Lack of energy and motivation are two of the most common symptoms of depression. If you’re struggling with these symptoms and want to know if antidepressants will help, this article is for you.
We’ll explain how antidepressants work, the different types available, which antidepressant is best for improving energy and motivation, and what to do if antidepressants don’t work for you.
What are antidepressants?
Antidepressants are prescription medications used to help manage symptoms of depression, such as persistent sadness, fatigue, and lack of motivation. They’re one of the most commonly prescribed medications in the United States and often the first line of treatment for depression.
Antidepressants work by helping balance neurotransmitters like serotonin, norepinephrine, and dopamine – important brain chemicals that influence mood, motivation, and mental clarity. Because they only target symptoms, and not the causes, of depression, antidepressants are often combined with other treatments such as talk therapy.
What do antidepressants help treat?
Antidepressants are used to treat various types of depression, including:
- Major depressive disorder (also known as clinical depression)
- Bipolar depression
- Persistent depressive disorder (also called dysthymia)
- Premenstrual dysphoric disorder (PMDD)
- Atypical depression
- Postnatal or perinatal depression
- Seasonal affective disorder (SAD)
- Treatment-resistant depression (TRD).
They’re also frequently used for other mental health conditions, including:
- Bulimia
- Generalized anxiety disorder (GAD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder.
Traditional types of antidepressants
Antidepressants can be classed into different types, each of which works differently to manage symptoms of depression. Types of antidepressants include:
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the most commonly prescribed antidepressants. They include medications like fluoxetine (Prozac) and sertraline (Zoloft), both of which work by increasing serotonin levels in the brain. Serotonin is a neurotransmitter that helps regulate mood, sleep, and emotion.
SSRIs are generally well tolerated, but they can take several weeks to start working and may cause side effects like nausea, restlessness, or changes in appetite.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
SNRIs, like duloxetine (Cymbalta) and venlafaxine (Effexor XR), increase serotonin as well as norepinephrine, which plays a role in alertness, energy, and focus. Because of this dual action, SNRIs can be more ‘activating’ than SSRIs and potentially more helpful for individuals dealing with fatigue or low motivation.
Common side effects of SNRIs include dry mouth, headache, and insomnia.
Tricyclic antidepressants (TCAs)
TCAs are an older class of antidepressants that are typically reserved for cases where newer medications haven’t been effective. Examples include amitriptyline and doxepin. These drugs also target serotonin and norepinephrine, but come with a higher risk of side effects like drowsiness, constipation, dizziness, and weight gain.
TCAs are not usually prescribed as a first option and their use requires close monitoring as they may impact the heart and nervous system.
Monoamine oxidase inhibitors (MAOIs)
MAOIs, like phenelzine (Nardil) and tranylcypromine (Parnate), are one of the earliest antidepressant classes. They can be very effective, particularly for treatment-resistant depression or anxiety, but require strict dietary restrictions as they can have dangerous interactions with certain foods (e.g. aged cheese or cured meat).
Because of this, MAOIs are generally reserved for people who haven’t responded to other antidepressants.
Atypical antidepressants
This is a broader category that includes antidepressants which don’t fit into other classes. One of the most common atypical antidepressants is bupropion (Wellbutrin), which affects dopamine and norepinephrine, two chemicals involved in motivation, energy, and pleasure.
How do antidepressants work?
Most antidepressants work by changing the way certain neurotransmitters, like dopamine, serotonin, or norepinephrine, are used in the brain. These chemicals act as messengers that influence how brain cells communicate and respond to stress, pleasure, and motivation.
Different types of antidepressants work on different combinations of these neurotransmitters. For example, SSRIs focus primarily on serotonin while SNRIs or atypical antidepressants might also target norepinephrine or dopamine.
Research also shows that antidepressants can support neuroplasticity, which is the brain’s ability to form new connections and pathways. This helps the brain adapt and heal, which is why some people notice additional improvements beyond mood.
