The facts about antidepressants + 5 things to know before starting one

In Tennessee, 12% of people take antidepressants, yet many of us still have questions.

What conditions can antidepressants treat? What are the side effects? What are the benefits?

WellTuned spoke with Karissa Hyrchuk, licensed clinical social worker at BlueCross BlueShield of Tennessee, to learn more.

What are antidepressants?

Hyrchuk: Antidepressants are medications that can help relieve the symptoms of anxiety and depression. These medications affect the balance of certain chemicals in the brain. And these chemicals are responsible for changes in mood and behavior.

There are several classes of antidepressants. Some older ones work very well, but have more side effects. While some newer ones may have fewer side effects but might also be less effective for some people. You should work with your provider to find the best option for you.

The antidepressants people are most familiar with are in a class called selective serotonin reuptake inhibitors (SSRI). SSRIs block the reabsorption of serotonin by the neurons in your brain. This makes it easier for those neurons to send and receive messages. That results in better, more stable moods. Most doctors will start with SSRIs for a patient who is seeking treatment for depression.

What conditions do antidepressants treat?

Hyrchuk: The most common conditions treated by antidepressants are:

Depression, including mild chronic depression, dysthymia (persistent depressive disorder or “PDD”) and seasonal affective disorder (SAD)
Anxiety disorders, including social anxiety disorder
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)

What are the side effects of antidepressants?

Hyrchuk: People may experience minor side effects at first. But most of them will wear off within a week or two as your body adjusts.

Possible side effects include:

Headaches
Abdominal pain or indigestion
Brain fog
Nausea
Constipation or diarrhea
Sweating
Dry mouth
Sexual side effects (decreased libido, inability to perform or orgasm)

Hyrchuk: If you experience persistent and uncomfortable side effects, your provider may adjust dosages. Starting an antidepressant can actually cause or increase suicidal thoughts. But this happens in a very small percentage of people. That’s why it’s important for patients to be educated and monitored for these changes. This is particularly crucial for people with an existing history of significant depression.

What are the benefits of antidepressants?

Hyrchuk: Antidepressants can be very effective. You can treat depression or anxiety with medication alone, but research shows that talk therapy can also be as effective. And a combination of therapy and medication together yields the best outcomes.

Is there anyone who shouldn’t take antidepressants?

Hyrchuk: If you have a diagnosis of bipolar disorder with mania or symptoms of psychosis, then antidepressants may increase those symptoms. For people who only have a history of depression, antidepressants aren’t likely to cause a problem. Be honest about your medical history when you talk to your doctor. If you see an increase in symptoms of mania (such as pressured speech, racing thoughts, decreased need for sleep) or psychosis, contact your doctor immediately.

There are fewer FDA-approved antidepressants for children and adolescents. But studies have shown that they can still effectively treat major depression in children and teens. They’ve also shown to lower the overall rate of pediatric suicide, so parents definitely shouldn’t rule them out as an option.

What parents need to know about teen suicide

5 things people should know before starting antidepressants

1. Antidepressants take a while to work

Hyrchuk: 30-60% of people don’t take antidepressants properly. It’s important to take your antidepressant every day exactly as prescribed. Understand it could be 4-8 weeks before you experience the full benefit of the medication. It must have a chance to build up to a therapeutic level in your system, so take it as prescribed even if you’re not feeling especially “depressed” every day.

2. Keep taking antidepressants after you start to feel their effects

Hyrchuk: Don’t stop taking your medication once you start feeling better! Antidepressants aren’t like antibiotics where you take a certain amount to permanently address a problem. Once you have achieved mood stability, it is important to continue taking your antidepressant regularly for at least 6 months. This helps lower the risk of a relapse.

3. Trial periods are part of the process

Hyrchuk: Finding the right antidepressant can be a frustrating process. Not every medication works for everyone. If you’re serious about finding something that’s going to help you, you may need to do a couple of 4-8 week trials. Stick with it because finding the medication that works for you is well worth the investment.

4. Antidepressants are not addictive

Hyrchuk: Many people avoid medication as a treatment option because they’re afraid of becoming addicted. But none of the SSRIs or older classes of antidepressants have been found to be addictive or habit-forming. You can take an antidepressant for a period of time in your life, receive the therapeutic benefit, and come off of it in a responsible manner.

5. If you want to stop taking antidepressants, tell your doctor first

Hyrchuk: Stopping antidepressants abruptly can cause problems. This includes uncomfortable physical symptoms or a relapse of depression. If, after 6 months to a year, you want to stop then talk to your doctor about tapering off. They’ll help you through it in safe way.

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Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).