There’s a New York Times article on mental health – and reactions to it – making the rounds on my social media feeds. The article under debate is “Many People Taking Antidepressants Discover They Cannot Quit.” And the NYT has a less than stellar track record on mental health. They’ve run articles on whether we should construct a new wave of “modern asylums.” Based on people’s reactions, and the NYT track record, I mostly expected the antidepressants article to be shaming medication use. It wasn’t. It discussed antidepressant usage and prescribing habits. And as the title promises, the people who can’t go off them, due to extensive and protracted withdrawal symptoms.
It’s not necessarily well-written as a public health article. And it is not an article that is telling people to stop using their medications long-term. Yet the discussions I’m seeing are talking about med shaming and taking meds long-term. Which, if you feel like long-term medication is most beneficial to you, you have every right to it. At least some of that discussion, I think, is rooted in fear that the article will contribute to medication shaming. I do get that. I’m on meds, including an antidepressant. I like a couple of them. I don’t like it when people think I shouldn’t have access to them because they think all meds are the same or evil.
But the article is about effects of withdrawal when people try to go off of them. It is about people not knowing these risks beforehand to make an informed choice. It is about doctors not providing informed consent. My perspective is shaped by the fact that I had been medicated for a long time before I was able to assert more control. Not “taken medication,” but “medicated,” with little information on the drugs I was being told to take. I am now on two that I cannot taper off of right now, because I’ve been on meds for so long. I know; I’ve tried. So: informed consent is a thing that should exist.
The article discusses people being unable to get off medications, and the response I’m seeing is to talk about it being okay to take them long-term. But not everyone on antidepressants finds an adequately stabilizing one. Not everyone on antidepressants wants to be on them forever. People get to make choices about if what the medication is doing is worth it. If a person wants to go off of a medication, reassurance that it’s fine to be on it long-term is a response I do not see as helping.
So I find it disconcerting that people would turn the subject to the stigma of taking long-term medications here. We need to be talking about side effects. We need to be talking about withdrawal. We need research on effects – positive and negative – that can help guide informed consent and people’s medication choices. I do understand stigma and medication shaming exists. If people do that in response to this article, or anytime, it’s inappropriate. And I have been on the receiving end of medication shaming, too, and it’s demoralizing.
But I don’t think criticizing the article for what it doesn’t say – as a preemptive defense against med shaming – is useful. We should critique and criticize based on some of its actual flaws: it is written with, perhaps, some sensationalism. It lacked clarity at some points. It may deter some people from finding something that works for them. But it does not argue against people’s personal choices to stay on antidepressants long term.