Recently at a concert at the O2 arena in London, Lady Gaga confessed to her fans that she takes antidepressants for depression: "I take medication every day for mental illness and depression and [I] don't feel bad about it." She then went on to serenade her fans with a rendition of her hit song "Born this Way."
Why would she feel bad for taking an antidepressant? Stigma.
But how can stigma exist in Canada when Canadians are among the highest antidepressant users in the world: "with as much as 9 per cent of the population on one depression-fighting drug or another, according to a new study from the OECD."
If 9 per cent doesn't strike you as a lot, do the math. The Canadian population was last estimated at roughly 35 million. That's over 3 million Canadians taking some form of psychopharmaceutical. That's a heck of a lot of people.
Stigma about medication and mental health exists because no one talks candidly about it. It's great that public figures like Lady Gaga are talking more and more openly about mental health, but it's not enough. Confessing you take medication for depression is only step-one in combating stigma. The rest is talking about the nuances of what taking medication is actually like. Demystifying the belief that it's a magic pill (it isn't) or that antidepressants are exclusively bad (they aren't).
Over the course of the past 10 years, I think I have taken more pharmaceuticals than the average person will take in their lifetime. I play a weird memory game with myself and I try and run through all of the prescriptions that I have filled over the years. The names of SSRIs, SNRIs, and antipsychotics have become like a mantra: Zyprexa, Ativan, Effexor, Lithium, Wellbutrin, Risperdal, Seroquel, Clonazepam, Zoloft, and Celexa.
But it hasn't always been this easy to confess that I have taken and am taking these medications. It took me over 10 years of silent suffering to admit that I have a mental illness and that I depend on medication to function. I've started openly talking to friends and family about how medication makes me feel, how it intrudes on my life, how it messes with my memory and recall, and despite knowing that it manages my mood that it's a struggle to swallow that little pill every morning and night.
To be honest, I'm embarrassed that I probably take more medication than my 80 year-old grandmother. When we have company over, I'm like a squirrel, stashing my pill bottles like nuts to keep them away from prying eyes. I spend five minutes every Sunday filling my pill dispenser that I refer to as my "pill hotel." No one knows that I need to remember to take my medication with me if I go out. I worry about taking my pills on time. If I take a certain pill too late, I'll never wake up the next day. If I forget a dose, I have the symptoms of a heroine addict going through withdrawal. I don't tell people about how I worry about going through customs with all of my pill bottles in my carry-on, lest I become like this lady. My medication causes my memory to really suck. And at this very moment I'm struggling with forming sentences and articulating words.
But it's not just these weird idiosyncratic life interruptions of taking medication. I often worry about the toll these pills are taking on the organs processing them. They all pass through the liver which is terrifying. Not only that, but most antidepressants and antipsychotics also wreak havoc on your metabolism and interfere with certain chemical receptors in your brain that cause weight gain. So, I'm about 30 pounds heavier than when I started taking psychopharmaceuticals and that's something I've had to learn how to cope with. It sounds like an okay trade off -- being heavier and alive versus depressed and suicidal -- and I agree. But with depression comes an inherent lack of self-esteem, so it's hard facing the mirror. And if all of that isn't enough, one of the medications I take also negatively impacts cholesterol. So at 28, I'm worrying about cholesterol levels and have my blood taken regularly. There's also the odd side effect of excessive sweating. Some people are lucky and it only happens at night but others are not (embarrassingly, I'm in the "are not" category). And let's not even get into what happens if I choose to become pregnant... that issue is its own blog post.
So if it's so shitty taking these medications, why do over 3 million of us decide to take them? Tell me what the alternative is. Therapy! Of course there's therapy, but those in crisis (e.g. suicidal or psychotic) know that expressing how we're feeling is basically impossible. So even if there are studies that show that antidepressants may do more harm than good and that they don't work, if you're in crisis and feel like ending your life, the ability to take a pill that might stop your brain from turning against itself is sometimes enough to keep you holding on.
If you are among the lucky population who does react well to medication, taking a pill may allow you to work through the problems you're facing in therapy and hopefully you won't have to be on medication for the rest of your life. But the reality is that for some of us suffering from chronic mental illness, therapy isn't enough. With Bipolar Disorder, I don't think a form of therapy exists that would allow me to manage my mood better than taking Seroquel and that's a reality I've started to come to terms with. I console myself with the fact that Seroquel is a better alternative to Lithium (for me).
Living with a mental illness, whether it's depression, anxiety, bipolar disorder, or schizophrenia, is always a balancing act. You have to balance out what's worse, the symptoms of your illness or the side effects of the medication, and it isn't always easy to decide. Some people decide not taking medication is the way to go, but many people decide pills are a good way to deal with their illness. Whatever your decision, never let anyone tell you that you're weak for having a mental illness or that taking a pill is the easy way out. We'd never say this to a diabetic taking insulin or a cancer patient going through chemo. Whatever you're facing, you're a mental health warrior on an incredibly difficult journey that is often filled with more downs than ups.
So I urge my fellow mental health advocates to continue talking candidly about what life is really like for those of us taking medication and living with our illness. At the end of the day, it's all about ending stigma and unfortunately there's no pill for that.
A version of this originally appeared on Healthy Minds Canada.
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