This weekend The Sun released an article interviewing television presenter Caroline Flack, in which she discussed her year-long battle with depression, and her experience with antidepressants. Using her platform to open up about suffering with mental health issues and the internalisation of the stigmas attached, contributes to a long, and much-needed, conversation about how we treat those with mental illnesses, and how we treat ourselves. Despite a number of risks, her interview was raw, honest, and brave, and hit on a number of the issues those with similar illnesses face — particularly the complex relationship with medication.
However, while I wish to stress that I admire the bravery that comes with being open about depression, especially whilst under the watchful gaze of national media, many of Caroline’s comments speak to wide and damaging misconceptions about depression and medication that already prevent so many from seeking necessary treatment.
Caroline opens up about her struggles and says she is ‘keen to quash the stigma around mental health problems’, however she perpetuates some of the exact discourse she claims to want to challenge.
She was prescribed citalopram — a type of antidepressant used to treat depression and panic attacks — but she didn’t tell her family, friends or boss Simon Cowell of her troubles.
She says: “I didn’t want to be a burden. It was a really lonely place. While anti-depressants can work for some people, I became a little too reliant on them — if you forget to take one, you feel awful.
Anti-depressants helped me get up in the morning, and stopped me from being sad, but what they also do is stop you from being happy. So I was just in this numb state. I stopped laughing at jokes, and that’s just not me.
Her experience with antidepressants is valid — a feeling of numbness is often cited as a common side effect of SSRIs, but framing both her depression and the side-effects she experienced as being solved by a ‘juice retreat in the Mediterranean’ is an insult to others suffering from mental health issues and the stigma attached to it. She speaks about the hardships of being both a celebrity and depressed, the difficulties with everyone assuming your life is ’perfect when you’re rich and famous, but then cites an expensive and glamorous holiday as the solution to all her woes.
Caroline expresses a feeling of numbness, claiming that antidepressants ‘stop you from being happy’, and speaks about becoming ‘too reliant on them’. This is a common and dangerous misunderstanding of how antidepressants work. Depression is an illness like any other, and antidepressants one form of treatment. It is often said to be caused by chemical imbalances in the brain, but a study by Harvard Health speaks to the more complex nature of the illness than that. The study found that the hippocampus is on average 9-13% smaller in depressed women, and that the illnesses is associated with low levels of neurotransmitters. Crucially, in regard to Caroline’s comment about feeling too reliant on them and consequently feeling awful if she missed a dose, the pathological effects on the brain cited in this study take weeks to regrow and form new connections through the treatment of antidepressants.
Antidepressants are not a quick or sure fix to depression. They are not something that you can take as and when, for a little pick-me-up. They need to be taken following doctors advice, consistently, and with awareness of the potential side-effects, such as a feeling of numbness, which can be counteracted by a dose adjustment or a switch to a different type of antidepressants. What Caroline describes as reliance is simply how medication itself words, antidepressants or otherwise. Antidepressants have a half life, and withdrawal from any type of medication, especially if done so without guidance from medical professionals, risks a range of side-effects that would equally be experienced if coming off, say, prescription painkillers.
Most importantly, I worry about how others taking or considering taking antidepressants will be impacted by her comments. For many, including myself, medication is a lifeline. With NHS government cuts hitting mental health provisions the hardest, waiting times for initial assessments and following therapy are leaving millions of extremely unwell and at-risk individuals without any support for the illnesses they are battling. A study in April 2010 by the We Need to Talk Coalition found that one in five people with mental health issues have been waiting over a year to receive treatment, and one in ten over two years. The state of our current healthcare system and the particular importance of accessible medication that results from this is clear; medication is both a vital part of treatment for many, and a lifeline whilst unable to access alternatives such as therapy.
In trying to deconstruct the stigma around both mental health and medication, which I do believe Caroline truthfully wants to achieve, we need to be very careful about the image we are presenting, and the images we are fighting, of medication. Sixty per cent of patients with anxiety or depression are not receiving any treatment, let alone able to afford a ‘detox getaway’ like the one Caroline describes. And whilst side-effects of such medication need to be talked about and taken seriously, and whilst it is true that antidepressants are not for everyone, that is a conversation best had with a doctor, and is not unique to antidepressants.
I worry about the potential of someone considering such treatment reading these comments, and as a result deciding against it. I worry about well-meaning friends and family of those taking antidepressants clinging on to the fact she said they made her stop feeling happiness, and skim over the part when she says they enabled her to get up in the morning. I worry that those who see the interview will take her comment about a juice retreat as evidence for the rhetoric of ‘you just need to get over it’, ‘it’s all in your head’, ‘try yoga’, and ‘you need a lifestyle change, not medication’ that ignores the highly complex and painfully real nature of depression.
In one interview Caroline, regardless of her intention, exposed a plethora of misconceptions about the complex relationship between mental health and medication, about which illnesses we often deem ‘in need’ of medicating, about which solutions and treatments are seen as socially acceptable and which are not. In one interview, many of her comments make clear the stigma she, and many others also suffering, including myself, internalise and reproduce.
I don’t want to demonise her for her comments, nor do I feel it’s anyone else’s place to comment on the treatment options she felt would work best for her. Instead, I believe it’s important to take this as an opportunity to reflect on ourselves. To examine how we treat ourselves and how we treat others with mental illnesses. Are we denying ourselves viable treatment options out of the shame that Caroline expressed herself? In the way that we discuss mental health and medication, and we guilty of inflicting the same onto others? Antidepressants do not work for everyone. But for some, they change and save lives. Ultimately, are we being kind to ourselves? Are we being kind to others?
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.