By Despina Karpathiou
In an increasingly destabilising world, more and more people are turning to psychologists and medication to assist them in coping.
Prior to the COVID-19 pandemic, the World Health Organisation (WHO) reported that one in every eight people (or 970 million people around the world), were living with a mental health problem. Anxiety and depression being the most common.
These numbers have since risen, and more and more people are being prescribed antidepressants. However, is anyone really looking at the long-term side effects of continued use of these medications and are they addictive?
The Greek Herald spoke to the Rev. Dr Emmanuel Chris (Chrysanthakopoulos) to break this all down.
Rev. Dr Chris is a priest of the Greek Orthodox Archdiocese of America, a trained Adult Psychiatrist & Psychopharmacologist and the Medical Director at Boston Health Care.
Dr Chris explained that mental Illnesses are not just “things or phenomena that occur in one’s head.” Nor are they signs of emotional weakness that can simply be willed away by the individual.
“Mental Illnesses are disorders of the Central Nervous System that often are chronic in nature and that are characterised by profound Physiologic Disturbances in the Brain and Central Nervous System that have both emotional and marked physical manifestations,” he said.
So, what are antidepressants / SSRI’s?
Antidepressants are a class of corrective medications that attempt to target various neurochemical imbalances in the Central Nervous System that result in the manifestation of various symptoms through the disruption of the proper and appropriate transmission of nerve impulses.
Dr Chris describes them like this: “In simple language, they help to correct some of these neurochemical imbalances that then allows for an alleviation of some of the symptoms caused by said imbalances. Likewise, they are in no way, shape, or form to be thought of as “Happy Pills.”
Prozac & Fluoxetine have been and remain the most widely prescribed SSRI antidepressant in the world and has been highly effective in the treatment of numerous conditions.
Dr Chris outlined that SSRI antidepressants are the first line medications employed in the treatment of Major Depression and other variants of depressive disorders such as Dysthymic Disorder (chronic persistent depression) & Generalised Anxiety.
So, why are doctors so quick to prescribe antidepressants without considering their side effects?
“Let’s look just at Major Depression in particular,” Dr Chris answered.
“Up to 20% of the adult population will suffer from at least one Major Depressive Episode in their lifetime. A first episode of Major Depression should be treated with a therapeutic dose of an Antidepressant medication for about nine months to one year, after which, with symptoms under control, the medication can then be withdrawn”.
As for the clinicians’ awareness of side effects, it’s important to remember that all medications have side effects, even over the counter paracetamol.
“The possibility of side effects always needs to be discussed by every clinician with every patient and a decision to use any medication must consider the risk benefit ratio of said treatment’s benefits versus risks,” he said.
“Any clinician worth their mettle must exercise discernment along with good clinical judgment when deciding to prescribe any medication…”
The million-dollar question is this: Can you become “addicted” to SSRI’s /antidepressants?
Dr Chris is very adamant that you absolutely “cannot become addicted.”
“As both a Psychopharmacologist and as an Addiction Medicine Specialist I can unequivocally state that Antidepressants in general, and SSRI’s in particular are in no way, shape, or form addictive,” he said.
Is it possible to successfully wean off SSRI’s and live a symptom free life?
Dr Chris said that this is possible, however, those cases, “quite frankly, are fewer and farther in between.”
“There are a number of circumstances in the treatment of more acute conditions as a single isolated Major Depressive Episode or of an Adjustment Disorder with Depressed Mood or Anxiety as examples, that an appropriate period of treatment with an SSRI at a therapeutic dose of medication for nine months to one year can then be tapered off with the patient then remaining symptom free, but this isn’t the norm.” he explains.
We asked Dr Chris what his advice would be for the many who are suffering now.
“For anyone suffering from anxiety or depression, one must first be honest with oneself as to how much of an impact this has been having on one’s life and ability to function, as many of us have blinders on as to how impaired we may become or seem to others. or think that we can “pull ourselves up by our bootstraps” or for others to think that we merely need to “buckle up” or “toughen up”,” he said.
“There is no shame in reaching out for help. We are meant to live in Communion, humankind being a social animal and part of God’s Creation, created in His image and His likeness, and must remember that “No man is an island.”
His ‘best advice’ is to keep things in life simple, to love others without judging them, maintain a positive attitude, and to place and keep our hope and faith in God.
