Can Antidepressants Work for Me?
A look at the complex mix of factors -- and key questions -- to consider.
Psychotherapy or even professional coaching might be the best route for
them, Mischoulon says. "A lot of these people with bereavement may get well on
But many are put on antidepressants too quickly, he says.
"Those people might be taking a medication that they don't really need.
Thus, they would be risking getting side effects, which many antidepressants
have." These effects include dizziness, drowsiness, and stomach upset, Leuchter
"Also, by giving everyone medications, we're sending a message that it's not
normal to feel badly," Mischoulon says. "To grieve when you lose a loved one --
‘that's something that we can treat with a medication,' and that's not the
case. There is a certain amount of normal suffering that is part of the human
condition, and unfortunately, we live in a society that increasingly wants to
be happy all the time and feels that if you're not happy all the time, then
something's wrong," Mischoulon says. "That's just not the way it is."
But in some cases, it's tough to distinguish normal sadness from clinical
"Sometimes it can be difficult," Mischoulon says. "Sometimes grief can
actually complicate into a major depression. A lot of people who lose their
jobs, as a result of the stress of it, may actually develop a major depressive
episode. One of the ways in which we make the distinction is that we look at
the degree of impairment."
For example, a grieving person might cut back on work and other
responsibilities for a while and then gradually return to a normal routine.
But if the person misses a lot of time from work, stops leaving the house,
stops engaging in activities, or feels suicidal, those are more serious signs
of depression, Leuchter says.
A2. Are you willing to stick
with treatment long-term, including trying more than one drug?
With antidepressants, patience matters. "I tell people, ‘You have to be
willing to stick with treatment for the long-term to get the most benefit,"
Mischoulon says. "Most antidepressants don't work immediately. They can take
several weeks to work. I tell people, don't feel discouraged if you don't start
feeling better right away because most people don't."
Side effects deter many people from continuing, Leuchter says. "People need
to work with their doctors to get past the first couple of weeks when side
effects occur so that they stand a chance to get the benefits."
Furthermore, Mischoulon says, "If they try a first antidepressant and it
just doesn't work or if it causes too many side effects, that doesn't mean that
it's going to be this way with all antidepressants. People should be open to
trying another one."
In some cases, patients require a combination of drugs to control
depression, Payne says.