Thomas* ’16 realized he needed to be taking antidepressants when he tried to kill himself February of last year.
He is taking a fluoxetine substitute for Prozac, which is designed to treat all types of depression and Obsessive Compulsive Disorder (OCD) primarily.
Prozac, as with all other common antidepressants, is a Selective Serotonin Reuptake Inhibitor. Serotonin is a neurotransmitter, a chemical that relays information between cells and the brain, and SSRIs increase the flow of serotonin in the brain, which is thought to help relieve the symptoms of depression.
Thomas is diagnosed with Chronic Depression or Dysthymia, different from Major Depressive Disorder, which can be diagnosed after only two weeks of extreme depressive symptoms or episodes. Dysthymia has to be diagnosed after two full years of mild, but still considerable symptoms. Dysthymia is mainly characterized by its persistence rather than its severity.
Thomas said he has seen a major difference with the introduction of medication, and can now find the strength to get out of bed and live his life. He has tried to get off medication multiple times, each with the same result.
“The few times that I’ve tried stopping, I pretty much immediately stopped caring about living,” Thomas said.
Stephen Burton, an Adjunct Professor in Psychopharmacology at Antioch University Los Angeles who practiced as a psychiatrist in the UK for 30 years before he retired from medical practice in 2010, says that it is recommended to taper off an antidepressant instead of quitting it immediately. This is to avoid a relapse of symptoms such as anxiety.
Leila* ’16 is taking three medications for three different yet interrelated conditions.
Leila is taking escitalopram, commonly marketed under the name Lexapro, for clinical anxiety, along with bupropion (Wellbutrin) for Major Depression Disorder (MDD), and alprazolam (Xanax) for major anxiety attacks.
Wellbutrin is considered an atypical antidepressant, because it is not an SSRI. It is largely considered a Norepinephrine-Dopamine Reuptake Inhibitor. NDRIs do the same thing to Norepinephrine and Dopamine as SSRIs do to Serotonin. Lexapro is an SSRI and Xanax does not have a category. It works by reducing the amount of excess activity in the brain.
One out of 20 adolescents in the United States have been diagnosed with Major Depression Disorder, according to the National Institute of Mental Health. According to the National Center for Health Statistics, 11% of Americans over 12 years old take antidepressants.
Despite these numbers, knowledge of depression and treatment options for children and adolescents is limited in comparison to knowledge of adult treatment, as shown by the recent paroxetine (Paxil) situation.
A study published by the magazine BMJ reported Paxil is not safe for teens; this was 14 years after a study saying it was. After observing its use, the new study found that Paxil actually drove people to commit more violent acts, including suicide.
While being shown to have no effect on the development of adolescent brains, there are some risks associated with taking other antidepressants. Like all medication, they can cause dry mouth, sleepiness, and headaches, but there are certain side effects specific to SSRIs including nausea, sexual dysfunction, increases in anxiety and sleep depravation. Some antidepressants can even cause sedation, which causes difficulties in being able to be present and focused.
Christina* ’17 has experienced some of these side effects. She has been taking antidepressants for five years, sertraline (Zoloft) for the first two and citalopram (Celexa) for the last three. She had to switch from Zoloft to Celexa after experiencing heightened anxiety, insomnia, and lack of appetite. These symptoms appeared suddenly during her second year of Zoloft without any explanation. She has not encountered any issues with Celexa as of yet.
Doris Iarovici, a clinical associate in the Department of Psychiatry and Behavioral Sciences at Duke University, wrote in the New York Times Wellness blog that more university level-students are taking antidepressants, and are taking them for longer. The National Center for Health Statistics also reported that usage of antidepressants from the years 1988-1994 and 2005-2008 increased by 400 percent.
“Antidepressants are an excellent treatment for depression and anxiety,” Iarovici wrote. “I’ve seen them improve — and sometimes save — many young lives. But a growing number of young adults are taking psychiatric medicines for longer and longer periods, at the very age when they are also consolidating their identities, making plans for the future and navigating adult relationships.”
Iarovici believes that there is not enough knowledge on the effects of medication to be prescribing antidepressants so much. Burton also agrees that very little research has been done on antidepressants, especially on dependency and whether or not someone can become addicted to their medication.
Katie* ’17 took Prozac for about eight weeks to treat Bulimia Nervosa. She said she was in denial that she ever needed them, and only took them after she had to go to away from home for treatment in a residential care facility.
“It took a week or two, but [the medication] eventually helped give me enough motivation, energy and clear-mindedness to focus on recovering,” Katie said.
When Katie tells certain people about her struggle, she said she notices they treat her as if she’s more fragile than she actually feels. While she was in treatment, though, she met people who had been completely shunned by members of their family for needing treatment at all.
NPR reporter Nancy Shute wrote on the NPR website in 2011 that a fear of antidepressants leads people to turn away the idea of treatment, and references the fact that some people have been turned away from receiving life insurance because they took medication in the past.
Antidepressant, I'm not eligible for any life insurance except their lowest cover which was full of terms and conditions.
— Jess McArthur (@mcjess1991) June 5, 2013
My mom’s life insurance expired so she went to renew it and they denied her because she’s on anti-depressants… That is SO ridiculous.
— Millie (@sillymillie_123) August 12, 2013
Insurance companies won't offer life insurance to those who have accessed treatment for depression, even 20 years ago. #qanda #endstigma
— Jacqui Manning (@Jacqui_Manning) October 5, 2015
Most people are just worried about having the identifier of being a psychiatric patient, according to Robert Bell, lead author of the Annals of Family Medicine study cited in the NPR article. But what they don’t know, is that primary care physicians are also trained to help treat depression and other disorders calling for antidepressants.
“I take [antidepressants] because I honestly can’t function without them,” Leila said. “It’s not about dependence or having medication as a crutch, it’s about giving me the willpower to take care of myself. Antidepressants helped me live again.”
*Names have been changed
