{"id":157264,"date":"2025-06-04T10:41:09","date_gmt":"2025-06-04T10:41:09","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/157264\/"},"modified":"2025-06-04T10:41:09","modified_gmt":"2025-06-04T10:41:09","slug":"more-problems-than-it-was-helping-behind-the-growing-distrust-of-antidepressants","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/157264\/","title":{"rendered":"“More problems than it was helping\u201d: Behind the growing distrust of antidepressants"},"content":{"rendered":"

In 2017, Julie moved to Massachusetts to start a new job in biotech. She was maintaining her relationship with her partner long distance, and starting a new position in an unknown city alone had her distressed. Her psychologist and doctor recommended she start taking the antidepressant Prozac<\/a> (fluoxetine) to feel better, and it helped her function \u2014 for a while.<\/p>\n

Then years went by, and she started to develop other symptoms. Her insomnia<\/a> got worse. She felt oddly detached from herself and she started to have thoughts about suicide that she had not had before. During this time, she was processing traumatic experiences from her childhood in therapy, but she felt like these symptoms were being exacerbated by Prozac. So in 2022, Julie started tapering off of her medication after talking with her primary care doctor.<\/p>\n

\u201cI just continued taking it, sort of without questioning,\u201d Julie, who is using a pseudonym to protect her privacy, told Salon in a phone interview. \u201cI came to believe that Prozac was causing more problems than it was helping.\u201d<\/p>\n

Antidepressants like Prozac were a major breakthrough in psychiatry when they were first marketed in the 1980s. However, their use has become so widespread in the U.S. that some argue they are now being overprescribed. In fact, an entire internet subculture has developed to help people get off of their antidepressants, which doctors warn can be dangerous if not performed under the medical supervision of a health care provider.\u00a0<\/p>\n

In an executive order<\/a> issued in February, President Donald Trump said the administration would \u201cassess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors,\u201d referring to SSRIs, a common class of antidepressants and other psychiatric medications. During his testimony at the Senate Finance Committee, secretary of the Department of Health and Human Services Robert F. Kennedy Jr. also said that antidepressants were harder to get off than heroin<\/a>.<\/p>\n

“At the same time we have people overtreated, we also have people who are untreated.”<\/p>\n

Antidepressants can be life-saving<\/a> and life-enhancing<\/a> for many people, but for most people with mild or moderate forms of depression they are not intended for long-term use. The drugs can also carry side effects that can significantly impact a person\u2019s quality of life, including weight gain, sexual dysfunction and emotional blunting<\/a>, in which people feel fewer positive emotions along with negative ones. While Kennedy is wrong \u2014 antidepressants are not harder to stop using than heroin \u2014 the withdrawal process can come with its own side effects as well, which some argue<\/a> is an underrecognized problem.<\/p>\n

\u201cThese are very individualized things,\u201d said Dr. Mark Olfson, a psychiatrist at Columbia University. \u201cThere is no one-size-fits-all in terms of how people make trade offs between the burdens of staying on the medication versus the protection the medication offers some individuals.\u201d<\/p>\n

The most commonly used antidepressants today are SSRIs like Prozac, which came on the market in 1988. In the decades that followed, the prevalence of SSRI prescriptions continued to increase year over year to a climax in the pandemic when the proportion of the U.S. population taking antidepressants approached 25%<\/a>. This more than tripled the proportion of people on them in 1990<\/a>.<\/p>\n

Depression has also increased over the years, or at least has been detected in more people. Yet the proportion of the population with depression remains lower than the proportion on antidepressants, in part because these medications are also commonly prescribed for other conditions like obsessive-compulsive disorder, eating disorders, insomnia and anxiety \u2014 which has also increased in the U.S. in recent decades<\/a>.<\/p>\n

Want more health and science stories in your inbox? Subscribe to Salon’s weekly newsletter Lab Notes<\/a>.<\/strong><\/p>\n

Still, some believe they are inappropriately prescribed for too long, or in cases when lifestyle changes or psychotherapy should be tried first. However, many people with depression and severe anxiety who could benefit with antidepressants are also not getting the help they need, Olfson said.<\/p>\n

