A post by Fedez is never a private matter. It reaches 14 million people (40 million, if you add the followers of his wife Chiara Ferragni) and is much more powerful than the countless awareness campaigns advanced by industry experts, from any sector. Reason why the words of the entrepreneur, rapper and influencer on the use of psychotropic drugs are today the right opportunity to think about the narration that is being done, what has been done and will be done, on the subject, on the net and beyond; the right opportunity to count the countless steps forward made towards breaking down the taboos still prevailing on mental health, but also to pay attention to some lightness committed by other influencer colleagues and beyond. We do it with Emi Bondi, president of Italian Society of Psychiatry.
Fedez, who in recent days has ended up in the spotlight due to a sudden stutter, explained that he was a victim of the “rebound effect” of the psychotropic drugs he was taking to treat his depression. What is it about?
“I don’t know your specific situation but I can generally say that drugs that act on the nervous system must never be discontinued abruptly but gradually and under medical prescription, because a sudden discontinuation can cause a rebound effect of the disease, i.e. the return of the disease in an even more accentuated form or a so-called “suspension” symptomatology. This is because the body does not have the necessary time to readjust to a pre-drug condition: the drugs contain substances, such as dopamine and serotonin, which are produced by the our nervous system but which perhaps, when it is ill, it does not produce in adequate quantities”.
In Fedez’s case, the drug was discontinued due to serious side effects.
“On average, almost all of our latest generation drugs, especially those of the antidepressant type, have very few side effects, so much so that they are used, without any problems, by millions of people around the world, in some cases even by pregnant women. This does not however, there may not be an individual sensitivity. In most cases, the side effects are minimal, but each person must be informed of them at the time of prescription. For example, some serotonergics can give a feeling of nausea. In other cases, the side effects are more serious. and the doctor can replace the drug with a more suitable one”.
If on the one hand there are those who praised Fedez for the invitation to take care of mental health, on the other there are those who accused him of generating misunderstandings about the use of psychotropic drugs, as he associated them with the word “shortcut ” *. What do you think?
“I appreciate the courage to speak. It is also thanks to figures from the past such as Vittorio Gassmann and Sandra Mondaini that depression, at the time defined as the ‘dark evil’ and unpronounceable, obtained its dignity as a disease, thus bringing people closer to the awareness of being able to ask for help. However, I do not find it correct to speak of a shortcut, if by shortcut we mean the use of drugs with respect to, for example, the psychotherapeutic process, which obviously requires a very long time. It is like saying that psychotherapy is a longer road, but more correct to get results. This is not the case: the disease must be faced in the way in which it can be resolved. Depending on the levels of the disease and the necessary times, there are international guidelines. In some cases, the discomforts arise from relational problems, in others there are biological forms of sudden drops in mood that can lead to great disability.There are those who never get out of bed and come to think of taking their own life and are not often able to tolerate the disease further nor is he able to face a psychotherapeutic course. Nothing prevents the treatments from being integrated, i.e. first pharmacological and then psychotherapeutic, but there are no shortcuts or flat roads. There are treatments indicated based on the severity and type of disease of the pathology”.
«I appreciate Fedez’s courage. However, I do not find it correct to speak of a shortcut, if by shortcut we mean the use of drugs with respect to the psychotherapeutic process, for example, which obviously requires a very long time. There are no shortcuts or flat roads. The disease must be faced in the way it can be resolved. There are, depending on the levels of the disease and the necessary times, international guidelines»
When is a psychiatric drug used and when is it not necessary to do so?
“Drugs must be taken when there is a clear-cut disease. Mild forms of depression can also respond to psychotherapeutic treatment, because psychotherapy also stimulates a certain brain plasticity and a certain production of antidepressant substances. But, if the symptomatology is more importantly, pharmacological treatment is indicated, possibly integrated with a psychotherapeutic process.We remind you that mental illnesses can also worsen the course of all organic illnesses: if a person has had a heart attack and suffers from depression, they have 5 times the risk of not recovering, treating depression in that case also means helping the patient to better deal with organic diseases”.
Mental health is today finally free from taboos: countless steps forward have been made in the imagination, especially thanks to the younger ones. What are the clichés that still stigmatize the use of psychotropic drugs?
