Here Are 6 Things Psychiatrists Wish People Knew About Taking Antidepressants
No, you won't get addicted to them.
If you’re taking an antidepressant—or you’ve ever thought you could benefit from taking an antidepressant—how much do you know about it?
Many people really don’t understand how antidepressants work, so they’re very concerned when they first start taking them, says Dr. Tony L. Byler, MD, psychiatrist and medical director for AmeriHealth Caritas’ behavioral health managed care organization.
“They want to know things like, ‘Is this going to help me?’ and, ‘Is this going to hurt me?’” says Dr. Byler. “And a lot of them are really really afraid that it is going to hurt them.”
Here’s what your doctor wishes that everyone knew about taking an antidepressant medication.
You Have More Options Than You Used To
Antidepressants have been around longer than you might think. When the selective serotonin reuptake inhibitor known as Prozac (fluoxetine) first hit the market, Ronald Reagan was president of the United States. George Michael’s “Faith” and Whitney Houston’s “So Emotional” were topping the pop music charts.
In other words, it’s been a minute since 1988, and many antidepressant medications have joined the market since then. Just in the SSRI category alone, we have sertraline (Zoloft®), citalopram (Celexa®), paroxetine (Paxil®), and escitalopram (Lexapro®). And that doesn’t even include all the older antidepressants, such as monoamine oxidase (MAO) inhibitors and tricyclic antidepressants (TCA), that have been around even longer.
According to the National Institutes of Health, SSRIs remain the most commonly prescribed type of antidepressant medication. People also commonly rely on serotonin and norepinephrine reuptake inhibitors (SNRIs), which are similar to SSRIs, as well as bupropion (Wellbutrin®), which is also used to treat seasonal affective disorder (SAD) and to help people stop smoking.
In other words, you have options. If you suffer from depression, and one antidepressant doesn’t work out for you, it might be worth trying another.
Related: 21 Things You Should Never Say to Someone With Depression (and What to Say Instead)
What Else Do Doctors Want You To Know About Antidepressants?
Here are the other things doctors want you to keep in mind before starting an antidepressants
Avoid self-diagnosing
You may think you know what’s affecting you, but it’s important not to make assumptions. “It’s critical that people seek health, ask questions and continue to trust medical professionals to help make the right diagnosis,” says Dr. LaMont Moss, MD, a psychiatrist with Kaiser Permanente in Colorado.
Once you have the right diagnosis, your provider can narrow down the options for appropriate treatment to choose the ones that seem best suited to your needs.
Related: 22 Depression Memes to Help You Feel Less Alone—And Maybe Even Make You Laugh
It’s not really about a chemical imbalance
“One of the most common misconceptions about antidepressants is that the medication works by simply increasing serotonin levels [in your brain]," says Dr. Moss. “In the medical profession, we know it’s not simply a matter of a chemical imbalance.”
As a study in the Journal of Neuroscience notes, chronic use of antidepressants actually works by promoting cell growth in an area of the brain called the hippocampus that’s central to memory, learning and emotion. Some research suggests that the volume of this critical brain structure shrinks in people with major depressive disorder. Stressful experiences seem to cause a loss of neurons in this area—but antidepressants seem to be able to block that loss.
“The medications help the brain heal, recover or otherwise get better,” says Dr. Moss. “It’s not simply alleviating a chemical balance—it is helping the brain grow a new way to heal.”
You will not become addicted
One thing that you don’t need to worry about is becoming addicted to an antidepressant. So that’s not a reason to avoid taking an antidepressant if you need one. “Some people are afraid they are going to become addicted to it,” says Dr. Byler. “But their abuse potential is quite low.”
However, you can experience side effects when you start taking an SSRI, although the Mayo Clinic notes that the side effects usually go away after the first few weeks of treatment.
You may also experience some withdrawal symptoms if you suddenly stop taking an antidepressant. Common withdrawal symptoms include nausea, dizziness, lethargy, an uneasy feeling or sensation and even flu-like symptoms in some situations.
You'll need to give it some time
Are you worried that the benefit of your medication hasn’t kicked in yet? You may be right. “It’s quite common that people think once they get their prescription, they’ll automatically start feeling different, or in their terms, better,” says Dr. Moss.
Dr. Byler says he tells his patients that he doesn’t expect them to be feeling noticeably better within the first two weeks of treatment (although some do). But he does hope to see some benefit after about a month.
It may take a while for your medication to work well enough to give you relief. In fact, it may take you longer than you expect. Because those meds may take a while to kick in, you may need to remind yourself to be patient. Over time, the right medication should lessen the severity of your symptoms so you can use other strategies in concert with the medication.
“They start to feel well enough to do other things such as eating better, exercising, engaging in social activities with family and friends—all ways that we can truly start to heal the whole mind, body and spirit,” says Dr. Moss. “Because all of these things work together. It’s not a magic pill. Much like for any health need, medication is just one piece to the health puzzle.”
It's important not to give up too quickly
Along the same lines, don’t give up if a particular medication doesn’t work quickly—or doesn’t work well for you at all. Many people do give up too quickly, says Dr. Byler. They may not realize that another treatment might be more effective, that another method of taking the antidepressant may help or that they may benefit from another medication used to augment their antidepressant.
And, he adds, almost everyone who sticks with treatment does get better. That being said, antidepressants don't work for everyone, and there are side effects to be aware of. So before starting on any SSRI or SNRI, it's important to have a thorough conversation with your doctor or a psychiatrist to weigh benefits and risks, as well as to schedule regular check-ins.
Next up: Here's What Major Depressive Disorder Actually Is—and How It Differs from 'Regular' Depression
Sources:
Addiction Center. Antidepressant Addiction And Abuse.
Biological Psychiatry. The Hippocampus in Depression: More Than the Sum of Its Parts? Advanced Hippocampal Substructure Segmentation in Depression.
Dr. Tony L. Byler, MD, board-certified psychiatrist
Experimental and Clinical Psychopharmacology. A brief history of the development of antidepressant drugs: From monoamines to glutamate.
Journal of Neuroscience. Chronic Antidepressant Treatment Increases Neurogenesis in Adult Rat Hippocampus.
LaMont Moss, MD, board-certified psychiatrist
Mayo Clinic. Selective serotonin reuptake inhibitors (SSRIs)
Medline Plus. Bupropion.
NIH Medline Plus Magazine. Commonly prescribed antidepressants and how they work.
Yale Medicine. Antidepressants shown to promote new cell growth in the hippocampus.
