By: Tenicia Talley, PharmD, MSCR
- Depression affects millions of people each year. Yet the stigmas around taking antidepressants and mental health often prevent people from seeking treatment.
- Antidepressants are a common treatment option for people with depression. They’ve been proven to improve mood and emotional function.
- It’s important to have the facts — not myths — about antidepressants when deciding which treatment option is best for you.
People who feel depressed aren’t alone. Depression affects millions of people each year. In 2018, an estimated 7% of adults in the U.S. had experienced at least one major depressive episode in the past year. What’s more, 35% of adults experiencing depression report not receiving treatment.
Antidepressant medications are commonly used to treat depression. Despite working well for many people, there can be stigma and myths around their use. If you’re considering an antidepressant, it’s important that you have the facts to help you make the best treatment decision.
Below we debunk several misconceptions about antidepressants to help you become familiar with how they do and don’t work.
Why is there a stigma around antidepressants and mental healthcare?
Despite advances in mental healthcare, negative beliefs about depression are still common. Society often links mental health with spirituality, character, or personality. This contributes to the idea that depression is a personal choice or a moral dilemma rather than a health condition.
Your culture and family background can also influence your mental health. For example, some people have cultural backgrounds that place a high value on spirituality. Because of this, they may prefer to seek treatment from less formal sources of care, such as from ministers or friends and family.
The stigma of depression may cause some people to feel like they’ve failed if they can’t improve how they feel through willpower, diet, or exercise. Instead of seeking professional treatment, they may resort to unhealthy coping mechanisms, like isolation or self-medication.
Like any other physical condition, depression can be diagnosed and treated. There’s no shame in asking for help to get the support you need. Speaking with a healthcare professional is a good first step towards feeling better.
And while you might benefit from counseling alone, sometimes adding an antidepressant can make a big difference. Let’s review a few common medication options.
What medications are commonly used to treat depression?
Although depression is a serious condition, it is treatable. Treatment usually includes medications such as antidepressants, therapy, or a combination of both.
There are many antidepressant medications available. No particular option has been shown to be more effective than others. Your healthcare provider will consider side effects, your underlying conditions, and your preferences when finding a treatment that’s right for you.
Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors (SSRIs) are a type of medication used as a first-choice treatment for depression. They’re also used to treat other mental health conditions, like generalized anxiety disorder (GAD). Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa).
SSRIs work by affecting a brain chemical called serotonin. Serotonin is thought to help ease depression by regulating your mood and emotions. Common side effects include dry mouth, trouble sleeping, and headache. They can also potentially cause sexual dysfunction (e.g., erectile dysfunction).
Serotonin and norepinephrine reuptake inhibitors
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another first-choice treatment for depression. Some medications in this class are also used to treat anxiety disorders and nerve pain. Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq).
Like SSRIs, SNRIs work by affecting serotonin. But they also affect another brain chemical called norepinephrine. Norepinephrine is thought to influence your mood, energy, and ability to concentrate. Both classes also share many of the same side effects, but SNRIs tend to cause more nausea, trouble sleeping, and dry mouth.
Bupropion (Wellbutrin) and mirtazapine (Remeron) are atypical antidepressant medications that don’t quite fit into the other classes. They’re also first-choice options, but they may be a better fit in certain situations. For example, either one might be a good choice if you’re experiencing sexual dysfunction from other antidepressants. This is because they’re less likely to have that effect.
Older medications, like tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), are sometimes used if other options aren’t working for you. They aren’t considered first-choice medications since they tend to cause more side effects.
What are some common myths about antidepressant medications?
You may have heard that antidepressants can change your personality or that they can cause physical changes to your brain. Below we set the record straight on seven myths.
Myth #1: Addressing your mental health is a sign of weakness
Sadness is a normal, healthy emotional response to the world around us. Although the causes and degrees of sadness can vary, they’re usually temporary and go away with time.
Depression, on the other hand, is a long-term mental health condition. It can affect how you think, act, and feel as well as negatively impact your quality of life.
You may feel you have to be strong and carry the weight of your issues on your own. But it’s OK to not be OK. Mental health issues have nothing to do with your being weak.
Depression is complex. There are many factors — including some beyond your control — that can lead to depression, including:
- Poor diet
- Family history of depression
- Certain medical conditions or medications
- Major life events, stress, or trauma
Remember: Asking for help is a sign of strength. Taking care of your mental health is as important as taking care of your physical health.