Keep Reading: Do Antidepressants Work and How Effective Are They?
Benefits of taking antidepressants
There are many advantages to taking antidepressants, including:
- Relief from depressive symptoms: Antidepressants can help reduce or even eliminate depression symptoms like low mood, fatigue, hopelessness, and difficulty concentrating. Many people also report improved sleep, appetite, and energy levels.
- Increased motivation & engagement with treatment: Depression can drain a person’s motivation, making even small tasks feel overwhelming. Antidepressants can help restore energy and emotional balance, making it easier to take part in everyday life, attend therapy sessions, and follow through with other parts of a depression treatment plan.
- Improved quality of life: Many people taking antidepressants report a better overall sense of well-being. They might feel more stable, less reactive to stress, and more able to think clearly and make decisions. Over time, this can lead to a better quality of life.
- Support for long-term recovery: Antidepressants can help reduce the risk of relapse in people with recurring or chronic depression.
- Safe and well-studied: Most antidepressants have been thoroughly researched and are approved by the FDA for safety and effectiveness. While they can cause side effects in some people, for most people, the benefits of antidepressant medication outweigh the risks.
Drawbacks of antidepressants
Like any other treatment, antidepressants may not be right for everyone. Some potential disadvantages of these medications include:
- Side effects: Antidepressants can cause side effects, especially when you’re starting a new medication or adjusting the dose. These side effects might include:
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- Nausea
- Gastrointestinal discomfort
- Headaches
- Changes in weight or appetite
- Sleep disturbances (i.e. insomnia or drowsiness)
- Dizziness
- Increased anxiety
- Sexual dysfunction
- In rare cases, certain antidepressants may increase suicidal thoughts.
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- Delayed effects: Unfortunately, antidepressants don’t work overnight. It can take several weeks, sometimes up to 8 weeks, to notice any meaningful improvement in your symptoms.
- Trial and error: Not all antidepressants work the same for everyone, or at the same dosages. You may have to try several medications before you find one that works for you. This process can be frustrating and emotionally draining.
- Stigma: Although antidepressants are some of the most commonly prescribed medications in the U.S., there can still be some stigma around taking them. Some people may feel ashamed to start medication, even though it can be a valuable part of recovery.
- Issues when stopping: You can’t just stop taking antidepressants whenever you want. To stop taking antidepressants safely, you need to slowly taper them off under medical supervision to prevent withdrawal symptoms.
How effective are antidepressants?
The effectiveness of antidepressants can vary depending on each person and their symptoms.
Some people might immediately respond well to a particular medication, while others may need to try several types – or even a combination – before they find the right fit. Different factors, like genetics, brain chemistry, coexisting mental health conditions, and life stressors can all influence how well an antidepressant works.
The time it takes for an antidepressant to work can also vary. Some people might start noticing changes within a couple of weeks, while others need to wait 4 to 8 weeks before they experience the full effects of medication. This delayed onset is normal and it doesn’t mean that the medication isn’t working.
Despite the varied experiences, numerous clinical studies have shown that antidepressants are more effective than placebos in treating depression. In fact, one major review of over 500 trials confirmed that antidepressants significantly reduce depressive symptoms, especially for people with more persistent or severe forms of depression.
That said, there are cases where antidepressants may not work. This is known as treatment-resistant depression (TRD), and help is still available. There are two treatments currently being offered for TRD, transcranial magnetic stimulation (TMS), and esketamine (SPRAVATO®) nasal spray, both of which show promising results in treating depressive symptoms effectively. We’ll discuss these in more detail later in this article.
Can antidepressants help improve energy and motivation?
Yes, antidepressants can help improve energy and motivation, but not all of them may help with these symptoms. Wellbutrin (bupropion) is often considered one of the most effective antidepressants for increasing energy and motivation.
