Experiences with antidepressants

Photo of people walking along a crowded street (PantherMedia / Iakov Kalinin)

People with depression have very different experiences of antidepressants, both good and bad. Some people hope that the medication will make them better or stop their depression from coming back. At the same time they may be worried about side effects or think that taking medication to treat their problems is a sign of weakness.

Antidepressants can help some people to get through phases of depression. Other people feel like their medication only has a small effect or doesn't help at all, and some stop taking it because of the side effects. Many are reluctant to take medication for psychological problems, or they worry that they might become dependent on it.

A number of factors will play a role when deciding whether or not to take antidepressants. These include your own or other people's experiences with psychotropic medications, discussions with doctors, and media reports. Some people completely refuse to take antidepressants, while others simply follow their doctor's advice and take the medication as it is prescribed. But many people carefully weigh the pros and cons of the medication beforehand.

Reservations about antidepressants

People are often reluctant to take antidepressants because they're scared of side effects and of becoming dependent. Unlike many sleeping pills and sedatives, antidepressants do not cause physical addiction. When people come off antidepressants, though, they may experience temporary effects like sleep problems and restlessness.

It can be frustrating to think that you aren't able to beat depression without the help of medication. People sometimes see antidepressants as a kind of "chemical crutch," and feel weak and helpless if they have to rely on them. Others question whether they really need medication to help them get better. Their thoughts and feelings often change and contradict each other.

Some people also worry that taking medication for a mental illness means that they aren't "normal." But there's no reason to be ashamed. After all, people are generally not ashamed of taking medication for physical illnesses.

It's important to discuss these kinds of concerns openly with your doctor. Some people don't dare to talk about their worries and reservations or to ask critical questions. It's not always that easy. Doctor's don't always give you the feeling that you can talk about or question things openly. But it's important that you make the treatment decision together with your doctor. A key part of this is carefully weighing the pros and cons of the medications.

You will need enough reliable information about a treatment to be able to make the right decision for you, and to cope with any problems that might come up when taking the medication. As well as advice from your doctor or pharmacist, you will find more information and support from counseling centers and self-help groups.

Starting treatment

Many people with depression seek medical help themselves because they want to live a normal life again. Some are encouraged or even forced to do so by worried friends or family.

Depression typically makes you feel helpless and like you no longer have any control over your life. That’s why it can be a relief if the doctor prescribes antidepressants. Many people would actually like to do without medication or try out other treatments first. But those affected are often in a very desperate situation and hope that taking antidepressants will make them better quickly so that they can cope again in everyday life. The medications can also be a way of getting by while waiting to start psychological treatment.

The antidepressants don’t help straight away, which can be disappointing at first. So it’s important to know that most medications only start to have a noticeable effect after one to two weeks, sometimes even longer.

Positive experiences

For some people with depression, their medication becomes a part of their life. They feel better thanks to the treatment and also feel like they have got their life back under control, are active and can cope well on their own in everyday life.

Some people also have hardly any or no side effects. The advantages of their treatment far outweigh any negatives. They feel like their medication helps them to stay emotionally stable.

If you’re going to take antidepressants regularly and for a long time, it’s important that you accept the illness and think the treatment is effective. If the positives of the medication outweigh the negatives, it is usually easier to deal with any side effects.

Negative experiences

Some people get the impression that the treatment isn’t helping or has changed their personality, for instance because they feel emotionally numb. The side effects are sometimes so bad that they stop taking their medication. Some have to try out various antidepressants before finding the right one for them. Others don’t feel any better despite trying several different treatments, and are then very disappointed.

Negative experiences are sometimes due to side effects. Physical symptoms like dizziness, a dry mouth, putting on weight, difficulties concentrating, and sleep problems can be difficult to cope with. But that also applies to emotional side effects. Some people miss the variety and intensity of their emotions. Antidepressants can also affect sexual desire.

It isn’t always clear whether these kinds of emotional changes are a result of the depression or side effects of the medication. Either way, people are more likely to stop treatment if they feel like the medication is having a negative effect on their emotional state.

Problems during treatment

Some people, especially older people with several health conditions, are concerned about taking too much medication. Others are put off by the thought of maybe having to take medication for many years. There are a number of strategies that can make it easier to take antidepressants for months and sometimes even years. They include seeing a doctor regularly. Along with a trusting relationship with your doctors, it is also important to have enough good information about the medication so that you better understand how it works and why it needs to be taken regularly.

If the medication doesn’t work as expected or causes severe side effects, some people try to adjust the dose themselves. They may start taking fewer or more tablets for a while. Others stop taking their antidepressants completely without talking to their doctor about it. But that can have life-threatening consequences, which is why it’s absolutely essential to discuss any problems that might occur with your doctor and not simply stop taking your medication. It might be possible to adjust the dose or switch to different medication instead.

Some people also stop taking their medication because they feel better so they think they no longer need it. But to make sure the depression really has gone, and to try to prevent it from coming back, it’s advisable to carry on with the treatment as planned – at least for four to nine months. You can then talk to your doctor about whether it’s necessary to carry on taking the medication after that time.

What information is important?

People who take antidepressants often wish that they had more and better information about the medication they have been prescribed. They would like their doctors to do the following:

  • Take their problems and worries seriously.
  • Tell them honestly and in detail about how long it will take for the medication to start working and what side effects it may have. Then they will be better prepared and cope better.
  • Discuss alternatives and explain the pros and cons of treatment in an understandable way. People may not be happy with their treatment if they are prescribed antidepressants without first being asked about their symptoms and any possible causes, and without talking about other treatment options.
  • Explain the reasons for changes in the dose.

Many people with depression have trouble processing or remembering information and feel unable to make decisions. It can then be helpful to write down what the doctor says, or take a friend or family member to the appointment with you.

It’s also a good idea to think about how you feel about antidepressants once you’re well again, and to discuss these feelings with your partner, family or friends.

Antidepressants: Neither “happy pills” nor placebos

Some media reports wrongly refer to antidepressants as “happy pills.” This could lead to false expectations. Antidepressants aren’t meant to and can’t make people feel happy. Instead, the aim is to help people with depression feel normal again. You might sometimes hear claims that antidepressants are fundamentally ineffective and at best have a placebo effect. But that’s not true either. Studies have shown that they are an effective treatment for moderate and severe depression.

The first antidepressant you try may not work for you. You can then talk to your doctor about increasing the dose or trying out a different antidepressant. These kinds of disappointments also occur with medications for other illnesses. Antidepressants can increase the chances of feeling better again, but they offer no guarantees. Sometimes depression is so severe that antidepressants don’t help much on their own. Sadly, some people end up taking their own life despite having treatment.

Most people with depression don’t expect antidepressants to be a miracle cure, though. Based on their experiences with them, many have formed a very realistic idea of what antidepressants can and can’t do. They tend to see antidepressants as a kind of aid or a safety net they can rely on when they have depression. Although most people would probably prefer not to take medication, it’s good to know it’s there if you need it.