Social Media Lies to You About Antidepressants

A little over a year ago, when I made the decision to switch to antidepressants, the social media landscape seemed very different—largely sympathetic to the pandemic-exacerbated mental health struggles. It seems incredible to write this, given the amount of misinformation and sarcasm being circulated online today about antidepressants. But this is the internet, a place where debunking disinformation is like playing kill the mole.

Such widespread misinformation is highly counterproductive for people who are struggling with their mental health and may be considering taking psychiatric drugs. When you’re experiencing debilitating symptoms – I barely ate, cried every day, and could barely get out of bed – one of your first impulses will probably be to do a Google search on the subject or check out what people are saying on social media. MASS MEDIA. I know what I did. At that time, I had found enough information to determine that medication was a good solution for me, although I still had many questions. On Twitter, I found compassion by meeting people who experienced similar symptoms and were brave enough to share their own journeys and decisions. Looking back, these tweets are the extra push I needed to talk to my doctor.

Since then, the online landscape has changed under the influence of alternative medicine gurus, tech billionaires, right-wing experts and conspiracy theorists. While good information about antidepressants and psychiatric drugs can be found, separating it from myths and misinformation is becoming increasingly difficult.

On social media, people are still speaking out and sharing their stories about depression and medication, but they are being silenced by powerful Republicans like Fox’s Tucker Carlson and Georgia Rep. Marjorie Taylor Green, who have gone so far as to blame the mass shootings . on antidepressants, despite the lack of evidence linking the drugs to such violence.

Jonathan Stea, a clinical psychologist and associate professor at the University of Calgary, told Lifehacker that social media is filled with misinformation about antidepressants, other psychiatric drugs and mental illness. He is one of many in the medical community seeking to debunk the current anti-psychiatric propaganda that is part of a decades-old movement.

“Anti-psychiatric propaganda is harmful: it stigmatizes people suffering from mental illness and is aimed at deterring them from seeking treatment,” Stea said. “He does this by using rhetoric and inaccurate statements that essentially deny the existence of mental illness and raise fear about the dangers of psychiatric drugs. That is why it is so important to promote mental health literacy in the population to guard against such misinformation.”

Lifehacker spoke with Stea and Dr. Jesse Gold, a psychiatrist and assistant professor of psychiatry at Washington University School of Medicine in St. Louis, to demystify antidepressants and highlight the facts about them. We also spoke with Dr. Tyler Black, a psychiatrist and clinical assistant professor of psychiatry at the University of British Columbia, about questions people considering antidepressants should ask themselves before they make a decision.

Depression is complex. Trust me, I know. However, people who go through this already have enough on their plates and don’t need to stress false myths about their current or future treatment options. We hope this guide can give you some answers and some degree of comfort. If you still have questions after reading, do not hesitate to contact your doctor.

Fact: There are different types of antidepressants.

When talking about antidepressants, many often do not mention that there is more than one type of drug. In fact, as Black explains, there are many types of antidepressants, and doctors even see different reactions to the same types. While the “pantheon” of antidepressants can be classified in many ways, Black said doctors pharmacologically classify them based on their action at the neurotransmitter level.

For example, in the case of selective serotonin reuptake inhibitors (SSRIs) such as Prozac or Zoloft—one of the most commonly prescribed antidepressants—Black claims they have a negative effect on the SERT receptor in the brain, which changes the way nerve cells work. serotonin process. Serotonin, also known as the “feel good chemical,” is a neurotransmitter that plays a role in mood regulation.

Gold notes that SSRIs work for many people and are often used as first-line medications because of their tolerability. But, she adds, they don’t work for everyone, which is why psychiatrists also prescribe serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants , and monoamine oxidase inhibitors (MAOIs), among others.

“We often choose drugs for people based on things like beneficial side effects or additional uses,” Gold tells Lifehacker, pointing out that drugs like Wellbutrin, officially known as bupropion , can reduce appetite, which is a good thing. an option when people have depression that causes them to overeat. “Medications in psychiatry, as unsuccessful as they may be for patients, are often trial and error,” Gold said. “What may work for one person may not work for another, and we will work together to find what works — the one that relieves symptoms with the fewest side effects. It’s a frustrating process and I wish it was more accurate to be honest, but maybe it will be as we understand more in the future.”

