Thursday, May 23, 2024

Why Am I Still Depressed On Antidepressants

How Long Will You Have To Take Antidepressants

Can a Depressed Person Have Good Days? – Atypical Depression

Usually, these drugs must be taken regularly for at least 4 to 8 weeks before their full benefit takes effect. You are monitored closely during this time to detect the development of side effects and to determine the effectiveness of treatment.

In order to prevent a relapse of depression, medicines are generally prescribed for 6 to 12 months after a first-time depression. When you and your provider determine that you are better, you should expect to continue the medication for at least 4 to 6 additional months. After this, your provider may gradually taper you off your medicine.

I Spent Half My Life On Antidepressants Today Im Off The Medication And Feel All Right

The prescriptions began in the wake of my fathers sudden death when I was 15: Wellbutrin XL and Effexor XR for anxiety and depression, two separate doses of Synthroid to right a low-functioning thyroid, a morning and nighttime dose of tetracycline for acne, birth control to regulate the unpleasant side effects of womanhood, and four doses of Sucralfate to be taken at each meal and before bedtime all given to me by the time I was old enough to vote.

My general practitioner asked what Sucralfate was after Id finished rattling off my prescriptive party mix during our first appointment. I was 22 and a recent Manhattan transplant. I had an apartment in Murray Hill and a job waiting tables at a local Italian restaurant.

Its for something called bile reflux disease, I said. I used to randomly puke up bile all the time.

Huh. Never heard of it. He ripped off a completed prescription slip and scribbled across the new blank page.

You should really get the prescription for antidepressants from a psychiatrist, but Ill give it to you along with all the rest since youve been on it for so long. And whenever you come back, maybe we should do a physical.

The suicidal gears in my mind came to a screeching halt.

Flash forward to today, 3½ years since I took my last antidepressant. Im all right. Deeply, honestly, joyfully, all right.

And the people who tend to contact me are not without other resources.

So let me introduce myself:

And Im all right.

The Role For Psychologists

Psychologists have a duty to stay informed about the science of antidepressants, says John McQuaid, PhD, associate chief of staff for mental health at the San Francisco VA Health Care System and chair of the APAs depression guideline development panel. Its important to understand what the options are for our patients, and to be informed as to the status of the literature, he says. Our task as psychologists is to facilitate the patient making informed decisions based on their values and goals, and to facilitate them in being their own advocates.

Psychologists can also help clients monitor potential side effects or withdrawal symptoms when they begin or discontinue a medication, he adds. We can help to track symptoms and help clients identify their own experiences so they can determine whether they need to work with their prescriber to make changes.

Psychologists can also support patients experiencing withdrawal symptoms, Horowitz adds. It can be a very difficult process for people, he notes. have to be mindful to say, Im having all these symptoms, but Ive made a decision to persevere through them. Supportive psychotherapy can help people through that process.

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Your 12 Biggest Antidepressant Problems Solved

If depression meds are giving you headaches, the shakes, or dry mouth, here are some expert-backed solutions to try.

Is this your scenario? You started treating your depression with antidepressants only to find that youre still wrestling with a number of tricky-to-treat symptoms or experiencing annoying side effects. If so, you’re not alone.

Each person’s reaction to an antidepressant is unique the side effects, strength, and efficacy of the same drug may be drastically different for you than for someone else. And given that the Centers for Disease Control and Prevention estimates that between 2015 and 2018 approximately 13 percent of American adults ages 18 or older had taken an antidepressant within the previous 30 days, its no wonder that there are lots of varying responses to those meds.

Some people are exquisitely sensitive to antidepressant side effects, says psychiatristHeidi Combs, MD, an associate professor of psychiatry and behavioral sciences at the University of Washington, and the director of inpatient psychiatry at Harborview Medical Center in Seattle. Others can take just about any medication without running into problems.

The good news: If you’re encountering problems, most of them can be easily managed or reversed. Here are the most common reactions and concerns you might run into while taking antidepressants and how to resolve them.

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This Is What No One Tells You About Coming Off Antidepressants


My relationship with antidepressants began over 20 years ago. Back then, as an anxious teenager crying in my doctors office, I had no idea that they would become such an integral part of my life.

I spent a long time wrestling with my need for medication. But you can have as much therapy as you can handle and self-care yourself silly, but for some people, nothing gets rid of that big black cloud or at least lifts it enough that you can take a breath like a daily pill.

Taking SSRIs for clinical depression on a long-term basis wasnt a decision I made lightly, and at various stages Ive stopped taking them. Maybe my mental health was good and I wanted to see how I got on without the meds. At other times, I succumbed to the stigma and bowed to the pressure inflicted be it intentional or not by people who proudly declared, I had depression and got through it without medication!

There are a ton of other reasons someone might quit their antidepressants, for example if they couldnt handle the side effects , didnt think they were working , or simply struggled to meet the expense of long-term meds.

After several rounds of trial and error, Ive accepted them as part of my life, and an essential component in my self-care toolkit.

Three months later, I was back on my meds.

Also, youre more likely to experience discontinuation symptoms if youve been taking a certain class of antidepressant, such as an SNRI or a shorter-acting SSRI, like paroxetine or sertraline .

