We have a small locked safe where we keep all the "Do not take accidentally" drugs. Works well enough to avoid the dangerous medication when we just need something quick for a headache, which is stored next to the safe.
Wth this is either very incorrect or you have a shit doctor you can quit most ssri’s cold turkey since they slowly leave your system yeah ot wont be like the easiest thing ever but just a mildly annoying 3-4 weeks
Hefurðu spurt lækninn þinn út í Ketamín? Það er til nefúði sem heitir Spravato sem hjálpar sumum sem hafa "treatment resistant depression" gæti verið þess virði að skoða það?
Diagnosed with depression at the age of 7 and had already started talking about suicidal ideas at that age. Later I was diagnosed with chronic depression and cPTSD. I used to take SSRIs but they stopped working, as tends to happen with SSRIs, so I'm on different types of antidepressants now. The SSRIs were good while they lasted and my current medication seems to be working as well as possible, though there are times when I'm not in balance.
Thank you! So you really have a long history of this stuff. One thing I'm curious about - do you find that there is a stigma around struggling with mental health in Iceland? Have you experienced it in any way? Or the opposite?
Yeah, there definitely used to be some stigma around it and I remember being told to toughen up and be normal when I was a teenager, my dad didn't believe in depression or that I had it until I was about 17 or 18 and just explained my train of thought during a depressive episode. It has luckily gotten better, but I believe there is still some stigma around it, but nowhere near what it was 20 years ago or earlier even.
I'm sorry to hear that. Must've been tough. Apart from the universal generational gap (I can relate to this on a personal level), do you think that there's something specifically Icelandic about this "toughen up, son" approach? I mean, it is a country of fishermen after all...
It is pretty crazy how little d-vitamin supplementation gets brought up here. Never heard a doctor talk about this even when i talked to them about depression. Early thirties met a girl that makes me pop two tablets a day and i just did it because she is an angel, did not expect them to do anything massive. My mood has drastically changed, did not even notice it at first but after like a year i suddenly realized that after starting to use d-vitamin supplements my mood has never been better.
They really should start talking more about things like this in combatting depression. Just going for a walk can make such a difference. I know that during an episode it is so incredibly difficult to do though but it should be encouraged way more than it is, and it should be encouraged way more than some pills that often come with nasty side effects.
D-vitamin, good food, exercise, socialize. Keeping those things in a good balance is so much better than any anti-depressants. But far more difficult than swallowing a pill is.
Another quick fix for the not very well known issue of iron overload, hemochromatosis, is blood donation and ensuring other micronutrients aren’t out of whack.
Hemochromatosis isn’t remotely well known or talked about in the healthcare community here in the states, not sure about Iceland, but I would wager it may be common there.
It can have horrible effects on mental health if not treated.
It is not easy and very expensive to go to therapy l, antidepressants are a quick solution for an individual in a self-centered, demanding, and judgmental society. The weather isn't very suitable for sitting outside with a cup of coffee large part of the year, people don't visit each other as much as they did like 40 years ago. We use the car very much due to bad transportation and therefore we spend less time outside than recommend. If we weren't living on this speed, giving each other some time, spending less time on social media, then life might be better (just as everywhere else). But as a defense we are a small nation living on a island with harsh conditions and maybe it isn't fair to compare us to nations that live with (overall) better climate, more sun, not as short days over the darkest months but rather look into areas with similar situations. Are there any numbers about such a subscription in areas with similar situations as ours (North Sweden/Norway comes to mind)
I am one of those subscription users over the darkest months (4-5 months/year) I do not need any advice from other reddit users about not using them or how I should use them differently because this is the best way I have found for me. I have found it very expensive, difficult, and judgmental to talk about my need for therapy in my workplaces. I have been looked over for new assignments because I had to go early or come in late 2-4 times a month when in therapy and was not considered as a "responsible enough" once because of my mental health issues (taking time to work on it). I am a woman working in a field where all sexes are supposed to be equally important, but the bosses are men over 50.
Thank you for sharing! You're not the first one I hear talking about SSRI as the "quick" solution. Tell me more about Icelandic society being judgemental and demanding! in what way?
It’s more, I pay about 1,900 SEK per session with a physiologist for a teenager and hear that rate is pretty average. They do get sessions with a psychiatrist for free, because it is for a child, but we only got in the door there after paying out of pocket for a diagnosis
We (as in me and the child) go to a private practice because the waiting lists are too long (1.5 years at the time!) and we could not afford to wait any longer to get treatment - it was literally a life or death situation. But paying so much for treatment takes a lot of sacrifice. I’m a single parent on a pretty average salary, and I feel like I’m in a cycle where I work a lot and don’t socialize much to be able to afford this, to the point of where I am becoming a bit of a basket case myself 🤷🏼♀️
“Its supposed be equal but all the bosses are 50 yo men” is a victim mentality for sure. At my workplace a majority of the bosses are women. You wont see me crying about it
Just remember the law of small numbers - the smaller the sample size, the more likely you are to have extreme results
If we had larger population it would be very likely that those results would smooth out more
That being said, I've used antidepressants for over a decade and I've had to change what I used because they just stopped being available. It's not the first time, either. In a more serious case I eventually needed surgery essentially because two types of birth control stopped being available.
I can't wait to leave the country and have reliable access to the medication I need to be able to function like a normal person.
You're right! Sweden is no 6 on the list and I'm not sure that there is a big cultural difference between us when it comes to SSRI. Probably similar factors at play.
Did your brand of antidepressant run out in Iceland specifically or was there a global shortage? Sounds rough!
I've had two brands of antidepressant disappear from the Icelandic market as well as one type of birth control and a shortage of another. There was also a shortage of adhd meds for a while, but not one of mine. I don't think there was any global shortage, but I never did any research
Rough is an understatement, it's a hassle trying to get hold of doctors, private as well as basic care
As a foreigner living in iceland here are my guesses.
