Do you sometimes feel bored with everything, don't feel like doing anything, and just feel sad? Or do you have a tendency to feel anxious and scared even for the smallest things? If these things don't go away after a few days and persist, you may have a condition like depression or anxiety. These are conditions that go far beyond ordinary sadness and require treatment. Today we are talking about antidepressants, a type of medication that doctors often recommend for such mental health problems.
What are these antidepressants?
Simply put, antidepressants are a type of medication that is used to treat mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD). They are also sometimes used to treat certain eating disorders, chronic pain, and insomnia.
Depression is more than just feeling sad. It's a persistent condition that affects your mood, thoughts, energy, and interest in doing things. You may lose interest in things you used to enjoy. You may also have trouble remembering things, eating properly, and sleeping well.
The important thing is that these medications only reduce your symptoms (such as sadness and fatigue), but they do not eliminate the underlying cause of the disease. That is why doctors often recommend psychotherapy, i.e. talk therapy, along with these medications.
What conditions is this medicine used for?
Doctors around the world have approved these antidepressant drugs mainly for the following conditions:
| Disease status | A simple explanation |
|---|---|
| Depression and related conditions | Conditions such as Major Depressive Disorder. |
| Anxiety Disorders | Things like Generalized Anxiety Disorder and Social Anxiety Disorder. |
| Bipolar Disorder | A state of extreme mood swings. |
| Obsessive-Compulsive Disorder (OCD) | Repetitive unwanted thoughts and behaviors that result from them. |
| Panic Disorder | Sudden extreme fear and physical symptoms. |
| Post-Traumatic Stress Disorder (PTSD) | The mental state that occurs after a traumatic event. |
| Eating disorders | Conditions such as Bulimia Nervosa. |
| Other situations | Chronic Pain, Fibromyalgia, Diabetes-Related Nerve Pain, and Premenstrual Dysphoric Disorder (PMDD). |
Additionally, sometimes a doctor may prescribe a medication for a condition for which it is not officially approved. This is called "off-label use." For example, some older antidepressants are prescribed for insomnia or migraines.
What are the main types of antidepressants?
There are several main types, or classes, of these medications. Each of them works in a slightly different way.
| Type of medicine | The way it works is simple. |
|---|---|
| SSRIs (Selective Serotonin Reuptake Inhibitors) | These work by increasing the chemical in your brain called serotonin, which controls our mood. These are the most commonly used. |
| SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) | These increase serotonin and a chemical called norepinephrine, which helps with mood, stress, and alertness. |
| Tricyclic Antidepressants | This also increases both of the chemicals mentioned above. However, since these are old medications, they have a few more side effects. |
| MAOIs (Monoamine Oxidase Inhibitors) | These block an enzyme that breaks down chemicals in the brain, increasing the levels of those chemicals. These are also an old type. |
| Other types (Atypical Antidepressants) | New drugs that do not belong to the above categories and work differently fall under this category. |
Often, a doctor will start with an SSRI medication first, because they have relatively fewer side effects than other types.
How does this medicine actually work?
To understand this, we need to know a little about the brain. Neurotransmitters are chemical messengers that the nerve cells in our brain use to communicate with each other. Serotonin and norepinephrine are such chemicals. In conditions like depression, the balance of these chemicals becomes disrupted.
Antidepressants work by controlling these chemicals and restoring their balance, which can improve your mood and behavior.
Also, when you continue taking this medication, the brain is able to make new connections between nerve cells. It's like covering up an old, potholed road and building a new, better one. We call this neuroplasticity. This can lead to permanent improvements in your mood over time.
How should I use this medicine?
These medications usually come in pill form. When you start taking them, your doctor will often start you on the lowest possible dose. Then, they will monitor you regularly and gradually increase the dose if necessary.
The important thing is, this is not like taking a paracetamol pill. It can take a few weeks, maybe a month or two, for the medicine to work and you to feel better. So you need to be patient.
Once you start feeling better, you should continue taking the medicine as directed for as long as your doctor tells you to. Do not stop taking the medicine suddenly just because you feel better. Doing so may cause unpleasant symptoms (such as fever, dizziness, and insomnia). Therefore, if you stop taking the medicine, you should do so according to your doctor's instructions, gradually reducing the dose.
How do I choose the right medicine for me?
This is not something you should decide on your own. Your doctor will choose the medicine that is most suitable for you. He will consider several factors.
- Your symptoms: Are you mostly sad? Anxious? Insomnia?
- Possible side effects: Some medications cause drowsiness, while others cause weight gain.
- Whether it will interact with other medications you are already taking: These can interact with other medications.
- Other illnesses you have: If you have other illnesses such as heart disease or diabetes, they will also be considered.
Think about it, if you are planning to have a baby, tell your doctor about it too. Because there are safe medications during pregnancy. So it is very important to discuss all your details with your doctor.
Sometimes the first medicine you are given may not work properly. If that happens, don't worry. That's normal. You can talk to your doctor and change the dosage or switch to a different medicine.
What are the side effects of antidepressants?
Like all medications, this medication can have side effects. However, most of the time, these are not serious and will decrease over time as you continue to use the medication. Some of the more common side effects include:
- Nausea
- Dry mouth
- Drowsiness or insomnia
- Dizziness
- Headache
- Decreased sexual desire
- Weight gain
- Sweating
If you are concerned about any of these side effects, tell your doctor about it.
A particular risk to be aware of
There is something special we need to talk about here. There is a small risk that suicidal thoughts may increase when someone under 24 starts taking this medication, especially in the first few weeks. This doesn't happen to everyone, but it's important to be aware of this and to tell your doctor or family right away if you are having these thoughts.
Possible complications from taking this medication
Most people take this medication without any problems, but it's good to be aware of some serious conditions that can occur in rare cases.
| Complication | What you need to know |
|---|---|
| Serotonin Syndrome | This is very rare, but serious. It occurs when there is too much serotonin in the body. Symptoms can include confusion, muscle stiffness, high fever, and seizures. |
| Discontinuation Syndrome | If you stop taking the medication suddenly, you may experience fever, dizziness, insomnia, and mood swings. |
| Overdose | Taking more medication than your doctor recommends can be life-threatening. If you suspect you have taken too much medication, go to the nearest hospital's Emergency Department (ETU) immediately. |
Can you become addicted to antidepressants?
No. This is a question that many people ask. These medications are not addictive. However, as mentioned above, if you stop taking them suddenly, you should do so only as directed by your doctor.
When should you seek emergency treatment?
- If you experience symptoms of serotonin syndrome (high fever, seizures, confusion) or suspect an overdose, go to the nearest hospital emergency room (ETU) immediately.
- If you are having suicidal thoughts , please don't be alone. Talk to someone you trust (a family member, a friend, a doctor) right away. Or, you can seek help from an organization like Sumithrayo in Sri Lanka. They are ready to listen and help you. Your life is very precious.
Antidepressants can really help with feelings of being overwhelmed and hopeless. But they take time. You need to give your brain time to reestablish that balance.
Work with your doctor to find the right medication for you. This is a process. You may need to make changes along the way. If you experience any discomfort or side effects, talk about them. Then you can make the necessary changes to get the best results.
Take-Home Message
- Antidepressants are medications given to treat mental illnesses like depression and anxiety, not just something to take for sadness.
- It takes about 4-8 weeks for these to work and you to feel the results; so be patient and continue with the treatment.
- Never start, stop, or change the dosage of medication without your doctor's advice.
- If side effects bother you or your symptoms do not improve, talk to your doctor about it.
- This medication is not addictive.
- To achieve the best results, it is very important to use talk therapy along with medication.
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