Key Takeaways
- Committing to taking an antidepressant is a significant decision, so it’s helpful to research your options and talk to your doctor.
- Antidepressants are safe, effective, and can give you the motivation to make other positive lifestyle changes that can improve your mental health.
- Be aware that they have side effects, it takes time to see results, and some medications might not be effective.
Antidepressants can be an effective tool for treating mental health conditions, but that doesn’t mean the decision to take them is always easy. You might be worried about side effects, stigma, or whether the medication will actually help you feel better. Some people worry about becoming dependent, while others are concerned that antidepressants might affect their personality or characteristics.
It’s important to talk to your doctor about what’s best for you so you can make an informed choice.
Are Antidepressants Worth It?
If you’re considering antidepressants and unsure if they’re the right choice, it’s important to understand their advantages and disadvantages. Work with your doctor to determine the best treatment options for you.
Antidepressants Are Effective
When a drug is tested for effectiveness, it is compared to a placebo, which has no active ingredients but can cause a response because some patients react to the suggestion of treatment. Medication benefits must exceed the “placebo effect” to be considered effective.
Antidepressants are proven to be more effective than a placebo with respect to relieving depressive symptoms and shortening the length of a depressive episode.
As these medications have been in use for over 40 years, there is a plethora of information about how they affect the body. Since the 1980s, several large-scale studies have compared these medications against placebo and each other as new ones come on the market. However, very little information is available regarding a hierarchy of efficacy among antidepressants.
The fact that antidepressants are effective is a significant pro. Depression is a terrible condition involving symptoms such as sleep disturbances, hopelessness, difficulty concentrating, lethargy, and suicidal thoughts.
A depressive episode can undermine close relationships, interrupt lives, and increase the likelihood of risky behaviors and poor choices. It can severely limit psychosocial functioning and diminish your quality of life.
According to the World Health Organization (WHO), major depression is the third leading cause of disease burden worldwide. They project that the disease will rank first by 2030.
Remember, the drawbacks of taking an antidepressant must be measured against the drawbacks of remaining depressed. If we only compared the shortcomings of taking a medication to not taking the medication, we would get a biased, incomplete view.
Antidepressants Are Safe
Antidepressants are considered safe. “Safe” refers to:
- The risk of overdose
- The severity of side effects at the therapeutic (prescribed) dose
- Whether the antidepressant has any dangerous interactions with other drugs or substances
There are studies demonstrating that antidepressants can even be safe for certain vulnerable populations, such as:
- Pregnant women
- Organ transplant recipients
- Those with active tumors
- Those who’ve recently had a stroke
Antidepressants Can Help Boost Motivation
Lifestyle changes can help manage depressive symptoms. Activities such as exercise, pursuing hobbies, and maintaining a balanced diet are beneficial for mental health.
The catch is that a depressed person cannot always get motivated enough to initiate these lifestyle adjustments. Antidepressants can provide a running start to the implementation of a healthier way of living.
If someone does exercise their option to take medication, ideally, that will be part of a holistic approach to their wellness that includes self-care and attention to physical health. One doesn’t replace the other.
Antidepressants Have Side Effects
Although antidepressants are safe, they are not free of side effects. A medication can be considered safe even if it has side effects if the side effects are not life-threatening and/or go away when the medication is discontinued. This is largely true for antidepressants.
A few of the more common side effects of antidepressants include:
- Fatigue
- Stomach upset
- Decreased libido
Many people don’t have side effects at all, or the side effects go away as the body adjusts to the medication. An ongoing open dialogue with your prescriber about your experience is a must, so make sure your concerns are heard from the start.
A thoughtful consideration of the side effects of antidepressants can only effectively be done by weighing those side effects against the effect depression has on your life.
Some people who have side effects decide that the benefits they are getting from the medication are worth it. So, they are willing to put up with things such as dry mouth, for example, and make sure they have plenty of water on hand, in exchange for living without depression.
It Takes Time for Antidepressants to Kick In
Antidepressants don’t work right away. Of course, it depends on the medication and the individual, but benefits can start a few days after taking your first dose.
Most will experience some benefits within two to four weeks. A trial of an antidepressant isn’t considered to technically be a failure unless you have felt no improvement after six weeks on a therapeutic dose.
Some medications are introduced at a low dose to allow your body to adjust, and then that dose is slowly titrated upwards. You and your doctor can discuss whether it is realistic to expect benefits before reaching that dosage.
Social Stigma Still Exists
We try to avoid being swayed by stigma when making major life decisions. However, one should be honest with themselves regarding the potential for considerable stigma and self-stigma involved with being on antidepressants and how it may affect their behavior.
Some individuals might feel so much ambivalence about taking medication that they skip doses or won’t disclose their use of antidepressants to other providers who may need a complete health history.
You also want to be comfortable enough with the idea of taking medications so that you can commit to it for approximately six months, as this is the usual recommendation.
Some Antidepressants May Not Work For You
At times, a medication is either ineffective or doesn’t result in the full desired effect. In this case, you and your doctor can work on a plan that might be a new medication or, in some cases, an additional medication.
Currently, there is no great way to predict in advance which medication might work for a given individual with just a standard interview.
However, there appears to be a genetic component to antidepressant response. Some companies offer genetic testing, which may be helpful in determining the best choice for you.
Your prescriber may also inquire about other relatives with a depression history and what medications worked for them to help guide their prescribing.
We Don’t Really Know Why Antidepressants Work
While it is commonly believed by many people that depression is caused by brain chemistry, researchers and doctors now know this is not the case. This theory has been on the decline for years, but a 2022 study demonstrated that there is no reason to believe that depression is caused by chemical imbalances in the brain.
This does not mean, however, that antidepressants don’t help. Instead, it means we don’t fully understand precisely why antidepressants relieve symptoms of depression.
Depression is complex and can have multiple causes. Because of this, no single treatment works for everyone.
Taking an antidepressant might improve your symptoms, but it won’t necessarily change the underlying factors contributing to your depression. For this reason, combining medication with psychotherapy, lifestyle changes, stress management, and other tactics may provide the best relief.
