Depression Health Center

There are many factors to consider when deciding whether to take medicines to treat depression, including the severity of the condition, whether you are taking medicines for other medical conditions, and your feelings about taking medicine. Consider the following when making your decision:

• If your symptoms are mild and not recurring, you can try lifestyle changes and professional counseling alone to reduce symptoms or resolve depression.
• Significant stress or changes in your life (such as divorce or being laid off from your job) can trigger depression (as opposed to temporary feelings of sadness or grief). See how to assess whether you might have depression.
• If you need medicines to treat depression, you don't need to be ashamed about taking them. Depression is a medical condition, not a character flaw or weakness. The medicines will not alter your personality.
• You can improve the quality of your life and your physical health by taking medicines. Untreated depression has been linked to the development of other diseases, such as stroke and coronary artery disease.
• If your condition gets worse while you are receiving professional counseling alone, medicines can be added to your treatment. Adding medicines to professional counseling for severe depression works better than counseling alone.

What is depression?

Depression is a mood disorder that causes symptoms such as low energy, prolonged sadness or irritability, and lack of interest in daily activities. It is thought to be a result of chemical imbalance and may be triggered by certain environmental, genetic, or medical conditions.

Am I depressed?

The symptoms of depression include a loss of interest in daily activities or feeling sadness or hopelessness and at least four of the following symptoms:

• A change in eating patterns that causes either weight gain or weight loss
• Sleeping too much or not enough
• Feeling restless and unable to sit still or feeling that moving takes a great effort
• Feeling tired all the time
• Feeling unworthy or guilty without an obvious reason
• Having problems concentrating, remembering, or making decisions
• Thinking often about death or suicide

Am I depressed enough to take medicines?

See how to assess whether you might have depression. It is possible that you have adapted to your ongoing symptoms of depression and may not realize that the quality of your life could be significantly better.

Will I have to take medicine for the rest of my life?

Continuing to take medicine after recovery reduces your risk of a recurrence of symptoms (relapse).¹ About half of those who experience one episode of depression will experience a relapse. Taking your medicine for at least 6 months after you feel better can help keep you from getting depressed again. If this is not the first time you have been depressed, your doctor may want you to take these medicines even longer. Medicines must be tapered off and not stopped abruptly.

Will taking antidepressant medicine change my personality?

Antidepressants can change how you feel and respond in certain situations, but they do not change who you are. You may feel more relaxed, more social, more assertive, or more outgoing when taking an antidepressant. Research indicates that these effects may be caused not only by the relief of depression but also by the direct effect of antidepressant drugs on brain chemistry.

What to expect if you do take medicines to treat depression

If you have depression, determining the severity of your symptoms and how much they interfere with your daily living can help you decide whether to take medicines. Antidepressants can help balance the chemicals in your brain (neurotransmitters) and reduce the intensity of your depressive symptoms.

You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.

It is important to remember that people respond differently to antidepressant medicines, and the first medicine you try may or may not be effective in relieving your symptoms of depression. If the medicine is not effective after several weeks, you may need to try another antidepressant.

Although medicines have potential side effects, these side effects are usually temporary and go away within the first few weeks of therapy. If your depressive symptoms are worse than the possible side effects of the medicines, you may benefit from taking medicines to treat depression. Common side effects include:

• Nausea, loss of appetite, or diarrhea.
• Anxiety or irritability.
• Problems sleeping, or drowsiness.
• Loss of sexual desire or ability.
• Headaches or dizziness.

What to expect if you do not take medicines to treat depression

If you determine that your symptoms are not interfering with your daily living and that your symptoms are less bothersome than the side effects of the medicines, you may decide against taking medicines to treat your depression. But you should seek other treatment for depression, such as professional counseling. Untreated depression may get worse.

If you do not take medicines to treat depression, continuing to monitor how much your symptoms interrupt your life and the lives of those around you can be helpful in your treatment. Professional counseling can help you deal with immediate problems and learn ways to better cope with future issues. Some people are able to overcome mild and sometimes moderate depression by seeking treatment other than medicine.

Your choices are:

• Take medicine to treat depression.
• Do not take medicine to treat depression, but seek professional counseling.
• Take medicine for depression, and also seek professional counseling.

The decision about whether to take medicine to treat depression takes into account your personal feelings and the medical facts.

Deciding about medicines for depression

Reasons to take medicines

Reasons not to take medicines

Your symptoms of depression interfere with your daily living. You have not been able to overcome symptoms of depression with other treatment. You would be willing to continue taking medicines as prescribed for a period of at least several months. You are willing to work through any side effects that the medicines may cause. Your symptoms are worse than any potential side effects of the medicine. Are there other reasons you might want to take medicines?

Your symptoms do not interfere with your daily living. The side effects of the medicines may be worse than minor symptoms of depression. You do not want to take medicines for a long period of time. You have been able to control your symptoms through professional counseling, use of complementary therapy such as St. John's wort, or home treatment. You have tried a number of different medicines, and all of them cause intolerable side effects. You are taking medicines for other health conditions that will interfere with antidepressants. Are there other reasons you might not want to take medicines?

These personal stories may be helpful in making your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about taking medicines to treat depression. Discuss the worksheet with your health professional.

Circle the answer that best applies to you.

My symptoms of depression interfere with my ability to enjoy my life.	Yes	No	Unsure
I think I can tolerate the side effects of the medicines.	Yes	No	Unsure
I am willing to try more than one medicine if the first one doesn't work for me.	Yes	No	Unsure
I will seek professional counseling to help with my depression.	Yes	No	Unsure
I will modify my lifestyle, if needed, to include exercising, reducing stress, and eating a balanced diet.	Yes	No	Unsure
After taking the risk assessment quiz, I think I may have depression.	Yes	No	N/A*
I still have symptoms of depression even after trying professional counseling and lifestyle changes.	Yes	No	N/A
I believe my symptoms may be worse than the potential, temporary side effects of the medicine.	Yes	No	Unsure

*NA = Not applicable

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to take or not to take medicines to treat your depression.

Check the box below that represents your overall impression about your decision.

Leaning toward taking medicines

Leaning toward NOT taking medicines

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
• A warning about the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.

Citations

1. Butler R, et al. (2007). Depression in adults (drug and other physical treatments), search date April 2006. Online version of Clinical Evidence: http://www.clinicalevidence.com.

Author	Jeannette Curtis
Author	Paul Lehnert
Editor	Katy E. Magee, MA
Associate Editor	Terrina Vail
Primary Medical Reviewer	Adam Husney, MD - Family Medicine
Primary Medical Reviewer	Catherine D. Serio, PhD - Behavioral Health
Specialist Medical Reviewer	Peter Hauser, MD - Psychiatry
Specialist Medical Reviewer	Lisa S. Weinstock, MD - Psychiatry
Last Updated	March 13, 2009