You know, I will say, that antidepressants of various categories can have very interesting affects... it's almost like what I *imagine*
hallucinagens to be like... colors are brighter, food has more flavor, sex is better, everything has more zest. You feel lighter and getting out of bed is easier.
Is this fake happiness? If we really want to buy into some concept of neurotransmitter balances playing a role in all of this.... What is more real? The apple being tasteless and dull? Or being able to enjoy the apple?
Depression is being stuck in hole. It is not a good state of being. Let's not discuss how normal it is or not. Antidepressants don't manufacture happiness... but I'll tell you this right now, it's easier to be happy when the apple has flavor. It's hard to argue in my mind that the apple *shouldn't* have flavor, that the flavor you now taste isn't real, and the lack of "reality" given the fact that you are currently only tasting it while on medication...
Patients like this piss me off. They shouldn't, I know.
Here's the thing, is what you're doing now, is that a state of existence you would like to continue? No??? Then why so choosy with the solutions? One would almost think you don't want to get better.
I tell my back pain patients this all the time. OK, you don't think tylenol or ibuprofen do anything, and you want narcotics. You know, I sorta get that. Here's the unfortunate truth: we all have this belief that for the person *truly* in pain, they would do any reasonable thing with low SE to try to alleviate that pain. That's what people expect you to do before they hand out hardcore drugs that have hardcore SEs.
Depressed people, like chronic LBP, have reasons to think they'll always continue to suffer. But I'm not hearing any convincing reason why they're not grabbing onto the life preserver thrown to them.
I loved what one psychiatrist used to say inpt, "You are literally fighting for your life right now. That's why you're here." (the ones who admitted they wanted to stop hurting, not really die)
I had one doctor say to me once, "You're here because what YOU'RE doing isn't working, right? That's why you're seeing a doctor. That's why you should consider doing something you haven't done before, right?"
And the last bit is all mine, "The proof is in the pudding." Meaning, who gives a **** how real any of it is? How real is your depression? How real is happiness? Maybe it's possible you have a mental illness (cuz honestly, not everyone is running around feeling the way you do, either you're just specially plugged into some higher school of thought, or you just think that) and it's distorted your thinking on all of this.
So do you want your "real" misery (that you just happen to think is "realer") or do you want "fake" happiness (never mind that the pills don't give you happiness or that the benefits are fake)? Isn't possible that your sense of real or not real is distorted now? And you're more worried about a pill distorting that in a way that makes you more functional, and a better family member/friend?
Basically, you're taking the chance that medications will change your perspective on all of this, and THAT is the very real "risk" of all of this. That you recover from all the distorted thinking of your depression and get "brainwashed" and seduced by tastier apples. The reality is that you're really only going to take antidepressants if they help you. And if they help you... then why shouldn't you take them? Worst case they do nothing and you stop. Best case you feel better. Why is real suffering more noble than manufactured happiness? At some point, you are a crossroads of possibly imperfect scenarios and have to pick one to try to live in. But what about being stuck on pills?
That's very very few people, most people they help the distorted thinking, put the flavor in the apple, help you get out of bed, and do stuff to maintain a new less shytty way of being.
It's highly probable that whatever degree of feeling better on antidepressants, you can feel off them. You're not there now, because as I put it, "it takes "oomph" to get over depression. You've probably used whatever oomph you had up to this point. You need to sleep well, wake, exercise, eat properly, and a load of other things to take good care of yourself and not be depressed. Sound like all the stuff you're having a hard time with now? So the pills will just help you get the "oomph" to do all the things you need to do not be depressed in general, let alone without pills like you are now."
Because of the distorted thinking of depression, patients will say they've never not been unhappy or depressed. So usually you just have to prompt them to remember that there was indeed a time where at minimum life was "easier" as far as showering, work, eating, whatever ADLs.
This is my spiel. I've never had a patient not acknowledge this as logic and theirs as flawed in light of this. Now, I've made peace with being right, being acknowledged as being right, and then it making not a God's bit of difference, because patients will always be as bad as they wanna be.
