There’s a lot of stigmas and stereotypes present in our society regarding all manner of mental health issues. Many people suffer from depression and never seek treatment or help, for a number of reasons. Some may feel they just have the blues, or are just down on the dumps, or find some sort of external factor to blame their constantly low moods on. There are many others who undergo treatment from depression (or an anxiety disorder) who will get embarrassed or not admit to what they have, even to their own physicians, and certainly not to the same degree that people will reveal a problem with high blood pressure.[1] There is definitely a trend in our society away from discussing emotional or mood-related issues, and so mental health is often relegated to the unspoken yet nearly universally-accepted societal role of “don’t ask, don’t tell.” Yet how common a problem is depression, and how serious a problem is it? A recent study by Mental Health
All of these factors, along my own personal history as a three-time suicide survivor, as someone who lives with depression, and as someone who wishes to work with college students as a full-time career, have contributed as to why I feel this is a serious problem and one that I wish to dedicate my efforts in tackling. Several other statistics have caused me to realize how much the stigma surrounding psychological aid and antidepressants in particular have contributed to the problem of suicide. According to a fact sheet offered by our campus’s very own Counseling & Psychological Services, approximately 70-75% of the people who attempt to commit suicide offer some kind of warning, either verbal or non-verbal, to their friends or loved ones before the attempt.[5] Note that these statistics only include actual attempts at suicide, and do not include the number of people whose warnings helped give them the aid they needed to avoid an attempt on their own life. This means that nearly three quarters of all suicide attempts in this country are easily preventable with the proper intervention. The aforementioned study by Mental Health
Stigmas are, in general, a societal issue, and so I will begin to undertake this problem as one that is strictly interpersonal. Stigmas exist because of widely held beliefs that often transmitted, person to person, as something that is “fact” or “truth.” There are many of these stigmas in existence, and I hope to confront them all, both through face-to-face, person-to-person dialogues, and also through both active and passive programming. Stigmas are also notoriously difficult to erase, and often require generational shifts before changes truly start to take hold. This is due to the viral nature of these “facts” and “truths” that spread. Even after my second suicide attempt, I refused to believe in the neurological causes of depression, or that antidepressants would help me. My third attempt was my most serious and the most damaging to me, physically and emotionally. It was only until after I started treatment of antidepressants was I able to calm down and center myself and reach a point where I could learn to manage my depression. If I can reach even one person and prevent them from going through what I had to go through, I will consider myself successful in my endeavors. Obviously, my goals are a bit more ambitious, but I believe in starting small.
As the stigma against antidepressants is an interpersonal problem, the key decision-makers would obviously be those who at best, firmly believe in said stigmas and, at worst, try to spread the misinformation that supports the stigma to others. As I’ve already said, I believe very strongly in the power of face-to-face communication, and I’d also like to hold events to discuss and deconstruct these stigmas, as well as creating information fliers and posters. All of these are first steps, however. I have plans on starting a blog to discuss, among other things, the very stigmas and stereotypes on mental health issues that I work to end (when I have the time to write!). As a playwright, I focus on telling my own stories with mental health in a way that hopefully, communicates universally that every individual’s mental health is different and therefore everyone’s road to mental wellness is different as well.
Oftentimes I find that the greatest factor in preserving these stigmas and stereotypes is an extremist point of view. When I speak of extremism, I refer to the idea that there are ideas that are absolutely universal: “you should never take antidepressants” or “there’s always a reason to be depressed.” This happens most often through a process referred to as universalizing the particular. Oftentimes people believe what is true for them must be true for everyone. This is the most often cause behind the stigma behind antidepressants. People who don’t deal with depression often don’t understand the difference between psychological depression and regular sadness. So that when an individual gets through a period of sadness without the need for pharmaceutical aid, they figure that nobody needs pharmaceutical aid to get through sadness. Depression, however, is much more powerful and much more constant that the pure emotion of sadness, and usually requires more effort than the average individual to manage. Many people have depression severe enough that they cannot manage without long-term pharmaceutical aid, and others (such as myself) needed the aid of antidepressants temporarily to overcome a severe period of depression.
