Understanding Antidepressants

About Depression
How Antidepressants Work
The Importance of Counseling
What About the Side Effects?
Interactions with Other Medications
Making the Decision
FAQ

If you're wondering about medication for depression... or your doctor has prescribed it for you, you might have some questions about what antidepressants can (and can't) do, about the proper way to take them, and about the sorts of side effects that you might experience. This brochure will give you an overview of some of these issues, but our real hope is that you'll feel free to have a more in-depth discussion of this information with your Barnard Counseling Services clinician (or your outside mental health provider). or your doctor has prescribed it for you, you might have some questions about what antidepressants can (and can't) do, about the proper way to take them, and about the sorts of side effects that you might experience. This brochure will give you an overview of some of these issues, but our real hope is that you'll feel free to have a more in-depth discussion of this information with your Barnard Counseling Services clinician (or your outside mental health provider).

About Depression

All of us feel down at times, and most of us have experienced moods that we would describe as "depressed." In depression, these feelings become so overwhelming that daily functioning becomes difficult or even impossible. Depression can take different forms in different people, but it commonly includes symptoms like:

• feeling sad or depressed most of the day for
• weeks or months
• lack of emotional response ("I feel numb") loss of interest in the things you usually enjoy
• feelings of hopelessness
• a sense of worthlessness and self-blame
• difficulty concentrating
• changes in appetite, sleep, and/or energy level
• thoughts of death or of hurting yourself

Many people with depression can be treated successfully without medication. However, when people experience symptoms that are particularly intense and/or prolonged, medication can have an important role in treatment. Antidepressants will not "fix" everything, but they can help to lessen your symptoms so that you begin to function better — and that can let you work through other problems more productively.

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How Antidepressants Work

Many different factors can have a role in causing depression, such as genetics, chemical changes in the body, external events, life circumstances, and cognitive and interpersonal styles. Research suggests that, for some people, depression is linked to the functioning of brain chemicals called neurotransmitters. Antidepressants are thought to correct imbalances in these chemicals. All antidepressants, however, take time to work: therapeutic response typically occurs within two to four weeks after treatment is started. In addition, treatment often involves "fine-tuning" of your medication. Because each person responds uniquely, your doctor may recommend a change in dosage, or of the medication itself, during the treatment process.

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The Importance of Counseling

We believe that the most effective way to use antidepressants in the treatment of depression is in combination with psychotherapy. As explained, medication can help improve many of the symptoms of depression, but it can’t change the events, thoughts, behaviors, or interpersonal patterns that may also be contributing factors. Working through issues in these areas is a fundamental part of treatment, and also builds a foundation for the maintenance of your recovery later on. By working with a therapist who is collaborating with your doctor (or with a psychiatrist who sees you for therapy as well as medication), you can begin to explore, understand, and resolve personal concerns as the medication helps to relieve some of your physical and mood-related symptoms.

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What About Side Effects?

Like many medications, antidepressants may cause side effects that are mild and temporary in most people. Common side effects include nausea, diarrhea or constipation, dry mouth, drowsiness, light-headedness, sleep changes, nervousness or over activation, and changes in sexual interest. While more severe side effects are not common, they are possible. Your doctor will talk to you about the side effects associated with your particular antidepressant, and during follow-up sessions, will ask you about your response to the medication. You should immediately report to your doctor any unusual side effects, or those that interfere with your ability to work or study.

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Interactions With Other Medications

When taking an antidepressant, it is important to be aware of the potential for interaction with other drugs (prescribed or over-the-counter) that you may be taking. Be sure to talk to your doctor about any medications, supplements, or herbal products that you are using. You will also need to let your other health care providers know that you are taking an antidepressant before you receive any subsequent prescriptions. In particular, antidepressants can interact with antihistamines, cold and allergy medications, diet pills, thyroid medications, blood pressure medications, and other psychoactive medications that you may be taking. Finally, the use of alcohol, which is a potent depressant, can reduce the effectiveness of your treatment, and is to be avoided.

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Making the Decision

If your counselor believes that your depression might respond well to medication, she/he owes it to you to suggest it. Even when antidepressants are suggested, however, the final decision is yours. Whether you find yourself leaning toward or against trying an antidepressant, be sure to explore all your thoughts, questions, and hesitations about medication with your counselor or doctor.

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FAQ

1. Are antidepressants addictive? Currently-prescribed medications approved for the treatment of depression are not considered addictive.

2. Will the medication change my personality? Medication will not change who you are as a person. Antidepressants assist people in experiencing the full range of emotions without feeling overwhelmed. This may seem like a personality change, but it is more accurately a sign that you are recovering your ability to react to people and situations in a non-depressed way.

3. My friend is being treated for depression, and her doctor did not suggest medication for her. Why did mine suggest it for me? Is it because my problems are really bad? Depression takes different forms in different people, so that two people who have depression can have completely different symptoms. Antidepressant medication is for depression where specific types of symptoms are present. Similarly, an antidepressant that helped a friend or family member may not work for you. Your doctor will assess your unique symptom pattern to determine whether a particular medication (or any at all) is indicated for you.

4. How long will I have to take my medication? Your doctor will continuously assess the effects of your treatment, but typically, people take antidepressants for 8 to 12 months or longer. It can be tempting to stop taking your medication as soon as you feel better, but stopping too soon without "tapering off" can result in the return of your symptoms.

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