Decoding Antidepressants: Insights from a Psychiatrist

When you’re struggling with depression, the idea of starting antidepressants can feel overwhelming. What do they do to your brain? How do they affect your mental health? And will they actually help? Find the answers to these questions and more in this guide on decoding antidepressants.

What Are Antidepressants?

These medications are designed to alleviate symptoms of depression by adjusting chemical imbalances in the brain. They primarily target neurotransmitters—including serotonin, norepinephrine, and dopamine—which influence mood and emotions. Modulating these chemicals allows antidepressants to improve mood, increase energy levels, and restore interest in daily activities.

Types of Antidepressants

There are several classes of commonly prescribed antidepressants:

Selective serotonin reuptake inhibitors (SSRIs) are often the first attempt at treating depression. They increase serotonin levels in the brain, with the intent to improve mood. Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro).
Serotonin-norepinephrine reuptake inhibitors (SNRIs) boost both serotonin and norepinephrine levels to address a broader range of symptoms. Examples are venlafaxine (Effexor) and duloxetine (Cymbalta).
Tricyclic antidepressants (TCAs) are an older class of antidepressants that affect multiple neurotransmitters. While effective, they often come with more side effects. Amitriptyline and nortriptyline (Pamelor) are notable TCAs.
Monoamine oxidase inhibitors (MAOIs) are typically reserved for cases where other antidepressants haven’t been effective. They require dietary restrictions to prevent adverse reactions. Phenelzine (Nardil) and tranylcypromine (Parnate) are examples.

How Antidepressants Work

While the exact mechanisms aren’t fully understood, antidepressants are believed to adjust the balance of neurotransmitters in the brain. Each one works a little differently:

SSRIs block the reabsorption of serotonin, making more of it available to improve transmission between neurons.
SNRIs inhibit the reabsorption of serotonin and norepinephrine, enhancing mood and energy levels.
TCAs and MAOIs affect multiple neurotransmitters but are less commonly prescribed due to their side effect profiles.

It’s important to note that while antidepressants can alleviate symptoms, they don’t necessarily address the underlying causes of depression. Therefore, combining medication with psychotherapy often yields the best results. After all, therapy provides tools and coping strategies that medication alone does not.

Potential Side Effects

Like all medications, antidepressants can have side effects. Common ones include:

Nausea
Weight gain
Dry mouth
Insomnia or drowsiness
Sexual dysfunction

Most side effects are mild and tend to diminish over time. However, if they persist or become bothersome, consult your healthcare provider to explore other options.

What to Expect When Starting Treatment

Antidepressant treatment requires patience and open communication with your provider. Here’s what to expect:

Delayed onset of effects: Antidepressants don’t work overnight. It may take several weeks before you notice significant improvements in your symptoms. This delay doesn’t mean the medication isn’t effective; it’s simply how these drugs function.
Treatment duration: Even after you start feeling better, it’s important to continue taking the medication as prescribed. Skipping doses reduces effectiveness and increases the risk of side effects, while stopping too early may lead to a relapse. A typical course of antidepressants can last six months or more, though the duration in your case may vary.
Open communication: Stay in close contact with your provider. Report any side effects or concerns as soon as they arise and schedule appointments to monitor your progress. Expect to adjust your medication or dosage as you refine your treatment plan.

Myths and Misconceptions About Antidepressants

Depression treatment is often misunderstood. Let’s debunk some common myths about antidepressants.

Myth: Antidepressants change your personality.

Fact: Depression can warp how you think, feel, and interact with the world. Antidepressants don’t “change” who you are. Instead, they help lift the fog of depression, allowing you to reconnect with your authentic self.

Myth: You’ll need to take antidepressants forever.

Fact: Most people don’t stay on antidepressants indefinitely. Your healthcare provider will work with you to decide on the best duration, along with when and how to taper off safely once you’re ready.

Myth: Antidepressants are a sign of weakness.

Fact: Treating depression is a sign of strength and self-awareness, and it shows you’re committed to improving your mental health. Taking antidepressants is no different from taking medication for high blood pressure or diabetes.

Myth: Antidepressants will make you numb.

Fact: Many worry that antidepressants will dull their emotions or turn them into “robots.” However, the goal of antidepressants is not to eliminate feelings but to help you manage overwhelming negative emotions and restore balance to your emotional life.

The Role of Lifestyle Changes in Depression Treatment

While antidepressants are a vital part of treatment, they are just one piece of the puzzle. Your psychiatrist may recommend incorporating the following healthy lifestyle choices to enhance their effectiveness:

Regular exercise to boost endorphins and naturally improve your mood
A balanced diet filled with nutrient-dense foods to support brain health
Adequate sleep to promote emotional well-being
Mindfulness techniques to manage stress, which only makes depression worse

When to Consider Antidepressants

Deciding to start antidepressants is a personal choice, best made in collaboration with your psychiatrist. It may be time to consider medication if your symptoms are getting severe. Fatigue, changes in appetite, or sleep disturbances may indicate a need for medical intervention, especially if they significantly interfere with your ability to function. Discussing your symptoms openly with your psychiatrist is the first step toward determining the best course of action.

The Telehealth Advantage

Therapy for depression has never been more accessible. Thanks to telepsychiatry, you can now connect with mental health professionals from the comfort of your home! Online therapy removes many barriers to receiving care. It’s ideal for those with busy schedules, transportation challenges, or limited access to psychiatrists in the area.

At Family Psychiatry and Therapy, we provide 100% online therapy for depression in New Jersey, allowing you to begin your mental health journey with ease. We believe in personalized, continuous care for every patient. So, whether you’re exploring antidepressants or seeking a supportive space to discuss other treatment options, we’re here to help. Begin your mental health journey by booking your first session today.