Myth: Antidepressants will change your personality.

Some people wonder if antidepressants will change their personality. I have been to this camp. Even when I knew that antidepressants would be of great benefit, I was afraid that I would lose part of myself in the process. As it turned out, this fear was overestimated, which my psychologist and psychiatrist gently explained to me when I expressed my concerns. Stee agrees, explaining that antidepressants can help manage symptoms of depressive and anxiety disorders. No study has shown that they change the patient’s personality.

“There are different ways of conceptualizing and understanding personality. In short, personality traits are, by definition, stable and durable. Antidepressants can help relieve symptoms associated with depressive and anxiety disorders,” says Stee Lifehacker. “There is no strong scientific evidence that these drugs change personality, and even if they did, it would be less than the debilitating effect of the personality disorders they are prescribed to treat.”

Fact: Antidepressants make your problems easier and control your symptoms.

After I started taking antidepressants, I remember asking my therapist if they would help me get rid of all my problems and sadness. She laughed and said that if that were true, people like her would have been kicked out of their jobs a long time ago. While searching for this article, I came across a simple explanation that I really liked: “Antidepressants make it easier for you to solve your problems.”

I asked Sti what he thought of this explanation and he said it was a good idea. The psychologist added that the goal of antidepressants and psychotherapy is not to eradicate inappropriate emotions.

“They are one tool in a toolbox that helps people cope with debilitating disorders and disorders associated with mental disorders and helps people return to a state of mental health, which includes practicing healthy ways to cope with and overcome life’s shocks. Stya explained. “In my clinical experience, these medications can sometimes help stabilize symptoms to help people do better psychotherapy.”

Myth: Antidepressants will work immediately and you will be taking them for the rest of your life.

There are many misconceptions about how quickly antidepressants begin to work and how long patients will have to take them. When my friend started taking them for postpartum depression, I applauded her for choosing to help herself, but also warned her that it might take her a while to start noticing changes. (Disclaimer: I’m not a doctor! These are just some nuggets of wisdom I’ve gained during my mental health journey.)

Gold stated that antidepressants take 6 to 8 weeks to work, although she has seen some patients notice benefits after 2 to 4 weeks. “It’s a very long time to wait for someone who is sad, and we’re lucky that treatments like ketamine are being developed that work much faster,” the psychiatrist said. “Usually the goal is to maximize the drug and its dose before adding more drugs or changing them.”

When it comes to how long you take antidepressants, Gold said it depends on many factors. The American Psychiatric Association practice guidelines recommend that patients take medication for an average of 6 months after doctors find a good medication at the right dose and achieve remission of symptoms.

Gold said that many people may try to stop the medication at this stage, though it’s important to do so with the help of a psychiatrist or GP because there are side effects.

“However, this does not work for everyone, especially for people who have had several episodes of depression. Some people may also stay due to the severity of their symptoms (such as suicidal tendencies or hospitalizations) or even family history,” Gold said. “It may be a personal preference for the patient to continue taking medication and for preventive purposes.”

It depends: Antidepressants negatively affect your sex life and can cause weight gain.

Given the complexity of side effects, we have chosen to categorize this topic as “depends on the person” rather than myth or fact. Side effects such as low libido and weight gain are a big reason some people are wary of taking antidepressants.

Gold said that all drugs have side effects, but “not all drugs have the same side effects for everyone.” In addition, she added, not all the same side effects bother people the same way.

“Sexual side effects are certainly one of the reasons people stop taking antidepressants or want to change antidepressants, but you have to weigh the risk of sexual side effects against the benefit of the medication for your depression,” she explained. “Some people will choose to stay on a low libido drug if they are no longer suicidal, while others feel it worsens their mood and worsens everything and want to change that.”

If someone experiences sexual side effects, psychiatrists can often change their medication to an alternative that won’t cause the reaction, Gold says. Doctors may also add a drug such as Wellbutrin, a drug that generally has the fewest sexual side effects and is often chosen for this particular reason.

In regards to appetite, Gold said the same principle applies. Some people taking antidepressants may experience an increase in appetite, but not everyone does. “Often people with depression are not interested in food (and anxiety makes them sick), so when people feel better after taking medication, they eat more. However, [drugs] can also have a metabolic effect and organically increase hunger in some people,” she said.

