Antidepressants aren't a 'shortcut.' They're a lifesaver

The following article discusses mental health issues such as depression and suicide which may be sensitive for some readers.

After 17 years of taking antidepressants, I’m intimately familiar with the roller coaster of emotions that comes with taking medication for mental health issues; the fear of filling out the prescription and taking the first pill, the hope that something will ease my pain and the desperation for a refill when the withdrawals set in.

Every time I leave the pharmacy, there are pages of literature stapled to my prescription with a lengthy list of side effects, rare side effects and extremely rare side effects to look out for: weight gain, weight loss, sleep disturbances, dry mouth, decreased sex drive, dizziness, drowsiness, nausea, increased sweating, heartburn and vomiting. For some people, the possibility of what could happen would be enough to prevent them from taking them; but for me the side effects pale in comparison to the almost certain knowledge that without them, I wouldn’t be alive.

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In a recent Instagram post, Paulina Porizkova opened up about living with anxiety and depression following the death of her ex-husband, “The Cars” singer Ric Ocasek. The model revealed to her more than 128,000 followers that she and her physician agreed that her depression “needs to be processed rather than medicated.” The response to Porizkova’s admission were mixed; some people applauded the 54-year-old for her vulnerability while others questioned whether she was against the use of antidepressants in general.

The reactions prompted a clarification from Porizkova, in which she revealed she “caved” after years of “white-knuckling it” and began taking Lexapro to manage her anxiety and panic disorder.

“I am so incredibly grateful for modern medicine and that it is available when we truly need it,” she wrote. “But I also think we are an over-medicated world. Everyone would rather pop a pill than do the work.”

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Porizkova’s “dislike” for medication is well documented. In 2011, she penned an article for Huffington Post entitled “Ending a Midlife Affair with Meds.” The article detailed detailing her decision to forego antidepressants, which she explained gave her “the two most mellow years” of her life. Despite the benefits, she admitted to feeling uninspired, having a decreased libido and feeling guilty for taking medication.

“...I think that those who try to take the shortcuts- the pill to lose weight, the pill to be happy, the pill to be smart, to sleep, to be awake, are just running up their tab,” Porizkova wrote at the time. “And there may not be a pill when you’re presented with the bill. Which you will.”

I’ve learned to pick my battles when it comes to stigma associated with mental health issues out of sheer necessity. The energy it takes to feel shame or anger whenever someone says something hurtful often exceeds my emotional bandwidth. It’s self-preservation when I keep my mouth shut, take my hands off the keyboard and walk away from conversations that veer into territory about mental health that’s offensive and misguided. I wanted to ignore Porizkova’s words but I couldn’t. I felt a sense of betrayal that took me by surprise.

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I always felt that whenever someone was vulnerable enough to share their mental health struggles there would be this moment of recognition that would help lay the foundation for healing. The isolation and shame could be permeated by the simple act of acknowledging one another. I see you, you see me and we are not alone. I couldn’t understand why there was this hand extended in solidarity, only to be pulled back at the last second by the suggestion that by taking medication, I or people like me, weren’t “doing the work.”

What is “the work”? Unlike a personality trait, having “a strong work ethic” doesn’t apply to a chemical imbalance. Living with a mental illness is work. Waking up, taking care of yourself, maintaining relationships and a job, taking medication, not taking medication, meditating, going to therapy, exercising or “white-knuckling” - it’s all work.

Porizkova’s key argument against medication is the idea that we live in an “over-medicated world,” which is something that research unfortunately supports. The American Psychological Association (APA) reports that from 2001 to 2010 the number of Americans prescribed psychotropic drugs increased by 22 per cent, with approximately 1 in 5 adults currently taking at least one psychotropic medication. However, as the APA notes, most prescriptions people receive for antidepressants or mood stabilizers are given by a primary care physician instead of from a qualified mental health professional after a full psychiatric assessment. This means millions of people are receiving psychotropics before they are ever introduced or referred to a specialist, which they may not even be able to afford.

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According to the US National Institute of Mental Health (NIMH), In 2017, only 42.6% (19.8 million) of Americans living with mental health issues received treatment in 2017. The reasons are varied, however studies point to stigma (including self-stigma), access, finances and time as key barriers to seeking help. Even when treatment is received, statistics fail to communicate what type of care people receive, what kind of assessments and monitoring are involved, whether they receive an integrated treatment plan that includes therapy and psychotropics or perhaps most importantly, whether or not they benefited from the help they received.

It’s taken me nearly 20 years to get to a place where my good days out number the bad. I’m alive because I’m fortunate enough to afford medication and private therapy. I have cultivated a team of professionals who understand my medical history, and have helped safely guide me through medication changes and stressful life events. Every day that I’m still alive is because I’m doing “the work” so why is that so hard for people to understand?

In a social media world, having a large social media following means that people are watching, but it doesn’t mean they are paying attention. I’ve learned to ignore hurtful comments regarding mental health stigma and antidepressants stigma when they come from ignorance, but I’ve also learned to recognize when they are said from a place of pain — and Porizkova is in pain.

I can't judge or argue with someone who has admitted they are suffering. Porizkova is still “in it” and her admission of that should have been the only thing I paid attention to from the start. I can’t expect someone to say the right things and be an advocate for mental health care just because they have money, fame and celebrity status; but I will remind people whenever possible that having options to treatment for mental health care is the difference between life and death.

Depression seeps into every aspect of your being, including your words. It doesn’t excuse Porizkova’s insensitive comments, or take away the guilt and shame they may have caused someone else who is suffering. However it allows me to see her more clearly and recognize her pain as the pain I have felt myself. I see you, you may not see me, but you are not alone.

If you or someone you know is suffering, please contact Crisis Services Canada at 1-833-456-4566, call 911 or go to the nearest hospital.

For a full list of resources including mental health services in your area, visit the Canadian Mental Health Association.

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