On Christmas Eve morning, when the cafes and restaurants were still open, I met a close friend from secondary school for a hot chocolate. In the midst of general catching up (work, family, pets), my friend mentioned that she had just started taking an SSRI (Selective Serotonin Reuptake Inhibitor). We’d chatted about this before, as my friend suffers from severe anxiety, and she had been considering medication for some time. I asked her which antidepressant she was taking, and she said that she couldn’t remember or pronounce the brand name. At that moment, I plucked my box of Escitalopram from my handbag and asked if that was her brand. She said it was, and I joked that I could never remember the name, usually calling it “escat-o-pram”, “escat-el-pram” or “estal-o-pram”. I’m relaying this anecdote because I think there is something meaningful about the image of two fairly innocuous women in their thirties openly discussing antidepressants in a busy café, audibly comparing SSRI brands as if they were moisturisers or a new brand of mascara. Within that conversation, the taking of antidepressant/anti-anxiety medication was framed as a mundane part of our daily routines, like getting dressed, brushing teeth, washing hair or applying makeup.
Although there is still much stigma attached to mental illness – with the degree and intensity of that stigma varying widely across age groups, communities and cultures – there has undoubtedly been an opening up of conversational space that has allowed for a greater honesty about mental health. Amongst Millennials and Generation Z, in particular, there is refreshing openness about mental health issues, how they impact our lives and the need to be gentle with our own psyches, and those of others. A friend of mine recently tweeted about how her antidepressants were interacting, in sometimes undesirable ways, with her birth control. That conflict can be imagined as a fight between Godzilla and King Kong.
There’s an excellent US-based podcast called The Mental Illness Happy Hour where celebrities like Mara Wilson (Matilda!!), Tim Minchin, Paul F. Tompkins and Jameela Jamil talk about their mental health struggles. There are also some wonderful, alternately funny and heart-breaking TV shows that deal with mental illness. Maria Bamford’s semi-autobiographical series Lady Dynamite (Netflix, 2016-2017) explores its creator’s experience of bipolar disorder (it also has talking pugs!), while Rachel Bloom’s incredible musical comedy series Crazy Ex-Girlfriend (2015-2019) deals with anxiety, depression and borderline personality disorder (often through song).
Not only are we talking more about mental illness, but we are doing so in surprising, funny and creative ways. This openness is certainly helpful. I’ve suffered from (often crippling) anxiety for much of my life. I would worry endlessly about anything that could be worried about. I was terrified of speaking to people throughout most of my youth. In college, if I had to speak in seminars or tutorials, my heart would race and I would shake, sometimes visibly. In work, I would obsessively and painstakingly double-check tasks I had already completed. My anxiety became even more pronounced after a trauma I suffered in my early twenties, and for a time that particular trauma flowered into other mental health problems that I’m probably still not capable of discussing objectively.
When I started lecturing in 2017, my anxiety thrived on the uncertainty and insecurity that often accompany a new job. I would regularly work from 6am-6pm each day, including weekends. I would torture myself about mistakes or perceived mistakes. In my very first lecture module, a student asked a question about the number of pages they should write for an exam. While stressing the importance of quality over quantity, I gave them a rough estimate, which I then began to worry was wrong. I spent the entire next day going through other lecturers’ folders on Blackboard (this was pre-Canvas) to see what advice they had given. It was not only a strange thing to do, but it was time-consuming and pointless. Back then, I didn’t see it that way. I was terrified that I had made a mistake and would “get in trouble”. Around the same time, I would repeatedly check that I had returned exams I was marking to my filing cabinet.
I started taking SSRIs in early 2018. In many ways, the frank conversations people were having in the media and popular culture helped to demystify medication for me. As an anxious, occasionally depressed teenager, I devoured memoirs about women who had suffered from mental illness: Susanna Kaysen’s Girl Interrupted, Sylvia Plath’s The Bell Jar, Elizabeth Wurtzel’s Prozac Nation. Although these books comforted me, they also equipped me with a distrust of psychiatry and medication. In all of these works, treatment for metal illness was oppressive, stifling, even cruel. Medication was frequently presented as something that dulled the senses and stripped individuals of their creativity or intellect. I avoided it assiduously, believing – like many young people – that my mental health issues made me more interesting, creative, special. The severity of my anxiety certainly pushed me towards medication or at least encouraged me to try it. At the same time, though, I think the frank discussions taking place on podcasts, television and even social media helped strip away many of my preconceptions about SSRIs and allowed me to see them as ordinary, perhaps even routine, forms of healthcare. That being said, I’m not sure simply talking is enough. We need to look at our culture more closely and address some of the factors that allow mental illness to thrive. While many sufferers are genetically predisposed to mental illness or suffer from low levels of serotonin, we also exist within a society that allows mental illness to go unchecked. We talk a lot about self-care, about the importance of sharing our struggles with others, but at a systemic level we do little to support or nourish mental health. It is still difficult for those without private health insurance to receive high quality psychological care. We also do little to address the social inequities that produce and exacerbate certain mental illness. Workplaces advocate mindfulness amongst their staff, but this does little to help young people who are faced with an increasingly inhospitable economy, a lacklustre job market and an exploitative gig economy. I don’t have solutions to these problems, but I do know that while talking is good, it isn’t always enough.