Unlike more common antidepressants, which target serotonin, bupropion works primarily on the neurotransmitters norepinephrine and dopamine – two chemicals that play a key role in focus, reward, and motivation. This can make it a good option for those struggling with low energy and a lack of motivation.
See: 10 Tips for Finding Motivation When You’re Depressed
How to find the best antidepressant for you
Finding the right antidepressant can feel overwhelming, but with the right support you can find a medication that helps ease your symptoms and improves your mental well-being. Here are some steps to guide you:
1. Talk to a healthcare professional
Start by speaking with someone you trust, whether it’s your doctor, therapist, or a psychiatrist. Even if they can’t prescribe medication themselves, they can help refer you to someone who can and work with your mental health provider to coordinate your care.
2. Know your main symptoms
As we’ve mentioned, different antidepressants work in different ways. Some might be better for improving sleep while others may increase energy or relieve anxiety. That’s why it can be helpful to pinpoint the symptoms that affect you most, whether it’s low motivation, appetite changes, poor concentration, or something else. Doing this can help your provider choose a medication that best aligns with your needs.
3. Ask about pharmacogenomic testing
If you’ve tried one or more medications without success, your provider might recommend pharmacogenomic testing. This is a simple saliva or blood test that offers insights into how your body might respond to certain medications, potentially helping avoid the trial-and-error process. It’s not right for everyone, but it can be a useful tool if past antidepressant treatments haven’t been effective.
4. Take a holistic approach
Medication is often just one part of depression treatment. Other factors, like sleep, exercise, and nutrition, can all play a role in recovery. Therapy is also an important complement that can help you explore the root causes of your depression and build long-lasting coping skills.
Learn More: How Diet and Exercise Affect Your Mental Health
What if antidepressants don’t work?
If it feels like your antidepressant isn’t working, you’re not alone. Many people need to try more than one medication, or a combination of treatments, before finding what works best for them.
Whether you’re noticing no change in depression symptoms, struggling with side effects, or experiencing a return of depressive feelings, the most important first step is to talk with your mental health provider. They can help guide your next steps.
Why antidepressants might not be working
Depression affects each person differently, and so do antidepressants. It’s very common to go through a few different prescriptions before you find the right one. Everyone’s brain chemistry is unique, so finding the right dose and medication can take time. This process can feel frustrating, and that’s understandable, but know that relief is possible with the right patience and support.
If you’ve tried two or more antidepressants at the correct dose and duration (often 6-8 weeks each) without feeling better, you might have treatment-resistant depression. Despite the name, TRD is treatable. It just means that standard medications haven’t worked and your mental healthcare team might recommend alternative therapies.
Depression treatments beyond medication
If you’ve tried antidepressant medications without results, you may find relief through alternative treatments like transcranial magnetic stimulation (TMS) and esketamine (SPRAVATO®) nasal spray.
Transcranial magnetic stimulation (TMS)
TMS is a non-invasive, FDA-approved treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulations. Sessions last around 20-30 minutes and don’t require any sedation or downtime, which means you can continue with your day as usual immediately afterwards.
Many people with TRD see significant improvement after a full course of TMS, which usually involves five sessions per week administered over six weeks. TMS is approved for people aged 15+ and it’s a safe and well-tolerated treatment with minimal side effects.
Esketamine nasal spray (SPRAVATO®)
Spravato is an FDA-approved prescription nasal spray treatment designed for adults with TRD. It works on different pathways than traditional antidepressants and is often used when other medications haven’t provided relief. Esketamine must be administered in a clinic under medical supervision, typically twice a week to start, and it’s used alongside an oral antidepressant.
Learn more about SPRAVATO® here.
Customized depression treatment plans
At BestMind Behavioral Health, we offer both TMS therapy and SPRAVATO® treatment, as well as customized depression treatment plans tailored to the unique needs and circumstances of each individual we work with. If antidepressants haven’t helped, or you just want to explore your options, we’re here to support you with compassionate evidence-based care.
Reach out to us today to see how we can help.