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Things You Might Not Know About Antidepressants

Taking an antidepressant is incredibly commonmore than 1 in 10 Americans do.

But despite their prevalence, these drugs are often misunderstood, in part because of stereotypes and stigma around mental health. That may keep some people who could benefit from an antidepressant from learning more, says UNC Health psychiatrist Elizabeth Cox, MD.

Medication is an important part of treatment. Therapy is also extremely important, and I recommend therapy to pretty much 100 percent of my patients, she says. But sometimes it can be difficult to participate in the therapy , or the therapy itself might not be enough.

Here are eight important things to know about antidepressants:

How Are Antidepressant Medications Selected

The type of drug prescribed will depend on your symptoms, the presence of other medical conditions, other medicines you are currently taking, the cost of the prescribed treatments, and potential side effects. If you have had depression before, your provider may prescribe the same medicine that worked for you in the past. If you have a family history of depression, medicines that have been effective in treating your family member may also be considered.

Usually you will start taking the medicine at a low dose. The dose will be gradually increased until it has reached the therapeutic dose, or until you start to see an improvement .

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Do I Need This Treatment

If you are distressed for more than two weeks by feelings of sadness, despair and hopelessness, or by excessive worry that is hard to control, see a doctor for an assessment of your symptoms and situation and to discuss treatment and support options. Early treatment can help to ensure treatment success.

Be sure your doctor knows if you have had times where you felt a reduced need for sleep in combination with an unusual amount of energy, or where your mood changed from feeling depressed to feeling unusually happy or irritable. Mood stabilizer medications may be more suited to your needs, either on their own or in combination with antidepressants. Antidepressants alone can cause some people to switch from depression into mania.

Medications are only one way of treating depression and anxiety. Talk therapies, such as interpersonal psychotherapy and cognitive-behavioural therapy, can be just as effective. Peer support, school and job counselling, and housing and employment supports can also help to deal with problems that may trigger or worsen depression or anxiety.

Why Antidepressants Cause Fatigue

Severe Depression vs. Feeling Depressed [& the Treatment that Works]

Certain antidepressants work by acting on brain chemicals called neurotransmittersin particular norepinephrine and serotonincausing them to linger in the spaces between nerve cells where they carry out their job of regulating mood.

At the same time, though, these medications affect other neurotransmitters, including histamine and acetylcholine, sometimes leading to unpleasant side effects such as dry mouth, blurry vision, weight gain, and sedation. It’s this last side effect that may be responsible for the fatigue you experience when you take an antidepressant.

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What It Means For You

Before taking an antidepressant, make sure you’re familiar with the possible side effects as well as the proper method of going off of them. Know that you may need to try several drugs before finding the best one for you.

While you’re on the medication, stay vigilant for side effects, and weigh how significant they are versus how much the drug helps you.

You should involve your doctor in any decisions you make regarding antidepressant use. That said, you’re the only one who can decide whether the benefits of taking a medication outweigh the drawbacks.

Starting An Antidepressant Doesnt Mean Youll Be On It Foreverbut Dont Go Off Cold Turkey

People who take antidepressants dont need to feel trapped, Dr. Cox says. Some people need medication indefinitely, but many do not. Their life circumstances change, or they make progress in therapy, and the antidepressants arent as critical anymore.

Just because youre struggling and you reach out to your doctor about medication doesnt mean youre signing up to take something for the rest of your life, she says.

If you are interested in stopping your medication, its important to do so in consultation with your doctor, who will tell you how to taper off slowly. This has two purposes, Dr. Cox says: One, it reduces the chance of withdrawal symptoms. Two, if you start to decrease your dose and your anxiety or depression worsens, you can increase back to your previous dose easily.

Think you might be dealing with depression or anxiety? Talk to your doctor or find one near you.

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What Are The Different Types Of Depression

A diagnosis of depression is made when a patient exhibits five or more of the nine diagnostic criteria listed in the DSM-5 lasting more than two weeks. These criteria include:

  • Low mood, feelings of despair or hopelessness
  • Loss of interest in daily activities or hobbies
  • Fatigue
  • Change in eating habits leading to sudden weight gain or loss
  • Change in sleeping habits caused by insomnia or hypersomnia
  • Slowed functioning, both cognitive and motor
  • Inappropriate feelings of guilt or shame
  • Inability to make decisions or concentrate
  • Thoughts of death or suicide

There are different types of depressive disorder, each with unique features that differentiate the types. These different types of depression include:

  • Major Depressive Disorder . The symptoms listed above
  • Dysthymia. A persistent type of depression, a milder form of MDD but lasting two years or longer
  • Premenopausal Dysphoric Disorder . Associated with a womens hormonal cycle as a more severe form of PMS
  • Postpartum Depression. Feelings of sadness, irritability, mood swings following the birth of a baby
  • Seasonal Affective Disorder . Occurs in areas further from the equator that receive minimal natural daylight during winter months, causing depression symptoms
  • Bipolar Disorder. Features intense mood swings, alternating between depressive episodes and manic episodes

When Antidepressants Dont Work

Why Am I Embarrassed That I Can

The gray veil of depression can touch every aspect of a persons life, from work, to family relationships, to ones marriage. The struggle to lift the veil and find joy again can often be a frustrating one. Possibly you have sought treatment for your depression and been disappointed in the lack of response you had to the antidepressants you had trialed. Your doctor may have had you try several different medications, and still none have effectively improved the depression symptoms.

