All of us feel sad sometimes, but the sensation usually passes after a while. However, people with depression may need to take medication – known as antidepressants – to help the sad, depressive feelings go away.
How Antidepressants Work
Most antidepressants work by changing the balance of brain chemicals called neurotransmitters in the brain. In people with depression, these chemicals are not used properly by the brain. Antidepressants make the chemicals more available to brain cells. Antidepressants can be prescribed by any doctor, but people with severe symptoms are usually referred to a psychiatrist for treatment.
In general, antidepressants work well, especially when used along with psychotherapy. The combination has proven to be the most effective treatment for depression. Most people on antidepressants report eventual improvements in symptoms such as sadness, loss of interest, and hopelessness. However, antidepressants are not a quick fit and may take 1-3 weeks before they start to work and even longer before you feel the full benefit. If your symptoms do not improve after 4 to 6 weeks, tell your doctor. You may need a higher dose or a different medicine.
Some people do not respond to the first antidepressant they try, but will usually respond to a different medicine. Remember, it can take up to 3 months to feel the full benefit of an antidepressant. Also, antidepressants may stop working in a small number of people who have been taking them for a while.
There is no difference in the strength, safety, or quality of generic versus brand-name antidepressants. However, some studies suggest there may be variations in how well generics are absorbed and used by the body. If you switched to a generic and it does not seem to be working, tell your doctor.
Length of treatment
A successful course of treatment usually lasts several months to a year. Do not quit, even if you feel better sooner. If you do, it’s likely your depression will come back. Your doctor can help you develop a convenient routine for staying on your medication, and he will be able to advise you on when to start decreasing your dosage.
Antidepressants can cause unwanted side effects. Do not hesitate to discuss these with your doctor. Antidepressant side effects may include nausea, sexual problems, fatigue or insomnia. There are often ways to manage side effects, for example, taking your antidepressant with food can help nausea. If you’re having sexual problems, changing antidepressants may help. If you feel fatigued, try taking your medicine 1 to 2 hours before bedtime. If the antidepressant causes insomnia, take it in the morning. Many side effects diminish on their own after a few weeks.
Antidepressants used most often today have fewer side effects and drug interactions than older versions. Still, any antidepressant can interact with other medications you are taking, and even with natural/herbal or dietary supplements. Drug interactions can lead to more severe side effects and decrease the effectiveness of your medication. Let your doctor know about any new prescription drug, over-the-counter medicine, or dietary supplement you plan to take.
It is vital to go for regular check-ups with your doctor while you are on antidepressants. Relapses in depression are common and your doctor will need to constantly evaluate if your medication is still working as it should. Alternatively he/she may advise changing the dose or trying a new medication if your symptoms return. Be sure to tell your doctor of major changes in your life, such as losing a job, developing another medical condition, or becoming pregnant as these life changes can greatly affect your psychological wellbeing.
Some people worry that antidepressants will leave them robotic. The fact is, antidepressants relieve feelings of sadness, but they do not eliminate your emotions. Another myth is that you’ll need to take the drugs for life. A typical course of antidepressants lasts only 6 to 12 months.
Getting psychotherapy while you take antidepressants is the most effective way to treat depression. Types of therapy include cognitive behavioral therapy, which focuses on changing negative thoughts and behaviors, and interpersonal therapy, which focuses on your relationships with others. It is important to see a psychotherapist while you are on antidepressants to deal with any underlying and root causes of your depression so that they do not reoccur when you come off the medication.
Exercise releases endorphins, chemicals linked to improved mood and lower rates of depression.
Several studies suggest regular exercise, without medicine, is an effective treatment for mild depression. Exercise can also help your medicine work better. Group sessions or exercising with a partner may be particularly helpful.
Coming off antidepressants
Your doctor will help you determine the right time to stop your antidepressants. Quitting abruptly can cause unwanted side effects or even a relapse. With many antidepressants, it’s best to gradually reduce your dose according to your doctor’s guidance.