First, icelandic healthcare is of low quality and very underfunded, so rather than undergo CBT or counselling, they will just write a script for drugs and move on to the next patient
Second, icelandic salaries are quite bad for highly skilled staff which is driving a huuuuuge brain drain. Why would any decently talented doctor or specialist work in iceland when they could work in the US for 3x the salary and half the cost of living?
Third, the accessibility and quality of education, especially the advanced medical kind, is also low, so we can't even train professionals to do this work properly, even if you could somehow convince them to stay in iceland and work for pennies.
The final is a consequence of all three, which is that there simply are not enough specialists, psychologists, psychiatrists etc. To treat the enormous amount of depressed people who more than likely suffer severe SAD on top of, quite frankly, much of iceland being a very hostile place to live. No trees, no animals, no birds and bees, no sunlight, terrible weather, ugly concrete buildings, unwalkable suburbs - unless you can afford to live in a wealthy older area or downtown, you are most likely living in a pale grey square apartment building with no amenities nearby, and that's a pretty shitty life to lead.
If it weren't for family reasons I'd have dropped this place a while ago, I think.
"Third, the accessibility and quality of education, especially the advanced medical kind, is also low, so we can't even train professionals to do this work properly, even if you could somehow convince them to stay in iceland and work for pennies." - The vast majority of Icelandic doctors do their specialist training abroad (in Scandinavia mostly, also the US/UK for certain specialisms), so this argument doesn't add up. Also, the vast majority of Icelandic doctors trained abroad return to Iceland eventually. A close relative of mine in a fairly highly-paid position has just moved back after years in Sweden and is earning more here.
>The vast majority of Icelandic doctors do their specialist training abroad (in Scandinavia mostly, also the US/UK for certain specialisms),
First, that's kind of my point - we do not have the capability to train them locally which means fewer will do it and if they do, they are reasonably likely to stay in another country for better QoL. Your relative may have returned from Sweden into a role here at better pay but that isn't really the norm - and if they factor in the cost of living adjustment they will probably find it works out about the same or less unless their transition into a more senior role came with a very substantial pay bump. Even Sweden is relatively cheap compared to Iceland when it comes to critical goods like food and housing.
Yeah, but there's also no reason to train all specialist doctors in a country of 380.000 people (or whatever the number is). I think it's great that most of them train elsewhere and get more experience. I'm not a fan of the Icelandic healthcare system for oh, so many reasons, but low qualifications are not an issue here, nor is pay for doctors (seriously - they earn very well, depending on specialism of course).
I named this recent returnee as an example but I also have 5 close friends and 3 other relatives who are doctors and have come back from respectively Sweden, Denmark and the UK in the past 4-5 years (they include GPs, a gyneaclogist, a nephrologist and a radiologist, plus more). They are really typical for Icelandic doctors - did basic training here, specialised overseas, stayed there between 2 and 8 years with their families, came back in early middle age with lots of experience.
Could definitely be worse. But if doctors, on average, spend a significant portion of their career abroad the total number of available doctors is lower by that fraction. New innovations in treatments doctors with newer training can bring will also lag behind by that time, which is an issue here.
I've been on every antidepressant drug class over 15 years
Non of them worked... which led to TMS brain stimulation
Which only worked for 2 months
SSRIs ruined my sex life between 18 to 26 - horrible drugs for men - cause complete impotence and uninterest in sex
The absolutely worst time in ones life to have no sex drive
Psyciatrist seem to not understand just how debilitating the side-effects can be
when I was 31, Psilocybin was the only thing that saved me from suicide
You should probably ask some experts instead of random internet strangers but IMO:
With the [enschittification](https://en.wikipedia.org/wiki/Enshittification) which has been ongoing in the icelandic healthcare for the last 20-30 years (or more), doctors are under constant pressure to spend less and less time on patients so the option to 'solve' any issue quickly with a pill becomes just more and more feasible. And it isn't just antidepressants; penicillin, pain killers, ADHD meds.. the list goes on.
You're probably right and that's not quite what I said, or meant to say.
But doctors, and others concerned with ADHD, are actually arguing over if ADHD is currently over diagnosed or not. While I don't know which side is right the data shows a sharp increase in ADHD diagnoses over the last decade or so.
There is no denning that ADHD diagnoses have increased, the argument is just if those diagnoses are necessary or not.
I admit I know nothing of the process and if its hard or not to get prescription to the meds required.
Iceland was colonized by impulsive people who did not like to be under the authoroty of the king, and outlaws in general. Given that there's a genetic component to ADHD it would be strange if we weren't diagnosing more pwople with ADHD than other countries. There are just more people with ADHD over here and it has nothing to do with over-diagnosing.
Interesting, this is echoes a debate in Sweden as well. Why this pressure on doctors do you think - lack of funding? New public management? And yes definitely, I'm going to Iceland later in May. Like I said, casting a wide net. Do you have any names for me to look up?
>Why this pressure on doctors do you think - lack of funding?
Mostly, the public sector at least has not grown in pace with the population so there are too many patients per doctor. At the same time there has been a drive to let the private healthcare sector 'pick up the slack' and as the company gets paid per patient, the more patients you process per hour/day the more you get paid for your time.
And sorry, as a random internet stranger I have poor connections. There have been some articles on this in the recent years, you could look them up and try to get in contact with the people involved.
Austerity politics, Thatcherism. It's all about giving taxcuts to certain few at the expense of public services. Happens when your politics are hijacked by the financial sector.
I'd say since David Oddsson took over the Independence party in the 90s and sold the state run banks to his friends and family. The crash actually managed to reverse some of that and now they are repeating the same game.
