bottle pillsSome people diagnosed with depression still question the legitimacy of antidepressants and worry they are akin to illicit substance taking, new research has found.

Researchers at the University of Westminster, along with partner Universities in Australia (Monash & New South Wales) and the UK (Oxford and Nottingham), found that nearly 30 years after the introduction of Prozac, people diagnosed with depression often wish to keep their use of antidepressants secret, and fear things like addiction and “going cold turkey”, the potential for personality changes, as well as the mind-altering strength of the medication. 

Such concerns mean that some people experiencing severe depression reject or stop a treatment that might be useful to them. Prozac and similar medicines have received mixed reviews since they were first introduced in the 1980s, with some experts believing that they may be ineffective for many people.

The research, which involved closely examining 107 interviews (68 in UK, 39 in Australia) conducted between 2003 and 2012, found that even before people take their first antidepressant, they are influenced by the controversial publicity surrounding the medication. For instance, everyone seems to have friends and relatives with strong opinions about antidepressants, including fears of addiction – although antidepressants are not known to be physically addictive, discontinuation can bring on distressing symptoms.

While some people in the research argued antidepressants made them feel ‘more authentic’, others were afraid that antidepressants might change their personality. One person involved in the study said: “[I was a] functional zombie…[it] takes away the bad, but also takes away the good.” 

The research found that many people diagnosed with depression talked as if their antidepressant use was “pseudo-illicit”. One man in the UK said of his medication: “it feels very sordid... my dirty little habit, a dirty little stash.”

In addition, while doctors usually tell patients it can take many weeks for antidepressants to work, some research participants believed they were feeling the effects – and even high – after only a few hours or days. One woman from Australia said: “… it was amazing… within two hours I could feel different.” A man from the UK said: “It was like being on really strong drugs… made your pupils dilate.”

The problems of this ‘pseudo-illicitness’ were clear to those considering or taking antidepressants: things can go wrong. One UK respondent said: “I found it quite scary… I wasn’t really ready for taking drugs of that strength.” While others reported they later crashed, or had frightening hallucinations on their antidepressant.

Being on antidepressants is frequently considered some kind of moral failing, and a barely legitimate practice in many quarters. Antidepressants are stigmatised, and their use can signal to people experiencing depression (and their friends and family) a kind of moral failing, or even something shameful.

Professor Damien Ridge from University of Westminster, said: “Given our findings, it is no wonder people in distress find it so difficult to decode the social messages they receive about antidepressants. Of particular concern, those experiencing severe depression who are the most likely to benefit from taking antidepressant medication may think twice about using a potentially life-saving treatment.

“People experiencing depression – no matter how positive about antidepressants – are still forced to engage at some level with a range of underlying moral concerns about antidepressants.

“But a number of people we talked to were defiant about the bad publicity. One person said that their antidepressant was really just ‘a bit like [energy release drink] Berocca, it’s you on a good day’, while another said: ‘I challenge anyone to live my life… without antidepressants!’

Associate Professor Renata Kokanovic, from Monash University in Australia, added: “Antidepressants as a treatment option are admittedly limited, but are said to be valuable by many users, with many claiming they are ‘life saving’ when experiencing severe depression. However, a broader debate is now necessary to better explore the social causes of depression and the societal changes needed to tackle depression.”

The final results of this research will be published in the journal Social Science and Medicine in December.