Depression and India have a scary relationship. A 2011 survey conducted by Biomed Central and the World Health Organisation concluded that India was the most depressed country in the world. In a country of a few thousand psychiatrists for a population of over a billion, the treatment of mental illness and prescription of antidepressants is often left to general practitioners. The stigma associated with mental disorders also makes antidepressants a popular choice for people who shy away from therapy. So it’s no surprise that pill-popping is a growing trend among people struggling with depression.
Antidepressants are increasingly being prescribed by gastroenterologists, physicians, neurologists, and surgeons as well. In some cases they are necessary. But there are sufficient chances of inappropriate dosage or misdiagnosis as these doctors are not equipped to make detailed psychological evaluations. There is also an obvious lack of follow-up or close observation. For most people, antidepressants are prescribed for an indefinite time which is unnecessary in some cases. Antidepressants have side effects which may bring down the quality of your life when continued on a long-term basis.
Are antidepressants effective?
According to a research article in PubMed Central (PMC), “ADMs seem to be symptom-suppressive rather than curative.” This means that though antidepressant medication is often effective in treating depressive episodes and is preventive while it is continued, there are no findings to show that they cure depression to any extent. So, patients may relapse if they stop using these drugs, though it’s not always the case. This is where therapy and counseling come in. Psychological therapy can help patients to understand and manage their problem, instead of leaving them wholly dependent on medication. There is also the risk of antidepressant abuse. Some patients enjoy the sedative effect of these drugs and use them even after medication period.
What are the side effects?
Patients who take antidepressant pills may experience headaches, drowsiness, insomnia, skin allergy, joint and muscle pain, diarrhea, nausea, or stomach problems. These effects are generally temporary or mild. A decrease in the concentration of serotonin levels in platelets can reduce your blood clotting capacity, which is a serious problem. Many people who are on ADMs suffer from lack of sexual libido, performance, satisfaction, interest or all four. Those who take antidepressants are more likely to need blood transfusions after a surgery. There is also an increased chance of for stomach or uterine bleeding.
When and how to discontinue anti-depressants
If you feel you have made significant recovery from your illness and don’t need to continue with these drugs, you need to consult your psychiatrist and raise the issue. While there is a risk of relapse, your doctor can assess if you are capable of managing your problem and if there are chances of recurrence.
This decision should be made after enough consultation and assessment to prevent premature termination. There are discontinuation symptoms that you will experience. Stopping antidepressant use can also cause withdrawals. You need to be aware of the ways in which you can cope and minimize these symptoms, with the help of your therapist.
An effective way to reduce or prevent many of the symptoms of SRI discontinuation syndrome is by slowly lowering, or tapering your dose over weeks to months, according to the doctor’s recommendation. Doctors may also suggest replacing long-term medication such as fluoxetine (Prozac) for shorter-acting drugs.
Studies have shown that cognitive therapy is as effective at treating depression as antidepressant medication and that too without the side effects. It also seems to reduce the danger of relapse even after its discontinuation. So before you jump into a lifelong commitment to pills, you should try psychotherapy as a viable and more holistic alternative.