I’ve been on a variety of ADs for the past 20 years and once posted here that they saved my life and my marriage. Which is true, but I am still not sure they have been so good for me. I stay on them because they are good for my children, not because they are so good for me.
For one thing, I find they don’t really make me less depressed. They just make me feel everything less. I appreciate this, since many of the feelings I have are so dire I would much rather not feel at all. They also seem to make me less likely to get angry and shout. This is good for everyone I interact with, not only my children and husband but innocent sales clerks, fellow drivers, etc. Not so sure it’s good for me.
On ADs, I don’t feel happy feelings any more strongly than I feel bad ones. I am very dopey: sleepy all the time, and also lethargic in the sense of not wanting to do things: I get nothing done more than the basics, shopping for food, cooking – and even that takes huge effort. I was once so organised, I had hobbies, my photo albums were up-to-date, I tried new recipes all the time, I played with my clothes, I wrote to friends and family at length and often. I do none of that now. I gained more than 2 stone in my first 6 months on ADs; I got stretch marks, which didn’t happen when I was pregnant. I need to sleep at least 14 hours a day – need to: if I don’t, I’m physically exhausted. I have no sense of excitement or invention.
I think that ADs are prescribed by doctors because they have nothing else to offer, since it is so expensive to get psychiatrists privately and so impossible to get any time on the NHS. (And this is NOT the fault of the doctors, who sincerely want to help.)
But then I have similar misgivings about talking therapies too. For one thing, talking to a professional seems like just a way to compensate for not having anyone in my life I can trust enough to talk honestly. I don’t think this is unusual in me. Very few people have such family and friends that they can talk gloomily and grumpily to them for months or years and still hope to be friends. Women especially are socialised to be upbeat and cheery. I’ve noticed that British women, while they bond over seeming to complain, still “complain” in a cheerful voice and about small things – “Oh, isn’t it so hot!” “Oh these toddlers – I can’t even go to the loo alone” kind of small talk. Not real talk.
I also think that the main function of ADs and therapists is too often to make it possible for us to function without acting out feelings that are sometimes quite legitimate. For example, with a disabled child, I have many (female) friends with disabled children. We moan (British word, so much more innocent than “grieving”) jokingly about how this one won’t eat anything but white food for years on end, or that one ended up in hospital just before our we were hoping to go on our first family holiday in years, but we never say things like: I am so angry. This is so unfair, I did nothing to deserve this load. I have to take whatever appointment I can drag out of the NHS for my child no matter how bad the timing or location. I cannot feel part of the wider world of mothers and children because we are different and perhaps scary to others; when my child acts up, I feel ashamed that other people blame them, and sure that they blame me for bad parenting. I am afraid my child’s life will become more and more miserable as they get older and recognise their own difference from their peers. They are so lonely, but they must stay lonely because how can they marry and have children? I am afraid I will never get any life of my own because I am stuck being a carer forever. Sometimes I blame my child for this. Then I blame myself, because I know they didn’t choose to be disabled. And maybe it IS my fault they’re disabled; maybe I did do the wrong thing in pregnancy, or early motherhood, or yesterday. We do not say these things, because if we did we would have to start screaming, or rioting in the streets.
I do think CBT, which I tried several times, is a bit back to front. It’s not that I’m depressed because I tend to engage in catastrophic thinking; I imagine trouble coming my way BECAUSE I’m depressed. And also, because my life has shown me that it’s logical to expect trouble: I was raped by a fellow student; I had years and years of infertility; I have a disabled child and also care for aging parents with dementia. And my husband tells me I’m “morbid” when I suggest we need to put Advance Decisions and Powers of Attorney in place. In fact, repeated studies have shown that people diagnosed as “depressed” (even if they have simpler histories than mine) tend to forecast more accurately than so-called healthy people.
Not to mention which, CBT seems to me to have an element of blaming the victim. Look, you’re depressed because you don’t know how to think right! You have failed to think right! We will teach you how to think right, like everyone around you, and then everything will be fine! The problem isn’t that mortgage rates are rising and real incomes are plunging, it is that you are no good at living life like everyone normal! Here, have a pill or a few hours' attention and there will be no more sexism in the world, no more racism, no more unpredictability or injustice – the problem was not reality, it was you all along!
I sometimes look around me at my fellow-women and think that we are all spending a huge amount of time drugging ourselves so we don’t start screaming. Women are disproportionately likely to be using ADs. Botox is also more and more common, and has been proven to reduce actual feelings of anger by preventing women from frowning. How can we turn the world upside down if we are putting all our energies into not feeling angry about the unfairness of the real world around us? My husband had an affair or two and I didn’t throw him out, I talked firmly but calmly about it and we got past it. This is for the best, because I have no income and three children, one quite disabled, but it does also let him off the hook, doesn’t it?
So my thinking brain tells me all this. But I don’t want to listen to my thinking brain, let alone my feeling brain. I have children. I cannot mess around. I am not likely to come off ADs anytime soon, because in the end I think protecting their happiness is more important than my own. This attitude may indeed be part of the reason I’m depressed – because my own happiness is not a priority to me – but I still believe that it is the deal I made when I chose to have children.