Antidepressants: 5 Facts You Need to Know

Prescriptions being written for antidepressant and antianxiety medications are on the rise, especially in the United States. Approximately 1 in 8 Americans take a medication for their mood and the majority of these people are women.  Are you surprised by this statistic? I’m not.  

I see this in my practice every single day. Women and men alike come to the office complaining of excessive fatigue, lack of interest, difficulty concentrating and irritability.

I’m a huge advocate for antidepressant therapy and I’m not ashamed to admit that I took an antidepressant more days than not over the past ten years. What does surprise me though is how little patients know about these medications, even if they have been on them before.  

Here are 5 facts you need to know about antidepressant/antianxiety medications.

1. They Take Time To Work:   Antidepressants are not antibiotics. Unlike antibiotics which begin taking effect after the first dose, antidepressant therapy will not provide improvement in symptoms in the first 24-48 hours.  In fact, most of these medications take 4-6 weeks before you will begin to notice a difference.
    
2. You Shouldn’t Feel Like a New Person: Let me be clear, you should feel better  on the medication but as a general rule I tell my patients “I want you to feel like yourself again. I want you to feel like a better version of yourself than you feel right now.”  If your antidepressant makes you feel physically ill, completely numb and void of all emotions, then it is not the right medication for you.  This does not mean that antidepressants are not right for you, it means that particular medication is not for you. 
   
   
3. Antidepressants Don’t Fix Everything: Life still happens. No amount of medications will make you love your job, fix your relationship or make grief or disappointment disappear. Antidepressant medication will help balance the neurotransmitter chemicals in your brain so that you are no longer clinically depressed or anxious. Happiness however does not come in a pill.  Remember that sadness is the opposite of happiness and sadness is not the same thing as clinical depression.  A large portion of being content with your life is up to you and for that reason I strongly encourage therapy in some form or another.  Ideally I would recommend counseling with a licensed counselor, but if you are hesitant other options include attending church, educating yourself (from reliable resources) about anxiety/depression, confiding in a trusted friend, yoga, meditation and journaling. 
   
   
4. Choosing One is an Educated Guess: As medical providers we do our best to tailor medications specifically to a patient, but every patient is unique in chemical makeup and genetics.  Prozac may have worked wonders for your coworker, but it may cause horrific side effects for you.  Wellbutrin may have helped your aunt’s depression, but it may worsen your anxiety. When starting an antidepressant, make sure you are completely honest with your medical provider regarding your symptoms and any concerns you may have. Up until recently, providers would prescribe a mediation, have the patient return in 4-6 weeks and report on their results in order to determine if the medication was successful.  Today we have advanced medical technology that can narrow down appropriate choices for antidepressant therapy based on the patient’s unique DNA makeup.  Tests like GeneSite provide comprehensive information on the medications that will work best for each patient.  The test requires a swab of saliva from the inside of your cheek and within two weeks a report is generated.  
               Antidepressants and antianxiety medications are grouped into one of three categories, conveniently color coded as red (stop), yellow (proceed with caution) and green (go). Using these results, your medical provider can narrow down your choices for a medication that will be best tolerated and most efficacious for you.  Keep in mind, this test does not diagnose depression or anxiety, but will provide insight as to which medication will work best. If you have been on a medication in the past and either had side effects or found it unhelpful, ask your provider about this test. The answers may surprise you.
   
   
5. Timing is Everything: Deciding to start an antidepressant for your mood is a big decision, but deciding if and when to stop a medication is equally important.  The best time to stop a medication is when you expect to have a constant exposure to sunshine, warm weather and fresh air.  Let’s face it, most of us feel better in the spring and summer months, especially if you live in the north or Midwest when half our year is spent indoors due to snow and cold temperatures!  When you consider stopping one of these medications, discuss this with your medical provider first.  Many of these medications require a gradual decrease in dosage and you will feel much better if you do this during late April or early May compared to stopping the medication in January. 

Remember, there is absolutely no shame in starting one of the medications; they can do wonders for your mood (I’m living proof). 

Talk with your medical provider and let me know if you have any questions about starting a medication for anxiety and/or depression.