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How to decide?

Information should not substitute for a consultation with a medical practitioner.

General information does not always fit a specific individual. The use of medication needs to be individualised.

Respect and concern are the cornerstones of a good therapeutic relationship and it is important that medication is prescribed in this context. It is essential that this is a partnership where the ‘patient’ or ‘consumer’ participates in the decision to take medication. It is OK to ask questions and participate in the decision making process.

Like most other illnesses medication is often needed as part of effective treatment. Before medications are started a thorough assessment is needed. Starting medication should not be rushed into. Conversely avoiding medication can also be detrimental.

Sometimes the first medication used doesn’t suit or doesn’t work – let your doctor know about side effects or lack of effect – don’t give up.

“Part of me felt betrayed and defeated going on medication. It went against my values, my ideals, what was important to me. At the same time there was the hope that things would soon improve.”

From Finding Hope: A journey through postnatal depression
by Louise Frame

Barriers to Taking Medication

It’s usual not to want to take medication, and it’s healthy not to want to take it unless you need it. Common reasons for not taking medication include:

  • Feeling you don’t need it, that you should be able to do it on your own.
  • Not believing that depression is an illness often helped by medication.
  • Other people not wanting you to go on it.
  • Feeling a failure or embarrassed.
  • Fear of other peoples judgement.
  • Worry that someone might use it against you (e.g. in a custody dispute).
  • Fear of becoming ‘dependent’ on it.
  • Fear of side effects.
  • Loss of custody of children if "mentally unwell". Being on medication does not weaken your case for custody/care of your children; in fact it may strengthen it as it shows you are seeking appropriate help.

What can happen?

Antidepressant medications are not addictive in the traditional sense. Sometimes it can take a while to find the right dose for you but unlike drugs of addiction you do not need more and more to get the same effect.

Some of the medications can lead to withdrawal symptoms if you stop them too suddenly (paroxetine is highly likely to cause this).

Some people who have had three or more serious depressive episodes in their life do best if they stay on medication because the risk of getting another episode is high if they are not on medication.

Side effects only occur for some people, if they do occur they are usually worst at the beginning of treatment and if you do get some side effects – let your doctor know – many of these can be managed or improved. The lists of side effects on the medication sheets can be very off putting and most do not occur.

It’s hard if you have a close relative or partner who is opposed to medication – invite them to come with you to support you when you see your doctor.

Becoming unwell should never be seen as a failure – this is judgemental and harsh – be easier on yourself – would you judge someone else as a failure if they needed medication for some illness?

“I never liked taking medication, even paracetamol for a headache. I didn’t really think I was depressed. I thought it was just me – that I needed to try harder. However no matter how hard I tried, I got worse. I didn't want to take medication at all and was really anxious when I started. Luckily I started to feel better." Erin

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