in Blackpool the problem deepens with a staggering one adult in every six snapping up a prescription for these pills each month. They’re everywhere. If you don’t know at least one person within your social circle that takes some form of antidepressant medication regularly, I’d be very surprised.

When you’ve fallen down a mental illness hole you’re desperate. You need solid advice, guidance, empathy and compassion. These are things I’ve always been lucky enough to receive from doctors when I’ve been depressed or anxious. In desperate, vulnerable times I have clung to the medical profession as an anchor of hope, and it’s got me through.

But what about that slippery, grey area that emerges a bit further down the road – when you’re well into recovery mode and you need to make some decisions about how to sensibly move forward with your health? When you begin to feel whole again, should you keep on popping the pills or try to wean yourself off and go it alone?

You’d think that determining whether something you put in your body every day actually makes you feel better or not would be a relatively simple task. Somehow, it’s really not.

Ultimately you’re the only one that can figure it all out. Doctors, friends, family, lovers and pet aardvarks can all offer their opinions but no-one can actually climb inside your brain and ascertain what you really need. The only person that can decide if you’re strong enough to make some changes to your treatment plan, might benefit from a break from chemical intervention or can’t put up with unwanted side effects any longer, is you.

Some will caution against cutting back on antidepressants too soon – that you’ll erase all the good work they’ve done and could fall back down the hole. It’s a reasonable worry to have. But there are arguments against staying on these types of medications long-term too – such as psychological dependence and harm to your baby during pregnancy. They’ve even been linked to type 2 diabetes.

There’s a lot of conflicting information at our fingertips when it comes to antidepressants and not a lot of help to make sense of it. Sometimes you just have to go with your gut – and that’s not just a pun on the delightful array of gastrological symptoms that can arise from SSRI use.

I will stress (here comes the disclaimer, kids) that you should NEVER stop taking antidepressants without consulting your doctor, and if you do decide you want to come off them you need to do it gradually. Stopping these sorts of pills cold turkey is dangerous, not to mention all kinds of unpleasant. Withdrawal is not something you want to mess with, believe me.

We’re all special, different, unique little creatures – and we all respond differently to things like antidepressants. For some they can be literally lifesavers – life enhancing wonder-drugs that beat the black dog back from their door. For others like me it call all be a bit, well, ‘meh’.

That’s not to say that just because I can’t seem to see palpable changes to my health, that the drugs don’t work. I’ve been on a gradual upwards gradient over the last year and perhaps antidepressant use has played a role in that. For now I’m not planning any drastic changes – but I don’t plan to stop asking these sort of questions any time soon either.