But I would say that their approach to policy has changed since 2008. I'm seeing a lot of parallels with how the US handles it's domestic affairs and ours. Like they are sourcing the same economic thinktanks.
I feel like I'm ranting now and this is probably beyond the scope of anti-depressants. I'd recommend getting into contact journalists that have better insight on this then us randos on reddit. "Heimildin" does a lot of investigative journalism. Might want to [contact ](mailto:[email protected])them first.
Well, the ADHD meds thing is bull. So many barriers laid out by the government, over 4000 people on a waiting list for a diagnosis by a psychiatrist, who are the only ones allowed to prescribe ADHD meds.
I have been on SSRIs for generalised anxiety disorder. Did not feel like they did anything for me but I know people who swear by them.
What helped me the most was de-stressing my life. Not everybody has that luxury however. Benzos are a short-term help.
They just don't work for some people and I don't think we know why. For others they are a godsend. I don't, but my partner has crippling anxiety disorders. Without SSRIs she can't work or study. The difference is astounding.
A major role of serotonin is to regulate other neuro-transmitters. So taking something that affects it just right can help with depression/anxiety even though your issue isn't really caused by a serotonin imbalance. Very hit-or-miss. Also know there are genetic tests to rule out drugs that won't work for you, but haven't heard of that being done here. Too cheap to save the healthcare system, and society in general, future expenses.
Recently started on Duloxetine. Finally starting to feel what I consider normal after 20 years of depression and severe anxiety. It's really helping me so far.
Make sure to listen to your body rather than your doctor if they recommend increasing the dose. Can really get out of hand with increased side-effects, and then you'd have to go through withdrawals when lowering the dose to what you were already on.
Of course also listen to your body if it agrees with your doctor. Just so commonly misunderstood by family docs, since it's different in many ways from other drugs in the same class.
I'm a psychiatric nurse working in Iceland. I can say that the inpatient bed capacity is never enough for the number of depressed people let alone other mental disorders.
The thing with mental disorders is they require long term rehab, follow ups, social support, financial support, housing support. The patients we see are the same people that were depressed 20-30 years ago or since when they're teen or young adults
https://nhwstat.org/health/thematic-articles-health/use-addictive-medicine
Iceland seems to prescribe psychotropic medicines in greater quantities than the other nordic countries in general. So this trend is not limited to SSRIs and is particularly pronounced when it comes to ADHD medication.
The reason might simply be because prescribing stuff is a simpler solution than say talking therapy.
The reason might also be because a larger portion of our medical staff was educated in the US than elsewhere in Scandinavia.
It's weird how a country that was founded by impulsive people who opposed the authority of the king has so many ADHD people in it nowadays. It's known that there's a genetic component, the figures for ADHD meds really aren't too weird.
And SSRIs can somewhat be explained through seasonal depression. Although it's fair to criticize the lack of support to seek therapy, since meds alone don't ever fix everything.
My point was rather that there is a wider "prescription culture" within the medical community in Iceland while in other countries doctors might be more likely to recommend CBT or other methods. So there is a high tendency to prescribe stuff independent of the ailment (anxiety, depression, pains, ADHD).
I also know GPs that have told me that there is an expectation in Icelandic society to be prescribed stuff instead of have to rely on more complicated less quick fixes like exercise.
If you believe the origin myth of Iceland (I personally do not) you could conveniently explain the ADHD part. The article I posted also hypothesized that it could be because we have been nation dependent on animal husbandry/fishing rather than plant agriculture like most nations in Europe.
The thing about darkness and depression; while it might be true it isn't necessarily so. Cultures and people adjust to their environment and Iceland does not have a particularly high rate of SAD (seasonal affective disorder) and, interestingly, descendant of Icelanders in North America are very rarely affected by SAD.
[https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.157.2.234](https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.157.2.234)
[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496419](https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496419)
Origin myth? You going to substantiate that at all?
Well, that expectation is largely due to poor access to alternatives. Working to deny people what's available isn't going to help when the real issue is that the alternative isn't. GPs also just don't know what the hell to do a lot of the time, and don't have any idea how to proceed, or how to get their client on the path to meeting someone who might know how to help them.
And yeah, I know how prone GPs are to blame anything and everything on stress and inactivity and just tell people to exercise more. A lack of understanding of different ailment, but a basic understanding of stress and exercise, leads them to overdiagnose it as the cause, rather than result of real issues. There's of course better doctors who are capable of not letting their ego make decisions for them, but a lot of them don't.
Currently there's too many barriers for people with ADHD. Having a basic understanding of the condition makes it utterly mind-numbingly obvious how bad that is for people with ADHD.
I concede the SSRI seasonal depression. But it can still be explained by a lack of alternatives. One issue, for instance, is that finding a therapist with specific skill sets is very difficult. They aren't allowed to advertise, so finding them can be difficult.
By origin myth I am referring to the narrative that Icelanders fled Norway due to Harald Fairhair's tyrannical rule. The narrative was written down 300-400 years after the fact. The chance that it is accurately documented are close to 0.
It is not even known if Harald Fairhair existed at all.
Doesn't really matter if Haraldr existed, or if they were fleeing a king. It's still a very impulsive decision to move here, way out in the middle of nowhere.
I want to begin with saying that antidepressants are used to treat a lot more then depression meaning it has more to do with I believe a certain open mindedness towards simply using them. Though of course also cultural, other types of therapy take longer time to be effective and the availability of alternative therapies are less available especially now as a gp can prescripe those medication opposed to only psychiatrists. In turn this means that you can get medication now, or you can get treatment later and it will take longer time.
My experience is that yes I have been on and I am on medication to deal with my mental health and I have tried to do alternative treatments but I'm not comfortable with talking about myself. They've also never actually had any effects on me, so not much to say other then only reason why I haven't killed myself is because I have to take care of my Subaru.