Other stigmas relate to ideas regarding antidepressant’s unfortunate side effects. There is one school of thought that states that antidepressants create an “artificial happiness” or that antidepressants somehow numb feelings. For many people on antidepressants, this simply isn’t true. Note that I say for many people- everyone has an anecdote about a friend of a friend of a neighbor for whom antidepressants made the problem worse rather than better. Anecdotes are often more compelling than scientific data and other forms of evidence, especially the fewer degrees of separation one is from these anecdotes, and especially if the anecdotes confirm our suspicions. This is again owed to the process of universalizing the particular. The prevailing thought is that if antidepressants actually sapped that friend of a friend of a neighbor’s energy, or increased that individual’s suicidal ideations, then surely they will do the same for me. Every body’s chemistry is different so obviously antidepressants do not have the same effect on everyone. Like with therapists, I would encourage individuals to shop around if they’ve had bad first impressions. One side effect that opponents of anti-depressants fall on most often is this idea that anti-depressants actually aggravate suicidal thoughts or ideations. This article leans heavily on this particular scare tactic, arguing “the percentage rates of suicide listed in the brochures may seem low, but the numbers do represent actual people who killed themselves as a result of that particular medication. Is that a risk you are willing to take (or let a loved one take)?”[7] As another article points out, however, the proper question isn’t whether anti-depressants cause suicide (studies have shown that while anti-depressants in youth have shown to cause a slight increase in suicidal ideation, in none of the cases studied were the ideations acted upon), but whether the question that should be asked is whether individuals with depression are more likely to commit suicide on medication than off medication. The article offers this little nugget of information: roughly 70% of individuals who have committed suicide had not seen a psychiatrist in the year leading up to their deaths.[8]
Of course, I could scream statistics at the top of my lungs as much as I want, but the truth is that for many people anecdotal evidence does trump. And so, while I do broadcast statistics as often as I am able, I also offer my own stories, many times through simple conversation, but also in the form of theatrical scripts. In this regard, my greatest resource is my fellow advocates, and this is where stigmas are the most dangerous and the most difficult to eradicate. The stigma regarding antidepressants not only keeps people with depression from seeking pharmaceutical aid, but also keeps those that do for disclosing this information. It’s embarrassing to talk about being on antidepressants. So, naturally, the only stories you do hear are those stories that speak out against antidepressants, which makes the stigma stronger, which makes our shame run deeper. I think that if everyone who has had experiences with antidepressants shared their stories, the voices of those with negative experiences would be drowned out. The same study that “warned” against antidepressants causing an increase in suicidal ideations in youth also found that antidepressants had an 11:1 reward/risk ratio; that is, you are eleven times more likely to have your depression lessened by antidepressants than have it worsened.[9]. And so I think it is important that those of us with positive experiences with antidepressants be more open and willing to share our experiences. The best way I can think of to do that is to broadcast my story, as widely as possible, so that people know that it’s okay to talk about, and that they aren’t alone.
One thing that I do want to keep in mind, however, is that I am not discounting or discrediting the experiences of others who have been negatively impacted by antidepressants. I believe that it happens. Hell, after antidepressants helped me get to a point of clarity where I could effectively manage my own depression, I had to ween myself off them. I was taking both antidepressants and anti-anxiety medication, and the combination kept me in bed almost as much as my depression used to. Medication was not the long-term solution to my mental well-being, but it saved me in the short-term. As I’ve stated earlier, everything is different for different people. For some, antidepressants are a long-term solution, for others, antidepressants aren’t the solution at all. I choose to broadcast my story, and to counter those whose stories further the negative stigma and stereotypes surrounding antidepressants, because I know for the overwhelming majority of people, the evidence is on my side. I would never refer to those whose stories run counter to my expectations as a liar, or even say their story is wrong, because it’s right for them. But if I can educate those people with my story, and present them with my evidence, and show the very real harm that the stigma surrounding antidepressants causes to those suffering from depression, then it is my duty to do so. Ultimately, no matter how grand or ambitious my intentions become, it is in these moments that I know I can do the most good.
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[1] Mags, "Why the Stigma Attached to Anti-Depressant and Anti-Anxiety Medication?" 25 Jan. 2008.[2] Mental Health America, "Ranking America's Mental Health: An Analysis of Depression Across the States."
[3] The Suicide Prevention Resource Center, "Suicide Prevention Basics."
[4] Centers for Disease Control and Prevention, "Suicide: Facts at a Glance," Summer 2009.
[5] Ralph L. Rickgarn, "The Issue is Suicide."
[6] Mental Health America.
[7] Dena Lambert, "Antidepressants: Should You or Shouldn't You?" 13 Jul. 2001.
[8] Chris Ballas, M.D., "Do Antidepressants Cause Suicide?" 14 May 2007.
[9] Ballas, M.D.
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