Many people wait years before getting help for depression or anxiety. Let me congratulate you for taking the first steps to feeling better. The journey begins after you’ve scheduled your first appointment and have been evaluated by a mental health professional. In your visit, they recommended medication management for your symptoms. Are you feeling hesitant and not sure what to expect?
Frequently, your psychiatric provider will recommend you start with an antidepressant. Antidepressants are the most common drug class in mental health. These medications can treat several different diagnoses including anxiety, mood disorders, post-traumatic stress disorder, panic disorder, or obsessive-compulsive disorder. Antidepressants work by increasing the amount of important chemicals in your brain or balancing out the effects of these neurotransmitters.
Neurotransmitters act like messengers to send signals from one nerve cell to another. These signals do everything from making your arms and legs move, to sending important messages throughout your brain. When people are experiencing depression, anxiety, PTSD, or OCD the brains messages are not working properly. For more information on this, read our upcoming blog post “The Default Mode Network and Glutamate, what the Serotonin model of depression missed.” This irregular routing contributes to many of the symptoms we see with depression, anxiety, PTSD, or OCD. These medications work by increasing the amount of neurotransmitter in your brain which helps the brain develop neuroplasticity and the ability to heal.
Some people are afraid to take this type of medication out of fear of side effects. One side effect that’s a common myth is that you will feel like a “zombie,” or feel emotionless. While people can feel tired when they first start medication, the benefits outweigh feeling tired. Antidepressants can help improve feelings of sadness, low mood, hopelessness, feeling on edge, and excessive worry. The medication shouldn’t make you feel out of touch with yourself or your emotions. If this occurs, notify your provider as you may need to change medications.
Because of the neural networks that antidepressants improve, medications work best to treat symptoms when combined with therapy. Therapy provides treatment for how your thoughts may be contributing to mental health symptoms, while medications treat the chemical side of things. This gives patients a chance to build new positive coping mechanisms and habits. Antidepressants can take 1 to 3 weeks to start working. Most people don’t feel a difference until 4 to 6 weeks as this is when the medication can reach maximum efficacy. Most symptoms associated with depression and anxiety will improve once the right dose is achieved. Changing the dose is a common occurrence, which can prolong significant improvement of symptoms. In some cases, clients may not respond to the first medication, and it may take a trial-and-error approach with other medicines to find one that works. Rarely, individuals don’t experience any relief with medication and may need to trial alternative treatments.
Fortunately there are new options for people when antidepressants don’t work. Take a look at our web pages on TMS, Spravato and Ketamine treatments. These important treatments have changed the lives of many medication non-responders for the better.
It’s important to always discuss any continued or worsening symptoms with your mental health professional. You need to be honest with yourself and your provider.
Some people falsely believe they may need to take medications for life. Treatment of symptoms with an antidepressant can last several months to years depending on the situation. Many people are treated between 6 to 12 months. You will have regular check ins with your provider to ensure you’re on the right treatment plan for you. You should take the medication at the same time every day for maximum benefit. Depending on your specific medication, you may want to take the medication in the morning or at night. Your provider will discuss this with you. It is important that you do not make any changes to your medication without talking to your provider. If you are feeling better, or no longer wish to take the medication, do not stop the medication abruptly.
If you’re experiencing side effects, please notify your provider. Some are expected but should improve with time. Commonly reported side effects are decreased appetite, sleep disturbances, weight gain or weight loss, and decreased sex drive. Some patients report nausea. This can be avoided by taking the medication with food. Your provider may be able to help you come up with solutions to handle potential side effects.
While these possible side effects sound concerning, our providers use their years of experience to find medications that minimize the negative side effects while creating the best improvement in symptoms.
You should notify all of your healthcare providers of any medications you are taking including supplements. This includes prescriptions or over the counter medications.
If you start a medication and have an abrupt worsening of symptoms, suicidal or self-harm thoughts you should contact your provider immediately.
People who are experiencing pregnancy may also need to adjust the type or dose of medication. It is important to notify your OBGYN of any medications you are taking. They will discuss the pros and cons of medication while pregnant.
Drinking alcohol while taking anti-depressants is not recommended and should be minimized. Please discuss alcohol use with your provider.