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Happy Pills

Happy pills, I’ve got those happy pills…

Recently I was fortunate enough to be interviewed by Philippa Willetts, a blogger and tweeter who has just launched a new podcast called Converge. Philippa plans to use podcasts to look at various forms of activism and, as a mental health service user herself, was keen to kick the project off by exploring the stigma surrounding mental health. One of the issues that came in our discussion was the stigmatising way in which the media refers to many mental health drugs, with “happy pills” being our least favourite description of what so many people know to be essential medication for their well-being. It got me thinking about the phrase, and I decided to unpack it a little.

First of all, for “happy pills” to be a negative term there has to be something wrong either with wanting to be “happy” or with wanting to achieve happiness by taking “pills”. There’s a kind of suspicion embedded in the phrase, a hint that people on antidepressants are trying to get something for nothing, to take a short cut towards something they’re not really entitled to. Except in my experience, mental health service users hardly sit around rubbing their hands with glee and trying to snaffle more than their fair share of the planet’s joy. Spend time with anyone suffering from depression, whatever their diagnosis, and the focus is always on relief from suffering. People who experience depression as numbness or emptiness often express a desire to feeling something, anything, while people who experience it as continual emotional pain talk of a desperate need to escape that pain, just for a day, even just for an hour. Either way, what people want is simply to feel how they used to, to feel normal.

Because no-one really takes antidepressants to feel “happy”. Being happy all the time would be abnormal, a pathological state in itself, as bipolars know only too well. Sometimes antidepressants can cause someone to “overshoot”, to go beyond and into that pathological happiness, but once hypomanic or manic the person simply has a whole new set of problems. What antidepressants are aiming for, along with drugs taken for their mood-stabilising qualities, is some semblance of normal mood or euthymia, well described on Wikipedia as “normal non-depressed, reasonably positive mood.” No-one’s searching for unreasonable happiness, undeserved joy. People are merely hoping for a mood state in which they experience transient happiness at some time, but no more than fleeting sadness at others. The normal human condition.

Suppose, however, we were after unreasonable happiness, a constant state of bliss? Would that be wrong? People are certainly willing to pay for drugs that induce a temporary state of bliss, and governments tend to want to make these illegal. The pharmacology of antidepressants doesn’t work that way, anyway; if an immediate high were what “happy pills” delivered, you’d expect to hear of fluoxetine or amitriptyline on drug dealers’ menus along with other prescription drugs. Yet we don’t, because even the smallest improvement in mood usually requires patience and commitment, with the user needing to take their medication consistently and as prescribed for at least a couple of weeks. Hardly a short cut to euphoria.

No, the root of the “happy pills” rhetoric is a fundamental misunderstanding of depression as a condition. If you don’t get how very low a depressed person is, then you won’t understand how big a hand up they need to be brought anywhere close to euthymia. Despite what the media would like us all to think, antidepressants are no shortcut to happiness, no means to “cheat your way to joy”. Just a vital route out of the deepest troughs of a life-threating illness.

Did you take your normal pills today?

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