Why antidepressants can make you feel worse, ruin your sex life and cause weight gain, by NHS psychiatrist PROFESSOR JOANNA MONCRIEFF. There are alternatives… and they may work better

‘I wasn’t sure if I needed them, but I thought I owed it to myself.’ This is how one young woman explained to me why she had decided to take antidepressants.

She was prescribed them by her GP for premenstrual tension and mood changes. Why should she go on struggling without them, she had asked herself? And, since most of her friends were taking them, she felt she might be letting herself down if she didn’t take them too.

This young woman is part of an epidemic of antidepressant use by young people. This is being fuelled by social media videos and posts that hype up the benefits of the drugs and gloss over their harmful effects.

UK data shows the number of people aged between 15 and 29 who were prescribed an antidepressant increased by almost a third between 2016 and 2023.

By 2023, 1,846,533 people in this age group were taking them in England alone – most of them women.

A recent survey by a teenage mental health charity, Stem4, found that 43 per cent of 19 to 21-year-olds claim to have been prescribed antidepressants for a mental health problem at some point during their lives.

I fear antidepressants are becoming seen as an essential lifestyle aid, something people – young women, in particular – should aspire to take, as if they were a new diet.

Young female influencers on social media effuse about the drugs’ effects.

 The antidepressant ‘literally changed so much for me’ said one. ‘I can’t believe how good it was’ said another. ‘I’m a better person because of it’.

They post videos of themselves proudly holding up bottles of pills, running to the mailbox to collect them and excitedly swallowing the tablets on camera.

They rarely mention the downsides of taking antidepressants.

These videos are shared by enthusiastic followers, who use cheeky-sounding hashtags that refer to commonly used antidepressants – such as #livelaughlexapro, #lexaprogirly and #zoloftgang – to make them sound appealing.

They reach billions of people worldwide. The TikTok hashtag #antidepressants has had more than 1.3 billion views.

This social media phenomenon was highlighted in a recent article in the Wall Street Journal about antidepressants becoming a ‘hot lifestyle accessory’ – it also revealed how some of the influencers are sponsored by online health companies that attract people by offering quick and easy online assessments for mental health problems such as depression. (Medical providers on these sites, mainly based in the US, can then prescribe medication if it’s deemed necessary.)

The message is, why wouldn’t you take antidepressants if you are feeling a bit down or stressed?

It seems as if taking them is as easy and harmless as taking a multivitamin or eating more vegetables. You don’t have to ‘struggle in silence’ anymore, said one influencer.

Of course, it is welcome that people are no longer afraid of stigma and able to be more open about their mental health problems.

However, this messaging implies two things about antidepressants that aren’t true: first, that they make people feel better; second, while they can have side-effects, they’re generally nothing to worry about.

Antidepressants are prescribed to treat mental health problems, such as depression and anxiety. But many people assume that because they are branded as antidepressants they must have some general uplifting effect.

As a psychiatrist who has seen hundreds of people who are taking antidepressants, I can tell you they don’t.

Studies with volunteers (people who don’t have a mental health problem) show that antidepressants either don’t have much immediately noticeable effect at all, or are experienced as unpleasant.

With continued use, some antidepressants can make people a bit groggy or lethargic. They also numb people’s emotions – which might sound appealing to someone who is acutely distressed, but many people find this effect unsettling.

And many antidepressants wreak havoc with your sex life.

Whether antidepressants improve symptoms is also uncertain.

In clinical trials, they are a little bit better than a placebo tablet at reducing symptoms of depression and anxiety.

In fact the data shows that people taking the placebo tablets improve almost as much as those taking the antidepressants.

What’s more, this small difference may be down to the fact that people in these trials can often guess whether they are getting the real drug or the placebo, due to side-effects.

This means people taking the real drug will get an extra psychological boost, which might account for the slim superiority of antidepressants.

There is a general consensus that antidepressants are not effective in mild depression. Based on my experience as a psychiatrist and knowledge of the research, I am not convinced these drugs are good for anyone.

And even in moderate or severe depression, guidelines from the National Institute for Health and Care Excellence (NICE) highlight that there are many effective alternatives to antidepressants, including talking therapies, exercise, social activities and guided self-help programmes, where a therapist helps you to work through self-help materials.

The most worrying aspect of the current trend, however, is the failure to highlight the significant side-effects of antidepressants.

On social media it’s only later, after the positive message has gone viral, that some of the influencers admit how the antidepressants had given them brain fog, made them gain weight – and sapped their emotion and libido.

And these effects didn’t just go away in a few days or weeks, as they said they’d been told by their prescriber.

Some of the influencers described severe withdrawal symptoms when they tried to stop antidepressants.

Withdrawal symptoms are more likely when people take these drugs long term, and the increasing number of people who remain on these drugs for years at a time are particularly vulnerable to these problems.

Persistent sexual dysfunction and emotional numbness have also been reported after people have stopped taking antidepressants. These can be devastating, especially for young people.

Many people struggle with their mental health. The fact that we are no longer burdened by the British stiff upper lip and can talk about our difficulties is progress. However, taking antidepressants is not a free lunch. It’s not even much of a lunch. Antidepressants are chemicals and taking chemicals has consequences.

There are other ways to improve your mood or manage your anxiety that are likely to have longer-lasting benefits with less risk.

• Joanna Moncrieff is a psychiatrist based in London, a professor of critical and social psychiatry at University College London, and author of Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth (Flint).