Why are antidepressants so stigmatised?

»I haven’t told my friends about it either…I’m afraid of their reaction. I told one person and now he doesn’t talk to me anymore.«

These are the words of a woman based in Copenhagen. You would be forgiven for thinking she is referring to something shameful or unacceptable. In fact, she is talking about her use of antidepressant medication.

However this was, admittedly, more than 20 years ago. 

Have things changed since then? Do we now live in a world where people feel comfortable, should they so choose, to discuss their use of antidepressants in the same way as other medications?

Unfortunately, this does not seem to be the case. More recent studies show that people feeling embarrassed about taking antidepressants makes it harder for them to stick to their treatment. 

People still expect judgement if they choose to open up about their medication use: 

 » I just thought I can’t be bothered being judged for it,« said one user in a 2019 study.

The studies I just quoted are not Danish. But a 2023 review shows that stigma towards the mentally ill is no less in the Nordic countries than the rest of the world.

Antidepressants are common, so why are they taboo? 

An astounding 82 percent of the Danish population will receive treatment for mental ill health at some point in their lives. Depression is the fourth most common of 199 chronic conditions in Denmark.

Antidepressant use has more than doubled in Europe over the past two decades. Given the pervasiveness of the disorder, it is likely that you know someone suffering from depression.

So why are people afraid to share that they take antidepressants?

One line of thinking points to the feeling that taking them is an indication that your mental illness is severe. 

Alternatively, people may be concerned about being perceived as emotionally weak and unable to deal with difficulties. 

Indeed, the increasing prescription of antidepressants has been argued to represent the over-medicalisation of difficult emotional states; perhaps people feel they cannot share their medication use for fear of judgement that they are unable to deal with ‘normal’, human emotions.

People want to ‘kick the habit’ 

Whilst these are valid and plausible explanations, they are intrinsically tied up with the more general stigmatisation of depression. 

So what is it specifically about medication for depression?

Conversations with individuals taking antidepressants often reveal concerns about their moral acceptability, with some discussions suggesting they are viewed as somewhat illicit. 

The aforementioned perception that depression is itself illegitimate extends to their treatment; people with the condition have equated their antidepressant use with the use of recreational drugs.

People are worried about drug dependency or ‘addiction’, expressing a desire to ‘kick the habit’. 

However, whilst this does get nearer to the crux of the matter, would these types of concerns be raised about medication for a somatic illness, like diabetes or hypertension? Probably not. 

So why is medication for depression stigmatised? 

Why are antidepressants seen differently to medication for somatic diseases?

Antidepressants work by balancing the neurotransmitter levels in your brain. So perhaps we should turn our attention to the very foundations upon which antidepressants are based – that depression is caused, in part, by one’s biology. 

This is correct, however believing genetics is the sole cause has negative repercussions (I’ll come back to this).

A 2014 study of almost 2.000 people taking antidepressants found that the longer people remained on antidepressants and the more effective they found them, the more likely they were to believe that biology plays a role in depression. 

Thus, the perceived efficacy of antidepressants goes hand-in-hand with a belief in the biological underpinnings of depression.

However, the influence of genetics on psychiatric illnesses is not as simple as ‘if you have the gene for depression, you will get depression’. 

Your genes play a role, yes, but they are not the sole actor. Everyone is born with a certain amount of genetic risk for psychiatric disorders, but no one is biologically destined to experience one. 

Your environment is always a part of the story.

Unfortunately, there has been little progress in successfully conveying this nuance to the general public. 

Perhaps because of this, reviews have found that public endorsement of the biogenetic explanation of mental ill health (i.e. that depression has a genetic basis) is linked to wanting social distance from people with depression and seeing them as more dangerous).

Even amongst mental health professionals, a review of the literature in 2017 found the majority of studies point to a link between biogenetic explanations of depression and less empathy towards those with the illness.

We can speculate that this is because of a misunderstanding of the biology – believing genetics alone can determine mental health.

Can we assume people understand the meaning of a bio-genetic explanation of depression?

Indeed, we must interrogate what these studies mean by ‘biogenetic’ explanations. 

The authors of the 2017 review stated that »the majority of these studies gave little information or details of the biogenetic information provided to participants.«. 

A look at the studies on the general public cited by the reviews revealed a mix bag of definitions, ranging from ‘brain disease’ to ‘bad nerves’ (se also this review). 

Crucially, none of the definitions explicitly stated the role of the environment in conjunction with genetics.

In other words: People were not fully informed about what a ‘biogenetic explanation of mental ill health’ really means, i.e., that genetics contribute but do not wholly cause psychiatric illness. 

Participants would have instead relied on their own interpretation which, given widespread misunderstanding of genetics and the complexity of psychiatric genetics as a field, is likely to have been incorrect. 

Such interpretations may have included the common-but-mistaken belief that an illness being ‘genetic’ means it is completely determined by your genes. 

Therefore, it may be more correct to conclude that greater stigmatisation of psychiatric disorders (and antidepressants) is tied up with misunderstandings of biogenetic causes, rather than the biogenetic explanation in its true form – that genetics contributes to but always interacts and combines with environmental factors.

Prejudice, self-blame, and guilt can be alleviated

Indeed, research demonstrates that providing clear information about the role of both genetics and the environment in mental health conditions to members of the public reduces prejudice towards psychiatric conditions.

Further, studies that provided psychiatric genetic counselling – a process through which a trained medical professional helps individuals understand the genetic and environmental contributions to their illness – have found such explanations empower people with mental illness and addresses internalised stigma. 

In other words, appreciating the role that genetics plays in one’s illness facilitates a fresh perspective and a deeper acceptance towards one’s condition.

Understanding that genetics likely contributed to their mental health condition helped participants alleviate the feelings of blame and guilt that stemmed from believing their condition was entirely within their control. 

This realisation fostered a sense of empowerment, not only by encouraging the adoption of protective strategies to improve mental well-being but also by reducing the shame associated with taking medication. 

Ultimately, this new perspective offered a profound sense of relief and agency over their mental health, shifting the focus from self-blame to a more compassionate and informed view of their condition.

So why are antidepressants still stigmatised in 2025? 

All in all, it is likely antidepressants are stigmatised due to a toxic blend of misunderstandings and historical biases towards psychiatric illness. 

First, we have the notion that people who take antidepressants might be severely ill or are ‘weak’ and unable to process what some people perceive as ‘normal’ emotional difficulties. 

Then, we have the concern that taking medication – even for psychiatric illness – could lead to ‘addiction’. 

Finally, antidepressants address neurotransmitter imbalances in your brain. The knock-on effect might be that people see depression as an illness largely or wholly caused by your biology.

From the evidence above, we know that such beliefs are linked to seeing sufferers as more dangerous and as people to avoid.

Mix all these things together and what do you get? A big bowl of stigma.

As we work to address these issues within the field of mental health and more broadly, we have to hope that in another 20 years, we can say that things have truly changed.

Click here to read the Danish version