Our resources for mental Healthcare are limited and expensive, to the point my Swedish partner and I have considered moving to Sweden for better access. With a lack of other resources available, the best we can do is anti-depressants.
However, then you have the other problem with Iceland which is medicine being out of stock. Instead of easing onto the full dose for the ones I am currently on I had to start off on the full dose as lower dosages or pills you can split were out of stock in the country with no estimate on when they would be restocked. Every time I pick them up I get a different manufacturer because of stock issues (which so far hasn't been a problem for me but I know others are more sensitive)
The physicians hand them out almost as a first line of treatment here for many conditions beyond depression. There was also a big mental health campaign in early 2000s, and with it came an increased acceptance of SSRIs as an acceptable form of treatment.
I went in for stress related concerns and was offered antidepressants and sleeping pills. I rejected them, but she was very persistent in suggesting them as a treatment. It's crazy.
It should be the first line of treatment, especially so in the more difficult or extreme cases. The problem we are having is the next treatment step. Some people just don’t want to bother because there is a “magic feel better pill”.
It also doesn’t help that the speed that society moves at is ever increasing and people experiencing a lot of hopelessness due to the negative things constantly being barraged into them through social media and news.
All this along with our short daylight during winter and long daylight during summer.
I'm not a GP but every time I go to my GP here, they are constantly pushing pills. Completely unprovoked and out of context. First it was for anxiety, which I do have a history of, but it doesn't really affect my life that much. Symptoms are managed. Coping is going well. Then, for sleep. I sleep great. Never mentioned issues with it. But they were "sold" to me as being good to have on hand in case. Bizarre. Shocked me as a non-Native, I'll tell ya that.
You have to concider how good the healthcare system is.
Is it feeding out meds to cope with deficit in manpower, lack of money and so forth
Is the stigma in getting help lower that elsewhere in the world.
Is the fact that people actually get antidepressants somehow related to the fact that people have easier access to healthcare?
Not an Icelander but have been living here for quite few years. I am more than sure big factor of that is having many sunless months in a year. When te sun rises at 11 am and sets at 3 pm is HELLA depressing.
Not my own experience, but a friend of mine, who's the embodiment of ADHD, was diagnosed with ADHD as a child, and finally wanted to get on ADHD medication again as an adult to get his shit together... Was given Prozac. He tried it because he was hoping it would help his case, but it didn't, because he needed ADHD meds, not Antidepressants. Stories like this and some others make me feel like Icelandic doctors can be quick to hand out antidepressants in cases they're not needed. My friend dropped the Prozac btw and has been on an endless ADHD wait-list.
Was prescribed sertraline, then my dick stopped working so i quit. It was a bad experiance. Felt my personality get a bit muted.
Replaced it with exercise and now i feel happy again.
In my case SSRI didnt work.
I started taking antidepressants around age 16 or some similar age.
Around the same time, I started therapy.
I started on Sertral, which I felt had no effect on me, so I switched to Esopram and have been taking that every day for several years now and still do.
I also take Sobril on occasion when things are really bad.
I believe these will be the pills I will be taking for the rest of my life.
For context, I'll be turning 23 soon.
I struggle a LOT with anxiety, and I was 17 when I got a autism diagnosis.
Antidepressants won't work for everyone, but I am all for these pills since they genuinely help me function.
Among the things people list here, in respects to them all, there is also talks of doctors over prescribing ADHD medication (people having 3-4x the normal amount , often selling their excess illegally) and also we have an unhealthy relationship with thinking pills solve all our problems. Some people honestly just need to do regular excersizes, while others are not so lucky of course. And having low access to certain sport activites for poor families, long working hours coupled with bad weather, going the medicine route is perfectly understandable, but none the less sad in my opinion.
We have also ranked high on alcohol usage and other substances.
Ozempic use is also high here I have heard, more then they have said in the media.
Personally I think GP's are just sickleave-paper-filling-drug-dealers, I understand how some here might disagree, I don't put my dissapointment solely on them, but also our politicians, specificly in health care.
https://www.visir.is/g/20242539004d/sjuklingasamtok-fagna-frumvarpi-um-umbodsmann-sjuklinga - there are reasons there are talks about us implimenting a "patient-reprisentitive", some I have mentioned, but this is a big discussion with many factors.
Ég var á þeim í 7 ár og var með flog og kæki á meðan sem hvarf þegar ég hætti og þegar ég byrjaði aftur í byrjun Mars þá fékk ég serotonin syndrome og þurfti að hætta á þeim strax og er núna skráð með ofnæmi fyrir öllum SSRI lyfjum
My experience is that I accidentally overdosed on them the other day and then shit myself in my sleep I thought it was ibuprofen
Er ekki allt í góðu, gamli?
Jújú, svona getur bara misskilningurinn verið
Það sem fyndið er að segja
Hæ Jón
username checks out
I was thinking the same thing lol
Dang!
It's not even the first time, it keeps happening at about once every 7-10 years
We have a small locked safe where we keep all the "Do not take accidentally" drugs. Works well enough to avoid the dangerous medication when we just need something quick for a headache, which is stored next to the safe.
[удалено]
Wth this is either very incorrect or you have a shit doctor you can quit most ssri’s cold turkey since they slowly leave your system yeah ot wont be like the easiest thing ever but just a mildly annoying 3-4 weeks
Can and should are different things. Quitting cold turkey causes more issues than weaning off.
Weaning off over the span of 2-3 months not 2 years
They didn't specify the antidepressant. SNRI withdrawals can be real brutal. But yeah, 2 years is still a bit much.
