I’ve never had a more negative reaction to an article I’ve written than I did to my last one: ‘Before you take antidepressants, read this.’ One of the big statements in the article was that there has never been a scientific study that shows that antidepressants have a clinically significant effect — i.e. one that would be felt by a patient.
Lots of studies have shown that they have a ‘statistically significant’ effect, which means you can measure the impact. But, according to Dr Mark Horowitz (the psychiatrist I had interviewed), they have the equivalent impact to a weight-loss drug that helps you lose 30g.
The article was described by different people as ‘damaging’, ‘irresponsible’ and ‘bullshit’. The consensus of about 40 comments on Facebook (from people I don’t know) was that antidepressants really had worked for them — saved their lives even — and that suggesting that they don’t work is a harmful thing to do.
When I first started writing blog posts, I was really nervous about getting negative feedback: people saying I didn’t know what I was talking about, and criticising me for being wrong or not well-enough informed. The criticism never materialised and the positive feedback I got built my confidence to keep writing.
The negative reaction to my recent article was just about the worst possible reaction I could have got, and it was really difficult to deal with. Somehow, my positive intention seemed to have become, ‘You are doing so much harm that you might cause people to commit suicide.’ That is no small thing to be accused of.
I felt angry and anxious. I wanted to win the argument and prove my critics wrong.
The context of the article is that my mum had a severe breakdown at the start of lockdown. In the last two years, she’s been prescribed multiple antidepressants, anti-anxiety medications and anti-psychotic medications.
By the summer of last year, she was on five different medicationss and spending almost every day in bed, in a zombified state.
During that time, my sister’s friend, who is a clinical psychologist, introduced us to her psychiatrist friend, Dr Mark Horowitz.
We had dinner and he told us his own story of being on antidepressants for years, and prescribing them to patients for years, before realising that the side effects were ruining his life. When he tried to come off them, he found it incredibly hard. He’s since done lots of research that has shown that many patients, and indeed psychiatrists, have been misled about the evidence base for these medications.
He says that they are less safe, less effective, more harmful and more addictive than we’ve been led to believe.
After that dinner, we replaced my mum’s psychiatrist with one of the very few who specialises in helping people come off their medication. Under his guidance, we have been slowly reducing her doses and, although she’s still really suffering with anxiety and depression, she is a lot less zombified and able to engage with talking therapy.
The intention of my article was to warn people that they might not have been told the truth about antidepressants, and to suggest that, rather than taking the word of their GP or psychiatrist, they should do more research before they either start taking or try to stop taking them.
It was not intended to be, ‘This is the definitive gospel truth on antidepressants.’
When I posted my response to the comments, I just antagonised people further by getting defensive and linking to studies I didn’t really understand to try and prove I was right. It must also have felt very dismissive when I responded that if people had had positive experiences from taking antidepressants, then according to Dr Horowitz, that was most likely to be the placebo effect.
It felt like I was getting further entangled in a web of never-ending arguments in which neither side was listening to the other, only making each other more upset and angry.
Sound familiar? See also Brexit, Trump, Extinction Rebellion, Covid vaccines, J.K. Rowling’s comments on gender,and whether or not Christina Aguilera looks good in green leather.
The situation consumed my thoughts for several days. And I kept trying to win the argument in my own mind.
I got two useful pieces of advice from friends.
One was to ask myself when I’d had similar feelings to this in the past, and I immediately realised that it reminded me of feeling bullied at school. People ganging up and attacking me without justification. Feeling alone. She suggested I work on healing those uncomfortable feelings.
The other piece of advice was from my friend who teaches Non-Violent Communication — she’s basically an empathy guru!
She asked me if I had offered the people who were angry with me shedloads of empathy. Because, if I hadn’t, they wouldn’t be listening to a single word I said. She said she was imagining how angry they must feel that I was saying something they believe saved their life doesn’t actually work. She was imagining how worried they’d feel about people not getting the same life-saving treatment if they were misled by articles like mine.
In the end, I wrote a response that was a lot more empathetic, while still saying why I trusted Dr Horowiz and his assessment of the science. It didn’t get any critical responses and I felt I could finally stop worrying about it and arguing my case in my own mind.
This article brought up a really important question: who can we really trust? For a lot of people, doctors are high up on the list. I have a lot of faith that the vast majority of doctors and psychiatrists have good intentions. But I also know that they are heavily influenced in their prescribing by drug companies, which have a long history of producing misleading information about the safety and efficacy of their drugs, and whose main allegiance is to profit..
I’ve ended up thinking the question of who to trust is a lot more complicated than I would like to think.
The main thing this brought up for me, though, was the issue of how to take criticism. I like to think of myself as someone who is willing to consider different perspectives, but it seems that when I consider your perspective to be a criticism of me, I don’t want to hear it! There’s part of me that feels angry, defensive and wants to silence you.
By having a strong intention to feel those uncomfortable feelings and meet the perceived criticism with curiosity, I will become more mature, willing to listen to feedback, and less terrified of people saying that I’m wrong, that they disagree with me or that they don’t like something I’ve done. I’ll be a stronger person who’s more willing to put their head above the parapet on important issues.
It was a very uncomfortable experience, but I learned a lot from it.
