For many during COVID-19, mornings have begun, not with sunshine and opportunity, but exhaustion and anxiety. Tasks not life’s joy, but its burden. Human interaction is not exciting, but dreadful. For many, this is not a phase ─ it is a constant. This is what it’s like to live with Major Depressive Disorder.
Of course, it looks different for many – some painful experience like that, though, is what 18.1% of Americans suffer from. It’s clearly hard enough on its own, which is why it’s preposterous that we subject those who are suffering to blatant stigma. Indeed, countless stories detail the anxiety that individuals face in admitting to others what they’re going through, a key aspect of getting help. For so long, sharing about mental health has felt like a taboo. Something to be ashamed of. Something to keep to yourself.
Forced by fear to keep everything to themselves, many also buy into the stigma surrounding treatments – specifically about antidepressants. Without others to turn to, we believe media headlines that espoused the idea that, as one headline puts it, “antidepressants do more harm than good.”
Negativity surrounding antidepressants have kept many from seeking life-changing treatment. It’s time, though, to recognize as a society that there is a science behind mental health disorders – that it isn’t just a weakness to overcome – and to then acknowledge the overwhelming evidence that antidepressants can help.
To begin to challenge this stigma, David Nutt’s commentary looked at why top researchers in psychiatry were endorsing negative headlines that the commentary characterized as a “polemic” that abandoned researchers’ training in evidence analysis. Nutt reasoned that this rebuke of antidepressants might come from a societal stigma spurred by an anti-psychiatry movement.
The negative attitudes ignoring “evidence analysis” rest on ignorance to the fact that neuroscience is linked to depression. However, decades of research have pointed out that depressive disorders are associated with brain abnormalities. While you may have heard of low dopamine and serotonin being linked with depression, a review by Alexander Kaltenboeck and Catherine Harmer in 2018 details how there have been many more areas of the brain found to be linked as well.
They argue that these new findings show how depression can look different in each person when examining their brains. This neuroscience research must be used to avoid reliance on general symptoms that oversimplify depression because, in reality, it’s complicated and different for everyone.
To acknowledge these findings is crucial because American bootstrapping ideology has infiltrated rhetoric surrounding depression. Margaret Wehrenberg, writing for Psychology Today, argues that the key “out of depression” is to “overcome fear.” Though she makes important points, like avoiding being alone, her overall message is that it’s a person’s responsibility to pull themselves out of depression through daily improvements.
This rhetoric is dangerous. Daily improvements are important, but reductive claims that depression is merely “fear” deepens the chasm between depression and neuroscience. It isolates suffering individuals from considering antidepressants, creating a self-perpetuating cycle of wondering why they cannot overcome “fear.”
Becoming vulnerable and open to the potential for treatment by transcending stigmas can turn us towards actual science that shows antidepressants can work. We can begin to acknowledge reviews such as Andrea Cipriaini’s at the University of Oxford. In 2018, their review looked at 522 existing clinical trials that tested the efficacy of antidepressants. They found that all of the antidepressants tested were more effective than placebos used in each study.
Antidepressants, though, are not for everyone. In some cases, the review showed that improvements were only “moderate,” or ineffective. Because of this, antidepressants aren’t complete solutions, other treatments like therapy should be considered as well.
What we shouldn’t do is write off antidepressants for everyone. Neuroscience shows how depression looks different in every person’s brain; it makes sense that different treatments work for different people. But if just one person could benefit from antidepressants, we shouldn’t deny them that opportunity. That means recognizing it’s time to abandon an unfounded stigma.
We must take the increased discussion and vulnerability about mental health during COVID-19 to change how we think about depression disorders to help ourselves and help others. Every treatment, from therapy to antidepressants, must be on the table. Without that, we continue to perpetuate a society that denies the suffering a chance. A chance to make days the opportunities they were supposed to be, not the dread they’ve become.