If you’ve been diagnosed with depression or prescribed antidepressants, it’s natural to ask, “how effective are antidepressants and will they work for me?” Some people fear that antidepressants might change their personality or cause them to become lifeless. Others think it’s all in your head and depression medication doesn’t actually do anything to help.
The truth is, antidepressants don’t work in the same way as other medications. When you take antibiotics for an infection, for example, you know for certain that they’ll eradicate the causes of your condition and make you better. This isn’t necessarily the case for antidepressants. While they’re effective for some people, they may not be for others.
In this article, we’ll look at how antidepressants work, their effectiveness, and what to do if antidepressants don’t work for you.
What are the signs of depression?
Before we explore the way antidepressants work, it’s important to understand depression and how it affects a person. Depression is a mood disorder that’s mainly characterized by a persistent feeling of sadness and a loss of interest in activities you once enjoyed.
If you’re taking antidepressants, or plan to in the future, understanding depressive symptoms can help you identify how well they’re working. Depression looks different for everyone, and understanding which symptoms you have and how they impact your quality of life is an important step in your treatment journey.
Common symptoms of depression include:
- Feeling sad or down most of the time
- Losing interest in activities you once enjoyed
- Feeling constantly tired or lacking energy
- Having trouble sleeping or sleeping too much
- Feeling hopeless or feelings of worthlessness
- Struggling to focus or make decisions
- Feeling irritable or easily frustrated
- Feeling guilty or fixating on past failures
- Suicidal thoughts.
These symptoms can also present in your physical body in what’s known as somatic symptoms. Physical symptoms of depression include:
- Weight fluctuations (i.e. weight gain or weight loss)
- Increased sensitivity to pain
- Fatigue
- Changes to sleep patterns (i.e. more or less sleep)
- Slow movements
- Back or joint pain
- Weakened immune system.
Different types of depression
It’s important to know that there are also different types of depression that can present different symptoms. Depending on which type of depression you have, you may be prescribed different treatment options or medications.
The different types of depression include:
- Clinical depression (also known as major depressive disorder or MDD)
- Bipolar depression
- Persistent depressive disorder (PDD)
- Premenstrual dysphoric disorder (PMDD)
- Atypical depression
- Seasonal depression (also known as seasonal affective disorder or SAD)
- Perinatal depression (including prenatal and postpartum depression).
How is depression diagnosed?
Depression is not a one-size-fits-all condition. It affects both young and old and people from all walks of life, and the way it manifests – such as symptoms, degree of severity, and when it onsets – can vary widely depending on the individual.
There are different ways to diagnose depression, including:
- Psychiatric evaluation: You may be asked questions or given a questionnaire about your symptoms, thought patterns, feelings, and behavioral patterns.
- DSM-5: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is often used to diagnose depression.
- Lab tests: You may be asked to do lab tests, as depression can sometimes be linked to underlying health conditions (i.e. thyroid issues).
Adults with depression can adeptly hide their symptoms, leading to potential misdiagnosis. The best way to identify depression is with a professional evaluation. Speaking with a mental health professional also ensures that your depression treatment is tailored to your specific needs.
If you’re not sure if what you’re experiencing is depression or not, start by taking our free depression self-assessment test. We offer resources to support you every step of the way.
What are antidepressants and how do they work?
Antidepressants are a type of prescription medication used to treat depression. They’re one of the most commonly prescribed medications in the United States, not only for depression but a range of mental health conditions, including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
Antidepressants treat the symptoms of depression by targeting neurotransmitters in the brain, such as serotonin, dopamine, and norepinephrine, that are believed to improve mood and regulate emotions. The exact way that they affect neurotransmitters will differ depending on the type of antidepressant. Some increase neurotransmitter levels, some work on receptors, and others simply help the brain use neurotransmitters more effectively.
Ultimately, antidepressants are designed to target depression symptoms by balancing brain chemistry. They don’t treat its underlying causes, which is why mental health professionals might sometimes advise using them in addition to other treatments, such as psychotherapy.
Different types of antidepressants
There are different types of antidepressants and each of them work differently. The main classes of antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs): These are the most commonly prescribed antidepressant medicines and include Fluoxetine (Prozac), Escitalopram (Lexapro), and Sertraline (Zoloft)
- Serotonin/norepinephrine reuptake inhibitors (SNRIs): These include Venlafaxine (Effexor), Duloxetine (Cymbalta) and Desvenlafaxine (Pristiq).
- Tricyclic antidepressants (TCAs): These tend to have more side effects and are often prescribed for treatment-resistant depression.
- Atypical antidepressants: This term refers to any antidepressant medication that works differently to most others. Atypical antidepressants include Bupropion (Wellbutrin) and Vilazodone (Viibryd).
- Serotonin modulators: These are an alternative to SSRIs and SNRIs and include Vortioxetine (Trintellix).
- Monoamine oxidase inhibitors (MAOIs): These are the oldest class of antidepressants and require dietary changes to avoid side effects. For that reason, they’re usually reserved for treatment-resistant depression and anxiety.
Most people who are prescribed depression medicine will have to try a few different antidepressant medications before they find one that works well for them. Each class of antidepressants, and even each medication, has its own side effects that might require careful management. Working with a medication management provider ensures you find the right antidepressant and dosage for your symptoms.
How effective are antidepressants?
