Experiences with antidepressants

Photo of two men talking (PantherMedia / M.G. Mooij)

People with depression have very different experiences of antidepressants – both good and bad. They hope that the medication will improve their symptoms or stop their depression from coming back. But many people may also worry 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. Others feel only a slight or no improvement, and some people stop taking them because of the side effects. Many people are reluctant to take medication for psychological problems, or they worry that they might become dependent on them.

Various things can influence the decision about taking antidepressants, including your experiences with medications for mental health problems, talks with doctors, and media reports. Some people refuse to take antidepressants on principle, while others simply follow their doctor’s advice and take the medication as prescribed. But many people carefully weigh the pros and cons of the medication.

Reservations about antidepressants

People often hesitate to take antidepressants because they're afraid of the side effects or of becoming dependent on the medication. But unlike many sleeping pills and sedatives, antidepressants don't lead to physical dependence or addiction. Even so, people may have temporary problems like trouble sleeping and restlessness when they stop taking the medication.

Some people are bothered by the idea that they might not be able to beat depression without medication. They think of antidepressants as a kind of crutch, and think they would see themselves as being weak and helpless if they had to rely on them. Others question whether they really need the medication to feel better. They often change their minds, and their feelings might be contradictory.

Some people also worry that taking medication for a psychological problem means that they aren't "normal." But there's no reason to be ashamed of taking medication for mental health problems, just as it's not an issue 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 because not every doctor gives you the feeling that he or she is open to that. But it's important that you make joint decisions together with your doctor. That particularly means carefully weighing the pros and cons of the medications.

In order to make the right decision for you and to cope with any problems that might come up when taking the medication, it's essential that you get enough reliable information about the treatment. Along with advice from your doctor, you can also find more information and support from psychosocial counselors and support groups.

Starting treatment

Many people with depression symptoms decide to seek professional medical help on their own because they want to get back to living a normal life. Some are encouraged or even pressured to do so by worried friends or family.

People who have depression typically feel helpless and like they no longer have any control over their life. So 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 they're often very desperate and hope that antidepressants will lead to a quick improvement. The medications can also be a way of getting by while waiting to start psychotherapy.

It can be disappointing at first because the antidepressants don't help straight away. 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're in control of their life again, are active and can get through life independently.

Some people also have hardly any or no side effects. The advantages of the treatment far outweigh any disadvantages. 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 feel like the treatment is effective. If the positives of the medication outweigh the negatives, it's usually easier to deal with the 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 may be so bad that people stop the treatment. Some need to try out a lot of different medications before finding the right antidepressant. Others don't feel any better despite trying several different treatments and then end up very disappointed.

Negative experiences can also be due to side effects. Physical effects like dizziness, dry mouth, putting on weight, difficulties concentrating and sleep problems can be very difficult to cope with. But that applies just as much to emotional side effects: Some people miss the variety and intensity of their emotions. The medications can also affect sexual desire.

It's not 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 worry about taking too many medications, especially if they're older and have several different health problems. Others are put off by the thought of possibly having to take medication for many years.

If you find it difficult to keep on taking antidepressants regularly for months or even years, various strategies might help. These include regularly talking to your doctor and having a trusting relationship with him or her. It's also important to have enough good information about the medication in order to 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 might start taking less or more tablets for a while. Others stop taking the medication completely without talking to their doctor. But that can have life-threatening consequences. So it's absolutely essential to discuss any problems with your doctor and not simply stop taking the medication. It might be possible to change the dose or try out a different medication.

Some people also stop the treatment because they feel better and think that they no longer need the medication once the symptoms have gone away. But to make sure that the symptoms and depression don't come back, it's important to carry on with the treatment as planned – for at least about four to nine months, as continuation therapy. After that you can talk to your doctor about whether it makes sense to keep on taking the medication.

What information do you need?

People who take antidepressants often wish that they had more and better information about the medication they have been prescribed. They want 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 can be prepared and cope with it better.
  • Discuss alternatives and explain the pros and cons of the treatment in an understandable way. People may not be happy with their treatment if they are prescribed antidepressants without first being asked all about their symptoms and any possible causes, and without talking about other treatment options.
  • Explain the reasons for changing the dose.

Many people with depression have difficulty processing or remembering information and feel unable to make decisions. It can then be helpful to write down the information or take somebody that you trust along with you.

It also helps to take the time during symptom-free phases to think about how you feel about the treatment, 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. That can give people the wrong idea. Antidepressants do not make people feel happy, and are not designed to: Their purpose is to help people with depression feel normal again. Some reports may claim that antidepressants are fundamentally ineffective and at best have a placebo effect, but that's not true either. Studies have shown that they are effective in treating moderate to severe depression.

But you might still feel that the antidepressant you are taking isn't working. You can talk to your doctor about increasing the dose or trying out a different antidepressant.

These sorts of disappointments also happen with medicines for other illnesses. Antidepressants can increase the likelihood that you'll feel better, but there's no guarantee. Sometimes the symptoms are so severe that antidepressants can't help much on their own. Sadly, some people end up taking their own life despite having treatment.

Most people with depression don't think of antidepressants as a miracle cure. Many have developed a very realistic idea of the medications' possibilities and limitations based on their experiences with them. They see antidepressants as a kind of aid or a safety net they can rely on when they need to. After all, most people would probably prefer not to take medication.