Why do people resist taking antidepressants?

[David Baxter PhD]

Why do people resist taking antidepressants?
by Deborah Gray
Thursday, October 15, 2009

Over the years, since I started my depression site, I've heard (read) many people say that they want to treat their depression "but without antidepressants." I always think, "Why?" It's just incomprehensible to me that some people have that knee-jerk reaction to medication.

Oddly enough, I have to include myself in this group. At least initially, I refused to take medication for my depression. Nearly twenty years ago, when I was first diagnosed with depression, I was in a pretty bad way. I had had two major depressive episodes in the past, without knowing what they were, but this third one was the worst, and so far, of the longest duration. By chance I read a book that helped me to recognize that what I was going through, and I promptly made an appointment with a doctor at the mental health clinic attached to the local hospital.

I was unutterably relieved when he gave me my diagnosis of major depression. Putting a name to what was wrong with me made it into a medical condition, one that presumably could be treated. But I wasn't so receptive to what he said next. "I want to put you on antidepressants." "No, I don't want to take medicine. Can I just try therapy first?" He and the therapist, who was also in the room, looked doubtful but agreed.

I'm not sure what was at the root of my refusal. From the perspective of many years and all I've learned about depression, it's somewhat inconceivable to me that I wasn't willing to try medication. The only reason that makes any sense at all has to do with my being prescribed medication for "migraine equivalent" headaches when I was a teenager. That particular diagnosis meant that the doctor didn't know what was causing the horrendous headaches that went on all day. Now I suspect that, since they eventually went away on their own and have never returned, they might have been caused by a fluctuation in hormones. Since I was up to about twelve aspirin a day, it was decided that I should take a sedative called SpaceTabs daily. I didn't mind at first, since the medication did keep the headaches away, but eventually I cut the amount per day down the half and then a quarter (kids, don't try this at home). At some point when I was in college, I stopped taking them altogether.

I didn't like the effect they had on me. The name was apt, because they did make me spacey. I felt less connected to what was going on around me. It's possible that when the psychiatrist mentioned antidepressants, I may have assumed that it would make me feel the same way. So that is one possible explanation for why I resisted taking antidepressants for six months.

I faithfully went to therapy twice a week for six months, but finally had to acknowledge that my depression was not getting better, but worse. While the therapy was, and has been since then, very helpful for unraveling a lot of the issues that probably contributed to my depression, it was almost impossible for me to participate fully in it. I was so depressed that my cognitive abilities and even my speech were slowed down.

So my desperation overcame my resistance to medication, and I am eternally glad that I took that step. If you're resistant to taking antidepressants, make sure that you have a reason, and that you've examined that reason for flaws in your logic before rejecting it outright. I wish I had, because that was a miserable six months that I went through when I didn't have to.

 

[Amodais]

I think people maybe resistant to taking medication because when diagnosied with a mental disorder, of any kind, they may feel nervious of the negetive stigmas attach to people who are diagnosed with a mental disorder. Taking the medication emphasizes the fact that "there is something wrong with you." and you may very well be ashamed of having to take it. I know i feel a little ashamed of telling doctors what perscriptions im taking, also getting them filled at the pharmacy. It's kind of like a secret shame that you dont want others to know about, that everything is ok. I think this maybe why some people commit suicide within hours of taking a antidepressent they got persrcibed, they want to be normal but "can't" so they take the easy way out.

 

[Into The Light]

i used to be uncomfortable about sharing the medications i was on, but these days i really don't care. there's nothing to be ashamed of, and if other people react negatively, that's not something we can control. it's an opportunity to educate, if it is someone you think would be open to listening.

 

[David Baxter PhD]

Eventually, pretty much everyone needs to take at least one kind of medication or another. That's part of the reason we live longer now than 100-200 years ago. And why suffer when you don't need to?

Better living through chemistry. Or at least longer living.

 

[crzycadn]

For myself, I am always resistant to taking any medication. For example, my doc has perscribed me pills for high blood pressure and high colestral. My blood pressure has been in the a little bit high range (154/90 for about 10 years and my colestral goes up and down, but usually is also in the "little bit high" range. I know that if I lost even 20 lbs. (I need to lose about 50), that would probably help my BP and colestral levels. I guess taking the medication is sort of like giving up.
In regard to anti-depressants, I have just recently went from 225 mg of Effexor XR to 20 mg. of Prozac, with the hopes of going off that as well (under a dr's supervision of course). My reasoning to that is because I believe that my initial symptoms about 8 years ago was from alcohol and perscription pain medication abuse. I do have a couple questions for Dr. Baxter.Aren't anti-depressant medications supposed to be used to correct brain chemicals?
What role are they supposed to play in regard to traumatic experiences? Isn't this sort of thing better dealt with in therapy? I would think no amount of chemicals could erase a memory of a traumatic event.

