Why I’m not ‘brave’ for coming off antidepressants
There’s no right or wrong way to do mental illness
Somebody recently complimented me on my decision to come off my antidepressants. They said it was ‘brave’.
This made me uncomfortable.
Was I not ‘brave’ before? Does that mean if I wasn’t brave while I was on medication, I was weak? Was I weak for taking it? Weak for not being able to cope without it (because for a while, I really couldn’t)?
Had I been doing my mental illness wrong? And what of thousands of others who have taken or are taking medication? Are they doing it wrong too?
There’s a raft of bloggers and even therapists out there telling them they are. Take this, from psychiatrist Kelly Brogan’s blog, written by a patient (who she commissioned, incidentally to write this piece — get your heads around the ethics of that). The author talks about the “Herculean effort” required to do her kundalini, Qi Gong, and meditation practices, which is contrasted with the poor choice her brother in law, who finally took his own life, made in taking psychiatric medications. He “chose medication over exploration” apparently. Another one who wasn’t ‘brave’ enough.
The author was roundly criticised in the writers’ group where she shared this for its shaming language, but she refused to engage in any dialogue, except to defend her stance and reply to the lone supportive poster with heart emojis.
One of the criticisms made of this and other blogs that I have seen lauding the natural approach to treating not just depression, but other mental illnesses as well, is that they show little to no awareness of how eye-wateringly expensive it is to afford the treatments, which are not available on the NHS, or on Medicare or Medicaid in the US, or similar schemes elsewhere. The special diets (gluten free, dairy free, organic…), the supplements (which of course you can’t just get from Holland and Barrett, they have to be super-high-concentrated-organic-biodynamic-harvested-in-the-right-phase-of-the-moon supplements), the yoga classes (aside from one studio here in Leeds, UK, that does one or two pay-as-you-feel sessions per week, expect to part with £5–15 per class or around £40–60 per month for a studio membership — and the general yoga class at your local leisure centre won’t do either, it MUST be some obscure, exclusive version), you must learn meditation and various other Oriental arts of relaxation and mind control, oh and don’t forget your weekly sessions with a private, medication-eschewing therapist.
So, if you can’t afford even a fraction of this and your only recourse to treatment for your mental health is through the NHS or your woefully inadequate basic health insurance, where does that leave you?
It leaves you and your un-Herculean ass slinking out of the doctor’s surgery with a prescription for psychiatric medication, that’s where it leaves you.
The day I got my prescription, I didn’t have any Herculean effort left in me. I didn’t want to take them. It wasn’t an ‘easy way out’ — I was afraid of the side effects, I was afraid of becoming dependent on them, I was afraid of the stigma I might face for taking them. But I couldn’t afford to keep taking time off work and lose my job. You try getting any sort of benefits here with a mental health condition — if they’re finding chronically and terminally ill people fit to work, what hope do you have if you have a mental illness that people cannot see or experience for themselves? When even the Daily Mail reports on the failure of the Work Capability Assessments, you know it’s bad. I had neither the time nor the money to engage in a “journey of self-love” at that time. It seems that “self-love” is only a luxury afforded to rich white women who can afford to take the time off work for “obsessively Google mapping their childhood neighbourhood” as part of their recovery.
It might sound like I’m picking on this author in particular, (and I will admit it is true that the sanctimonious tone of this piece particularly irritated me) but the real culprit here, of course, is the system. The mental health system more than any other part of the healthcare system is very much two-tier, because of the lingering stigma that still affects how people with mental health issues are seen by clinicians. This is also compounded when you consider other issues such as race (Black people are more likely to be sectioned and more likely to be forcibly medicated) gender (women are often treated as ‘hysterical’, men as violent) and sexuality (1/10 health and social care professionals report that they have heard colleagues saying they believe people can be ‘cured’ of homosexuality, according to charity Stonewall). It is not uncommon for those who try to stay off medication to be judged by professionals for being ‘stubborn’ and not helping themselves. For a single parent on a low income struggling with a mental health issue, you can see the implications it might have if they choose not to take the professional advice and continue to have difficulty meeting family and household obligations.
My reasons for coming off antidepressants wouldn’t even make it onto the ‘brave’ list — it’s purely down to the fact that the negative side effects started to outweigh the benefits. My weight had ballooned, particularly around the stomach, and I was struggling to lose any of it. I craved carbs and sugar, all the time. The depression may have lifted, but in its place came frightening anxiety. A heart rhythm disturbance (Long QT syndrome, which is associated with psychiatric medication, particularly when used long term) has affected my ability to exercise and thus lose the weight. My decision to come off the medication has really only been made because staying on them had begun to feel like a worse option than white-knuckling my way through withdrawal, as I am doing at the moment. There was no ideological reason, I’m not embarking upon a spiritual quest, and as for self-love, well I’m finding that pretty hard when I’m looking in the mirror every day and seeing myself two stone heavier and with bloating so bad from the withdrawal (serotonin affects your gut as well as your brain — be warned!) that I look several months pregnant.
It would be easy for me now, in the midst of a difficult withdrawal process, to say that I wish I’d never gone on them in the first place. Despite working in the survivor movement and using a humanistic, non-medical model approach in my work, I refuse to entirely condemn psychiatric medication or those who use it, as it seems fashionable in some corners of the movement to do. I am not, however, ignorant to the serious side effects and downsides of medication and how overprescribed it is, often at higher doses than necessary, and the fact that the system often blocks access to alternatives due to cost, prejudice, belief in their efficacy, or a mixture of all three. The fact is though, for me medication served a purpose — and my journey while I was on it is of no less value than my journey now I’m not. The ‘jagged little pills’ gave me enough emotional and mental stability to cope for a few years with being in a very difficult place. They may have also helped to preserve my support structures — partner, family, friends — simply because they did take the edge off the worst of my symptoms, which gave them a break as well as me.
I have never met a single person, either in my personal life or in my mental health work, who went to the doctor’s office actively looking for a prescription for psych meds. What we go there looking for is help and support, which is pretty brave to seek out in the first place, and if that’s the only thing available to us, then why wouldn’t we take it? Medication has to be (where there is even a genuine choice about it) a personal decision. When we herald people who choose not to take it as ‘brave’ we implicitly tell others they were weak for making what might have been the only choice available to them that might have some hope of at least limiting the severity of their illness and helping them to function. ‘Bravery’, for so many of us, is simply doing what we need to do to survive another day.
I write about mental health on an open platform to help fellow survivors, inform professionals, and challenge stigma.
