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Depression: Should I Take an Antidepressant?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Depression: Should I Take an Antidepressant?
Get the facts
- Take antidepressants to treat depression.
- Don't take antidepressants.
If you're pregnant, there may be other issues that affect your decision. Pregnant women need to be more careful about taking antidepressants.
Key points to remember
- Taking medicine for your depression can help you get your life back to normal, especially if you also get counseling. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
- You don't need to be ashamed about taking antidepressants. Depression is a health problem, not a character flaw or weakness. The medicines won't change your personality.
- Antidepressants don't work right away. And you may need to try a few before you find one that works.
- Side effects are one reason that people stop taking antidepressants. But talk to your doctor. There are many ways to manage side effects. And lowering the dose or changing medicines may also help.
- The thought of needing to take medicine for a long time can be scary. But many people are able to slowly stop taking antidepressants after a while.
The symptoms of depression include a loss of interest in daily activities or feeling sad or hopeless and having at least four of the following symptoms:
- A change in eating patterns that causes either weight gain or weight loss
- Sleeping too much or not enough
- Feeling restless and unable to sit still, or feeling that moving takes a great effort
- Feeling tired all the time
- Feeling unworthy or guilty without an obvious reason
- Having problems concentrating, remembering, or making decisions
- Thinking often about death or suicide
Antidepressants are medicines for treating depression. They work by helping to balance certain chemicals in your brain. They can make your symptoms better or get rid of them completely.
There are several kinds of antidepressants. There is no evidence that one works better than another. But the side effects are different.
Antidepressants don't change your personality. They help your symptoms.
You don't need to be ashamed about taking antidepressants. Depression is a health problem, not a character flaw or weakness.
Most people are able to find an antidepressant that helps their depression. But you may have to try a few before you find one that works for you. The right medicine is one that helps your symptoms and has the fewest side effects.
You may start to feel better within 1 to 3 weeks after you start taking an antidepressant. But you may need to take it for as long as 6 to 8 weeks to see more improvement.
It's best to keep taking your medicine for at least 6 months after you feel better. If this is not the first time you have been depressed, your doctor may want you to take these medicines even longer.
The thought of needing to take medicine for a long time can be scary. But many people are able to slowly stop taking antidepressants after a while.
Antidepressants can change how you feel and respond in certain situations, but they don't change who you are. You may feel more relaxed, more social, more assertive, or more outgoing when you are taking an antidepressant.
Depression treated only with antidepressants, and not also with therapy, is more likely to come back later.
Most antidepressants cause minor side effects that go away or improve in the first few weeks of treatment. If you keep taking your medicine, there is a good chance that you will start to feel less depressed and that the side effects will decrease. Most people feel that the benefits of antidepressants are well worth the price of living with some side effects.
Side effects may vary depending on the medicine you take, but common ones include:
- Dry mouth.
- Loss of appetite.
- Diarrhea or constipation.
- Sexual problems (loss of desire, erection problems).
- Trouble falling asleep, or waking a lot during the night.
- Weight gain.
- Feeling nervous or on edge.
- Feeling drowsy in the daytime.
Some side effects may not go away, but usually there are ways to manage them. Talk with your doctor about how to manage side effects.
Problems with sexual arousal and a lack of interest in sex are common side effects. If this happens to you, talk to your doctor. There are other medicines that may help with these problems.
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
Counseling is an important part of the treatment for depression. The types of counseling most often used for treatment of depression include:
- Cognitive-behavioral therapy, which teaches you how to become healthier by changing certain thought and behavior patterns.
- Interpersonal therapy, which focuses on your relationships and the problems they may be causing.
- Problem-solving therapy, which focuses on the problems you are facing and on helping you find solutions.
- Family therapy, which involves the entire family.
There are also lifestyle changes you may be able to make that may help your depression symptoms:
- Eat healthy foods.
- Don't drink alcohol.
- Get regular exercise.
- Get a good night's sleep.
- Get social support from family and friends.
- Try to keep a positive attitude—remember that feeling better takes time, and your mood will improve little by little.
Other treatment choices
Besides counseling and lifestyle changes, there are some other treatments you can try:
- Alternative treatments such as massage therapy and yoga may help you get better faster and make your life better.