\u201cI do think there was and maybe still is overprescription,\u201d he told Salon in a phone interview. \u201cBut at the same time we have people overtreated, we also have people who are untreated.\u201d<\/p>\n

Although antidepressant use is still on the rise, a study<\/a> Olfson co-authored last month found that, for the first time since these drugs were introduced, the use of psychotherapy increased at a higher rate than medication alone. This may in part be due to the increased availability of telehealth counseling, he explained.<\/p>\n

\u201cIt’s still the case that most people with depression or anxiety who receive treatment receive antidepressants, but in the last few years, a rising proportion of them are receiving psychotherapy and the growth of psychotherapy has occurred more quickly than the growth of antidepressants,\u201d Olfson said. \u201cThis change is coming after years and years of medications just sort of dominating mental health care in America.\u201d<\/p>\n

However, psychotherapy remains steeped in stigma and inaccessible to many. This may be one reason that antidepressants are prescribed when other strategies could work as well. Sometimes a person\u2019s only point of contact with a medical professional who could help them with depression is their family doctor, who could refer them to a psychologist. But if they are not available or too expensive, patients are left with few options other than antidepressants, explained Dr. Awais Aftab, a psychiatrist at Case Western Reserve University, who said we often end up using antidepressants \u201cas a matter of structural convenience.”<\/p>\n

\u201cHowever, if you look at the practice guidelines<\/a>, they recommend that for mild to moderate depression, it is better to start with psychotherapy and lifestyle change and reserve antidepressants for cases of mild to moderate depression that are not getting better or those of more severe intensity,\u201d Aftab told Salon in a phone interview.<\/p>\n

Julie struggled to find an affordable psychiatrist in her area that could help guide her through the process of getting on antidepressants back in 2017. Her primary care doctor ended up overseeing her prescription, but once she got on Prozac, they didn\u2019t really discuss it anymore, she said.<\/p>\n

Aftab said this can happen often: \u201cThey just put people on antidepressants and then they kind of forget about it and it just keeps getting refilled,\u201d he said. Then, the discussion about whether the medication is working or if they need to stay on it “doesn’t really happen,\u201d he explained.<\/p>\n

However, the problem with staying on antidepressants longer than necessary is that withdrawal symptoms can be more difficult the longer you stay on them<\/a>. If someone is stopping antidepressants, it’s recommended to wean off them slowly and under medical supervision because doing so too quickly and without the right dosage can be dangerous. It can lead to side effects such as a symptom called “brain zap” in which patients feel sudden shocks in their head.<\/p>\n

Depending on a range of factors including the dosage and medication, it can take months or more. Julie did it in eight weeks, but she experienced symptoms that were worse than the original depression she felt, she said.<\/p>\n

\u201cMy biggest symptom after that was extreme anhedonia, like a feeling of not being myself or getting pleasure from anything \u2014 almost not feeling human,\u201d she said. \u201cAlong with extreme physical fatigue, both of those symptoms lasted for about two years.\u201d<\/p>\n

“The evidence for the serotonin theory of depression was weak and inconsistent but the general public thought it wasn’t just a theory.”<\/p>\n

Sometimes the withdrawal from antidepressants can be mistaken for the return of the original depression it was intended to treat. This could lead some people to go back on medication, if the feeling is so uncomfortable that being on the medication ends up providing relief, Aftab said.<\/p>\n

Overall, there is relatively limited research<\/a> exploring the right protocol to get off of antidepressants and how to avoid the symptoms of withdrawal, Aftab said. There is even still much debate about what causes depression in the first place. In 1967, an English psychiatrist named Alec Coppen proposed the \u201cserotonin theory,\u201d<\/a> suggesting a chemical imbalance of serotonin in the brain caused depression.<\/p>\n

In response, the pharmaceutical industry developed Prozac, the first SSRI. However, in the decades that followed, some questions were raised about the trials<\/a>\u00a0used to demonstrate the effectiveness of SSRIs. Around the same time, researchers started to question the serotonin theory that had been publicized as a potential cause of depression.<\/p>\n

Joanna Moncrieff, a professor of critical and social psychiatry at University College London, co-authored a review<\/a> in Nature in 2022 that concluded there was \u201cno consistent evidence of there being an association between serotonin and depression.\u201d\u00a0<\/p>\n

