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July is mental health awareness month: busting the myths surrounding antidepressants and depression

In a startling revelation, recent studies have shown that over a quarter of South Africa’s population suffers from depression, yet only 1 in 4 individuals seek the necessary help.

The South African Society of Psychiatrists (SASOP) emphasises that the persistent stigma around mental illness and misconceptions regarding the advantages and usage of antidepressants indicate major challenges for people in need of treatment as Mental Illness Awareness Month (July) takes centrestage.

Addressing the misconceptions head-on, Dr Gagu Matsebula, a dedicated member of SASOP, emphasises the critical need to dispel the belief that depression is a mere condition one can simply “snap out of”.

It is crucial to recognize that depression is a medical ailment that negatively impacts brain function, often triggered by biological or environmental factors.

No one willingly chooses to be burdened by depression; rather, it is a real and debilitating condition that warrants professional attention.

Dr Matsebula highlights the significance of understanding that depression is treatable, primarily through medication that targets the underlying biological causes contributing to the condition.

“The most widely adopted treatment approach combines medication with talk therapy, known as psychotherapy, which has demonstrated the most favourable outcomes for patients.”

Dr Gagu Matsebula, member of South African Society of Psychiatrists (SASOP).

Most doctors initially prescribe selective serotonin reuptake inhibitors (SSRIs), such as Sertraline and Fluoxetine, to alleviate symptoms of moderate to severe depression. Although some people fear antidepressants, they are safe to use.

There are, however, several types of antidepressants, with different side effect profiles, explained Dr Matsebula.

“SSRIs work by increasing the levels of serotonin in the brain, a neurotransmitter that carries signals between the brain’s nerve cells, ultimately improving one’s mood.

“The ultimate goal of antidepressants is to restore the balance of deficiencies of serotonin and other neurotransmitters that may be causing the depressive symptoms,” he said.

As Mental Illness Awareness Month sheds light on South Africa’s untreated depression crisis, society needs to challenge the stigma and misconceptions surrounding mental health.

While many individuals respond well to the first prescription of antidepressants, some may need to try several different antidepressants before finding the one that works best for them, said the renowned psychiatrist.

“What’s important is to be patient when using antidepressants and to take the medication daily as prescribed by a doctor. It may take several weeks for the medication to take full effect and it is important to continue with the prescription for at least six months to prevent symptoms from recurring.

“Every person responds differently to antidepressants and some individuals may require long-term usage.”

Additionally, it’s vital not to stop the medication or reduce the dosage independently, even if feeling better.

Unlike other medications such as sleeping tablets, antidepressants do not cause physical dependence or addiction. A doctor’s guidance is crucial when increasing or reducing the dosage or ending the treatment.

If you are experiencing any of the following symptoms of depression for more than two weeks, it is essential to seek help:

Feelings of hopelessness and pessimism.

Loss of interest or pleasure in hobbies and activities that were once enjoyed.

Persistent sad, or empty, mood.

Feelings of guilt, worthlessness, helplessness and self-reproach.

Insomnia or hypersomnia (oversleeping) or early morning awakening.

Loss of appetite and/or weight loss, or overeating and weight gain.

Decreased energy, fatigue and feeling run down.

Increased use of alcohol and drugs.

Thoughts of death or suicide, and suicide attempts.

Restlessness, irritability and hostility.

Difficulty concentrating, remembering and making decisions.

Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain.

Deterioration of social relationships.

Allow enough time for the medication to work before you stop taking them. Generally, antidepressants take anything between two to six weeks before presenting with their full effects.

Follow your doctor’s instructions and take the full dosage without skipping any days or tablets. This will ensure that the medication works as it should. Your doctor will advise when it is time to gradually decrease the prescription.

It’s advisable that you ask your doctor about when it is time to stop using antidepressants. Stopping the medication too soon, even if you are feeling better, can lead to the depression returning or worsening.

Different antidepressants work in different ways. As such, your doctor may have to adjust your medication – and its dose – before finding the right one that relieves your symptoms.

To get help for your friends, family, colleagues, or yourself, please:

Contact the South African Depression and Anxiety Group (Sadag) at 0800 12 13 14, or send an SMS to 32312 and a counsellor will call you back.

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