Nigel 
July 8th,2009Wouldn’t it be great if whatever the ailment you just went to your family doctor and were prescribed some medicine which fixed it? Fortunately life and the human body aren’t that simple. I wonder what kind of creatures we’d be if it were that easy,if we had to make minimal effort ourselves. In childhood in order to grow we need to experience some risk,pain,trauma,disappointment,rejection. In adult life we need reminding of our own responsibilities to ourselves,and of our vulnerability to so many things.
With depression there is no magic pill,although occasionally it might feel like that. I haven’t felt as good since I was 14 as when a few years ago I switched from one antidepressant to another. The new one was like someone injecting sunshine and energy into me. The effect reduced over a few months,but I still recapture it most years if only for a while. Medication comes with limitations,and it can be useful to understand this. Here are some potential limitations of any anti-depressant:
- Medicines are being improved year by year. Occasionally there’s a major breakthrough such as when the first SSRI was discovered. SSRI? I’ll explain that in a later article,but if I say Prozac you’ll probably understand. It was a new way to try tackling depression. It was called the sunshine drug. It has proved to be the best so far for me (but it is not right for everyone –follow professional advice. Under no circumstances try buying it over the internet;the risk is too great).I had to wait thirty years for Prozac. My father wasn’t so lucky;they invented it too late.
My point is that the drug you really need may not yet have been invented. - Teenagers (and cats) do not respond to antidepressants in the same way as adult humans. The medicine may be totally ineffective. I’ve heard there can be odd and potentially dangerous side effects. Teenage depression is different from adult depression,and if serious it needs expert professional help. (See Myth 3 coming soon.) And cats? Before vets in this country were so tied up in red tape our cat was prescribed a mild tranquiliser. As predicted it had no discernible tranquilising effect,but did restore his appetite. Creepy.
It may be hard or impossible to identify a suitable antidepressant for a teenager,so other methods are needed. - Two people with identical depressive symptoms can react quite differently to the same medication. There are so many factors to be considered,and some are very well hidden. Psychiatrists are not magicians. Sometimes they need to try you on something for a while. It feels absurd,but a bit of supervised trial and error may be necessary. And then,of course,there may be no medicine on the market yet that helps you. Chill. There are other therapies available.
- All medicines have side effects. Check out the information leaflet in any pack of medicine in the UK and you’ll see a frightening list of possibilities. Relax,you are very unlikely to get most of them. With luck you may not experience any of them. The list is there in case,so my approach is to not read it unless something changes after I start taking the medicine. If there’s anything dangerous to watch out for your doctor will have told you. The exception to this is anything fairly new on the market. In the eighties my consultant put me on something only recently approved for use. It was fantastic,although a little too much so. I was a bit high for about a month till he contacted me to tell me to stop the tablets and come back in to see him;apparently around the world too many people on that drug had died. Ah well. Another medicine I tried for six years took away most of the taste of food,made steak taste like cardboard,and often made me nauseous. If it had worked then fine,but it didn’t.
- Some antidepressants tend to make people a bit drowsy. I was on one for a couple of years. The morning after I first took it I slept through the alarm and woke up after lunchtime feeling like a mule had kicked me in the head. To be honest it never really helped me. Initially I had difficulty concentrating enough to read more than a couple of pages of even an easy novel. Textbooks? Forget it. I loosely estimated my IQ dropped at least thirty points for the two years. This is okay for some people provided the depression is eased significantly in the process,but whenever I can’t think clearly or read extensively I start to feel down and the depression gets worse. For me the result is that the dopiness caused by the tablets actually makes me feel in some ways more depressed. According to the textbook this should have been the best drug for me,but in fact it wasn’t.
- An antidepressant may help you through an extended bad spell,but it can only ever treat your body and brain chemistry. This may be enough. For you sake I hope so, but no chemical can resolve underlying issues. It can’t sort out destructive childhood memories. It can’t teach you how to socialise –although it may make you feel well enough to experiment in social situations. It doesn’t provide problem solving skills.
- The good effects may not last. Maybe you’ll need to go back to a less helpful medicine for a year or two and then return to the best one. That’s life. Let’s enjoy it as much as possible,and benefit as many other people as we can.