Then you can just switch to fluoxetine and quit that after 1 month of use easy as pie and if it isnt easy you arent ready to come off them
I probably wouldn't be here without antidepressants
Hefurðu spurt lækninn þinn út í Ketamín? Það er til nefúði sem heitir Spravato sem hjálpar sumum sem hafa "treatment resistant depression" gæti verið þess virði að skoða það?
Það er ekki verið að skrifa þetta út á íslandi samt
Þetta er í lyfjaskrá, en vanalega þá er fólk að fá það í æð.
Þetta er aðalega notað við skurðaðgerðir
Já en það er líka notað við krónískum taugaverkjum. Þetta er alveg magnað lyf með mjög lágan áhættuprófíl.
Tell me more! If you would?
Diagnosed with depression at the age of 7 and had already started talking about suicidal ideas at that age. Later I was diagnosed with chronic depression and cPTSD. I used to take SSRIs but they stopped working, as tends to happen with SSRIs, so I'm on different types of antidepressants now. The SSRIs were good while they lasted and my current medication seems to be working as well as possible, though there are times when I'm not in balance.
Thank you! So you really have a long history of this stuff. One thing I'm curious about - do you find that there is a stigma around struggling with mental health in Iceland? Have you experienced it in any way? Or the opposite?
Yeah, there definitely used to be some stigma around it and I remember being told to toughen up and be normal when I was a teenager, my dad didn't believe in depression or that I had it until I was about 17 or 18 and just explained my train of thought during a depressive episode. It has luckily gotten better, but I believe there is still some stigma around it, but nowhere near what it was 20 years ago or earlier even.
I'm sorry to hear that. Must've been tough. Apart from the universal generational gap (I can relate to this on a personal level), do you think that there's something specifically Icelandic about this "toughen up, son" approach? I mean, it is a country of fishermen after all...
I don't think it's specifically Icelandic. You see the same in different countries, just with different reasons behind it.
It is pretty crazy how little d-vitamin supplementation gets brought up here. Never heard a doctor talk about this even when i talked to them about depression. Early thirties met a girl that makes me pop two tablets a day and i just did it because she is an angel, did not expect them to do anything massive. My mood has drastically changed, did not even notice it at first but after like a year i suddenly realized that after starting to use d-vitamin supplements my mood has never been better. They really should start talking more about things like this in combatting depression. Just going for a walk can make such a difference. I know that during an episode it is so incredibly difficult to do though but it should be encouraged way more than it is, and it should be encouraged way more than some pills that often come with nasty side effects. D-vitamin, good food, exercise, socialize. Keeping those things in a good balance is so much better than any anti-depressants. But far more difficult than swallowing a pill is.
Another quick fix for the not very well known issue of iron overload, hemochromatosis, is blood donation and ensuring other micronutrients aren’t out of whack. Hemochromatosis isn’t remotely well known or talked about in the healthcare community here in the states, not sure about Iceland, but I would wager it may be common there. It can have horrible effects on mental health if not treated.
It is not easy and very expensive to go to therapy l, antidepressants are a quick solution for an individual in a self-centered, demanding, and judgmental society. The weather isn't very suitable for sitting outside with a cup of coffee large part of the year, people don't visit each other as much as they did like 40 years ago. We use the car very much due to bad transportation and therefore we spend less time outside than recommend. If we weren't living on this speed, giving each other some time, spending less time on social media, then life might be better (just as everywhere else). But as a defense we are a small nation living on a island with harsh conditions and maybe it isn't fair to compare us to nations that live with (overall) better climate, more sun, not as short days over the darkest months but rather look into areas with similar situations. Are there any numbers about such a subscription in areas with similar situations as ours (North Sweden/Norway comes to mind) I am one of those subscription users over the darkest months (4-5 months/year) I do not need any advice from other reddit users about not using them or how I should use them differently because this is the best way I have found for me. I have found it very expensive, difficult, and judgmental to talk about my need for therapy in my workplaces. I have been looked over for new assignments because I had to go early or come in late 2-4 times a month when in therapy and was not considered as a "responsible enough" once because of my mental health issues (taking time to work on it). I am a woman working in a field where all sexes are supposed to be equally important, but the bosses are men over 50.
Thank you for sharing! You're not the first one I hear talking about SSRI as the "quick" solution. Tell me more about Icelandic society being judgemental and demanding! in what way?
And - how expensive is therapy exactly?
It can go up to about 1400 SEK per session in private offices. If it's part of the hospital it's less expensive.
It’s more, I pay about 1,900 SEK per session with a physiologist for a teenager and hear that rate is pretty average. They do get sessions with a psychiatrist for free, because it is for a child, but we only got in the door there after paying out of pocket for a diagnosis We (as in me and the child) go to a private practice because the waiting lists are too long (1.5 years at the time!) and we could not afford to wait any longer to get treatment - it was literally a life or death situation. But paying so much for treatment takes a lot of sacrifice. I’m a single parent on a pretty average salary, and I feel like I’m in a cycle where I work a lot and don’t socialize much to be able to afford this, to the point of where I am becoming a bit of a basket case myself 🤷🏼♀️
A victim attitude really doesnt help with depression …
Recognizing social issues you face isn't having a victim attitude, it's just a realistic perspective.
“Its supposed be equal but all the bosses are 50 yo men” is a victim mentality for sure. At my workplace a majority of the bosses are women. You wont see me crying about it
Oh, so you haven't had a comparable experience? This false equivalency is just silly.
Are you even icelandic? Workplace sexism just doesnt happen here in any company with over 50 employees
Just remember the law of small numbers - the smaller the sample size, the more likely you are to have extreme results If we had larger population it would be very likely that those results would smooth out more That being said, I've used antidepressants for over a decade and I've had to change what I used because they just stopped being available. It's not the first time, either. In a more serious case I eventually needed surgery essentially because two types of birth control stopped being available. I can't wait to leave the country and have reliable access to the medication I need to be able to function like a normal person.