“Absurd things happen to me, like a boy who uses drugs and is hospitalized because he freaked out and then refuses psychotropic drugs, because they act on the brain forgetting that drugs also work on the nervous system, but certainly not in a therapeutic way , so much so that he took him to a psychiatry ward.They are taboos linked, in part, to the drugs of the 1960s, the first so-called “old generation” drugs: they created the stigma against psychiatric drugs, because they gave muscle stiffness and side effects such as to make the patient recognizable.Let’s not forget, however, that they were drugs for psychosis and not for depression and at the time, thanks to those drugs, people were able to leave psychiatric hospitals and re-enter the social sphere, because it was possible for the first time to control the most serious psychiatric symptoms. Then there are taboos concerning the disease itself”.
How does prejudice affect those who are victims of psychiatric illness?
“There is this conviction of the omnipotence of our will, so that those who are ill, if they commit themselves with all their strength, can heal. It is as if someone who is ill wants to be ill in some way, but it is not true: they are diseases. No one chooses to be ill. One cannot blame those who are already suffering and even a lot. For no organic disease, the patient is asked to heal voluntarily, on the contrary, it is recommended that he go to the doctor and be treated”.
«You should never resort to DIY. We don’t care with what the neighbor or a friend says, especially if we’re really sick: we wouldn’t do it for any serious illness. Among young people, drugs are also used inappropriately: there is also a search for psychiatric drugs to reduce withdrawal symptoms from substances, but these are deviations from the correct intake on a voluntary basis”
Mental health is one of the most debated topics, especially among the younger generations, so much so that it has become a “trend” in the online debate. This summer, a controversy concerned the influencer Giorgia Soleri, who literally listed the drugs she had taken, so much so that she was accused of being able to encourage emulation. Could it be a risk?
“Whoever is a public figure must be aware of his or her social role. Carlo Verdone himself spoke of it irreverently in his films to defuse it, one must be careful to send correct messages: even psychotropic drugs are drugs and one does not play with medicines of any kind. They should be taken when needed, if necessary and under strict medical supervision. You should never resort to do-it-yourself. You don’t care what your neighbor or a friend says, especially if you are really ill , we wouldn’t do it for any serious illness. Among young people, drugs are also used inappropriately: there is also a search for psychiatric drugs to reduce symptoms of substance withdrawal, but these are deviations from the correct intake on a voluntary basis” .
In January, the Italian Society of Neuro-psycho-pharmacology (Sinpf) declared that one teenager out of ten uses psychotropic drugs for fun, running into serious health risks. In September, an Espad study denounced the increasingly widespread use of psychotropic drugs in adolescents without a prescription as a European-wide phenomenon.
“The use “for fun” by the adolescent can be part of that search for transgression and experimentation with what is forbidden, typical of the age. Normally it shouldn’t be like this, because all psychotropic drugs, i.e. drugs that act on the nervous system, require a medical prescription. Whether it goes from anxiolytics to antidepressants. But today there is great use of substances via the Internet. Slowly, even for drugs, the drug dealer around the corner disappears and one gets anything at home I’m not aware that this also happens for psychiatric drugs but I think it is very probable”.
Has there been an increase in the use of psychotropic drugs in Italy?
“Yes, but it is an increase that corresponds to the increase in the incidence of mental illness: in recent years anxiety and depression disorders have increased steadily and with Covid it is estimated by around 30 percent. It should certainly be understood because nervous diseases are increasing so much and we know the correlations between these and stress well, but these are considerations that a sociologist would be able to make better. Mental diseases are the most widespread worldwide: WHO data from 2017 estimated 322 million people worldwide suffering from depression alone.In my opinion, however, the number of people who are not treated for these diseases is still very worryingly high. And I say worryingly because they are diseases that carry a high personal cost of suffering and collective social and economic costs”.
«There is an increase in the use of psychoactive drugs, but it is an increase that corresponds to the increase in the incidence of mental illness: in recent years, anxiety and depression disorders have increased steadily and with Covid it is estimated that about 30 percent. Which groups are most at risk? Women and young people»
Is the increase in disorders transversal across genders and age groups, or are there categories more at risk?
“Women have an incidence of depression up to three times greater than men and an increase in the incidence of eating disorders up to 10 times greater than men. Neurodevelopmental disorders, schizophrenia and substance use affect men more The age groups most at risk are certainly the young ones, among which we have seen an increase in depression and anxiety but above all a lowering of the onset age of almost all diseases: for example, eating disorders get sick earlier of 14 years, compared to 16/19 before”.
* (“Taking care of mental health will mean for me in the coming months to face the traumatic events of my life in the most complex, most uphill and most painful way, that of therapy, without looking for shortcuts as I have been looking for in recent months. Don’t look for shortcuts because they can hurt you”, are Fedez’s statements, ed)