Antidepressants; a GP ponders the urban myths…

I’m writing this blog purely as a GP who, every day, sees patients who take antidepressants. So these are my thoughts, based on experience, as well as evidence.

I also see patients every day who should consider taking antidepressants, because they clearly have all the signs and symptoms of significant clinical depression, anxiety, obsessive compulsive disorder or social phobia. Up to one in three of my consultations is for a mental health problem, and I suspect most of these people have finally come to see a doctor because they have reached a crisis point, or no longer know how to cope. They do not come lightly, and I understand that. They will often have already tried sensible measures, though we usually discuss those anyway, such as minimising alcohol or drug use, better sleep and eating routines, and exercise.

I always suggest counselling or other talking therapies, though again, many have had unsuccessful experiences of these. I will probably mention giving them another go…a different approach or technique perhaps?

But finally we come to medication, always approaching the subject gently, knowing that everyone comes with preconceptions and concerns.

“But they’re addictive”

“I don’t want to feel like a failure, needing medication”

“They’ll make me fat”

“They’ll make my acne worse”

“My parents won’t approve”

“I’ll be on them forever”

 

I have heard all of these, and many more, hundreds of times in the 15 years I’ve been a GP.

And it takes time and patience to pick my way through the concerns, which are mainly based on hearsay/myth (especially because they are NOT addictive or dependency inducing, and only one specific antidepressant is classically associated with possible weight gain. They have no effect on acne!).

 

But it’s worth the time, and listening to the concerns, because often a patient will then agree that it might be worth ‘giving them a go’, and that there is little to lose by trying them. Side effects are usually minimal for most people, especially if started at a half or low dose, and we always like to review how things are going at 2-3 weeks. And then when they have given them a go, and they return 4-6 weeks later, I have lost count of the number of people, but it is the vast majority, who have noticed an improvement, and as time goes on, at 8-12 weeks, say “I wish I’d tried these sooner”.

 

So all I would say is this; if you’re struggling and unsure about medication, then talk to a GP, sooner rather than later, and discuss your concerns, so we can see if antidepressants might help you too. And if they’re not right for you, we will still support you, and meet with you, to discuss other options and therapies.

You are not alone, and we are here to help.