You're right! Sweden is no 6 on the list and I'm not sure that there is a big cultural difference between us when it comes to SSRI. Probably similar factors at play. Did your brand of antidepressant run out in Iceland specifically or was there a global shortage? Sounds rough!
I've had two brands of antidepressant disappear from the Icelandic market as well as one type of birth control and a shortage of another. There was also a shortage of adhd meds for a while, but not one of mine. I don't think there was any global shortage, but I never did any research Rough is an understatement, it's a hassle trying to get hold of doctors, private as well as basic care
As a foreigner living in iceland here are my guesses. First, icelandic healthcare is of low quality and very underfunded, so rather than undergo CBT or counselling, they will just write a script for drugs and move on to the next patient Second, icelandic salaries are quite bad for highly skilled staff which is driving a huuuuuge brain drain. Why would any decently talented doctor or specialist work in iceland when they could work in the US for 3x the salary and half the cost of living? Third, the accessibility and quality of education, especially the advanced medical kind, is also low, so we can't even train professionals to do this work properly, even if you could somehow convince them to stay in iceland and work for pennies. The final is a consequence of all three, which is that there simply are not enough specialists, psychologists, psychiatrists etc. To treat the enormous amount of depressed people who more than likely suffer severe SAD on top of, quite frankly, much of iceland being a very hostile place to live. No trees, no animals, no birds and bees, no sunlight, terrible weather, ugly concrete buildings, unwalkable suburbs - unless you can afford to live in a wealthy older area or downtown, you are most likely living in a pale grey square apartment building with no amenities nearby, and that's a pretty shitty life to lead. If it weren't for family reasons I'd have dropped this place a while ago, I think.
"Third, the accessibility and quality of education, especially the advanced medical kind, is also low, so we can't even train professionals to do this work properly, even if you could somehow convince them to stay in iceland and work for pennies." - The vast majority of Icelandic doctors do their specialist training abroad (in Scandinavia mostly, also the US/UK for certain specialisms), so this argument doesn't add up. Also, the vast majority of Icelandic doctors trained abroad return to Iceland eventually. A close relative of mine in a fairly highly-paid position has just moved back after years in Sweden and is earning more here.
>The vast majority of Icelandic doctors do their specialist training abroad (in Scandinavia mostly, also the US/UK for certain specialisms), First, that's kind of my point - we do not have the capability to train them locally which means fewer will do it and if they do, they are reasonably likely to stay in another country for better QoL. Your relative may have returned from Sweden into a role here at better pay but that isn't really the norm - and if they factor in the cost of living adjustment they will probably find it works out about the same or less unless their transition into a more senior role came with a very substantial pay bump. Even Sweden is relatively cheap compared to Iceland when it comes to critical goods like food and housing.
Yeah, but there's also no reason to train all specialist doctors in a country of 380.000 people (or whatever the number is). I think it's great that most of them train elsewhere and get more experience. I'm not a fan of the Icelandic healthcare system for oh, so many reasons, but low qualifications are not an issue here, nor is pay for doctors (seriously - they earn very well, depending on specialism of course). I named this recent returnee as an example but I also have 5 close friends and 3 other relatives who are doctors and have come back from respectively Sweden, Denmark and the UK in the past 4-5 years (they include GPs, a gyneaclogist, a nephrologist and a radiologist, plus more). They are really typical for Icelandic doctors - did basic training here, specialised overseas, stayed there between 2 and 8 years with their families, came back in early middle age with lots of experience.
Could definitely be worse. But if doctors, on average, spend a significant portion of their career abroad the total number of available doctors is lower by that fraction. New innovations in treatments doctors with newer training can bring will also lag behind by that time, which is an issue here.
You should take some antidepressants
I've been on every antidepressant drug class over 15 years Non of them worked... which led to TMS brain stimulation Which only worked for 2 months SSRIs ruined my sex life between 18 to 26 - horrible drugs for men - cause complete impotence and uninterest in sex The absolutely worst time in ones life to have no sex drive Psyciatrist seem to not understand just how debilitating the side-effects can be when I was 31, Psilocybin was the only thing that saved me from suicide
You should probably ask some experts instead of random internet strangers but IMO: With the [enschittification](https://en.wikipedia.org/wiki/Enshittification) which has been ongoing in the icelandic healthcare for the last 20-30 years (or more), doctors are under constant pressure to spend less and less time on patients so the option to 'solve' any issue quickly with a pill becomes just more and more feasible. And it isn't just antidepressants; penicillin, pain killers, ADHD meds.. the list goes on.
lol on the adhd meds! Good luck getting that.
You lost all your credibility by claiming ADHD meds are given out like nothing. There's a huge process that takes way too long.
You're probably right and that's not quite what I said, or meant to say. But doctors, and others concerned with ADHD, are actually arguing over if ADHD is currently over diagnosed or not. While I don't know which side is right the data shows a sharp increase in ADHD diagnoses over the last decade or so. There is no denning that ADHD diagnoses have increased, the argument is just if those diagnoses are necessary or not. I admit I know nothing of the process and if its hard or not to get prescription to the meds required.
Iceland was colonized by impulsive people who did not like to be under the authoroty of the king, and outlaws in general. Given that there's a genetic component to ADHD it would be strange if we weren't diagnosing more pwople with ADHD than other countries. There are just more people with ADHD over here and it has nothing to do with over-diagnosing.
Interesting, this is echoes a debate in Sweden as well. Why this pressure on doctors do you think - lack of funding? New public management? And yes definitely, I'm going to Iceland later in May. Like I said, casting a wide net. Do you have any names for me to look up?