In this case, it is also possible to change the medication after doctors weigh the risks and benefits.

Myth: Antidepressants cause suicidal thoughts.

Earlier this year, Tesla CEO Elon Musk weighed in on another thing he has no right to talk about: antidepressants. The tech billionaire said that Wellbutrin should be taken off the market, and that every time it is mentioned in conversation, “someone at the table has a history of suicide or near-suicide” associated with it. As pointed out by many psychiatrists at the time, including Black, there is no concrete evidence that Wellbutrin causes suicidal thoughts.

Musk’s comments, while ill-informed, highlight a myth that is not limited to Wellbutrin. Many believe that antidepressants cause suicidal ideation, although experts who spoke to Lifehacker say this is extremely rare and often age related. If patients experience an increase in suicidal thoughts, doctors stop taking the medication.

“Missing nuance and rarity in Musk’s argument and the fact that you’re being watched when you start taking medication and you need to tell your doctor about anything you’re experiencing,” Gold said. “Also, antidepressants are very good at treating suicidal tendencies and help most people live long-term. I have seen many more people have their suicidal thoughts reduced and treated with medication than I have seen them increase.”

Black, a child psychiatrist and co-author of The Clinical Guide to Psychotropic Drugs for Children and Adolescents , has elaborated on the possible effects of antidepressants in people younger than 24 years of age. According to Black, studies have shown that “there is a statistical signal that links antidepressant use before the age of 24 with a possible increase in suicidal thoughts and behavior.” However, he explained, this is commonly misinterpreted as an effect on people of all ages, or as a claim that antidepressants cause suicide, which is not true.

“Whenever I talk to families and youth about starting antidepressants, I tell them about this connection, so we need to be vigilant for any changes in suicidal ideation, especially in the first few weeks of starting medication,” Black said. e-mail. “This is due to over-caution, and as a suicidologist, I can state bluntly that this should be the standard of care for all children entering treatment, whether or not medication is used. I have been on and off antidepressants for many children (thousands), and I know that in most cases suicidal thought changes are related to circumstances in their lives and their general well-being, and NOT whether they started taking medication or not.

Fact: More People Take Antidepressants Than You Think

The stigmatization of depression can make some people feel like they are the only ones who need to turn to medication when their symptoms are severe and long lasting. However, they are much more common than you might think. A survey conducted by the Centers for Disease Control and Prevention found that from 2015 to 2018, 13.2% of adults aged 18 and over had taken antidepressants in the past 30 days.

According to Stee, the use of antidepressants is too common, which is problematic in itself. “Antidepressants are great tools, but at the same time, overdiagnosis and overprescribing are serious problems that diminish their usefulness and carry risks,” he said, adding that clinicians need to mitigate those risks by practicing ethically and competently.

Myth: Once you start taking antidepressants, you will be hooked.

When some people stop taking antidepressants, they may experience a withdrawal syndrome, which is known medically as ” antidepressant withdrawal syndrome ” or ADS. Approximately 20% of people who have been on antidepressants for at least a month will develop ADD if they stop taking them too abruptly, Gold says. Symptoms of ADS include flu-like symptoms such as headache, joint pain, and sweating, as well as insomnia, nausea, imbalance, and sensory disturbances.

However, ADS is not the same as withdrawal due to drug abuse and addiction. As Stee pointed out, addiction has certain characteristics. “Antidepressants are non-addictive in the sense that they are not associated with addiction characteristics such as feelings of loss of control, cravings, a strong desire for more medication, and immediate reinforcers such as euphoria,” Steya explained.

To further illustrate the difference, Gold gave an analogy to Dr. Caroline DuPont, vice president of the Institute for Behavior and Health , an organization that specializes in addiction treatment. DuPont compares the need for antidepressants and the dependence on wearing glasses every day.

“I can function better in all my roles in life with my glasses [and] I use them as prescribed,” DuPont Gold said in a 2019 article for SELF , noting that she is dependent on them but not dependent. “This is very different from addiction, in which a person will continue to use drugs at great personal cost and despite many painful consequences for their health and relationships.”

Myth: If you’re dieting, exercising, or taking supplements, you won’t need antidepressants.

