I often read about people who say coming off antidepressants was the best thing they ever did, but mental health conditions are deeply personal, and the treatment that works for one person won’t necessarily help another. It has taken some trial and error to find the right combination for me – the worst drug, mirtazapine, caused a nine-day migraine, yet my friend takes it every day with no ill effects. The BBC report also discusses withdrawal effects from these medications. Slowly reducing the dosage, known as tapering, should always be done under supervision of your GP or psychiatrist. It’s important to remember that withdrawal symptoms are by no means exclusive to antidepressants, yet we rarely hear about the side effects for patients on other prescription drugs. When switching medications I had some slight symptoms, like insomnia when coming off a pill called quetiapine with a sedative effect, but nothing that lasted longer than a few days.
Talking therapy is another part of a treatment plan for many mental health conditions, but it isn’t easily available. NHS provision of talking therapy can be patchy and often limited to a strict number of sessions (typically 6-12). There’s certainly a demand for these services; NHS England handled 1.24 million patients for its IAPT programme in 2021-22, an increase of 21.5% on the previous year. In Scotland, the Scottish Government has a standard that 90% of people needing psychological therapies should start them within 18 weeks, but more than four months is still an incredible delay if you’re depressed or anxious; in Wales, a report by Mind found that some people had been waiting two years for talking therapy. It’s also worth noting that each therapist has their own approach, and you might not gel with the person you’re assigned, or the type of talking therapy they offer – for example, I found it impossible to work with a counsellor who used the Freudian method of sitting in silence and waiting for me to speak. Equally, talking isn’t for everyone, as the Princess of Wales said when she visited an arts therapy charity earlier this year.
What’s more, private talking therapy is an extra burden during a cost-of-living crisis (and, unsurprisingly, the ONS found that rates of depression are higher among renters than owners, and those who struggle to afford energy bills or housing costs). If you’re facing private therapy bills, it’s worth looking for counsellors or therapists that offer subsidised rates. Because of this gap in care, it’s unrealistic to expect long-term antidepressant use to decrease – many of us need more support right now, not less, and medication provides that. I’ve tried several different talking therapies over the years, from counselling to Cognitive Behavioural Therapy (CBT) in groups and individually. I’ve also tried mindfulness, meditation and art therapy, with mixed results; my best combination has been CBT, peer support and yoga, with medication enhancing it all. If you know someone who takes an antidepressant long-term, be proud of them for managing their health. They need your support.
Samaritans volunteers are there – day or night, 365 days a year. Whoever you are and whatever you’re facing, they won’t judge you or tell you what to do. They’ll listen so you don’t have to face it alone. Call free, day or night, on 116 123, email jo@samaritans.org or visit samaritans.org.