Should I take antidepressants?

If you are living with depression or anxiety and wondering if medication may help, you’re not alone. Between 2015 and 2018, more than 1 in 8 adults in the US reported taking antidepressants—and that was before numbers increased due to the pandemic. 

‍

When you’re struggling with anxiety or depression, everyday tasks may seem like mountains you have to scale. Some days, it may feel like just putting one foot in front of the other requires a Herculean effort. Between work and caring for your family, taking care of yourself often comes last.

‍

If any of that sounds like you, we’re guessing the idea of starting antidepressants may have crossed your mind, but maybe you didn’t have time to fully consider what doing so could mean.  

‍

If you’ve found yourself asking, Should I take antidepressants?, this article is for you. Below we do a deep dive into the pros and cons of taking antidepressant medication and how to know if it might be right for your symptoms.

‍

Note: This article is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your prescribing doctor, nurse practitioner, or Minded psychiatry provider before taking any prescription medication or following any treatment or regimen.

‍

Should I take antidepressants?

Antidepressants may be a good option if you have tried treating your depression or anxiety using other methods—such as lifestyle changes and therapy—but have found that your symptoms persist. You should talk to your prescribing doctor, nurse practitioner, or Minded psychiatry provider if symptoms of anxiety or depression are interfering with your daily life.  

‍

Having questions about going on medication is normal. You may be thinking about side effects or whether your personality will change—or maybe you feel there is a stigma around being on medications for a mental health condition. We get it. Did you know that people wait an average of 11 years between symptom onset of mental health conditions and beginning treatment?

‍

The good news is that many—if not all—of these concerns can be addressed by your prescribing doctor, nurse practitioner, or Minded psychiatry provider. Antidepressants aren’t right for everyone, but for many people, they can be life-changing. 

‍

{{ads-green-dots="/templates/cta"}}‍

‍

Do I need antidepressants?

Even if all the above concerns have been addressed, questions about whether you really need an antidepressant can persist. For many, antidepressant medications are an effective treatment for forms of clinical depression (such as major depressive disorder, or MDD, a type of severe depression) and anxiety, including generalized anxiety disorder and panic disorder. Whether you need an antidepressant depends on individual factors, including the severity of your symptoms, your physical and mental health history, your provider’s clinical judgment, and your own preferences. 

‍

If you’ve already been diagnosed with a mental health condition, you’re likely aware of the main symptoms. But if you haven’t already had a formal diagnosis and recognize any of the below signs, it may be worth speaking with a mental health professional, like a psychiatry provider at Minded, about whether you are living with clinical depression or anxiety—and if medication may be right for you. 

‍

Symptoms of depression include:

• Appetite changes
• Changes in movement—moving less or moving more/seeming agitated
• Changes in sleep patterns
• Decreased interest in day-to-day activities
• Difficulty concentrating
• Feelings or thoughts of guilt or hopelessness
• Lack of energy
• Physical pains/aches
• Suicidal thoughts

‍

Symptoms of anxiety include:

• Always being on the lookout for the worst/watching for signs of impending danger
• Fatigue
• Feeling dread or apprehension
• Feeling jumpy or tense
• Headaches
• Insomnia
• Irritability
• Racing/pounding heart
• Restlessness
• Shortness of breath
• Sweating
• Tremors/twitches
• Upset stomach, urinating frequently, and/or having diarrhea

‍

If you have not already been formally diagnosed with depression (or anxiety), your healthcare provider may give you a brief self-assessment for depression called the Patient Health Questionnaire (PHQ-9) or for anxiety called the General Anxiety Disorder-7 (GAD-7). Both questionnaires are meant to gauge whether a formal evaluation is needed to determine the severity of your symptoms and the best treatment options for you. These assessments can also be used to monitor how well your treatment is working if you are already being treated. 

‍

Keep in mind that major life changes, medical problems, acute stress, and traumatic events can all trigger a depressive episode or induce anxiety. Even though your symptoms may be temporary, it’s important to seek treatment if they are interfering with your everyday life. 

‍

How well do antidepressants work?