My battle with depression began when I was in university almost ten years ago, so believe me when I say that countless genuinely well-meaning people in my life have told me that I could stop taking antidepressants if I just kept healthy. diet or exercise. more – you know, recovering “naturally”, without drugs. Social networks and the Internet are full of such advice, although not all of it comes from a good source.

Stee told Lifehacker that in this area, health influencers and alternative medicine practitioners often “tread on the heels” of mental health professionals to sell pseudoscientific treatments and spread misinformation about the nature of mental illness and its treatment, despite to the fact that they do not have the right to comment on these same ones. serious topics.

In clinical practice, treatment teams are turning to lifestyle changes as part of evidence-based care, Stea says. However, he added, sometimes diet and exercise “alone are not enough to solve complex and serious mental health problems.” He emphasized that no one should stop taking their medication without consulting their healthcare team.

Regarding psychiatry, Gold noted that there is nothing people can do to help them stop taking antidepressants. It’s not that easy, in part because depression is caused by biological, psychological, and social components of a person. In addition, according to her, “it’s a spectrum of seriousness.”

“It’s good to exercise, eat well, and gain the ability to cope, but tell someone who can’t get out of bed, wants to sleep all day and is hopeless, run, and you’re out of luck,” Gold said. “It is important to approach treatment holistically and understand that for many people, therapy in combination with medications is more beneficial than alone, and that many people need medications even in order to undergo therapy or yoga, and this helps them function in own life. “.

Myth: Antidepressants don’t work because recent research says so.

Recently, research into selective serotonin reuptake inhibitors (SSRIs) — a type of antidepressant — gained traction online, concluding that there is “no clear evidence” that low serotonin causes depression. This is nothing new, as the “serotonin theory” was not accepted as an official explanation in the psychiatric community for decades, Black explained. However, some of the media that picked up the news claimed that this showed that SSRIs had no scientific basis and, as a result, these antidepressants did not work.

This is not true, and even the study’s lead author, Joanna Moncrieff, a professor of psychiatry at University College London, has said so. Speaking to Rolling Stone , Moncrieff explained that the study is an analysis of one of the mechanisms by which scientists believe SSRIs work.

“We don’t need to know how something works to know it works,” Black told Lifehacker in an email, pointing out that Tylenol is a good example of this. “The evidence that antidepressants work against depression, anxiety, and a range of other problems is extremely compelling.”

In addition, it should be noted that Moncrieff does not have a reputation for impartiality. She spent years questioning SSRIs as well as the classification of depression as a mental illness, according to Rolling Stone . At one point, Moncrieff said there could be evidence to support a conspiracy theory that pharmaceutical companies are intentionally hiding information about the side effects of SSRIs.

Black said the incident worries him because it is a situation where people distort science in order to distort what is known about the treatment of mental illness.

“A lot of people will be drawn to the misinformation that the latest study ‘proves antidepressants don’t work’ when the study didn’t actually show that,” he said. “We have overwhelming evidence that they do work, and the entire article is an attempt by biased professionals who have only portrayed drugs in a negative light in the past.”

Things to remember if you’re thinking about taking antidepressants

The thought of taking antidepressants can be overwhelming and can even feel overwhelming. If you are considering taking this step, the last thing you want is to face misinformation about antidepressants on social media and the internet.

Black stressed that when people start thinking about taking antidepressants, they should feel comfortable knowing that these medications work . Other things that are claimed to relieve depression, such as exercise, yoga, homeopathy, acupuncture, naturopathic and herbal medicine, traditional Chinese medicine, and healthy eating, among others, are not supported by sufficient evidence to meet clinical criteria. Still, another great option is to start seeing a certified psychotherapist, he said, since many forms of therapy have shown benefits equivalent to starting medication.

For those interested in a “gold standard” approach, Black suggested combining therapy with medication. Physicians are quite convinced that people who take this approach have the best outcomes for depression, he says.

“Ultimately, one of the biggest questions anyone needs to ask themselves is: “What is the trajectory of my symptoms, and if this trajectory continues, will I face consequences in my life, in pleasure, productivity or safety?” Black emphasized. “If the trajectory is bad, it is necessary to talk to a qualified psychotherapist or doctor about starting evidence-based treatment.”