Maybe She’s Born With It, Maybe It’s Sertraline

Do you ever feel like modern day mental wellness is a bit… vague? It’s all about the natural, ‘wholesome’ route to leading a perfect life; buzzwords like ‘mindfulness’ and ‘self care’ spring to mind. It’s a positive thing, of course – any conversation about mental health is –but to me it feels like accepting a recommendation to try prescribed antidepressants is being seen more and more often as a failure to really commit to mental wellbeing.

Questions and comments fielded by those on medication for their mood often sound something like “have you tried exercising more?”, “are you drinking enough water?” or the particularly dreaded “you should read *insert wellbeing book here* – it changed my life!”. Sigh.

Sure, a walk can clear your head, yoga might take the edge off, a chapter of a good book can provide some comfort. It’s just that sometimes these things aren’t quite hitting the spot, and that’s when medication may be a necessary intervention to get your life back on track.

Thanks to less of a taboo on the subject, we know that many people will suffer from depression at some point, through no fault of their own. So why is it that when we’ve made such amazing progress as a society in terms of mental wellbeing, so many people taking antidepressants still feel like they’ve failed?

It may have something to do with the kind of mental wellbeing that has become so acceptable in the social consciousness. There’s a particular brand of influencer that is increasingly popular, and that’s the organic, all natural, overnight oats loving kind, the one who insists that gut bacteria is the secret to happiness, and that meditation is the cure for depression.

(I still appreciate the wholesome influencer, don’t get me wrong – I just ask that you take them with a pinch of pink himalayan salt).

Instagram is saturated with brightly coloured infographics on wellbeing, often paired with an anecdote in the caption about how being on medication for years did nothing and the person in question only found relief when they started snorting kale. (I’m being facetious – please don’t try that). Trends in reading material have followed, with self help books that champion natural methods of treatment jumping to the top of bestsellers lists.

On one hand, this is a great sign of the way in which happiness and mental stability has become a priority for people, and there are now a number of fabulous resources online to check out if you’re feeling blue. But in another way, the wellness trend has brought with it a stigma surrounding treatments that are considered ‘artificial’ or ‘unnatural’ – and medication is often held up as an example of this.

Confused about this increasing sentiment, which feels unfair, I got in touch with Dr. Aoife O’Callaghan from the College Of Psychiatrists of Ireland, to ask her about the different angles on the growing trend of mental wellbeing– and why taking antidepressants doesn’t mean you’ve failed at looking after yourself.

“Seeing medical intervention as ‘unnatural’ really impacts people who have mental health difficulties. It’s unfortunate, but a lot of patients we see feel that there’s an impression that using an antidepressant is a sign of weakness. On the one hand, there’s been a great focus on wellness, with treatments like talk therapies becoming more widely accepted, and that’s had a de-stigmatising effect as people are speaking more openly about mental illness…but there is an over reliance on wellness trends,” says Dr. O’Callaghan, adding that “mental wellness and mental illness are two very different things.”

What’s the difference? We know that the definition of mental health is a person’s state of psychological and emotional wellbeing. Mental wellness tends to refer to self–directed tools to improve that health, covering everything from having a bath at the end of a long day to going for a run to boost your serotonin.

Mental illnesses are different again – they are diagnosed conditions that affect your thoughts, behaviours and moods. So everyone has mental health, and everyone should practice mental wellness. But not everyone has mental illness – and for those without it, mental wellness isn’t going to work in the same way as it would for a person with, say, depression.

Of course, there are a lot of useful coping mechanisms and healthy habits that can be utilised to boost your mood and improve your quality of life. Exercise, eating healthily and sleeping well are all great tools for mood regulation, but they aren’t the only answers. Dr. O’Callaghan tells me that most patients seeking medication have tried all the suggested methods.

When it comes to people being told they haven’t tried hard enough with alternative solutions before resorting to medication, Dr. O’Callaghan feels that it’s really disheartening for patients who get that message. “The majority of people presenting will already have done those interventions – people really try. They try meditation, they try exercise and when those aren’t working, that’s when they come and seek medical advice.”

Dr. O’Callaghan went on to say that while mental wellness is important, depression can be a result of biological factors that may need a medical approach to be treated effectively. “Treatment providers can often recognise patterns of symptoms that tend to respond well to medication,” so they’ll usually be able to tell if what you’re suffering from is going to need a little more than practising self care.

She highlighted that medication isn’t a perfect solution either – if you’re being prescribed medication for your mood, psychiatrists will usually recommend that you combine it with wellness practices, like talk therapies and mindfulness too.

So, when should you consider enquiring about antidepressants with your doctor? Dr. O’Callaghan says to look out for persistent low moods and low energy, accompanied by a change in your appetite and sleep, but she reminds me that everyone is different.

“Everyone is unique. It’s really useful to discuss what’s going on with a medical professional. There’s no one thing that we can identify as the single cause for depression, but looking at a person’s unique symptoms can help direct us toward the treatment that will work best”.

Most importantly, Dr. O’Callaghan stresses that there’s absolutely no shame in seeking help, or taking antidepressants. “I don’t see why mental health should be treated any differently to physical health. In terms of keeping your heart healthy, you might make positive lifestyle changes, but no one blames you for eventually seeing a cardiologist! Don’t be discouraged from seeking treatment.”

So, there you have it. Keep on journaling, eating your oats and getting your steps in – but don’t be afraid to ask for medical help if you need it, and to be proud of whatever steps you’ve taken to be happy. After all, happiness and healthiness are really the most important things in this life.

Maybe she’s born with it, or maybe it’s sertraline. Maybe, it doesn’t really matter either way.

This article was originally published in the June 2022 issue of Stellar Magazine.