Many studies have shown that antidepressant medications can be an effective treatment option for people with depression. For instance, a 2018 Lancet study that looked at over 500 past studies that included more than 100,000 people with major depressive disorder found that “all antidepressants were more effective than placebo.” 

‍

While studies have indicated that these medications tend to be more effective against severe depression compared to mild depression, on average, up to 60% of people with moderate-to-severe depression saw improvements in their symptoms within 6 to 8 weeks of starting to take antidepressant medications.

‍

Additionally, a 2019 study published in Expert Opinion on Pharmacotherapy noted that two types of antidepressant medications—selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs)—were particularly effective for treating generalized anxiety disorder. They specifically stated, “SSRIs should be considered the first line interventions, followed by SNRIs.”

‍

What are the different types of antidepressant medications?

There are many different types of antidepressant medications. Which one to take is a decision you and your prescribing doctor, nurse practitioner, or Minded psychiatry provider can make together based on factors including:

• Your age: Antidepressants may increase the risk of suicidal actions or thoughts in people younger than 25. And older adults’ bodies may process medications more slowly, which could affect which medication is chosen as well as the starting dose.
• Side effects: Every medication has its own potential side effects, but it’s important to remember that not every person who takes that medication will experience those side effects.
• Pregnancy: Certain antidepressants are considered safer than others for people who are pregnant or breastfeeding.
• Interactions with other medications or supplements: Always tell your prescribing healthcare professional about all medications and supplements you are taking. Some medications should not be taken together because they may decrease the effectiveness of each other or increase the risk of serious side effects.

‍

‍

For the most part, antidepressant medications are classified based on which neurotransmitters they affect. Neurotransmitters are molecules in your brain that relay messages from one nerve to another. By helping to increase or decrease the amount of specific neurotransmitters, antidepressants can help relieve depression and anxiety symptoms.

‍

Different types of antidepressant medications include:

• Selective serotonin reuptake inhibitors (SSRIs)—such as Lexapro and Prozac—work by boosting the amount of serotonin in your brain.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)—such as Effexor—work by boosting the amounts of both serotonin and norepinephrine in your brain.
• Tricyclic antidepressants—such as Pamelor or Tofranil—work similar to SNRIs by boosting amounts of serotonin and norepinephrine.
• Monoamine oxidase inhibitors (MAOIs)—such as Marplan and Nardil—affect serotonin, norepinephrine, and dopamine levels.
• Atypical/other antidepressants—such as Wellbutrin—don’t fit into one of the above categories.

‍

Benefits of antidepressants

Antidepressant medications can help control or reduce symptoms of anxiety and depression. As mentioned above, they do this by adjusting the levels of different neurotransmitters in your brain, which can help regulate your thought patterns and emotions. 

‍

It may take time for these medications to take their full effect—sometimes up to 12 weeks—and you may have to try different doses and/or different medications until you find the combination that is best for you. But in some cases, you may notice symptom improvement as soon as 2 weeks after starting to take the medication. 

‍

Appetite, energy, concentration, and sleep can sometimes be the first symptoms to improve, followed by mood. As your depression and anxiety symptoms begin to improve, you may find that other aspects of treatment—such as attending therapy or making lifestyle changes like fitting more physical activity into your routine—become easier to do as well.

‍

Potential risks and side effects

As with any medication, antidepressants come with possible risks and side effects to keep in mind when deciding which medication is right for you.

‍

Antidepressant side effects

Antidepressant side effects can vary based on the type of medication—and even within each category, specific medications come with their own lists of possible side effects. For example, tricyclic antidepressants may cause blurred vision or excessive sweating, whereas selective serotonin reuptake inhibitors (SSRIs) may cause headaches or nervousness.

‍

That being said, SSRIs typically have fewer side effects and are the most commonly prescribed type of medication to treat depression.

