Taking medication for depression can feel like a huge step, and it’s normal to worry about what it means for both your current and long-term health. But, if you’ve been diagnosed with depression and prescribed antidepressants, remember that you're taking medicine for a condition that could make a marked difference to your mental and physical health. They may or may not work for you, but antidepressants are simply another treatment option to help you on your mental health journey.
Taking antidepressants is still associated with a lot of stigma and there are plenty of people who believe that mental health conditions shouldn't be treated pharmacologically. However, antidepressants have the power to stabilise mental health and save lives. Of course, every case is different, but you should never feel ashamed or embarrassed of taking medicine that may help you get better and live a fuller life.
"Unlike many physical illnesses, mental health issues cannot always be seen, but this does not mean they’re not there," says Claire Nevinson, superintendent pharmacist at Boots. "It is totally normal for people to go through periods of feeling down, but if the feelings are interfering with your daily life and don’t go away after a few weeks then it could be a sign of depression."
Do I need antidepressants?
"Depression can affect people differently, but the symptoms are often the same." Nevinson explains. "Indicators that someone is experiencing mental health issues could include feeling sad or down for an extended period, excessive fears or worries, or extreme feelings of guilt, withdrawal from friends, family and social activities, and feelings of loneliness and isolation."
"It’s important to speak to your GP if you've noticed changes in the way you are thinking or feeling and you’re worried about your mental health, or if you notice any changes in a friend or family member’s mental health you should try and encourage them to seek advice from a GP," she advises.
It can be hard to tell whether you need to start a course of medication to help with anxiety and depression so a check in with your doctor accompanied by some questions about your mood is usually the best place to start. You might also want to consider your stress levels, how your work, your relationships and your day-to-day activities make you feel.
If you are prescribed antidepressants, it's important to remember that, as with any drug, everyone has an individual response, though there are some common side effects that you might experience such as loss of libido and issues with the strength and frequency of your orgasms, trouble sleeping and headaches.
Side effects of antidepressants
What are antidepressants?
Before we take a deep dive into the side effects of antidepressants, let's first understand what they actually are.
"Antidepressants are a type of medicine used to treat clinical depression, but they can also be used for other mental health conditions and to help treat long-term [chronic] pain," Nevinson explains. "Most people go through periods of feeling down, but when you're depressed, you feel persistently sad for weeks or months. The good news is that with the right treatment and support, most people with depression can make a full recovery."
"For moderate to severe depression, a combination of talking therapy and prescribed antidepressants is often recommended," she says. "Antidepressants are not usually recommended for mild depression, unless other treatments have been tried first and been unsuccessful, like talking therapy."
How do antidepressants work?
"Antidepressants work by increasing levels of certain chemicals in the brain called neurotransmitters, such as serotonin and noradrenaline, which are linked to mood and emotion," Nevinson points out. "While antidepressants can treat the symptoms of depression, they do not always address its causes, which is why they're usually used in combination with therapy to treat more severe depression or other mental health conditions."
What types of antidepressants are there?
There are several types of antidepressants, and which one you're prescribed will depend on your current condition as well as your medical history.
Selective serotonin reuptake inhibitors (SSRIs) are a widely used type of antidepressant. According to the NHS they're mainly prescribed to treat depression, particularly persistent or severe cases, and are often used in combination with a talking therapy such as cognitive behavioural therapy (CBT). One of the most common types of SSRI is Sertraline, which many people take for anxiety and depression in the UK.
Tricyclic antidepressants (TCAs) are an older type of antidepressant. They're no longer usually recommended as the first treatment for depression because they can be more dangerous if an overdose is taken. They also cause more unpleasant side effects than SSRIs.
Serotonin antagonists and reuptake inhibitors (SARIs) are not usually the first choice of antidepressant, but they may be prescribed if other antidepressants have not worked or have caused side effects. Similarly, "monoamine oxidase inhibitors (MAOIs) are an older type of antidepressant that are rarely used nowadays.
What are the side effects of antidepressants?
"Different antidepressant medications can have a range of different side effects, so it’s important that you always check the information leaflet that comes with your medicine to see what the possible side effects are," Nevinson advises.
According to the NHS, these are the most common side effects of SSRIs (which are the most widely prescribed antidepressants):
Feeling agitated, shaky or anxious
Feeling and being sick
Indigestion and stomach aches
Diarrhoea or constipation
Loss of appetite
Not sleeping well (insomnia), or feeling very sleepy
Loss of libido (reduced sex drive)
Difficulties achieving orgasm during sex or masturbation
Difficulties obtaining or maintaining an erection (erectile dysfunction)
"The most common side effects of antidepressants should improve within a few days or weeks of treatment, as the body gets used to the medicine. It’s also important that you talk to your doctor before you stop taking antidepressants and that you do not stop taking antidepressants suddenly," she adds.
"Once you're ready to come off antidepressants, your doctor will recommend reducing your dose gradually over several weeks to help prevent any withdrawal symptoms you might get as a reaction to coming off the medicine."
What should you do if you’re experiencing side effects of antidepressants?
"The side effects of antidepressants can cause problems at first, but they will generally improve with time. It's important to continue treatment, even if you're affected by side effects, as it will take several weeks before you begin to benefit from treatment and you should find that the benefits outweigh any problems from any side effects," Nevinson advises.
"During the first few months of treatment, you'll usually see your doctor or a specialist nurse at least once every two to four weeks to assess how well the medicine is working for you," she adds. "It’s important to be aware of any information about your specific antidepressant medicine, so you must always read the patient information leaflet that comes with it."
This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Samaritans are here to listen, day or night, whenever anyone needs, providing a safe and confidential space to talk openly and honestly. Whatever you are going through, you don’t have to face it alone. Call Samaritans free on 116 123, email email@example.com or visit www.samaritans.org.
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