Areas › Low mood and hard feelings › When everything feels flat
No option comes without a cost. The useful question is not which medicine has side effects, it is which side effects you could live with.
One drug may unsettle your stomach for a fortnight and leave your sex life alone. Another may be kind to the stomach and flatten desire for as long as you take it. For one person that is an easy call and for another it is the opposite, and nobody can make the judgement from outside. Say plainly which effects would make you stop, because a prescriber who knows that can choose differently from the start.
Qur’an and Sunnah
So truly where there is hardship there is also ease (Quran 94:5). Ease and hardship arriving together is the ordinary shape of a treatment rather than a sign that something has gone wrong.
فَإِنَّ مَعَ ٱلۡعُسۡرِ يُسۡرًا
So truly where there is hardship there is also ease
Qur’an 94:5read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
When options are compared properly, the obvious one is not always the best. A meta analysis of ways to reduce loneliness found that the approaches which worked best addressed how the lonely person thought about social situations, rather than simply arranging more contact. Weighing what an option actually costs and delivers, instead of what it looks like it should do, is the same habit of mind.
Masi CM, Chen HY, Hawkley LC, Cacioppo JT. (2011). A meta-analysis of interventions to reduce loneliness.. Personality and social psychology review : an official journal of the Society for Personality and Social Psychology, Inc doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Side effects get traded rather than removed, so the choice belongs to the person who has to live in that body.
When not to
Some effects are not trade-offs at all: a rash, a fever or thoughts of harming yourself mean contact someone now rather than weighing it up.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
With the fast acting treatments, the plan for what happens afterwards matters as much as the treatment itself.
A newer version of a familiar medicine is usually a tidier version rather than a leap, and tidier is still worth something.
Match the tablet to the person rather than to the diagnosis. For someone flattened and slowed who has said clearly that they will not accept sexual side effects, paroxetine is close to the worst choice available.