‍

Common side effects of SSRIs include:

• Agitation, anxiety, and/or restlessness
• Decreased or increased appetite—which may lead to weight loss or weight gain
• Dizziness
• Drowsiness
• Dry mouth
• Headache
• Insomnia
• Sexual problems, such as decreased interest in sex or difficulty/inability to perform sexually
• Stomach upset, such as nausea, diarrhea, and/or vomiting

‍

Common side effects of SNRIs include:

• Constipation
• Decreased appetite
• Dizziness
• Dry mouth
• Excessive sweating
• Headache
• Insomnia
• Nausea
• Sexual problems, such as decreased interest in sex or difficulty/inability to perform sexually
• Tiredness

‍

Common side effects of tricyclic antidepressants include:

• Blurred vision
• Constipation
• Drowsiness
• Dry mouth
• Excessive sweating
• Increased appetite—which may lead to weight gain
• Orthostatic hypotension (low blood pressure that occurs when you change position from sitting to standing, causing you to feel lightheaded)
• Sexual problems, such as decreased interest in sex or difficulty/inability to perform sexually
• Tremor
• Urine retention
• Weight loss

‍

Common side effects of MAOIs include:

• Dry mouth
• Difficulty urinating
• Dizziness and/or lightheadedness
• Drowsiness
• Headache
• Hypotension (low blood pressure)
• Insomnia
• Involuntary muscle jerks
• Muscle cramps
• Paresthesia (a prickling or tingling sensation in your skin)
• Sexual problems, such as decreased interest in sex or difficulty/inability to perform sexually
• Stomach upset, such as nausea, diarrhea, and/or vomiting
• Weight gain

‍

Antidepressant risks

Antidepressant medications come with a “Black Box” warning from the US Food and Drug Administration (FDA). This means that the FDA has identified certain serious safety risks that might occur when taking these medications. “Black Box” warnings are serious safety warnings—though the actual risk may be low or even rare.

‍

The Black Box warning for antidepressants typically states:

• Antidepressant medications may increase the risk of suicidal thoughts or behaviors in children, adolescents, and young adults with major depressive disorder and other mental health disorders.
• Whether the specific medication is approved for use in children.

‍

Who should avoid antidepressants?

In addition to heeding the Black Box warning, there are other situations where the use of antidepressants should be discussed with your healthcare provider or avoided.

‍

Antidepressants and alcohol

You should not drink alcohol if you are taking antidepressant medications. Alcohol may seem to boost your mood in the short term, but it can actually worsen your mental health symptoms in the long run. It can also decrease the positive effects of antidepressants—and increase the negative effects. Additionally, there is a risk of unintentionally overdosing on antidepressant medications if they are taken with alcohol.

‍

Antidepressants and pregnancy

You should talk to your care team if you are planning on becoming pregnant, are pregnant, or are breastfeeding. Some antidepressants are considered safer than others to take during pregnancy. Work with your prescribing doctor, nurse practitioner, or Minded psychiatry provider to determine the best option for your depression or anxiety treatment during pregnancy and while breastfeeding. They can help you make a decision that is best for both you and your baby.

‍

Antidepressant medication withdrawal

If you need to stop taking your antidepressant medication—for any reason—it is important that you work with your prescribing doctor or nurse to develop a plan that involves carefully and gradually decreasing your dose in order to avoid antidepressant medication withdrawal symptoms. These symptoms vary by medication, and may be mild and last a week or two—or they may be more severe and last for weeks or months.

‍

Alternatives to antidepressants

In addition to antidepressant medications, other treatment options for depression include:

• Talk therapy/counseling (also called psychotherapy)
• Lifestyle changes, such as:

• Aiming for at least 30 minutes of physical activity each day
• Keeping a regular wake up and bedtime
• Eating healthy meals—and eating them regularly
• Staying connected with friends, family, and loved ones
• Avoiding alcohol, nicotine, and drugs
• Focusing on just what needs to be done and postponing important decisions (if possible)

‍

How to decide if antidepressants are right for you

To find out if medication could work for your depression or anxiety treatment, visit Minded for a free mental health assessment. If you’re eligible for care, Minded offers affordable video appointments with board-certified psychiatry providers. If you already have a prescription for an antidepressant, Minded may be able to help you refill it, when appropriate. Our team of psychiatric professionals also can assist with adjusting your dose or advising you about other medications that might be a good fit for your needs.

‍