1. First, you need to talk to an expert.
Never take medication without consulting a doctor or trained mental healthcare professional. Antidepressants and other medications used to treat depression can interact with other medications (e.g., birth control) and pose risks to your health, especially with certain chronic conditions. Be sure to let your practitioner know about any health concerns or issues you have.
2. Be aware of common side effects.
- Reduced reaction time, requiring caution when operating heavy machinery or driving a vehicle
- Sleeping problems
- Weight gain
- Muscle pain or tremors
- Change in sexual behavior
These side effects can vary widely from medication to medication and person to person. Commonly, they are felt most strongly during the first few weeks of taking the medication and diminish over time. Be sure to discuss possible side effects with your health care practitioner BEFORE you decide which medication to take. Once you begin taking medication for depression, if you experience unusual symptoms, be sure to contact your practitioner to discuss the best way forward. Do not stop taking the medication or vary the dosage without first consulting your practitioner.
3. Medication changes brain activity.
The exact mechanisms by which antidepressants affect depression are not yet fully understood. Generally, however, antidepressants influence the regulation of chemical substances, known as neurotransmitters (specifically serotonin, noradrenalin, and dopamine), in the brain which have been shown to be related to depressive symptoms.
4. Antidepressants don’t have the same effect on everyone.
There are many different kinds of antidepressants. While some might have a rather calming side-effect, others might make you more active. Sometimes it is necessary to try more than one type of antidepressant before finding one that will work for you.
5. Antidepressants are not the only type of medication for depression.
Though antidepressants are the most common medication for depression, other types of medications can be prescribed as well:
- Lithium: a salt like substance that already exists in the body. It stabilizes mood and is therefore effective in treating bipolar disorder with depressive and manic episodes. It is often used as a supplement to antidepressants.
- St. John’s Wort: This herbal supplement that you can usually find in drug stores or other places where vitamins are sold has been found to have an anti-depressant effect, especially with mild to moderate episodes. However, there is a lot of debate about efficient dosage levels. Interactions with other medications can also be severe, so speak to your health care practitioner before taking!
- Antiepileptics: Can be a good alternative to lithium in cases of bipolar disorders, as they have similar effects. This medication is usually prescribed for epilepsy, but it also stabilizes mood.
- Neuroleptics: Neuroleptics are usually prescribed when extreme anxiety or delusions occur. However, the side effects of this drug can be very severe, so the use should be carefully considered and possible risks and costs should be weighed against the benefits.
6. Antidepressants take time.
It usually takes about 4 weeks to begin to feel better with antidepressants. If after four to six weeks you don’t begin to notice an improvement, you should contact your mental healthcare practitioner to adjust or change the medication.
7. There are differing views regarding efficacy.
Antidepressants have been around for a long time, but not everyone is convinced of their efficacy. Research has shown that there is a benefit from treatment with antidepressants. However, the degree to this effectiveness is not clear and how much might actually reflect a “placebo effect.” A study by Kirsch and colleagues found that the symptoms of people with mild- to moderate depression did not improve with the antidepressants any more than the group who took a placebo. However, those with severe depression did show a higher benefit from the medication than those taking the placebo.
The recommendations according to medical standards are as follows:
Mild depressive episode: Psychotherapy has shown the best results. Medication shouldn’t be the first choice but can be used if there were previous depressive episodes in the past or if the person affected had positive experiences using medication before. Medication may also be considered if no other options for treatment are available.
Moderate depressive episode: Either medication or psychotherapy can be used, as they have shown comparable effectiveness in studies. A combination of both hasn’t shown better results, so people affected should try out one treatment option and consider a combination only if the treatment isn’t successful. A combination can be used if there were previous depressive episodes or if the person affected showed good results with medication before.
Major depressive episode: A combination of medication and psychotherapy seems to be the most effective treatment option, as it shows better results than using either psychotherapy or medication on their own.
Concerning long-term solutions, cognitive behavioral therapy (CBT) has been proven to prevent the reoccurrence of depression. Psychotherapy in general shows lower rates of reoccuring depressive episodes than medication.
8. Certain substances are addictive.
Sleeping pills and tranquilizers are highly addictive and should only be taken under the care of a healthcare practitioner and in acute and severe situations. While tranquilizers such as benzodiazepines do not function as antidepressants, they do help with relaxation and can alleviate sleeping problems. Because of their extremely high risk of addiction, however, use extreme caution when taking them and always consult a doctor before use.
9. Education has to come before medication.
Consider carefully and be sure to educate yourself fully on the various treatment options for depression before beginning any medication. Discuss all your options with your therapist or doctor and inform yourself about the chances, risks, and consequences of different treatment options.
Is Medication Right for Me?
Medication can be an effective treatment option for depression, especially if your symptoms are severe or if you have experienced depressive episodes in your past. If your depressive symptoms are mild, however, and you’ve never before experienced depression, psychotherapy should be your first treatment choice.
Remember that in addition to psychotherapy and medication for depression, there are other actions you can take to help reduce symptoms. These include increasing your physical activity, eating a healthy diet, and engaging in more social activities. A holistic approach is always best. If you’d like more information about psychotherapy and your treatment options, you can find it here.