People have received treatment for depression as far back as the second millennium B.C., when it was thought of as a spiritual problem to be addressed by religious leaders. Over time, we’ve learned more about the illness and its potential treatments, including antidepressant medications.
The old taboos about acknowledging and seeking treatment for depression are fading, but it still can be hard to ask for help when you or your loved ones are suffering.
Arpit Aggarwal, MD, a child and adolescent psychiatrist at MU Health Care, addressed some common concerns his patients and their families have about taking medication to treat mental health conditions such as depression.
If I’m diagnosed with depression, will I be forced to take medication?
Medication is not usually the first treatment option. For mild to moderate depression, it is recommended to start with psychotherapy to help patients understand what’s causing their depression. If we decide that medication is necessary, it is still the patient’s decision to take our advice. We give patients a list of treatment options. Medication is only a small part of the solution.
How could medications help?
The most common definition of a psychiatric disorder is impairment in function or significant distress in daily living caused by depression or anxiety. Essentially, when the depression starts interfering with a patient’s ability to work or do daily tasks, we recommend treatment to restore overall function. At the basic level, medication works with neurotransmitters, chemicals in the brain such as serotonin, norepinephrine and dopamine. The medications help balance those chemicals to improve overall function and reduce symptoms. Medication in conjunction with psychotherapy can reduce the symptoms of psychiatric disorders.
Will I have to be on medication for life?
There are guidelines specific to the type of problem patients are having. For depression, patients taking an antidepressant for the first time generally are on it for six to twelve months. If they have a second episode of depression that requires medication, then we recommend a longer duration, but it doesn’t have to be a permanent solution. The goal of medication is to clear some of the fog caused by depression so the patient can work through issues and over time wean off of drug therapy. More severe condition s such as schizophrenia will require longer drug treatment.
Do I have to worry about side effects making things worse?
A lot of people worry about side effects after seeing commercials for antidepressants. One thing to remember is that companies are required by the FDA to report every side effect that occurs during the drug trial period. This means that even if somebody happens to have an issue that may not be related to the drug, it still has to be reported while the patient is on medication. That said, patients can expect a short period of symptoms while they adjust to being on the medication. It may feel tough in the beginning, but if medication is taken as prescribed, symptoms should subside and overall function should improve. Doctors will work with patients to adjust the treatment plan for a better outcome so patients shouldn’t be afraid to let their doctor know if something doesn’t feel right. If patients have an increase of suicidal thoughts while taking antidepressants, they need to go to the ER and get help immediately or call the suicide hotline.
Depression has lost some of its stigma in recent years, and continuing to have honest conversations about it will help others be more receptive to seeking treatment. Surround yourself with people who will support and encourage you to focus on your mental health.
If you think you could have depression, let your doctor know so you can work together to get a treatment plan started. Taking the first step to ask for help is one of the hardest things for people who are struggling, but there is hope ahead.