Everyone experiences life's ups and downs. But for people with depression, the downs stick around — and can feel overwhelming.
People with depression may experience lethargy, diminished interest in normal activities, altered sleeping or eating patterns, feelings of guilt or anxiety, and suicidal thoughts.
Among the treatment options are the antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Compared to older types of antidepressants, these drugs are safer and better tolerated by patients.
SSRIs and SNRIs are believed to work by affecting the levels of brain chemicals called neurotransmitters — like serotonin and norepinephrine — that are involved in regulating mood, anxiety and thinking.
Here, Pollack addresses some common concerns people may have about antidepressants.
SSRIs and SNRIs don't change who you are. In fact, treatment often allows one’s personality to emerge without the overlay of anxiety and depression.
The effects of antidepressants on sexual function can vary among individuals. For some people, the effects can be positive.
"Depression itself can decrease libido, so with treatment, sexual function often improves," Pollack says.
But, he says, some patients will experience decreases in sex drive. "This can be managed or reversed, either by switching to alternative treatments or by supplementing with other medications, including some that increase dopamine functioning."
Though putting on pounds with antidepressants is less common with the newer medications, it may still happen. If it does, your doctor might suggest switching to a different antidepressant or augmenting with another medication to reduce or reverse the weight gain.
And, as Pollack notes, "It's always important to attend to diet and exercise in order to try to control weight gain while on medication."
"Although antidepressants are much more likely to alleviate suicidal thoughts associated with depression than to cause them, a small proportion of individuals taking them — usually young adults, adolescents and children — may develop agitation or suicidal thinking," Pollack says.
For this reason, communication between patient and doctor (and parents, when children are involved) is critical — especially early on in treatment.
"If a patient starts to feel uncomfortable or notices new, unusual thoughts, that's the time to call the physician," he says.
Seeking treatment is critical. And there is reason to be optimistic. With persistence, we can help most people with depression get their lives back to normal.
SSRIs and SNRIs are not addictive, like substances such as alcohol, nicotine and opiates.
However, if they're discontinued too quickly, it's possible to have withdrawal symptoms, including dizziness, sleep disturbances or flu-like symptoms. So it's best to wean yourself off of them gradually, with the guidance of a physician.
"While adverse drug interactions are not generally a problem with SSRIs or SNRIs, they can occur, so it is absolutely critical, before starting these medications, to tell your doctor about all the other drugs you take," Pollack says. "That helps your doctor select an appropriate antidepressant that minimizes the potential for interactions."
In the end, it comes down to this: "Seeking treatment is critical," says Pollack. "And there is reason to be optimistic. With persistence, we can help most people with depression get their lives back to normal."
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