Checklist: How do I know if I need an anti-depressant? Dr Uzma Ambareen answers questions you were too afraid to ask
We can all get depressed in life, at one time or another. But when do we need medication to help get better, or therapy? It isn't easy for many people, especially journalists, to consider taking medicines because of the fear surrounding them. In this article we bring you Dr Uzma Ambareen's advice and explanations for our most common questions on psychiatric medication.
How do I know I need help (therapy, medication)?
Dr Uzma: When our day-to-day ability to function gets harder and even small and routine activities are hard to maintain. Work, education, family-life and social-life become seriously affected. Things like showering, changing your clothes, eating, going to work, doing groceries... when your social, family and work life is seriously affected.
When all non-psychological approaches don't work, such as therapy, spirituality, when you've done all that and nothing has helped. When you start feeling dependence on Xanax, drugs, alcohol...
So many people come to me and say, "We smoke up, drink and we feel better" because they don't want to take antidepressants. What people don't understand is that Benzodiazepines and alcohol are "downers" and have a similar effect on the brain. They make you feel calmer but they are depressing your brain and it can worsen over time.
Taking drugs or tranquilizers are a quick fix but can make the problem worse over time. If you are self-medicating to tackle a problem or low moods this is also a bad indication. If you start thinking about suicide, you should immediately seek help. (Please see the contact details for the free therapy service at the CEJ at the end of this article).
What is the importance of antidepressants?
Dr Uzma: They keep you functional. Many people are on antidepressants, but you won't even be able to tell.
I am worried that antidepressants are addictive?
Dr Uzma: Antidepressants are not addictive However, you can talk to a mental health professional, preferably a psychiatrist, who can address your concerns. DO NOT believe everything that other people are telling you, or what you read on the internet (or package insert), about these medications.
Are antidepressants toxic?
Dr Uzma: All antidepressants are approved by the American Food & Drug Authority (FDA). Not all medicines are toxic. There are some which have serious side effects. But the new antidepressants don't have that many serious side effects.
Do all antidepressants work equally well?
Dr Uzma: Yes, I want you to know that all antidepressants work equally well. If someone tells you that this antidepressant is better than another one, then they are wrong. The only difference is side effects.
Some medicines might be better in a specific kind of depression or a specific kind of anxiety or in some disorders but it is not the case that one medicine is better than another.
The tricky part is that not every medication works for everyone. We don't have a way to predict that this medicine will suit you. Psychiatrists work on trial and error.
How do psychiatrists find which antidepressant will suit you?
Dr Uzma: I'll tell you how we try this. There are some general side effects. We tell our patients about major side effects like this or that can happen. But usually people Google or talk to others or read the package insert which lists every side effect under the sun. People who are more apprehensive about taking the medicine in the first place then think that whatever is happening to them, is happening because of the medicine.
The best thing to do is talk to your doctor about any concerns you have. You should trust your doctor.
Always consult a doctor before taking any antidepressants or medication. Do not self-prescribe.
The CEJ's Wellbeing Centre is resuming its free counselling service for media workers. We believe Pakistani journalists need immense support because of their high stress work. The Covid pandemic has created more job insecurity and news challenges as well. We are offering in-person sessions for journalists in Karachi and online appointments for those outside the city.
Who is eligible: Anyone who works with a media organisation or is a freelance media worker Sessions last 50 minutes each and you can receive up to 08.
This counselling service is entirely confidential and it is not just work-related stress.
Make an appointment through
counsellingservice@iba.edu.pk
Cell: 0349 200 2567
Reliable websites to consult:
Mayo Clinic
Harvard Clinic
This article is based on an IBA-CEJ workshop on 'Depression, anxiety, medicine' held December 11, 2019 in Karachi at the IBA with Dr Uzma Ambareen.
Profile of clinical psychiatrist Dr Uzma Ambareen
She did her residency training in Psychiatry from Hahnema University and Brown University, US and her fellowship in Public Psychiatry from Columbia University, US. Dr Uzma has been the Medical Director of The Recovery House in Karachi since 2013 and runs her own practice.
Since her return to Pakistan in 1998, she has been associated with the Pakistan Association for Mental Health. She has served as Clinical Director at the Institute of Behavior Sciences and subsequently at the Free Mental Health Clinic.
Apart from Psychiatric Rehabilitation, her areas of interest include community psychiatry, public mental health awareness, individual psychotherapy and family therapy.