When Caroline Ashrafi stopped taking the drugs, she was totally unprepared for the debilitating withdrawal symptoms that followed — from crippling stomach pains and crushing headaches to dizzy spells that left her unable to drive.
But Caroline wasn’t coming down from anything illegal. The 49-year-old tax manager from Market Harborough, Leicestershire, was being weaned off something far more prevalent among middle-class women — antidepressants.
Only now, eight years later — and an astonishing 30 years after she was first put on antidepressants — she has finally stopped taking them altogether.
Long-term pain: Caroline, left, and Lynda have taken antidepressants for years
While it is shocking that a woman can spend decades on medication, Caroline’s experience is far from unusual.
This year, it emerged that a record number of adults rely on antidepressants. NHS figures revealed that almost 47 million prescriptions for the drugs were handed out last year — a 9 per cent increase on the previous 12 months.
And it’s women, in particular, who are caught up in the antidepressant epidemic: recent research reveals one in three takes the medication at some point in their lives. For men, it’s one in ten.
Women are twice as likely to be diagnosed with depression as they were 40 years ago, and the rise has been put down by some experts to the increased pressures of modern life, particularly on those juggling motherhood and work in an increasingly harsh financial climate.
But others believe an alarming number of women are being placed long-term on powerful antidepressants when their emotional distress could be dealt with by talking through their problems with a professional or adapting their lifestyles.
And there are also those who say many are simply misdiagnosed. ‘Depression has become an umbrella word for all kinds of ills,’ says Mandy Saligari, clinical director of Charter Day Care, which treats people with depression and addictions.
‘Clinical depression must be medicated, but only around a quarter of people who say they’re depressed actually are.’
As a result, it’s feared thousands of women are finding themselves pulled into a never-ending — and unnecessary — cycle of antidepressant dependence.
According to a study by women’s campaign group Platform 51, nearly half of those using antidepressants have taken them for at least five years, while a quarter have used them for ten years or more.
Rebecca Gill, of Platform 51, says: ‘These shocking figures reveal an escalating crisis in use of antidepressants.
‘We know from working with women and girls in our centres that drugs have a role to play, but they are too readily prescribed as the first and only remedy.’
When Caroline was prescribed antidepressants at 17, she never expected still to be taking them 30 years later. She had gone to her doctor when she began experiencing devastating bouts of bleakness. As her mother had struggled with depression, she knew the signs.
‘Unlike many teenagers, I’d never had mood swings and was happy and sporty, but suddenly had crushing lows,’ says Caroline. ‘One minute I’d be hyperactive, the next flat on my back, exhausted, tearful, irritable and unable to get out of bed or talk to people.
‘My GP discussed my symptoms and family history before prescribing antidepressants. I stuck with it, even though they made me feel detached from reality and I suffered terrible dizziness.’
Caroline was still taking antidepressants a year later when she started a sports science degree.
After graduating, she was on and off antidepressants for the next six years, during which time she trained to become an accountant and met her first husband.
Then, in 1991, after starting a new job, Caroline once again found her mood plummeting, so her GP changed her medication, putting her on Prozac.
‘I took it for the next six years, on repeat prescription, but had assessments by my GP every three months,’ she says. ‘It suited me and stabilised my mood, which enabled me to lead a normal life. I married and had my son William, who is now 17.’
But when reports — later disproved — suggested Prozac might trigger violent behaviour, Caroline’s doctor swapped her medication for Seroxat.
That change was trouble-free, unlike when she came off Seroxat in 2003, after research suggested it increased suicidal tendencies, and once again found herself taking Prozac.
‘During the eight weeks I was weaned off Seroxat, I suffered dreadful stomach pains, crushing headaches and dizzy spells so severe I was unable to drive or go to work,’ she says.
While antidepressants aren’t clinically addictive, many experts believe they can cause dependence.
This is partly because taking them reinforces the idea that a person can’t cope without them, and also because of the severe withdrawal symptoms many suffer when coming off certain types of the drugs.
‘You get dependent on them physically because you are putting chemicals into your body,’ says Caroline. ‘Then you get used to them psychologically, because you can’t imagine coping without them.’
Her GP eventually referred her for cognitive behavioural therapy — a talking therapy that teaches you to challenge your thought processes — which she found effective.
But while she started sessions on the NHS, she was only able to access the extensive CBT counselling she needed because she had private health insurance.
Finally, last December, she felt ready to stop taking medication. While her first marriage broke up in 2002 (not due to her depression), Caroline says her second husband Feri, 56, is very understanding.
And she believes CBT techniques and a strong support network have contributed to a successful transition to a pill-free life. It’s been a long journey, and while it’s not one Caroline regrets — ‘I am still here, and I can’t fault my GP’ — she is scathing about the way antidepressants are seemingly handed out so freely.
As someone who has close links with mental health charities Rethink and Depression Alliance, she hears the experiences of many others.
‘Antidepressants enable you to cope and get on with life, but they don’t tackle the cause,’ she says.
‘Too many doctors hand them out without proper assessment. Mental illness is complex, but GPs often don’t have proper training.
