If you are struggling with anxiety, or have been depressed for a few weeks and visit your GP, they are likely to prescribe antidepressants. But should you take them? And is medication really what you need? In a large number of cases, I think not. Before I explain why, let me be really clear – if you are severely depressed, your mood may be so low that some of the alternatives I'm about to suggest just won't work. In that case, you may need a course of antidepressants to lift your mood enough for talking therapy, for example, to work.
If you have bipolar disorder, you will probably need to take a combination of different medications, such as a mood stabiliser and possibly antidepressants. And, crucially, if you are currently taking antidepressants you should never stop taking them without consulting your psychiatrist or GP. This can be extremely risky, so please don't do it.
That said, I do worry that many hard-pressed GPs now dole out antidepressants far too easily. I don't blame them for this – they have so little time with patients now that they are often forced into the simple solution that medication represents. They may also want to refer a patient for a talking therapy such as cognitive-behavioural therapy (CBT), but know the waiting list is so long it would not be helpful for someone who was struggling (some of my clients say they faced a 12-month wait for CBT on the NHS – an impossibly long time to wait if you're in a bad way).
One of the biggest problems with antidepressants, though, is that they only help with the symptoms of depression as long as you're taking them. When you stop, unless you have addressed the issues that made you depressed in the first place (like negative or overly self-critical thinking, or low self-esteem) you are likely to get depressed again. That's why all the evidence shows that combining antidepressants with psychotherapy is far more effective than the meds alone.
Research also shows that regular cardiovascular exercise is just as effective as antidepressants for mild to moderate depression. As is mindfulness-based cognitive therapy (MBCT), which is especially good at preventing relapses. Both are completely free, once you've learned how to do them, have no nasty side effects and work straight away, unlike the 2-6 week wait for the meds to take effect.
So I'm not saying you should never take antidepressants – far from it. Just that they are powerful drugs that don't help everyone, have strong side effects and should not be taken lightly. And – especially for milder forms of anxiety or mild to moderate depression – other approaches work just as well.
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