According to a recent investigation by the Sunday Times, more than 3.8 million individuals in England have been taking antidepressants for five years or longer. This alarming statistic includes one in six women over the age of 50. The data, obtained from NHS England through freedom of information requests, shows that the number of long-term antidepressant prescriptions has nearly doubled since 2022 when there were approximately two million such prescriptions.

Currently, around 7 million people in England are on antidepressants, which represents 12 percent of the population. The surge in antidepressant use has been attributed to a rise in anxiety and mental health issues that escalated during the COVID-19 pandemic. Additionally, many individuals have faced prolonged wait times for therapy, which is often utilized in conjunction with medication as part of comprehensive mental health care.

While long-term antidepressant use can be effective for managing chronic depression, it is not without its drawbacks. Patients may experience several physical side effects, including weight gain, risks during pregnancy, sexual dysfunction, and a heightened risk of developing diabetes and osteoporosis. Additionally, many individuals report emotional blunting and cognitive dullness, alongside challenging withdrawal symptoms when attempting to discontinue the medication or even after missing a dose. A significant number of patients feel uninformed about withdrawal symptoms and report a lack of support in tapering off their medications safely.

The data shows that women are more likely than men to be prescribed antidepressants and to continue using them long-term. Specifically, 4.6 million women, or 16 percent of the female population in England, are currently on antidepressants compared to 2.4 million men, which is 9 percent of the male population. Notably, nearly 25 percent of women in their fifties and sixties are currently taking these medications, and about 15 percent of women over 50 have been on antidepressants for longer than five years, a figure that is almost double that of men.

Many women in this demographic begin taking antidepressants after consulting their general practitioners (GPs) about menopause symptoms, which can often be misinterpreted as signs of depression. Dr. Quratulain Zaidi, a clinical psychiatrist, describes this age group as facing a multitude of stressors, particularly those in the “sandwich generation.” This group often juggles escalating career demands, the challenges of menopause, shifts in family dynamics—caring for children or adult children moving out—and the responsibility of looking after aging parents. Women frequently prioritize others' needs over their own, leading to chronic stress and mental health struggles.

Dr. Zaidi states, “What I’m seeing more and more, even in my own practice, is that people in this age group are finding it very challenging. Managing care for aging parents, especially if you’re living away from them, while dealing with family dynamics, all without feeling guilty, is a real struggle.”

In England, one in six adults is on antidepressants; however, rates are higher in Scotland and Northern Ireland, where it reaches one in five. Although there are no official statistics for Wales, estimates suggest that the rate is similarly close to one in six. The Royal College of Psychiatrists asserts that antidepressants can effectively alleviate symptoms of moderate to severe depression, particularly when paired with therapeutic interventions.

Nevertheless, the evidence supporting the long-term benefits of antidepressants is limited. The lack of structured support for patients who wish to discontinue the medication remains a concern, as many experience withdrawal symptoms, particularly if they stop suddenly. Withdrawal symptoms can include debilitating effects such as “brain zaps,” nausea, insomnia, physical pain, and issues with vision and memory.

Dr. James Davies, a psychotherapist and professor advocating for non-medical mental health solutions, highlights the troubling trend of prescribing antidepressants for mild depression, noting that studies indicate such prescriptions are often no more effective than placebos—but unlike placebos, they have side effects. He emphasizes that the real issue lies in the lack of adequate resources for social and psychological support, stating, “The imbalance isn’t in our brains, it’s in our provision.”

Dr. Louise Newson, a GP and menopause specialist, underscores the frequent misdiagnosis of common perimenopausal symptoms—like low mood and anxiety—as depression. She emphasizes that the National Institute for Health and Care Excellence (NICE) guidelines recommend hormone replacement therapy (HRT) as the primary treatment for menopause-related low moods, yet antidepressants are often prescribed instead, commonly without discussing hormonal treatments.

Reflecting on her own experiences, Wendy Austin, a 50-year-old geography teacher from Nottingham, has faced numerous offers for antidepressants since her menopausal symptoms began. Despite previously taking them, she encountered significant negative side effects, including suicidal thoughts. After being diagnosed as perimenopausal in her late thirties, she actively tracked her symptoms and linked her mood fluctuations to hormonal changes. “All the time I was on antidepressants, I just got worse and worse,” she asserts.

After struggling to convince her GP to consider hormonal factors in her symptoms, Austin finally received a referral to a specialist who prescribed her HRT. Now, she feels revitalized and has taken up activities like triathlons and musicals, saying, “It’s with hormonal treatment that I’ve finally got my life back.”

Research shows that long-term sickness is a primary driver of economic inactivity among women over 50, with one in ten women leaving the workforce due to menopausal symptoms. Alarmingly, the suicide rate among women of menopausal age is steadily rising, and those aged 45 to 64 possess the highest suicide rate of any age group among women, according to Office for National Statistics data.

In the past decade, the number of patients in England receiving antidepressants has surged by 45 percent. Although some individuals can discontinue antidepressants without issues, many experience withdrawal symptoms when ceasing their use. These symptoms can be severe and long-lasting, causing significant distress.

Teenagers are also increasingly being prescribed antidepressants; the rate has doubled since 2015, with over 118,000 under-19s currently on these medications, including 12,000 who have been on them for more than five years. Current guidelines recommend that children receive antidepressants only in conjunction with therapy, but this practice is often not followed, with average wait times for therapy exceeding 100 days.

Carrie Clark, who has been on antidepressants for over two decades, was prescribed her first medication at just 14 years old following her father’s death. Now at 34, she feels “trapped” and has faced debilitating withdrawal symptoms after attempting to discontinue her medication. Clark's experience of withdrawal left her with severe psychological and physical symptoms, leading her to return to antidepressants and plan a slow tapering strategy over the next five years.

Clark expressed the frustration of feeling unprepared for the realities of withdrawal and the implications for her desire to start a family. “I was so young when these drugs were prescribed, and I wasn’t warned about the possibility of withdrawal or the safety concerns during pregnancy,” she lamented. Her experience has left her feeling trapped by medication that she feels she never truly needed.

In 2019, the NHS revised its guidelines to reflect that withdrawal can be severe for some patients. Mark Horowitz, a clinical research fellow at the NHS, noted that many patients with withdrawal symptoms are often dismissed by their GPs, leading to a “huge medical scandal.” He has received thousands of emails from patients seeking help with tapering off their medications, and his waiting list currently exceeds a year.

Horowitz advocates for more robust support systems for patients looking to discontinue their medications and for pharmaceutical manufacturers to be mandated to conduct research on safe discontinuation practices. He argues, “If regulators allowed cars to be sold that couldn’t be stopped safely, it would be an outrage. But this occurs regularly with medications.”

The Royal College of Psychiatrists emphasizes that long-term antidepressant use should only be considered for individuals with recurrent depression and severe relapses after discontinuation of the medications. For such patients, the benefits of continued antidepressant use may outweigh the risks. However, regular reviews should be conducted to assess the necessity of ongoing treatment.

Additionally, the Royal College of GPs advises that long-term reliance on medication should be avoided whenever possible, acknowledging that most patients prefer to address their issues without long-term medication dependency. GPs are encouraged to conduct regular medication reviews to determine the ongoing appropriateness of treatment and to ensure that any decisions to discontinue medication are medically supervised, with necessary precautions in place.