Myth #2: Antidepressants cure depression right away
Antidepressants don’t work overnight — they take time to become effective. It can take up to 6 weeks for you to see an improvement in your symptoms.
While you wait for your medication to start working, talk with your healthcare provider about things you can do to take care of your mental health.
Don’t be discouraged if the first medication you try doesn’t work well for you. Since everyone is different, finding the right treatment may take some time. Your healthcare provider can help you navigate this process.
Myth #3: You can stop taking antidepressants when you feel better
You may be tempted to stop taking your antidepressant on your own once you start feeling better. But this can potentially cause your depression symptoms to return. You might also experience withdrawal symptoms — called antidepressant discontinuation syndrome.
This syndrome can happen if you suddenly stop taking your medication or lower your dose too fast. You may experience symptoms like nausea, sleep problems, and burning and tingling sensations.
It’s important that you keep taking your medication as directed by your healthcare provider to get the best results. But if you want to stop taking it or lower your dose, first talk to your healthcare provider about how to do it safely.
Myth #4: You need to take antidepressants for the rest of your life
Antidepressants help get your symptoms under control so that you feel better. And they also help prevent them from coming back, too. Some people take antidepressants only for a few months. Others may need to take them longer — depending on the likelihood symptoms might come back.
If it’s your first time experiencing a depressive episode, you may need to take an antidepressant for only 4 to 12 months after your symptoms resolve. However, people with chronic or recurrent depression may need to keep taking them for a few years. This is because antidepressants help prevent a relapse.
In other words, you may not need to take antidepressants long term. Depending on your risk factors and symptoms, your healthcare provider will determine the benefits and risks of continuing the medication. Remember: The ultimate goal is to get and keep you feeling better.
Myth #5: Antidepressants cause permanent physical changes in your brain
Ongoing research suggests depression can potentially cause permanent physical changes to your brain. This includes brain shrinkage and inflammation. These changes can occur if depression isn’t treated.
Conversely, antidepressants have been shown to lower inflammation and potentially help repair or reverse some of the brain changes caused by depression. But you may not get as much of a benefit the longer the condition is left untreated. This is why it’s important to seek treatment sooner rather than later.
Myth #6: Antidepressants are addictive
Antidepressants aren’t considered to be addictive. They don’t cause the cravings or “high” that you might associate with other substances. But they can cause some withdrawal symptoms if you stop taking them or lower your dose too quickly.
Again, this is called antidepressant discontinuation syndrome. Symptoms are usually mild and appear a few days after stopping the medication and last for 1 to 2 weeks.
Because of these potential symptoms, discuss any potential changes to how you’re taking your medication with your healthcare provider first.
Myth #7: Antidepressants change your personality
Your personality is what makes you unique. The goal of antidepressants isn’t to change you into a different person. Instead, they should help uncover your natural personality. Antidepressants do this by lessening the impact of depression on your mood.
However, you might experience a lack of emotion while taking antidepressants. This may be more common with higher doses of medications that affect serotonin (e.g., SSRIs). It may also be a sign that the medication or dose you’re taking isn’t the right fit.
If you’re taking antidepressants and not feeling like yourself, let your healthcare provider know. They may decide to lower your dose, add another medication, or switch you to a different antidepressant.
What else can you do to take care of your mental health?
There are many things people can do to care for their mental health. Here are a few tips you may be able to incorporate into your daily routine:
- Exercise regularly. Research has shown that exercise can help provide mental health benefits. You can start small and exercise in a way that feels good to you.
- Eat a balanced diet. What you eat can potentially affect your mood. Try incorporating healthy choices into your diet, like whole grains, fish, and vegetables.
- Drink plenty of water. In addition to a healthy diet, it’s important that you’re drinking enough water. Hydration can also play a role in your mood.
- Make time to rest — physically, spiritually, and emotionally. Stress can have a negative impact on your mood, so it’s important to take time to relax and recharge.
- Make time for activities that bring joy. Taking time to do things that make you happy can help boost your mood.
The bottom line
It takes courage to acknowledge what’s happening to you and to focus on taking care of your mental health. Depression is not a hopeless situation: It’s a medical condition that involves chemical changes in the brain.
The good news is that, like many other physical conditions, depression is treatable. There are a variety of treatment options that can meet your needs. Antidepressants are widely prescribed but often misunderstood. Working with a healthcare professional to find the best treatment plan for you can help you return to your normal daily functions.