A scheme prescribing pot plants to treat depression caught the attention of the nation’s media at the end of the summer. Instead of antidepressants (ADs), patients at a Manchester surgery are being given herbs with ‘mindful qualities’ in the hope that caring for a living thing will lift their spirits. This follows Health Secretary Matt Hancock last year urging GPs to engage in similar forms of ‘social prescribing’ to steer patients away from ‘unsophisticated drugs’, proposing gardening and arts clubs rather than pill popping.
As someone who has been medicated for depression for the best part of a decade, can I be the first to issue a hearty ‘fuck off’? Social prescribing may be a nice idea for the mildly, passingly unhappy.However, this charming, bucolic fantasy perpetuates the myth that we seriously wretched types simply don’t know how to live, merely requiring to try harder to cheer up. After losing yet another friend to the condition this spring, I know that depression can be fatal. And I’m over being patronised by a political establishment that would never dream of telling stroke patients to give up their statins, diabetics their insulin. I like plants, I love art galleries, but neither is going to cut it when I’m so miserable I want to die. For that, I’m going to stick with Citalopram.
Citalopram (or Cipramil) is one of eight SSRIs administered in this country: that is, selective serotonin reuptake inhibitors, or drugs that increase the amount of serotonin (the chemical that helps regulate mood) available in the brain. Other popular examples include fluoxetine, known by its brand name Prozac, sertraline (Lustral) and paroxetine (Seroxat).
Far from proving ‘unsophisticated’, SSRIs are a daily miracle allowing millions of us to function – a benefit not enjoyed by previous generations. SSRIs not only save lives, they make them worth living. And, nine years in, I remain fervent with gratitude. While I acknowledge that a few have found the side effects outweigh the benefits, for me, the only side effect – other than a mild thirst – has been stability. As Professor Wendy Burn, the president of the Royal College of Psychiatrists, argues: ‘The drugs do work – that’s why we prescribe them.
Social prescribing perpetuates the myth that we wretched types simply don’t know how to live.
And yet anyone who picks up a newspaper will be aware that we live in what might be referred to as an age of happy-pill hysteria. Latest NHS figures reveal that over 70 million antidepressant prescriptions were issued in 2018 – almost double the amount distributed 10 years earlier. Cue headlines demanding inquiries into the scandal of over-prescription, scare stories regarding aggressive and suicidal behaviour while on ADs, and horrifying accounts regarding the difficulty of withdrawal.
In an age of social media extremism, those of us who have defended SSRI use – from the Royal College of Psychiatrists as an institution, to individual patients – have found ourselves on the receiving end of savage trolling. After Dr David Baldwin, professor of psychiatry at Southampton University, wrote to a newspaper arguing that the symptoms of coming off ADs were minimal, he was branded ‘a pharmaceutical rapist’ and ‘a lying serial murderer worse than Hitler’; a sustained campaign of abuse that led to his own period of depression and SSRI treatment. When I wrote a lengthy article in which I spoke about my own and others’ varied experiences with and without medication, I was trolled for being a shoddy journalist and drug-company stooge.
And yet, even as we’re being abused, Professor Baldwin and I know that we are the lucky ones. We’ve had the guts to acknowledge our situations to ourselves and to others, the luxury of being listened to, and the luck to get treated. For as Dr Carmine Pariante, professor of biological psychiatry at King’s College London, tells me: ‘If prescriptions are going up, this simply means that more people are asking for help. More significant is that only a third of people suffering from depression actually seek help.’ Worry not about the number of individuals receiving treatment, worry about the two-thirds who aren’t.Happy-pill hysteria – and the provision of pot plants – will only make these individuals less likely to seek help.
If I sound militant, then I am militant. I’m sick of being condescended to, sick of losing people, sick of the blame and shame culture that tells us to feel guilty, not only about our illness, but its cure. My SSRI changed my interior monologue from ‘I want to die’ to ‘Things could be worse’. If this appears slight then, I can assure you, it is everything; meaning I – like millions of other depressives – am grateful to live in an age in which our misery can be abated. Better Elizabeth Wurtzel’s Prozac Nation than Sylvia Plath’s Bell Jar.
In July, Hannah Betts was awarded a President’s Medal by the Royal College of Psychiatrists for improving the lives of people with mental illness through her journalism.