After spending 2017 doing little to help the mental health of any UK citizen, as an early New Year’s gift, the Daily Mail made one last attempt to attack people struggling with mental disorders by stamping “A NATION HOOKED ON HAPPY PILLS” in big black capital letters on its front page.
The study the Daily Mail based this absurd statement on was one showing that antidepressant use is on the rise in all developed countries and Britain is fourth among a list of 29 other Western countries, slightly up from the year 2000 when we were seventh on the list. According to the OECD, the current UK consumption rate of antidepressants is 94.2 doses a day for every 1,000 inhabitants. This is nearly double the number of France, Italy and Holland. Basically, it would seem that proportionally, a reasonable number of us are using antidepressants for no doubt numerous reasons.
They weren’t the only tabloid to report the story sensationally and badly: The Sun ’s “ Fears Brits are getting hooked on antidepressants as prescription rates TREBLE in past 15 years” and The Mirror ’s rehash of the Daily Mail’s, “ Britain is ‘becoming hooked on antidepressant medicines dubbed 'Happy Pills' as patients seek quick fix” . But it was the Daily Mail that went in the hardest to reinforce the stigma around antidepressants. The takeaway message from their story was firmly: we’re taking them far too frequently when we don’t need them at all. Alongside this article it ran a separate piece of commentary by a doctor that stated “magic pills” are “not the answer to feeling down”.
The Daily Mail has history here. The tabloid has consistently – stubbornly – used those words to stand in for antidepressants for years as if it’s written in their style guide: “ GPs over-prescribe happy pills” (2004), “ Paedophiles offered ‘happy pills’ to curb their sex drive” (2007), “ Will we ever wake up to the deadly risks of happy pills?” (2010), none less than Janet Street-Porter with her column “ Doctors doling out happy pills are just as bad as drug pushers” (2011) and “ Our terrifying addiction to antidepressants: GPs dole out 25 percent more ‘happy pills’ in just three years” (2014) are a handful of many.
It goes without saying that the expression “happy pills” is more than just misleading, it's just plain wrong. It implies there is some sort of high involved with antidepressants which regrettably isn’t the case. Depression isn’t the opposite of happy. Rather than make you happy antidepressants can, in certain cases, save your life. They can enable you to cope with waking up in the morning. They can emotionally blunt you. They can prevent you from being able to have an orgasm, take away your sex drive. They can make you sweat like you’re wearing a long sleeve at the beach. They can make you put on weight. It’s not an easy decision to go on antidepressants. No one has ever swallowed an SSRI chasing a buzz.
But none of that matters in the hivemind of the Daily Mail, which clearly wants to align anti-depressants and recreational narcotics, in order to mislead their readers and blur the line between treatment and addiction.
This latest instalment in the “happy pills” crusade contains enough failings to fill a dissertation. It demonises medication without offering alternatives, while quietly acknowledging the long waiting lists for CBT and talking therapies. There is no context provided about depression or anxiety disorders or what health problems are treated with antidepressants (everything from PMS to IBS). It ignores the many studies which say that, for severe depression, a combination of therapy and medication is the most effective course of treatment. It doesn’t mention the fact that CBT and talking therapies alone can be ineffectual if you’re struggling too much to do any of it.
Reporting guidelines set out by Time To Change, the leading anti-stigma mental health campaign, advise if you’re talking about mental health to use case studies to humanise mental illness. The only case study this article used was a scare story of a woman who died after using a combination of prescription drugs that happened to include antidepressants. The tips also tell journalists to “remember you have the power to help improve understanding and attitudes towards mental illness” by, among other things, “breaking down myths about mental illness, encouraging openness”.
Rather than following that advice, the article states that “experts last night said patients were demanding a quick fix to avoid feeling down” as if those seeking treatment are insolent and preempting pain they don’t want to have to tolerate.
The National Union of Journalism (NUJ) reporting guidelines remind journalists that with mental illnesses such as depression, proper treatment is needed: “Psychotherapy and/or medication have been shown to help. Many people who have gone through this actually feel stronger.” Instead, the article firmly suggests without balance that we’re needlessly hooked on them.
Finally, the NUJ explicitly tells journalists not to glamourise or sensationalise, and not to use colloquialisms such as “happy pills” for antidepressants.
The clout of anti-medication media coverage is criminal. For all the “breaking down” of stigma surrounding depression and anxiety there is a great deal of lingering shame about mental health meds. Most people who take antidepressants, and its around 1 in 10 people who do, keep them a secret from most people. Real experiences of antidepressants - from teachers, parents, sucessful people - are almost absent in the media and in our lives. Instead television gives us jokes about Citalopram-popping stepmums and a bathroom cabinet with a bottle of Prozac as precursor to on-screen murder, suicide or otherwise plot twist/dramatic behaviour.
Looking retrospectively at the surge of celebrities “being open” about their mental health “struggles” in recent years, discussing problems from panic attacks to OCD, a key missing element is talk of antidepressants or medication. From the top of my head Kristen Bell and Amanda Seyfried have talked about antidepressant use, Jon Hamm said the combination of therapy and antidepressants helped his depression and of course, Carrie Fisher was famously open about medication, inviting journalists to see her pill organisers and even, according to one profile, had a tiled floor, each tile shaped and labelled like pills of prozac. I have those in a mental bank because it’s such a rarity. Most often, if medication isn’t completely ignored in discussion of illness or hardship, they’re talked about in a shady past tense, for example, Jim Carrey said he was on them for years but they numbed him out. Not that anyone has to explicitly say what form of treatment helped them but from a PR point of view it’s acceptable to now say I went through a struggle without giving any details and gesturing to some form of safe breakthrough or therapy but not giving details.
I always remember a Guardian comment piece that said, “At some deep level we want people to be wrong for choosing to take antidepressants” and I think that’s true. There’s an instinct in people outside the chronic community to think that because they’ve had depression or anxiety – potentially self-diagnosed – and haven’t resorted to antidepressants, that another individual is somehow lacking for using them. They haven’t tried hard enough with self talk or natural options like yoga and meditation. The internal shame for those with long-term illness can be intense too. They’ve fought a long time to reduce their dose or stop taking them entirely only to have what falsely feels like a relapse or a step backwards if they go back on them again.
Unfortunately for right-wing propaganda, enough people and their loved ones know “happy pills” and understand their place in treatment. Frankly, the Mail and their journalists can pry the Citalopram from my cold dead hands.