An astounding 11% of Americans over the age of 12 have reported taking antidepressants, as reported by the National Institute of Mental Health. In fact, the report continued, in 2010 254 million prescriptions were written for the drugs. Antidepressants were lauded back in the 80s as the miracle cure for major depression, but as more and more clinical trials are revealing, as many as 50% of the patients who were prescribed antidepressants did not experience a successful resulton antidepressants but still depressed.

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Can Tms Also Help Anxiety

Individuals with co-occurring anxiety disorders have also reported improvements in those symptoms as well as the depression symptoms. In particular, patients with coexisting post-traumatic stress disorder , obsessive-compulsive disorder , and generalized anxiety disorder experienced symptom relief following treatment with TMS therapy. Many TMS practitioners now use TMS therapy off-label to treat individuals whose primary mental health disorder is anxiety.

TMS Clinical testing continues in Europe and the U.S. for applying the technology to the treatment of a wide variety of medical and psychological conditions. These include Parkinsons disease, Alzheimers disease, OCD, PTSD, stroke rehabilitation, smoking cessation, chronic pain, and schizophrenia. In Europe and Israel, TMS therapy has already been cleared to treat several of these conditions.

What Causes Depression Medications To Stop Working

Multiple factors can change the way your body responds to an antidepressant, including:

  • Drug or alcohol use. Illicit drug use and alcohol can cause strong mood changes, which can make antidepressants ineffective.
  • Pregnancy. Your body’s weight and blood volume increase when you’re pregnant. Talk to your doctor about taking antidepressants while pregnant, and about potentially adjusting your dosage to continue relieving symptoms.
  • New stressors. A new stressful situation at home or work can result in a mood response for which the antidepressant can’t compensate.
  • Other medications. Interactions between antidepressants and medications for other health conditions can affect how well an antidepressant works.

Most often, though, antidepressants stop working for what seems to be no reason. “There’s no good research that shows why a medication may stop working for someone,” says Nestadt. “I think it’s less an issue of building up tolerance and more likely constantly changing stressors and factors in the brain.”

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Your Antidepressant Doesnt Pack The Same Punch

If youve been on an antidepressant for a long time, your body may develop a tolerance, notes Hullett. As a result, a medication that once worked well at quelling your sadness, anxiety, and other symptom no longer has that power. Sometimes, Hullett says, increasing the dose under supervision by your doctor may help. If youve been taking 10 milligrams of Prozac , for example, your physician may increase the dose to 20 mg, he says. In other cases, trying a different medication or treatment is helpful.

Keep Taking Your Medication

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Medications to treat depression depend on a delicate balance. If that balance isnt working for you right now, there are ways to go back to it.

Stopping your medication all of a sudden may create other symptoms that make your experience even more challenging.

Its a good idea to keep taking your antidepressants even if you feel theyre no longer working for you.

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Common Reasons Your Meds May Not Be Helping Your Mood

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Verywell / Bailey Mariner

An antidepressant can work wonders for people dealing with symptoms like low mood, loss of interest in things they once enjoyed, ennui, and lack of energy. This is especially true of those who have moderate, severe, or chronic depression mild depression isn’t as responsive to medication.

However, an antidepressant is not a miracle cure, nor is it a permanent fix. Some studies suggest that the rate of relapse while using an antidepressant is about 23% during a two-year period.

Possible reasons why your antidepressant is no longer working include: using another medication that interferes with its effects, using alcohol or other drugs, having another medical condition, undergoing added stress, and more.

Understanding the reasons why antidepressants stop working can help you and your healthcare provider figure out what to do about it.

Depression Discussion Guide

Feeling Depressed Maybe Even With Anti


Antidepressant pills definitely do help some people who feel depressed. They often, however, do not help and even cause unfortunate side effects. Fortunately, psychotherapy options are plentiful and effective.

The following four cases illustrate why you may still feel depressed even if you are taking antidepressant medication. After the cases, see the video illustrating a highly effective and yet surprisingly simple self-help therapy option.

Jonathan came to my therapy office feeling disappointed. For several weeks he had taken the pills a psychiatrist had given him for depression, but he felt no better.

Gail came for help in response to a wave of intense suicidal thoughts. After she had been feeling down for over a month, she filled the prescription that her doctor had given her for antidepressant medication. She began taking the pills. Within hours she became obsessed with suicidal thoughts about killing herself using kitchen knives.

Gail sensed that this sudden shift might be related to the pills. She phoned her doctor, who told her to discontinue the medication immediately. She also phoned her parents who encouraged her to go to and stay overnight at their house until the thoughts had ceased. By the next day she felt substantially back to normal, although normal was still depressed.

When my clients feel depressed . . .

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