Self-medication as a social and clinical phenomenon

Self-medication is an increasingly common practice in response to psychological suffering, especially in cases of depression. Faced with difficulties in accessing specialized care or due to the stigma that still surrounds mental disorders, many people opt for “quick fixes,” resorting to medications without a proper prescription.

This behavior includes the use of antidepressants, anxiolytics, or hypnotics recommended by family members, friends, social media, or even previous treatments, without considering the risks involved.

A response to structural and cultural barriers

From a social perspective, self-medication can be understood as a way of coping with obstacles such as lack of mental health coverage, long waiting lists, misinformation, and fear of psychiatric diagnosis.

Added to this is the medicalization of everyday emotional distress, which leads to the trivialization of psychiatric treatments and their use without adequate follow-up. In many contexts, self-medication with psychotropic drugs is no longer seen as risky behavior and has become normalized, which increases its danger.

Clinical risks of self-medication

In the clinical setting, self-medication is particularly risky in cases of severe depression. As explained in the presentation, the diagnosis of depression requires the assessment of affective symptoms (sadness, anhedonia), cognitive symptoms (hopelessness, suicidal thoughts), somatic symptoms (sleep and appetite disturbances), and behavioral symptoms.

The inappropriate use of psychotropic drugs—in low doses, for a short time, or without the appropriate medication—can mask symptoms, hinder diagnosis, increase resistance to treatment, and, in some cases, increase the risk of suicide.

Impact on the treatment of refractory depression

Self-medication can significantly interfere with the treatment of refractory depression, which does not improve with at least two appropriate drug treatments. These cases often require more complex interventions such as augmentation strategies, electroconvulsive therapy, or transcranial magnetic stimulation.

When a patient has taken several medications on their own or has interrupted treatments, it is more difficult to develop a clear and effective treatment plan. Drug interactions or cumulative adverse effects may also occur, further complicating clinical management.

Supplements and “natural” alternatives: a false solution?

Many people, distrustful of psychotropic drugs or seeking “more natural” options, turn to magnesium, tryptophan, vitamin B, or supplements such as SAMe. While some of these compounds have been studied, the evidence for their use in treating depression is weak or insufficient.

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