In my work as a clinical psychologist and neurobiologist, I have spoken to many people who are considering taking antidepressants such as selective serotonin reuptake inhibitors (SSRIs). Many ask me for my opinion on whether they need medication, whether talking therapies would be enough, or whether they are “tough” enough to get through it without medication.
I always try to listen to both my patients’ reasons for taking medication and their hesitations. Many of the reasons are valid, such as possible interactions with other health conditions, but I also hear time and again unfounded reasons, suggesting that the underlying myths holding back antidepressants lie deep within our collective psyche.
Given the rising rates of depression and anxiety, it’s time to have a conversation about how treatment works and why people are hesitant, especially when that hesitation is not based on scientific evidence, so that we can make informed treatment decisions.
Below are the most common misconceptions I hear and my responses to them.
Myth 1: Doing this without drugs will make you stronger
Overcoming depression is like overcoming a broken leg. Even if you are a very strong competitive weightlifter, if you break your leg you can’t use it the same way. Even if you are a very strong mental person, when you become depressed your brain doesn’t respond to everyday life in the same way and it needs to be “healed” before you can function like you did before you had depression.
Myth #2: I have to rely on antidepressants to be happy
Antidepressants do not make a person happy. They allow a person to experience the full range of emotions in an appropriate and balanced way. Antidepressants do not provide immediate relief and can take 4-6 weeks to actually take full effect. However, they are a long-term (usually at least a year) and (hopefully) curative treatment, much like chemotherapy for certain types of cancer, where a certain number of treatments are usually required within a prescribed time period to kill the cancer cells and be considered in remission.
Similarly, most studies have shown that most people who take antidepressants for a year and then stop taking them don’t relapse, meaning that while you may need to take them for a period of time to maintain their effectiveness, the benefits often last long after you stop taking them. However, a small number of people have more chronic depression and may need to continue taking the medication for a longer period of time.
Myth 3: Drugs will change me, make me a different person, or get me high
Antidepressants don’t make you “high.” They don’t change what you know, what you’re learning, or who you are, but they do help you see things from a more balanced perspective. I once heard a patient describe taking antidepressants very simply: “Good and bad look the same, but when I was depressed I only focused on the bad, and now I focus on the good.”
Myth #4: It’s addictive
Antidepressants taken as prescribed are generally not addictive and have low potential for abuse. Antidepressants are not associated with drug cravings, as are addictive drugs such as opioids. Some patients report withdrawal symptoms such as headaches and nausea when they suddenly stop taking certain antidepressants, but these are usually short-lived and can be minimized by gradually tapering treatment.
Myth 5: Medication should only be used as a last resort
Reserving antidepressants only in extreme cases doesn’t make sense for several reasons. First, it’s a quality of life issue. Depression is painful. It has a huge impact on society, affecting the sufferer, those around them, and work productivity. The economic impact of depression is enormous, in terms of days missed from work, lost jobs, accidents, etc.
In fact, there are medications that are effective, non-addictive, and have been around for so long that their long-term effects after treatment have been studied. To date, few significant long-term effects of taking antidepressants as prescribed have been observed in the short term, but new evidence suggests that long-term use of antidepressants (10 years or more) may be associated with an increased risk of cardiovascular disease. However, it is important to note that depression itself is also associated with an increased risk of cardiovascular disease.
So if it can help improve someone’s quality of life – their focus, their sleep, their relationships, their ability to be present at work or as a parent – and help them worry less and find the energy to do the things they love, why not consider treatment?
Another factor in favor of treatment is that while no significant long-term adverse effects have been observed from taking antidepressants for a depressive episode, there certainly are significant long-term effects from living with depression. Depression significantly increases the risk of cardiovascular disease, gastrointestinal disease, respiratory disease, Parkinson’s disease, and more. It also appears to worsen cancer outcomes.
If taking medication generally isn’t associated with long-term health consequences, but living with depression is, the answer seems simple:
Treating depression
I’m not saying that everyone with depression should take medication – of course, this is something you should discuss with your doctor and there may be reasons why this is a good or bad option for you.
Like any treatment, antidepressants can have side effects and pose risks for certain patients. If you’re seeing improvement by going to therapy or getting support in other ways, by all means continue. But if myths about antidepressant resistance have held you back from considering medication and you’re struggling, you might want to reconsider and discuss the possibility with your doctor.
It’s also important to note that talk therapy and antidepressant treatment generally result in similar numbers of people improving (about 50 to 60 percent). However, combining antidepressants with talk therapy can lead to greater improvements and a much reduced chance of relapse.
One theory for why this happens is that antidepressants increase neuroplasticity, making the brain better able to maintain and apply the gains made in treatment. In this case, one might think of antidepressants as facilitators of treatment.
Antidepressants have come a long way from the first generation of drugs used in the 1950s. We now have more data on their long-term effects and underlying function. Newer drugs are designed primarily based on scientific theory.
Clearing up misconceptions surrounding antidepressants is important to enable patients to make educated treatment decisions.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
