Should I be taking antidepressants?: Inside the pouch
People have very strong opinions about taking antidepressants. Are antidepressants right for you? Keep reading to find out more.
Some people find antidepressants a bit scary. Others tell all their friends they need to take them. Antidepressants are some of the most commonly prescribed drugs in the UK. In 2018 alone, antidepressants were prescribed over 70 million times. This figure has doubled in the last ten years. As so many of us taking antidepressants, we’re taking a look inside the pouch to find out more.
What do antidepressants do?
The brain consists of different chemicals. There are chemicals that make us feel happy and sad. Various internal and external factors determine our emotions. So, doing things like cuddling a pet or going for a run can increase the release of ‘good chemicals’ to our brains. This makes us feel happier. Conversely, an abundance of ‘stress hormones’ can make us feel anxious or depressed. The body is pretty good at regulating these chemicals to achieve a good balance of both. However, sometimes there’s too much of one and not enough of the other. The imbalances can lead to mood changes, and sometimes depression and anxiety.
Serotonin is a key chemical in the brain. It regulates our mood to help us feel well. For this reason, it’s often known as ‘the happy hormone’. A shortage of serotonin can lead to anxiety or depression. Antidepressants work to redress the chemical imbalances that can cause mental health issues.
Types of antidepressants
There are several different types of antidepressants. They work in different ways. Some are more common than others these days. Your doctor will make a clinical judgement about what’s suited to you. Here are the different categories:
SSRIs: Selective Serotonin Reuptake Inhibitors: SSRIs increase the brain’s serotonin levels. are the most commonly prescribed anti-depressants, as they are least likely to cause any side-effects. Fluoxetine, citalopram and sertraline are all types of SSRIs.
SNRIs: Serotonin Adrenaline Reuptake Inhibitors: Common examples include duloxetine and venlafaxine.
NASSAs: Noradrenaline and Specific Serotonergic Antidepressants: Mirtazapine is the most commonly-prescribed NASSA in the UK.
TCAs: Tricyclic Antidepressants: These are an older form of antidepressant and aren’t normally recommended as a first line of treatment due to more severe side-effects. However, where other treatments fail to help symptoms of depression, TCAs may be prescribed. Examples include amitriptyline, clomipramine, imipramine, lofepramine and nortiptyline.
MAOIs: Monoamine Oxidase Inhibitors: These are rarely used these days, as they can cause potentially serious side effects. Specialist doctors may feel these appropriate in rare circumstances. Examples include tranylcypromine, phenelzine and isocarboxazid.
Antidepressants take a few weeks to ‘kick in’
It’s important to remember that you may not notice any benefit, at first. You may also experience some initial side-effects. However, you should try the treatment for several weeks before assessing whether it works for you. If your doctor prescribes anti-depressants, you should persevere with minor side-effects at first. Hopefully, you’ll find that the benefits outweigh any initial difficulties. However, if you are concerned about any severe side-effects, consult your doctor straight away. It may be that you’re more suited to a different type of anti-depressant.
Knowing when you need extra support
When struggling with mental health issues, we may not always realise that we need support. Often, loved ones notice this before those who are suffering. Are you showing signs of depression or anxiety? These signs could include:
- Not sleeping, or sleeping too much
- Poor appetite
- Not taking time to look after your hygiene or appearance
- Feeling more introverted than normal
- Drinking excessively
- Backing out of social events
- Being overly concerned with timescales and deadlines
Antidepressants vs other treatment
Anti-depressants can help regulate the hormone levels in your brain. However, they won’t address the things that may be worrying you in the first place. Taking anti-depressants is most effective when paired with other treatment. Don’t feel you should struggle through one without the other. Everyone is different. Treatment that’s appropriate for someone else might not be right for you. Consult your doctor and ask advice for various treatments. You can use these tactics in place of or as well as taking anti-depressants.
- Getting regular exercise
- Talking therapy
- Spending time with loved ones
- Mindfulness and meditation
- Cognitive Behavioural Therapy (CBT)
Are antidepressants over-prescribed?
Antidepressant prescriptions have doubled in only ten years. Many are concerned that antidepressants are prescribed as a first line of treatment, where other treatments may be more appropriate.
The President of the Royal College of Psychiatrists says, “For many people antidepressants can be lifesaving, but they should not be the ‘go-to’ for first instances of mild depression.” If you are experiencing symptoms for the first time, or they are mild, consider highly-effective alternatives.
Antidepressants and sex
Taking antidepressants can reduce libido. They may also cause difficulty achieving orgasm. If you’re concerned that antidepressants are affecting your sex life, speak to your doctor. They may be able to reduce your dose, or try a different type. Most commonly, it’s SSRIs that cause these issues.
Antidepressants and pregnancy
Antidepressants can cause potential risks to the foetus. These include premature birth and lower birth rate. If you are pregnant and experiencing depression, you should consult your specialist. Depression can have a damaging effect on both mother and baby. So, this is a big consideration. Similar concerns apply when breastfeeding.
A medication for life?
“Will I have to take these forever?” Lots of people ask this when first taking antidepressants. This is a common fear. However, that’s not the case for most people. Antidepressants help regulate your hormones to make you feel well. Once your symptoms have ceased, revisit your doctor. You can ask them about withdrawing from the medication. Most often, antidepressants will be prescribed for six months or more. Your doctor will advise the best way forward to manage any ongoing symptoms. You should not quit taking antidepressants ‘cold turkey’.