A Considered Choice

I was motivated to write this after reading Deborah Orr’s piece in Saturday’s Guardian. I was confused by this article - what was it trying to say? Clearly, the writer is going through something personal and difficult. It’s a positive thing that a prominent journalist in a major paper is willing to share her experiences of mental health. There is a valid point to be made, sadly, about the weakness of mental health provision before, during and after diagnosis and it is right to attribute this to funding shortfalls in NHS mental health. But – to generalise from a personal experience is not always appropriate. 

Ms Orr’s experience of Citalopram was clearly difficult for her and I feel sympathy for that.  I don’t want to minimise or pass judgment on how she felt after her first dose, because I am not her and she knows how she felt. But the information leaflet that should have been in the pack would have advised against taking it in a public place; it would also have said that Citalopram needs to build up before it can impact, which can take a minimum of 3 weeks, and potentially even longer, and negative side-effects are likely to decrease after the first 1-2 weeks. A quick google search could also have given her this information.

There is a danger in her piece because Citalopram works for many, and her article may have scared people away from something that could be the answer for them. I have seen it help someone I love, who has had a long and hard path to improving her anxiety and depression, of which Citalopram was one element, but an important element.  There was a time for her when it was the only thing that made it possible to be.

Many people, me included before I saw it work, have a kind of inbuilt fear of anti-depressants.  We think they are a slippery slope down.  Ms Orr is right to say that support and counselling are needed as well as medication, and it shouldn’t be the first response for everyone, but to make Citalopram a villain is not helpful.  There is more to it than that. Reading that article might just push someone away from something that could make their days tolerable enough to live through.

Of course, she’s right, there is so much lacking in our mental health system at present and you need to fight and push to get what you need-something a mentally unwell person is often going to struggle to do.  But don’t run away from an anti-depressant because of that article – think it through, get counselling and support whenever you can, as well.  But make it a considered choice, not one fuelled by misunderstanding or fear.