‚These drugs just numb me. I’d give anything to feel like myself again‘
‘People get into a spiral where they can’t help themselves. You need to take responsibility for your own depression, but if you are given antidepressants and sent away, that’s never going to happen.
‘You need so many other tools, such as talking therapies and being part of a network of those who have had depression, because learning that it is possible to get better is also very powerful.
‘As my psychologist says, the best way to conquer depression is how you live your life. So far, my mood is stable and positive and, while I have good days and bad days, this is no different from everyone else.’
Caroline has come off medication, but full-time mother-of-two Brooke Christian is desperate to finish with the antidepressants she’s been taking for seven years.
‘Over the years, I’ve tried so many drugs — at least five.I feel like a guinea pig,’ she says. ‘I know all I’m doing by taking antidepressants is putting a sticking plaster over a wound that needs to be given a proper chance to heal.’
Given her medical history, there are few who would deny medication has, at some points, been the most appropriate course for Brooke, who lives with her fiancé Jonathan in Bolton.
She began taking antidepressants in her late teens, when she felt suicidal after the birth of her daughter, Isabel.
‘I wasn’t eating and couldn’t stop crying. I went to the doctor and was immediately prescribed an antidepressant called Citalopram,’ she says. ‘I needed help so I tried the pills, only to find that after two months my symptoms were worse and I felt suicidal again.’
Some in the medical community feel this is just one of the drawbacks of antidepressants: they drive as many people to suicide as away from it.
When Brooke, now 25, explained how desperate she was feeling, her GP changed her prescription. But since then Brooke — mum to Isabel, seven, and Zoe, two — has been reliant on one antidepressant or another.
‘I’ve tried to come off the drugs many times,’ she says. ‘When I was pregnant with Zoe, I stayed off them because I didn’t want to drug my unborn baby — but once she was born, my mood dipped and I was prescribed more drugs. I’m constantly going back and forth to the doctors, who seem keen to try different medications when what I’ve wanted all along is some therapy to get me off these drugs.’
There is evidence that one-to-one therapy or group sessions can be just as effective as drugs — and far less expensive. It’s something Brooke feels would help her condition, but she says waiting times are too long and what’s on offer is insufficient.
‘I was constantly fobbed off by doctors telling me about 18-month waiting lists and the cost,’ says Brooke.
‘Finally, a few months ago, I got some therapy on the NHS and felt it was really starting to help, but they will fund only 12 sessions, which barely touches the surface. I’m not in a position to pay for it privately.’
Brooke has also suffered the complete suppression of any mood.
‘These drugs just numb me. I’d give anything to feel like myself again,’ she says. ‘I’ve put on a stone and a half, suffer from a fast heartbeat, confusion, forgetfulness and loss of libido. I’m lucky, because my partner has been so supportive and loving.’
Lynda Hamilton has also suffered unpleasant side-effects. The 34-year-old company director from Fife has been on antidepressants for the past four years, and while she admits they transformed her life when they were first prescribed, she doesn’t want to be on them for the rest of her life.
‘I worry I’m reliant on medication as my body doesn’t seem to function properly without it,’ she says.
‘I can’t remember what is normal any more. And though weight gain isn’t listed as one of the side-effects of this drug, I’ve gone from a size eight to a size 16 and I’m convinced that’s not all down to diet.’
Lynda says she first experienced the symptoms of depression after the birth of her eldest daughter, Hannah, now 13.
Her doctor prescribed Prozac, but put off by stories of people feeling emotionally numb on the drug, she resisted taking it.
After taking a supplement from a health food shop, and getting more independence as her daughter grew older, she found her symptoms dissipated. But then she got post-natal depression after the birth of her daughter Jessica five years ago.
‘I didn’t want to get out of bed, and felt ugly and insecure,’ Lynda recalls. ‘My GP immediately prescribed Citalopram. It felt as if as soon as I walked through the door he was writing the prescription. Nothing else was offered to me such as therapy. I felt I was just another statistic, not an individual.
‘It makes me wonder whether I’d still be taking drugs if I’d been offered a talking therapy, but I was put on repeat prescription and haven’t been offered a review since.’
Lynda adds: ‘Maybe it was mind over matter, but within hours of taking the first pill I felt a sense of euphoria I’d not felt in ages.’
But recent Australian research suggests antidepressants often have nothing more than a placebo effect. People feel better because they are told the drugs will make them less depressed. Some argue the theory works in reverse: people revert to depression when they come off drugs because they no longer have this crutch.
Lynda doesn’t want to remain on drugs, but admits she fears what might happen if she does stop them.
‘I forgot to take them on holiday once. I was a wreck,’ she says. ‘I’ve managed to reduce my dose so I take my pills every two days, but I’m scared to reduce it further.’
One can only hope that, like Caroline, Lynda and Brooke manage to find a strategy that works for them.
Because while a growing body of evidence suggests antidepressants are not the miracle drugs they were once thought to be, it seems more women than ever now find themselves trapped in a cycle of pill-popping that can be dauntingly hard to escape.