Menschen, die ihre Depression oder Angstzustände als Folge eines chemischen Ungleichgewichts betrachten, neigen dazu, Antidepressiva über einen viel längeren Zeitraum zu verwenden, als diejenigen, die ihre Erkrankung als Reaktion auf Lebensereignisse betrachten. Es ist auch weniger wahrscheinlich, dass sie versuchen, ihre Medikamente abzusetzen, selbst wenn die Symptome mild sind.

People who view their depression or anxiety as the result of a chemical imbalance tend to use antidepressants for much longer periods than those who see their condition as a reaction to life events. These individuals are also less likely to attempt coming off their medication, even when their ongoing symptoms are mild. The research detailing these patterns was published in the Journal of Affective Disorders.

Since the 1990s, pharmaceutical marketing and educational campaigns have heavily promoted the idea that depression is a biological disease. Many of these campaigns specifically claimed that emotional distress originates from a lack of serotonin in the brain. This medical explanation was originally intended to reduce social stigma and encourage people to seek professional help. Over the past few decades, prescriptions for depression and anxiety have surged in both the United States and the United Kingdom.

Today, long-term prescribing is a primary driver behind the massive increase in continual antidepressant use. In the UK, millions of people take these drugs, and at any given time, half of them have been taking their medication for more than two years. In the US, nearly half of all patients on antidepressants have been taking them for more than five years. While medical guidelines do recommend ongoing treatment for some individuals, health experts estimate that a large portion of long-term users might be taking the medication unnecessarily.

A growing body of modern research has failed to support the original biological theories of depression. Recent systematic reviews of the scientific literature have found no consistent evidence linking depression to abnormal serotonin levels. Despite this shift in scientific understanding, public perception remains heavily influenced by older marketing messages. Survey data from recent years shows that up to 80 percent of the population in Western countries holds onto the chemical imbalance theory.

When the researchers looked at medication habits, a distinct behavioral pattern emerged. People who held biological beliefs about their mental health had used antidepressants for a median duration of 12 months. In contrast, patients who did not endorse biological explanations had used the drugs for a median of only six months.

The views patients held also corresponded to differing attitudes about the medication’s effectiveness. Individuals in the biological belief group were more likely to report that the drugs had improved their symptoms. They were also much more likely to express that they could not cope with daily life without their antidepressants.

This psychological reliance translated into a lower willingness to stop treatment. Among those with biological beliefs, only about 58 percent had ever attempted to stop taking their medication. In the group lacking these beliefs, nearly 68 percent of patients had tried to come off their antidepressants.

The team checked the clinical assessment scores to ensure these differences were not driven by underlying illness severity. They found no differences in the initial depression or anxiety scores between the two belief groups. The patients holding biological views were not objectively more unwell than the others, meaning their prolonged duration of use was tied to their perspective rather than their pathology.

The researchers also evaluated how these beliefs interacted with drug withdrawal. Patients who attempt to stop taking antidepressants often experience a discontinuation syndrome, which can include dizziness, electric shock sensations in the brain, and emotional swings. In this study, among the people who had tried to quit, holding a biological belief was not associated with experiencing more severe withdrawal symptoms. However, using the medication for a longer period of time was linked to much worse withdrawal effects down the line.

https://www.sciencedirect.com/science/article/pii/S016503272502511X