- You can try relaxation exercises at home to lower your stress.
- The herb St. John's wort may help if you have mild depression. But it can cause problems with other medicines you may be taking, so talk to your doctor before you try this herb.
- Electroconvulsive therapy may be used to treat severe depression or depression that hasn't responded well to other treatment. It also may be a treatment choice for someone who cannot live with the side effects of antidepressants.
Your doctor might suggest that you try antidepressants if:
- You have tried counseling and lifestyle changes, and they haven't worked.
- Your symptoms are bad enough that they interfere with your daily life.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You take a pill or liquid medicine one or more times a day for months or sometimes years.
- Antidepressants can improve or completely relieve symptoms.
- Antidepressants usually help when counseling and lifestyle changes haven't worked.
- It takes weeks, and sometimes months, for the medicine to start working.
- You may have to keep taking antidepressants for a long time.
- Side effects—which can include nausea, diarrhea or constipation, sexual problems, weight gain, and trouble sleeping—cause many people to stop taking the medicine.
- You treat your depression with counseling, such as cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.1 You can also help your depression with support and lifestyle changes, such as exercise.
- You may try alternative treatments, such as massage and relaxation techniques.
- Counseling works well for people whose symptoms are mild to moderate. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.2
- You avoid the side effects of the medicine.
- Counseling may not be enough if your symptoms are severe.
- Untreated depression is likely to get worse.
Personal stories about deciding whether to take antidepressants
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I didn't even realize that I was depressed for a long time. I thought everyone felt this way; at least everyone in my family seemed to. I probably would have just gone on like that if my doctor hadn't asked one day if I had ever thought about taking an antidepressant. I was relieved to find out that it isn't normal to feel like I do and that a lot of people are helped by medicines. I know it might take a while to find the right one, but I'm in no hurry; I've spent my whole life feeling sad.
Jackie, age 62
I tried antidepressants about a year ago. I really was not prepared for the first few weeks, when the side effects seemed to get me down even more than the depression did. So I stopped taking them. It took me about 3 months, but I eventually started to feel better without any medicine. Then last month, I started to feel depressed again. I don't want to wait so long to feel better this time. So I'm going to try the antidepressants again. This time, I know what to expect and am better prepared for it.
Tyrone, age 43
I guess I'm just not comfortable with taking medicine for my depression. I feel like I ought to be able to manage this on my own without needing medicine. It seems too much like taking the easy route. But maybe I just don't feel bad enough yet.
Bob, age 50
I recently began going to counseling. I know that if I took an antidepressant, I might feel better sooner, but I don't like the sound of the side effects I could have. My therapist and I have set some goals for me to work on, and we agreed to revisit my decision in 3 months. I want to wait and see how the counseling goes before I take medicine.
Joslyn, age 28
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take antidepressants
Reasons not to take antidepressants
My symptoms are keeping me from living my normal life.
My symptoms aren't bad enough to get in the way of my life.
I'm willing to take medicine every day for at least 6 months, and maybe longer.
I don't like the idea of taking medicine for a long time.
My symptoms are worse than the possible side effects of the medicines.
I think the side effects will be worse than my symptoms.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking an antidepressant
NOT taking an antidepressant
What else do you need to make your decision?
Check the facts
Are antidepressants right for everyone with depression?
- YesSorry, that's wrong. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
- NoYou're right. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
- I'm not sureIt may help to go back and read "Get the Facts." Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
Is it possible to manage the side effects of antidepressants?
- YesThat's right. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.
- NoSorry, that's wrong. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.
- I'm not sureIt may help to go back and read "Get the Facts." There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.
Will you start to feel better right away?
- YesNo, that's wrong. Antidepressants don't work right away. And you may need to try several before you find one that works.
- NoThat's right. Antidepressants don't work right away. And you may need to try several before you find one that works.
- I'm not sureIt may help to go back and read "Get the Facts." Antidepressants don't work right away. And you may need to try several before you find one that works.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Specialist Medical Reviewer||Lisa S. Weinstock, MD - Psychiatry|
- Kennedy S, et al. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. Journal of Affective Disorders, 117(Suppl 1): S1–S64.
- Hollon SD, et al. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62(4): 417–422.