Should I Take Antidepressants?

According to the CDC, in 2018, over 13 percent of American adults had been on antidepressants in the last 30 days.

The impact of these medications on the production of serotonin, norepinephrine and dopamine — the neurotransmitters and hormones that regulate various body functions — have gained them popularity in their treatment of common mental disorders like anxiety and depression,,.

We’ll cover how this class of drugs works to treat mood disorders with the goal of helping you figure out when it might be time to consider harnessing the power of antidepressants to care for your mental health.

Antidepressants are the medications most commonly used to treat clinical depression. They can also be used to treat a host of other conditions, like anxiety, pain and insomnia. 

In some cases, while not FDA approved for this purpose, they are employed as a treatment for ADHD.

We’ve already put together an in-depth guide to the different types of antidepressants, but here’s a quick refresher on the most common types:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are usually the first medication prescribed for depression and a host of other mood disorders. This antidepressant medication works by discouraging the reabsorption of serotonin, thereby allowing for higher availability of the neurotransmitter.

• Serotonin and norepinephrine reuptake inhibitors (SNRIs): These work similarly to SSRIs, focusing on the neurotransmitter, norepinephrine alongside serotonin.

• Bupropion: This drug works slightly differently, by instead, discouraging the reabsorption of dopamine and norepinephrine.

Antidepressants affect the neurotransmitters in the brain, making it easier for the nerve cells to communicate.

You can think of neurotransmitters like dopamine, serotonin and norepinephrine as messages that the nerve cells in your brain send to one another. 

They’re passed between receptors in the brain, allowing bits of information to transfer between your various nerve cells. 

Over time, antidepressants have the effect of increasing the availability of some of these neurotransmitters, resulting in improvements in mood and anxiety.

Antidepressants currently come in oral, topical and transdermal forms, but scientists are actively studying other routes of delivery.

The minor side effects related to the use of antidepressants include nausea and vomiting, weight gain, diarrhea, drowsiness, physical restlessness and sexual dysfunction,. 

Less than 20 percent of the time, symptoms of dry mouth, insomnia, fatigue, nausea, dizziness and tremors have been observed.

In the case of depression, antidepressants have also been known to cause a temporary increase in suicidal thoughts in 18 percent of patients. 

However, this symptom is most common in antidepressant users who are 25 and younger, and improves in 91 percent of cases.

These thoughts prompt the FDA to put what’s known as “Black Box Warnings” on the package inserts for many of these medications, and why users are prompted to contact their healthcare provider immediately if they experience them. 

Antidepressants take time to work, usually a minimum of two to four weeks of treatment. It’s common for the symptoms of the disorder to improve before your mood lifts. 

It’s important to take your medication as directed, and continue taking them even if you don’t see immediate improvement. 

Once your mood has stabilized with a proper regimen, your provider will help you safely taper off — when and if appropriate.

As indicated by their name, antidepressants are most commonly used as a treatment for depression, medically known as clinical depression or major depressive disorder. 

They can also be used to manage the symptoms of anxiety, pain and insomnia.

And, as we mentioned above, they’re sometimes used off-label in the treatment of ADHD.

Depressive Disorder

While it's a normal part of the human experience to feel down every now and again, or have a mood that isn’t always perfectly balanced, depression takes this experience further. 

It has the effect of putting the sufferer in a negative state of mind, eliciting feelings of extreme sadness, unhappiness and discontent, resulting in difficulties around going about daily life. 

It can further result in issues with eating and sleep, energy, concentration, and social engagement.

You can think of “normal” sadness as a short-lived state of mind, while depressive symptoms last for longer periods of time. 

In fact, to qualify as clinical depression, symptoms must occur nearly daily and last a minimum of two weeks.

It's important to know that depression can present differently in men than it does in women. 

Men are more likely to hide emotion-based depression symptoms, causing them to display as anger, irritability and aggression.

Furthermore, men in general are more likely to visit a healthcare provider for physical symptoms rather than mental ones. 

Physical depression symptoms can include a consistent rise in heartbeat, aches and pains, headaches and digestive problems — including excessive eating or under-eating, which can lead to weight fluctuations. 

Another common symptom that spans both the physical and mental is sexual dysfunction or a lack of interest in sex. 

It's important to note that severe depression carries the risk of suicidal ideations, resulting in a risk of suicide.

Our deep dive into the types of depression and treatment options can help you better understand any conditions you may have.

If you find yourself experiencing the symptoms listed here for more than two weeks, it's important to get in touch with a mental health professional to have yourself evaluated. 

Your provider will help determine the severity of your depression, ranging between mild depression, moderate depression and severe depression. 

Mild depression can often be treated with lifestyle changes like eating healthy foods, getting enough sleep and engaging in regular exercise. 

Moderate depression and severe depression will benefit from a combination of medication and online counseling.

Untreated depression can have long-term adverse effects on quality of life.

Anxiety Disorder

Like sadness, feelings of anxiety are a normal part of the human experience. Anxiety is a natural and healthy response to stress, helping us become alert and ready to react to a variety of situations.

It's important to remember that anxiety is different from fear, though both can be indicators of an anxiety disorder. 

Fear is a reaction to an immediate threat, and is the trigger for the fight or flight response in humans and animals. 

In contrast, anxiety occurs from worry about something that may or may not happen in the future.

When anxiety or fear escalate to the point where they are out of proportion to the situation that is causing the worry, age inappropriate or hinder a person from living their life normally, it can be an indication that the person has an anxiety disorder.

Anxiety disorders are the most common mental health disorder, affecting nearly 30 percent of adults at some point in their life. 

Symptoms can include restlessness, fatigue, difficulty concentrating, panic attacks, weight gain or loss and fear of everyday situations (like leaving the house) — among many others. 

Our blog, What Is Anxiety? can help you better understand any conditions you may have.

Along with various forms of therapy (including cognitive therapy) and anti-anxiety medications, antidepressants are an effective treatment for anxiety disorders. 

When considering whether or not to use antidepressants to treat your mental health struggles, the biggest considerations will be the severity of your condition, treatment methods you’ve tried previously and common side effects of antidepressants of the medicine.

Signs that you should consider antidepressants for the treatment of your disorder include:

• You’re experiencing moderate or severe depression or anxiety. If your mood disorder is having an outsized impact on your life, a combination of psychotherapy and antidepressants can be a good treatment option.

• You’ve tried other options for treatment. If you have already tried other treatment options like lifestyle changes and talk therapy for your moderate to severe depression or anxiety with limited success, antidepressants may be a good next step in your treatment journey.

• You’ve found previous success with taking antidepressants. If antidepressants have previously been successful for you, and you’ve found a recurrence of symptoms of anxiety or depression, returning to this treatment option may be a good choice.

• You’ve considered the side effects. If, having considered the side effects of taking antidepressants, the benefits continue to outweigh the risks, then it may be worth talking to a healthcare professional about your options.

The best way to get access to antidepressants is to schedule time for an evaluation with an online psychiatry provider.

Answering the question, “Do I need antidepressants?” is a highly personal experience. There are many factors to consider, from other treatment options, to side effects and the severity of your disorder.

Ultimately, your mental health provider will be your strongest partner in helping you make mental health decisions and finding the solution that best fits you.

To learn more about accessing quality providers who can provide both talk therapy and access to medication, check out the hims page on mental health.