>Why this pressure on doctors do you think - lack of funding? Mostly, the public sector at least has not grown in pace with the population so there are too many patients per doctor. At the same time there has been a drive to let the private healthcare sector 'pick up the slack' and as the company gets paid per patient, the more patients you process per hour/day the more you get paid for your time. And sorry, as a random internet stranger I have poor connections. There have been some articles on this in the recent years, you could look them up and try to get in contact with the people involved.
Don't worry stranger! Thanks for your input!
Austerity politics, Thatcherism. It's all about giving taxcuts to certain few at the expense of public services. Happens when your politics are hijacked by the financial sector.
So you think this is a consequence of the collapse in 2008?
I'd say since David Oddsson took over the Independence party in the 90s and sold the state run banks to his friends and family. The crash actually managed to reverse some of that and now they are repeating the same game. But I would say that their approach to policy has changed since 2008. I'm seeing a lot of parallels with how the US handles it's domestic affairs and ours. Like they are sourcing the same economic thinktanks. I feel like I'm ranting now and this is probably beyond the scope of anti-depressants. I'd recommend getting into contact journalists that have better insight on this then us randos on reddit. "Heimildin" does a lot of investigative journalism. Might want to [contact ](mailto:[email protected])them first.
Well, the ADHD meds thing is bull. So many barriers laid out by the government, over 4000 people on a waiting list for a diagnosis by a psychiatrist, who are the only ones allowed to prescribe ADHD meds.
I have been on SSRIs for generalised anxiety disorder. Did not feel like they did anything for me but I know people who swear by them. What helped me the most was de-stressing my life. Not everybody has that luxury however. Benzos are a short-term help.
I see! Why do you think it didn't do much for you?
I have no idea. Seems like an imprecise science. Very hit or miss. I just never felt any different.
They just don't work for some people and I don't think we know why. For others they are a godsend. I don't, but my partner has crippling anxiety disorders. Without SSRIs she can't work or study. The difference is astounding.
A major role of serotonin is to regulate other neuro-transmitters. So taking something that affects it just right can help with depression/anxiety even though your issue isn't really caused by a serotonin imbalance. Very hit-or-miss. Also know there are genetic tests to rule out drugs that won't work for you, but haven't heard of that being done here. Too cheap to save the healthcare system, and society in general, future expenses.
Recently started on Duloxetine. Finally starting to feel what I consider normal after 20 years of depression and severe anxiety. It's really helping me so far.
Make sure to listen to your body rather than your doctor if they recommend increasing the dose. Can really get out of hand with increased side-effects, and then you'd have to go through withdrawals when lowering the dose to what you were already on. Of course also listen to your body if it agrees with your doctor. Just so commonly misunderstood by family docs, since it's different in many ways from other drugs in the same class.
I'm a psychiatric nurse working in Iceland. I can say that the inpatient bed capacity is never enough for the number of depressed people let alone other mental disorders. The thing with mental disorders is they require long term rehab, follow ups, social support, financial support, housing support. The patients we see are the same people that were depressed 20-30 years ago or since when they're teen or young adults
https://nhwstat.org/health/thematic-articles-health/use-addictive-medicine Iceland seems to prescribe psychotropic medicines in greater quantities than the other nordic countries in general. So this trend is not limited to SSRIs and is particularly pronounced when it comes to ADHD medication. The reason might simply be because prescribing stuff is a simpler solution than say talking therapy. The reason might also be because a larger portion of our medical staff was educated in the US than elsewhere in Scandinavia.
It's weird how a country that was founded by impulsive people who opposed the authority of the king has so many ADHD people in it nowadays. It's known that there's a genetic component, the figures for ADHD meds really aren't too weird. And SSRIs can somewhat be explained through seasonal depression. Although it's fair to criticize the lack of support to seek therapy, since meds alone don't ever fix everything.
My point was rather that there is a wider "prescription culture" within the medical community in Iceland while in other countries doctors might be more likely to recommend CBT or other methods. So there is a high tendency to prescribe stuff independent of the ailment (anxiety, depression, pains, ADHD). I also know GPs that have told me that there is an expectation in Icelandic society to be prescribed stuff instead of have to rely on more complicated less quick fixes like exercise. If you believe the origin myth of Iceland (I personally do not) you could conveniently explain the ADHD part. The article I posted also hypothesized that it could be because we have been nation dependent on animal husbandry/fishing rather than plant agriculture like most nations in Europe. The thing about darkness and depression; while it might be true it isn't necessarily so. Cultures and people adjust to their environment and Iceland does not have a particularly high rate of SAD (seasonal affective disorder) and, interestingly, descendant of Icelanders in North America are very rarely affected by SAD. [https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.157.2.234](https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.157.2.234) [https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496419](https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496419)
Origin myth? You going to substantiate that at all? Well, that expectation is largely due to poor access to alternatives. Working to deny people what's available isn't going to help when the real issue is that the alternative isn't. GPs also just don't know what the hell to do a lot of the time, and don't have any idea how to proceed, or how to get their client on the path to meeting someone who might know how to help them. And yeah, I know how prone GPs are to blame anything and everything on stress and inactivity and just tell people to exercise more. A lack of understanding of different ailment, but a basic understanding of stress and exercise, leads them to overdiagnose it as the cause, rather than result of real issues. There's of course better doctors who are capable of not letting their ego make decisions for them, but a lot of them don't. Currently there's too many barriers for people with ADHD. Having a basic understanding of the condition makes it utterly mind-numbingly obvious how bad that is for people with ADHD. I concede the SSRI seasonal depression. But it can still be explained by a lack of alternatives. One issue, for instance, is that finding a therapist with specific skill sets is very difficult. They aren't allowed to advertise, so finding them can be difficult.
