Depression isn’t diabetes

That may seem like an obvious thing to say. But I am really, really sick of conflating mental illnesses with physical ones (which is a false dichotomy in itself) in order to make them and their treatments seem more palatable.

I knew I had depression by the time I was thirteen. It took me until I was eighteen, with my life at serious risk, to “give in” and agree to try antidepressant medication.

One of those most common things I hear said in order to fight the stigma around taking mental health medication – antidepressants in particular – is “Oh, but it’s like diabetes. You wouldn’t deny a diabetic their insulin, would you?”

This is a way of demonstrating that taking antidepressants isn’t a decision made in weakness. It’s a health necessity for many people. Saying this has been a useful way of communicating that depression is a chronic health problem, often with physiological causes, that can be aided by medication in the same way many physical illnesses without the same stigma are.

It’s been useful for people who don’t have depression, and for people who do. For me, saying to myself “Well, my brain doesn’t process serotonin properly, and these drugs will help that, in the same way that diabetics use insulin,” meant I could take the medication without feeling like it was a moral failing. Like I just hadn’t tried hard enough.

However, I think the time has come where we need to move beyond this comparison.

Mental illness is not the same as physical illness. I know that there has been a movement to treat it that way, both to reflect that many mental illnesses have physical causes or exacerbations, and to give it the validity that physical ailments are given, but I think we’ve reached a point where comparing the two can do harm.

I am not diabetic. I don’t need to compare myself to a diabetic in order to feel like my taking medication is somehow more socially acceptable. I take medication because without it I wouldn’t be alive. Period.

I am utterly done trying to sanitise that fact for people by comparing the medication I take for my mental illness with what I take for my physical illnesses.

I am utterly done trying to combat the stigma and shame around the use of mental health medication by drawing false dichotomies.

Comparing antidepressants to diabetes also tries to say that people with depression don’t have a choice. They have to take antidepressants the same way that people with diabetes have to take insulin.

That’s not true for many of us. Many of us do have a choice. And making the choice to take medication is strong, not weak.

Do you know how many risk factors there are with the huge range of antidepressants, antianxiety, and antipyschotic medications doctors can prescribe? Do you know that there’s only a tiny percentage of a chance that the first one they try will work? Doctors guess. It’s an educated, informed guess. But it’s a guess.

I have tried six… seven… nine? medications, I think? All of which came with their own lovely list of side effects. All of which played havoc with my life; going on, being on, and coming off them. Most antidepressants are just as likely to make you suicidal as they are to stop you feeling suicidal, at least at the start. That’s what I’m always told when I’m prescribed something new. “You’re probably going to feel worse before you feel any better. And you might not feel better. But we have to wait three to six months to find out. In the meantime, have fun.”

If it’s not bravery and strength to look at that pill in your hand and go “well, ok. This could push me off the edge. But it could make me feel like I have a future again,” – and swallow it back? … then I don’t know what is brave and strong.

I cannot count the number of times I have confessed “I’m depressed,” and the response has been “But aren’t you on antidepressants?”

Yes. I am. They do not cure me. They don’t even make me feel like life is worth living a lot of the time. But they do keep me living it.

After having grown up staunchly anti-pill, I’m now a woman who has to take ten to fifteen a day. Not to mention the weekly injections. And I shouldn’t have to feel fucking ashamed of any single one of those, regardless of which of my illnesses they’re helping.

Depression isn’t diabetes. Anxiety isn’t asthma. Obsessive Compulsive Disorder isn’t high blood pressure.

All of those  physical illnesses are important, and the medication for all of them is, too.No one forces people who suffer from them to endure their suffering because they “should be able to manage without medication.” No one tries to placate them when they do take medication by saying “Oh, it’s ok, if you had broken leg, you’d get a cast.” Because they’re not the same fucking thing.

I don’t need a cast. I just need people to accept that mental health drugs are vital for many people with mental illness. And taking them doesn’t make those people weak.

It makes them very, very strong.

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