There are a lot of misconceptions around the effectiveness of antidepressants. A medication that works for you might not work for someone else, and you may need to be on medication for a certain period of time before you feel any relief.
Studies also show that an antidepressant’s effectiveness depends on the severity of the depression. Generally, antidepressants are more effective in treating moderate, chronic, or severe depression compared to those whose symptoms are more mild.
That said, antidepressants can provide long-term relief from depression. In one study, depressed adults who used antidepressants were found to be three times less likely to still be depressed after eight years when compared to their unmedicated counterparts. This shows that antidepressants can, indeed, be effective.
However, it’s important to remember that antidepressants address symptoms and not root causes. When some people experience relief after antidepressants, they think they have been cured and may stop taking the medication. Depending on the person and whether the root causes have been resolved, this can cause the depression to return.
Why antidepressants don’t work the same for everyone
Approximately 280 million people around the world suffer from depression, and antidepressants won’t work the same for every one of these people. Why? Because each one of us has individual brain chemistry and the causes of depression will be different for everyone. We all tolerate medications differently, experience different side effects, and follow treatment protocols in different ways. This makes it difficult to find a one-size-fits-all solution. Depression takes on a unique form in each individual and that requires an equally unique approach to treatment.
It’s important to be patient when using antidepressants as it can take anywhere between 4-8 weeks before you begin experiencing relief from depression symptoms. You’ll usually be started on a low dose to gauge the medication’s effects. If it doesn’t seem to be working after that period, your medication management provider might adjust the dose or try a different medication.
It’s essential for you to keep an eye on how your body and mind responds to different medications once you try them and share this with your provider. For example, consult your doctor if a new medication impacts your sleep negatively or you don’t notice any improvements. This systematic process of personalizing treatment is a cornerstone of effective depression treatment.
Tips for taking antidepressants
To get the best results from your antidepressants, it helps to follow a few guidelines. Below, we share some tips to help you get the most effectiveness out of your depression medications:
- Don’t give up too soon: It can take anywhere from 4 to 8 weeks for antidepressants to show their full effects. Be patient and give the medication time to work before you give up.
- Be diligent with taking your antidepressants: Be sure to take your medication exactly as prescribed. This includes taking the correct dose and not skipping dosages. Doing so can change the effectiveness of the medication.
- Consult your doctor before you stop: If you’ve decided that medication isn’t for you, don’t stop without consulting your provider first. They’ll be able to advise you on whether you should stop, and if so, how to do so safely. Stopping your antidepressants suddenly can cause issues such as discontinuation syndrome or worse depression symptoms, and it’s important to stop them while under careful guidance. If you’re experiencing unpleasant side effects, your provider can also help you address these issues.
- Try other medications: If the first medication you’re prescribed doesn’t seem to work, don’t give up too soon. Different antidepressants function in different ways and you may need to try a few different classes or brands before you find the one that works best for you.
- Don’t stop just because you feel better: If you’re experiencing relief with antidepressants, that’s great news! But don’t stop too soon. Your provider will help you find when, and if, it’s a good time to stop your medication.
What to do when antidepressants don’t work
The first step to take if your antidepressants don’t work is to contact your doctor or psychiatrist. Let them know that you’ve been taking an antidepressant regularly but either feel the same or worse than before.
Before you reach out to your provider, make sure you’ve been taking your medication at the right dosage for the recommended duration of time. This ensures that the antidepressants have had enough time to show results. If you’re experiencing serious side effects, it’s OK to reach out earlier as you may need to stop the medication and try something else.
There’s also the possibility that the antidepressants don’t work for you. Studies show that after trying three different medications, the chances of finding relief from depression are significantly reduced. Sometimes, you might be recommended an augmenting medication to improve effectiveness. In other cases, you may be diagnosed with treatment-resistant depression and advised to try alternative depression treatments.
Alternative depression treatments
There are effective alternative treatments for depression. Some alternative treatments include TMS therapy, Spravato (esketamine), variations of talk therapy, exercise, and meditation. And ideally, a crafted combination.
Let’s look at some of these alternative depression treatments:
- Transcranial Magnetic Stimulation (TMS) therapy: This treatment directly impacts how your brain functions. It uses magnetic fields to stimulate the nerve cells in your brain. More specifically, it treats depression by targeting the left prefrontal cortex. It’s a non-invasive and non-pharmacological option. This often requires commitment on the patient’s part. However, it has proven highly effective in treating depression.
- Spravato: This is a prescription nasal spray that provides fast, temporary relief from depression symptoms. It works differently from traditional antidepressants and can complement their effects.
If you or a loved one can’t find relief, even after trying antidepressants, it may be time to learn more about treatment-resistant depression and look into alternative treatments for depression.
Find depression treatment near me
Antidepressants are very effective for some people, however, it may take some trial and error with the help of a mental health professional to find the right medication and dosage for your unique needs. If you’ve tried and haven’t found success with depression medications, other alternative treatments offer opportunities to find relief.
If you’re in Broomfield, Denver, Portland, Salem, or Clackamas and are still wondering how to treat depression when antidepressants don’t work, BestMind Behavioral Health is here. We are dedicated specifically to the mental health needs of our communities, specializing in effective depression treatment.
Contact us for a free consultation for depression treatment including medication, TMS therapy, and Spravato.