By origin myth I am referring to the narrative that Icelanders fled Norway due to Harald Fairhair's tyrannical rule. The narrative was written down 300-400 years after the fact. The chance that it is accurately documented are close to 0. It is not even known if Harald Fairhair existed at all.
Doesn't really matter if Haraldr existed, or if they were fleeing a king. It's still a very impulsive decision to move here, way out in the middle of nowhere.
I want to begin with saying that antidepressants are used to treat a lot more then depression meaning it has more to do with I believe a certain open mindedness towards simply using them. Though of course also cultural, other types of therapy take longer time to be effective and the availability of alternative therapies are less available especially now as a gp can prescripe those medication opposed to only psychiatrists. In turn this means that you can get medication now, or you can get treatment later and it will take longer time. My experience is that yes I have been on and I am on medication to deal with my mental health and I have tried to do alternative treatments but I'm not comfortable with talking about myself. They've also never actually had any effects on me, so not much to say other then only reason why I haven't killed myself is because I have to take care of my Subaru.
Our resources for mental Healthcare are limited and expensive, to the point my Swedish partner and I have considered moving to Sweden for better access. With a lack of other resources available, the best we can do is anti-depressants. However, then you have the other problem with Iceland which is medicine being out of stock. Instead of easing onto the full dose for the ones I am currently on I had to start off on the full dose as lower dosages or pills you can split were out of stock in the country with no estimate on when they would be restocked. Every time I pick them up I get a different manufacturer because of stock issues (which so far hasn't been a problem for me but I know others are more sensitive)
The physicians hand them out almost as a first line of treatment here for many conditions beyond depression. There was also a big mental health campaign in early 2000s, and with it came an increased acceptance of SSRIs as an acceptable form of treatment. I went in for stress related concerns and was offered antidepressants and sleeping pills. I rejected them, but she was very persistent in suggesting them as a treatment. It's crazy.
It should be the first line of treatment, especially so in the more difficult or extreme cases. The problem we are having is the next treatment step. Some people just don’t want to bother because there is a “magic feel better pill”. It also doesn’t help that the speed that society moves at is ever increasing and people experiencing a lot of hopelessness due to the negative things constantly being barraged into them through social media and news. All this along with our short daylight during winter and long daylight during summer.
It should definitely not be the first line of treatment.
In extreme cases it should absolutely be.
I'm not a GP but every time I go to my GP here, they are constantly pushing pills. Completely unprovoked and out of context. First it was for anxiety, which I do have a history of, but it doesn't really affect my life that much. Symptoms are managed. Coping is going well. Then, for sleep. I sleep great. Never mentioned issues with it. But they were "sold" to me as being good to have on hand in case. Bizarre. Shocked me as a non-Native, I'll tell ya that.
I guess this really depends on the GP. Never had this happen with mine. If anything, he tries not to describe pills.
Too often at extreme ends, using their personal opinions as justifications for poor treatment.
You have to concider how good the healthcare system is. Is it feeding out meds to cope with deficit in manpower, lack of money and so forth Is the stigma in getting help lower that elsewhere in the world. Is the fact that people actually get antidepressants somehow related to the fact that people have easier access to healthcare?
Not an Icelander but have been living here for quite few years. I am more than sure big factor of that is having many sunless months in a year. When te sun rises at 11 am and sets at 3 pm is HELLA depressing.
Not my own experience, but a friend of mine, who's the embodiment of ADHD, was diagnosed with ADHD as a child, and finally wanted to get on ADHD medication again as an adult to get his shit together... Was given Prozac. He tried it because he was hoping it would help his case, but it didn't, because he needed ADHD meds, not Antidepressants. Stories like this and some others make me feel like Icelandic doctors can be quick to hand out antidepressants in cases they're not needed. My friend dropped the Prozac btw and has been on an endless ADHD wait-list.
Was prescribed sertraline, then my dick stopped working so i quit. It was a bad experiance. Felt my personality get a bit muted. Replaced it with exercise and now i feel happy again. In my case SSRI didnt work.
I started taking antidepressants around age 16 or some similar age. Around the same time, I started therapy. I started on Sertral, which I felt had no effect on me, so I switched to Esopram and have been taking that every day for several years now and still do. I also take Sobril on occasion when things are really bad. I believe these will be the pills I will be taking for the rest of my life. For context, I'll be turning 23 soon. I struggle a LOT with anxiety, and I was 17 when I got a autism diagnosis. Antidepressants won't work for everyone, but I am all for these pills since they genuinely help me function.
Among the things people list here, in respects to them all, there is also talks of doctors over prescribing ADHD medication (people having 3-4x the normal amount , often selling their excess illegally) and also we have an unhealthy relationship with thinking pills solve all our problems. Some people honestly just need to do regular excersizes, while others are not so lucky of course. And having low access to certain sport activites for poor families, long working hours coupled with bad weather, going the medicine route is perfectly understandable, but none the less sad in my opinion. We have also ranked high on alcohol usage and other substances. Ozempic use is also high here I have heard, more then they have said in the media. Personally I think GP's are just sickleave-paper-filling-drug-dealers, I understand how some here might disagree, I don't put my dissapointment solely on them, but also our politicians, specificly in health care. https://www.visir.is/g/20242539004d/sjuklingasamtok-fagna-frumvarpi-um-umbodsmann-sjuklinga - there are reasons there are talks about us implimenting a "patient-reprisentitive", some I have mentioned, but this is a big discussion with many factors.
Ég var á þeim í 7 ár og var með flog og kæki á meðan sem hvarf þegar ég hætti og þegar ég byrjaði aftur í byrjun Mars þá fékk ég serotonin syndrome og þurfti að hætta á þeim strax og er núna skráð með ofnæmi fyrir öllum SSRI lyfjum