Myths About Antidepressants

Web-only article from "Medications" issue of Visions Journal, 2007, 4(2)

Antidepressants are one approach to treating symptoms of major depression that have good evidence of effectiveness. Although antidepressants are among the most widely prescribed of all medications, many people considering them as a treatment option still have many fears and questions. The following myths and facts seek to address some of these concerns and were prepared by the Canadian Mental Health Association’s BC Division as an information bulletin for the BC Pharmacy Association to distribute to patients through member pharmacies in 2001. Please keep in mind that these responses are for adults. See the article on children and youth in this issue of Visions and a related article in the Suicide issue of Visions for more on antidepressant recommendations for young people.

Myths About Antidepressants

MYTH: Medication can’t really help a “mental” problem.

FACT: The illness of depression may have symptoms related to emotions and thoughts but it is nonetheless a very physical illness with often-disabling bodily symptoms. Antidepressants help alleviate those symptoms as well as work on the neurotransmitters that influence both the physical and psychological symptoms.

MYTH: Even if they can help, antidepressants are a “quick fix” or a “crutch” which don’t get at the root of the problem.

FACT: While it is true that antidepressants won’t do much to alleviate the environmental circumstances that cause situational depression, they can be “enabling” medicine that alleviate symptoms of major depression enough to enable a person to pursue and receive more benefit from lifestyle changes, support groups, and counselling techniques.

MYTH: Antidepressants are addictive.

FACT: No. Unlike sleeping pills and some anxiety medications, antidepressants are not addictive. However, you should never just stop a course of antidepressants on your own without the supervision of a treating physician; while your body will not crave the medicine, it will be affected by a sudden stop, particularly at higher doses.

MYTH: Once on antidepressants, I’ll be on them for life.

FACT: Not true. A general rule clinicians often use is that a person should be treated with antidepressants at least one-and-a-half times as long as the duration of the depressive episode before they can begin to be weaned off. Longer-term antidepressant usage is considered only for a smaller percentage of people who have two or more relapses of major depression.

MYTH: Antidepressants are “happy pills”

FACT: Antidepressants are often called “drugs” in slang but they have no relation to amphetamines (“uppers”) or euphoria-inducing recreational drugs. Antidepressants are designed to correct imbalances in certain brain chemicals and get you back to feeling like yourself, not merely a happier self. A person without those imbalances, who is not depressed, will feel no effect from antidepressants and may even feel ill.

MYTH: Antidepressants will change your personality or prevent you from feeling “normal” moods

FACT: Many people are nervous when taking any kind of psychotropic medication (medication for a mental illness) because they feel anything affecting the brain—the very heart of our humanity—may interfere with their identity and feelings. Actually quite the opposite: antidepressants are designed to return you to your former demeanour or personality, not create a different one.

MYTH: If the first antidepressant I try doesn’t work, others won’t work either.

FACT: There are currently a few dozen antidepressants on the market, and while they have a lot in common they’re not all identical. Add to that varying dosage levels and combinations of antidepressants and it is clear that there are countless variations within antidepressant treatment. Finding the right one is largely a process of trial and error. Many people have to try several different medications before they find one that works. Augmenting antidepressants with another mood stabilizer (e.g., lithium) or augment agent (e.g., thyroxin) may also help.

MYTH: If someone I know has done well with one type of antidepressant, it’ll probably work on me too

FACT: Everyone’s body is unique—including the way our brains are wired. Therefore, medication targeted at chemical messengers will work differently in each person just like the same perfume can smell nice on one person and not quite right on someone else. Trial and error is still the best process we have to find out which medicine will work for someone. Patience during this process is key.

MYTH: Antidepressants have horrible side effects

FACT: Like other medications, antidepressants carry the risk of side effects. These range from fatigue to dry mouth to sexual side effects. Fortunately, newer brands of antidepressants have relatively few or mild side effects. Many of these lessen or disappear with time, or can be corrected in other ways. Be sure to talk to your doctor and pharmacist to learn more about what you can expect.

MYTH: I’ll probably know right away if the antidepressant is working.

FACT: Unfortunately, no. It takes about four to six weeks at a clinically effective dosage to be able to determine if the antidepressant is alleviating symptoms. You’ll feel the side effects much sooner, however. Stick it out the six weeks though before you pass judgment.

MYTH: Once I start feeling better, I can stop taking the antidepressants.

FACT: The evidence is clear: just like you shouldn’t prematurely discontinue a course of antibiotics even if you feel better, clinicians recommend that you stay on antidepressants for the prescribed amount of time, even when you’re already feeling recovered. This will prevent a relapse. Then your doctor will instruct you on how to gradually wean off the medicine.