The More Acceptable Kind of Stigma

Today is World Mental Health Day. Among the various excellent articles I’ve read to mark the occasion, the one that stuck out the most for me was on the F-Word blog.

I’ve taken psychiatric medications for 17 years, and that’s unlikely to change any time soon. I’m not overjoyed at the sheer range of pharmaceuticals I swallow every morning and evening, but it is far from the most significant aspect of my mental distress. So why do so many people focus on the pills as the problem?

The author points to articles raising concerns over the rise in antidepressant use. She responds that, while it’s true that medications shouldn’t be a replacement for psychological therapies where required, we also shouldn’t criticise people who genuinely need those medications. She quite reasonably concludes.

Antidepressants are not the enemy. I agree that appropriate psychological support should be more widely offered, and that medications should be reviewed regularly. However the problem is not with the pills. The problem is the world we live in that makes so many of us despair enough to seek medical help to manage it. It’s with the levels of rape, domestic violence, female genital mutilation and sexual abuse that can make live unbearable for so many. World Mental Health Day should not be ‘celebrated’ by stigmatising us for coping in whatever ways we can.

I couldn’t agree more. When I tell people I work in mental health, I regularly get asked whether I “believe in therapy or medication”. I always think that’s a really weird question. It’s not as if car mechanics get asked if they “believe in” spanners or screwdrivers. If somebody did, then that mechanic would respond that some problems need a spanner, some need a screwdriver, and he needs a variety of different types of each.

Likewise, some people need a certain type of meds, some people need a certain type of therapy. Some people need both. I really don’t get why that’s so difficult to understand.

But some people do seem to have a problem understanding it. There’s pretty much an industry in chin-stroking broadsheet articles decrying the evils of psychiatric medications – the Guardian seems to average one every couple of weeks at the moment. They have a habit of coming out with slightly crass remarks like this.

But doctors could recommend group running for depression, proved to have far better effects than SSRIs. Reading groups, too, offer a definite lift.

Depressed? Join a reading group! Well, that’s fine until you remember that as people get more depressed their concentration and short-term memory gets worse and worse. I’m sure a reading group would get somebody out of a bit of a rut, but a deep depression? They’d probably smack you in the mouth for suggesting it, if only they had the energy.

I really am tired of this tedious meds-versus-therapy false dichotomy, as though offering one prevents us from offering the other. I’m not saying everybody should take a pill, but there are a lot of people who can cope with life when they use psychiatric medications and can’t when they don’t. Those people shouldn’t be criticised or patronised for it.