Our candid conversation about depression with registered counsellor Lauren Spangenberg continues.
In the second of three Q&As, Spangenberg shares how she's witnessed antidepressant meds and talk therapy changing the lives of her patients.
What changes have you seen in clients who started taking medication after not taking any, and in those who began therapy after not having any therapy before?
I’ve seen amazing changes, literally life-turnaround changes. I’ll give you an example of a man who was in one of my groups, who had a life-altering incident at a point and who had been recommended to go on antidepressants at that stage. He did not do that for thirteen years.
When he started the group process, he wasn't in a good space. He'd had major conflict in his family, which resulted in an angry outburst. He was brought to the hospital and the psychiatrist on duty had given him a harsh diagnosis, I feel.
But it’s very hard. You only see people in one split second in time and you see them at the worst moment of their lives. You don’t see all of the other stuff. You don’t see them being gentle, and warm and loving – and a brother and a son, and all these other things. You just see this really bad behaviour in one moment, that has come from literally years of feeling trapped, alone, and limited. Just an outburst.
Luckily, for that moment, he was motivated to try and do something. That was when he got onto the medication and started coming to group therapy. And within a year, he was a completely different person. Calm and optimistic. He had started a new relationship, which was something that he had struggled with before.
If you’re stewing in anger and frustration, even if it’s on a subconscious level, people can pick up on that. You’re desperate to get into a relationship, but it’s hard. When all that stuff shifted, he was able to find somebody who loved him and who he was able to love. That’s just one example of somebody who had taken the medication and was doing the therapy work and was able to shift his perspective on life and actually start activating all the good stuff. It’s so powerful.
Do you have another example that’s maybe not so black and white? Maybe a more everyday case of someone struggling?
I have a lot of young people who come to me. People in their early 20s who are struggling to find their feet and also manage boundaries. It’s quite hard. The world is an interesting place right now. And I think sometimes people start to feel quite lost.
I have had a few of those sorts of clients, who after doing some therapy and taking medication, which I have explained, isn’t a life sentence, it’s helped them be a little less emotional, a little bit more optimistic and start being proactive.
It can just be for a year or two, while you’re finding your feet, while you’re developing tools. While you’re figuring all of this out. And it’s just helped
As you were talking, I was thinking it’s giving them building blocks, to rebuild.
Your mental wellness journey, it’s not one thing. It is a recipe. If you’re cooking something, there’s quite a lot of things that go into the pot. Obviously, you’ve got your main ingredients, but then you’ve got a lot of other little things. And all of us have our own little recipes, our own little mixes. And sometimes, when you really need to stabilise, you have to have the medication. And you have to have therapy. And the other things you bring into the recipe are your exercise, your breathwork, whatever works for you.
Why is talk therapy so important to be combined with an antidepressant? When I went on an antidepressant, the doctor was adamant that I had to go to talk therapy too, I couldn’t just take the pill. Could you elaborate on that?
Your doctor was completely right and your doctor was probably giving you that advice based on all the research. There’s been so much work on this, over the years. It’s a massive industry, people don’t do things by accident. And all the research does show that if you just do therapy, it has about a 40% success rate. And if you just do the medication, it has a pretty similar rate. Combine them and it’s significantly better. We don’t live in the matrix. You’re not going to take a pill and make your life better.
Antidepressants can give you the neurological safe ground so you can start doing the cognitive work around thinking about your life and starting to work on some of the other things, like your self-talk. It’s a big thing. It’s a cognitive tool that you can work on and learn in therapy. Also just understanding why you feel the way you feel about a lot of things. Because that gives you the power to put an intervention in there.
A lot of us feel something and react to it immediately. If you start to be able to understand the why … When you feel something, you go, 'wait a second. I know what’s going on here.' And then as soon as you get to that, you’re able to go: 'I can choose how I am going to react to this. Because I know what’s happening.' That’s why the two work so well together. Because antidepressants can start giving you the ability to move into the space where you can do the cognitive work.
Is there still a stigma around using antidepressants or are people still scared of them?
Yes, definitely. There is a huge amount of stigma that comes from ignorance about what mental health problems actually are. Many sectors of the community don’t believe that there is such a thing as a mental health issue. You’d be surprised. That’s one side of it. People not understanding the space at all and just thinking that if you have some kind of a mental health issue there is something wrong with you, you are weak, maybe just mad. You’re either ok or not ok. There’s nothing in between.
Understandably, people really don’t want to put themselves in the bad apple category, which they feel they’ll never get out of, once you’re in there. That’s just ignorance but it does exist. And lots of people are worried, I have it all the time, people say: 'I don’t want to become addicted.'
It’s really interesting that people have this idea that these medications are somehow addictive. I know anti-anxiety medication can be, but antidepressants are absolutely not.
When people say they’re scared they’re going to become addicted, don’t they mean that they’re scared they’re just going to rely on it, that they won’t be able to wean off?
Yes, some people are scared of that and other people are scared that it’s like a nicotine addiction. That you’ll have your one pill every morning for the first six months and then suddenly you’ll be wanting to take two and then suddenly you’ll be on five, you’ll be popping them at lunch and in the afternoon. But no, that really does not happen, you will be fine.
*More about how antidepressants work and the difference between them and anti-anxiety meds in the Q&A coming next week.
If you’ve read this and you’re like fuuuuuck, I need help, registered counsellor Lauren Spangenberg recommends the first step is to reach out to your GP. Talk to them about it. You can also reach out to Spangenberg for a private session, in person or on Zoom (local or international). If you’re in SA, join a group therapy session through SADAG (we’ll be sharing more about that next week) or drop us an email at helloanonymiss@gmail.com and we’ll put you in touch with the right people. Always better together.
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