\u201cWe can\u2019t conclude that depression is related to serotonin abnormality,\u201d Moncrieff told Salon in a phone interview. \u201cThe evidence for the serotonin theory of depression was weak and inconsistent but the general public thought it wasn’t just a theory: They thought it was an established scientific fact.\u201d<\/p>\n

Moncrieff\u2019s paper received significant backlash, with five responses published in the journal along with a comment<\/a> authored by 35 academics that challenged Moncreiff\u2019s findings.<\/p>\n

It\u2019s likely that the cause of depression is far more complex than something operating on a single neurotransmitter like serotonin, said Philip Cowen, a professor of psychopharmacology at the University of Oxford and one of the co-authors on the comment.<\/p>\n

Nevertheless, that doesn’t mean these drugs don’t help people. For one, it’s common for medications to not target the direct cause of illness. Instead, many are designed to alleviate symptoms and suffering, Cowen explained. For example, asthma inhalers activate receptors, which relax the airways to help facilitate breathing. This helps with asthma symptoms but does not treat the direct cause of asthma, which is ultimately an allergic reaction. A similar thing may be happening with antidepressants, Cowen said.<\/p>\n

\u201c[The serotonin theory] is a simplistic view and it can’t be right,\u201d Cowen told Salon in a phone interview. \u201cTaking SSRIs might make you feel better for various psychological reasons, but it doesn’t necessarily mean it’s working on a fundamental problem with serotonin.\u201d<\/p>\n

Although these medicines are still not fully understood, the fact remains that antidepressants do help many people feel better. Yet the back and forth within the medical community about the efficacy of antidepressants and the cause of depression might be why some have grown to mistrust them<\/a>. Other false claims in the media and some scientific papers<\/a> have stated that antidepressants can be addictive like alcohol.<\/p>\n

Add on misleading criticisms from the White House, and more people are likely to get off of them, said Rifaat El-Mallakh, a psychiatrist who leads the Mood Disorders Research Program at the University of Louisville Depression Center.\u00a0<\/p>\n

\u201cWhen you have your leaders saying things like, ‘it’s harder to get off an antidepressant than it is to get off heroin,’ you say, \u2018Oh my god, I better get off now before I’m stuck on this forever,\u2019\u201d El-Mallakh told Salon in a phone interview.<\/p>\n

As distrust grows and it remains challenging for many people to access psychotherapy or medical treatment, many are seeking advice online. In fact, there is an entire subculture online<\/a> where people talk about getting off of their psychiatric medications.\u00a0<\/p>\n

While Julie did talk with her primary care doctor about getting off her medication, she felt there were more resources on the internet, she said. As she explained: \u201cMost of the support I got through that process was just through online forums.\u201d<\/p>\n

Despite the difficulty of the withdrawal process, Julie has been tempted to go back on them again during challenging parts of her life. If she is ever in a place where she feels like her own safety is threatened by her mental health, she would consider it, she said. At the same time, she questions whether she actually needed them in the first place.<\/p>\n

\u201cI wish we had a different culture in the medical care community around recommending antidepressants,\u201d she said. \u201cIf they were treated more as a last resort, then maybe I would have made a different choice.\u201d<\/p>\n

Nevertheless, Julie feels more stable these days and developed strategies in the process of the antidepressant withdrawal that help her move through challenging moments, she said. Some of her symptoms, like problems with her libido, have not fully recovered. But she has started exercising again and feels like her body is more responsive to lifestyle changes she implements.<\/p>\n

\u201cI think getting better is now a bit more under my control,\u201d she said. \u201cSo there is potential for things to keep improving.\u201d<\/p>\n

Read more<\/p>\n

about mental health<\/p>\n","protected":false},"excerpt":{"rendered":"In 2017, Julie moved to Massachusetts to start a new job in biotech. She was maintaining her relationship…\n","protected":false},"author":2,"featured_media":157265,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4317],"tags":[105,218,16,15],"class_list":{"0":"post-157264","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-health","9":"tag-mental-health","10":"tag-uk","11":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114624678067043273","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/157264","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=157264"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/157264\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/157265"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=157264"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=157264"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=157264"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}