Also, in my opinion and experiences, some doctors are a little too free with the pen - they would rather just give you a perscription and send you on your way than actually deal with the problem.
Thanx

 

[Jackie]

Side effects makes me resistant to taking them and thats the only reason

 

[Into The Light]

]Aren't anti-depressant medications supposed to be used to correct brain chemicals?
What role are they supposed to play in regard to traumatic experiences? Isn't this sort of thing better dealt with in therapy? I would think no amount of chemicals could erase a memory of a traumatic event.

yes, traumatic experiences need to be dealt with in therapy. the medication doesn't erase those memories. the medication helps alleviate depressive symptoms that are a result of the trauma. the medication basically helps you be able to do the work in therapy. without it, the work in therapy is that much more difficult.

 

[David Baxter PhD]

For myself, I am always resistant to taking any medication. For example, my doc has prescribed me pills for high blood pressure and high cholesterol. My blood pressure has been in the a little bit high range (154/90 for about 10 years and my cholesterol goes up and down, but usually is also in the "little bit high" range. I know that if I lost even 20 lbs. (I need to lose about 50), that would probably help my BP and cholesterol levels. I guess taking the medication is sort of like giving up.

So, if I understand you correctly, you're willing to risk blood clots, stroke, or a heart attack while you're waiting to lose weight just to avoid taking medication? That doesn't seem to me to be entirely logical.

In regard to anti-depressants, I have just recently went from 225 mg of Effexor XR to 20 mg. of Prozac, with the hopes of going off that as well (under a dr's supervision of course). My reasoning to that is because I believe that my initial symptoms about 8 years ago was from alcohol and prescription pain medication abuse.

Doubtful. It's more likely to have been the other way around. But I'll leave that for you and your doctors to work out.

By the way, although it may seem like a lower dose, the 20 mg of Prozac you're taking now is about the same as the 225 mg of Effexor you were taking previously.

I do have a couple questions for Dr. Baxter. Aren't anti-depressant medications supposed to be used to correct brain chemicals?

In a way, yes.

What role are they supposed to play in regard to traumatic experiences? Isn't this sort of thing better dealt with in therapy?

It's not either/or. Every study that has ever asked the question has come to the same conclusion: The combination of medication and psychotherapy is more effective and creates greater resistance to relapse than either option alone.

I would think no amount of chemicals could erase a memory of a traumatic event.

That's correct. They are not intended to do that.

Also, in my opinion and experiences, some doctors are a little too free with the pen - they would rather just give you a prescription and send you on your way than actually deal with the problem.

I think many therapists would or could say the same thing about some patients: They would rather try to find a quick fix rather than do the hard work to truly address the issues. And of course many stubbornly refuse to try medications based on misinformation and stigma when often that is part of their recommended treatment.

 

[crzycadn]

So, if I understand you correctly, you're willing to risk blood clots, stroke, or a heart attack while you're waiting to lose weight just to avoid taking medication?

You sound a little sarcastic in your reply(s) - not appreciated. Of course, I don't want any of those things to happen. I just don't feel I am at the point where I need medication for it. If it gets worse, I'll start taking it. FYI - I had a stress test for my heart and it's fine. I won't deny that I have all of the markers for trouble down the line if I don't smarten' up, but I still think I'm a little young for all this medication.

Thanx for the info on the Prozac. I did not realize the dosage and I have been curious about that.

I agree with you about Doctors and patients wanting a quick fix. I'm guilty of that and I'll admit it. Probably because illegal drugs made me feel so good, I was hoping legal ones could do the same. Doesn't work that way though does it - too bad.

I guess I'll have to quit smoking, quit drinking, eat right and get some exercise and do some volunteer work

 

[David Baxter PhD]

You sound a little sarcastic in your reply(s) - not appreciated.

No. I'm merely trying to emphasize the flaws in your thinking about this.

Of course, I don't want any of those things to happen. I just don't feel I am at the point where I need medication for it. If it gets worse, I'll start taking it. FYI - I had a stress test for my heart and it's fine. I won't deny that I have all of the markers for trouble down the line if I don't smarten' up, but I still think I'm a little young for all this medication.

No, at 51 you're not at all "a little young for this medication". In fact, this is an excellent time to start taking that medication to prevent problems down the line,. I've seen colleagues with no idea they had a problem drop dead from heart attacks overnight. We all tend to think it won't happen to us, but that's what they thought too.

I used to have similar arguments with my doctor but in the end I realized that he was the expert and I was just being stubborn and refusing to look at reality. And FYI, your BP values are quite a bit worse than mine were and I didn't have the cholesterol problem you have.

 

[Andy]

Resistance is futile!

 

[Banned]

I will admit that I am one of those people who is highly resistant to taking medication. For me, it's because it reinforces the fact that there's something wrong with me, and it makes me feel less than someone who is not on meds. I *am* on medication now; a whole lot of it actually, but I do hope for the day that I can get off it. For now, it is what it is. I think, too, that once I am at a point where I'm happy to be alive, I might be less resistant to taking meds because I will see how they are positively impacting my quality of life, vs right now, where I think they are just a pain in the butt and I don't want them. Having said that, I know that therapy will be more successful with them too...

 

[crzycadn]

No, at 51 you're not at all "a little young for this medication". In fact, this is an excellent time to start taking that medication to prevent problems down the line,.

Your above point is something for me to think about, however, the rest of it about your BP, your collegues, etc. - everyone is different.

I think the point that I am trying to make in regard to resisting taking anti depressants, or any medication for that matter, is sometimes, a few positive changes in your lifestyle can also help physically and mentally. If I had of made more effort to do things that were good for me instead of drugs and booze, maybe I never would have needed anti depressants, BP or colestral medication today.

I'm not saying that medication is not the way to go - I mean, I do take medication. i take prozac, low dose aspirin and a multi vitamin religiously everyday. The last 2 is something I just started as part of my positive changes. I am trying a few other "baby steps" as well, like raking leaves and joining an agency to help me get a job.

There are obvious reasons why people take anti-depressants and I am not saying there is another way to deal with depression and anxiety. But if that is the only way someone is coping, I think they are doomed to failure.

 

[David Baxter PhD]

There are obvious reasons why people take anti-depressants and I am not saying there is another way to deal with depression and anxiety. But if that is the only way someone is coping, I think they are doomed to failure.

Well, not necessarily "doomed to failure", but as I said earlier:

Every study that has ever asked the question has come to the same conclusion: The combination of medication and psychotherapy is more effective and creates greater resistance to relapse than either option alone.

 

[white page]

I've read this thread with interest,

I've seen colleagues with no idea they had a problem drop dead from heart attacks overnight. We all tend to think it won't happen to us, but that's what they thought too.

Two friends of mine died this way, one was 58 the other 60, the younger one was overwieght and never went to have a check up, the second one, knew she had high blood pressure but pooh poohed the idea of meds, she continued to eat thick butter on everything, and just dropped dead one day.

I would just like to add that the side effects of untreated depression are seriously life threatening, however the side effects of antidepressants are minimal compared to the renewal of a quality of life, we are so fortunate to have these meds now, they are literally life savers.

 

[Andy]

I would just like to add that the side effects of untreated depression are seriously life threatening, however the side effects of antidepressants are minimal compared to the renewal of a quality of life, we are so fortunate to have these meds now, they are literally life savers.

"...they are literally life savers."

I second that! :goodjob:

 

[Cat Dancer]

There was a time in my life where all I could do was take antidepressants. I was not able at all to be in therapy. The medication alone probably saved my life. I do totally agree that therapy and medication together are ideal, but sometimes one isn't able to do both.

Right now I'm only able to have therapy and can't take any medications and it is a lot harder than with the meds. Very, very hard.

I'm one who was also extremely resistant to medications, but once we finally found the right combinations I did a lot better.

 

[David Baxter PhD]

There was a time in my life where all I could do was take antidepressants. I was not able at all to be in therapy. The medication alone probably saved my life. I do totally agree that therapy and medication together are ideal, but sometimes one isn't able to do both.

Right now I'm only able to have therapy and can't take any medications and it is a lot harder than with the meds. Very, very hard.

I'm one who was also extremely resistant to medications, but once we finally found the right combinations I did a lot better.

That's a very good point, CD.

Both is best but if that's not possible either opne alone will still benefit you.

 

[blackdogwalker]

Thanks for this thread, very interesting. I have always been resistant to meds, after being give some kind of tranx when a teenager which just spaced me out, that scared me as I never wanted to "get high" (I was a boring teen) and I figured they wouldn't solve anything. Plus which my other half is very, very leery of meds in general. For a long time we have been hoping to avoid any kind of meds but with the chronic pain I ended up with 2 different pain killers to take every day. And he ended up with stuff to take too, he finally caved, for BP pills... Now the family doc suggested an antidepressant, which I figure is different from those long-ago tranx, and I am finally opening up to the idea. As for stigma, I have learned to put on a bit of a mask, and when I can't hide it any more I hide myself away till I can get my mask back on. And I don't need to tell anyone about the pills I take (apart from docs, of course). But Do the anti-d's make you spacey at all? Because I'm scared of being spacey, especially if I have to drive.
sorry I;m rambling a bit...

 

[Banned]

Hi bdw,

No, antidepressants won't make you spacey. You'll still experience emotions, but they take the edge off the lows and basically put your brain in a better place to cope.

I'm on two antidepressants and I still have good days and bad days. I still cry, laugh, and everything in between.

They've come a long way in the past ten years or so. They are not designed to turn you into a zombie, as that's not beneficial either. They are designed to bring your moods back to a more balanced level so that you can live life more fully and experience all that life has to offer.

Every now and then I think about going off mine, but I remember how I was before I started them and I know it's not an option at this time. I definitely don't want to go back to how I was five months ago. It was really ugly, with wild mood swings and intense emotion that was completely uncontrolled. I need to be on them, because they keep me balanced and in a better mental space.