Not everyone can afford antidepressants – and many people are skeptical about their efficacy. Antidepressants are associated with an increased risk for suicide, for example, and there is a lot of content online dedicated to making people believe antidepressants are far more dangerous than they are helpful. But the reality is that it isn’t that simple.
Knowing several people who use these medications to combat severe depression – including frequent thoughts of suicide and worthlessness – I can tell you that antidepressants most definitely save lives. But they’re not always necessary. Depressive disorders can be treated without medication, on a case-by-case basis. Some people don’t need to be prescribed antidepressants. Other people, however, do need them. The key lies in differentiating between the need for antidepressants, and the need for a treatment that does not involve medication.
Differentiating Between Sadness and Depression
Depression exists on a spectrum, but there is a healthy range of negative thoughts that exists outside that spectrum. Usually, where depression is involved, there is some kind of condition to be treated. But the human condition cannot be treated, it can only be addressed and lived through. Sometimes, these normal emotions can grow in power and potency, and turn into something worrying. But often, there is a clear line between what it means to feel sad and what it means to be depressed.
That line is reality. Sadness is a normal emotion and can be further tied to many different thoughts or emotions. We may be sad and guilty, or sad and mournful, or sad and filled with regret. Trying to live a life without sadness is futile and irresponsible, because it’s these powerful and painful memories that help us grow as individuals. There is a reason for sadness, and it is to help us avoid pain – or more accurately, learn from it and adapt.
Depression is removed from reality and has no place in the mindscape of a healthy individual. Where sadness helps us become better people and allows us to rise from adversity stronger than before, depression tears us down and makes us cower, making life harder, and chipping away at us without any meaningful purpose. Depression is not a test to conquer – it’s a disease to treat. Where sadness might let us re-evaluate our actions, depression puts thoughts in our head that defy the truth, making us think less of ourselves and forcing us to put ourselves down and lose trust in who we are. It’s wholly destructive, where sadness can be constructive. It’s wholly negative, where sadness can be positive.
But even in depression, there are different levels of severity. At the top are depressive thoughts that encourage, normalize, and glorify suicide, eventually leading to death. At the bottom are thoughts that eat away at our confidence and self-esteem, subtly yet enough to make an impact on who we are and what we do. In between lies everything – a journey of doubt feeding into self-loathing, apathy, and suicide.
Not All Depressive Disorders Are Alike
Depression can be generalized as severe sadness or low mood, but it comes in different forms and for different reasons. Some are biological, others are purely psychological, and often there’s the factor of genetics. This matters immensely, especially in the treatment of depression. If you have not been diagnosed by a therapist or doctor, it’s worth investing in getting a full checkup. Blood tests can reveal vitamin deficiencies that have been linked to depression. Underlying conditions, including thyroid problems and benign brain tumors, can lead to mood disorders like depression. And sometimes, depression has nothing to do with an abnormality in the body, but simply occurs in perfectly healthy people due to a genetic predisposition, or a long series of grueling and unfortunate events.
Getting a proper diagnosis that takes a look into your individual factors and comes up with a reasonable origin for your depressive thinking is important in figuring out treatment, both from the perspective of professionals, and from your own. There are many things you can do to relieve depressive symptoms without picking up a single prescription, including:
- Healthier lifestyle choices and a complete diet.
- Regular exercises of the kind you enjoy the most.
- Spending time with friends and family.
- Removing yourself from people who drain you emotionally.
- Balancing work and play.
- Switching to a more rewarding career or job.
- Taking herbal supplements to combat depression.
- And more.
There are cases where the depression is too severe to wait for therapy to take effect. It can take weeks and months for therapy to work, and it takes much longer if the patient has a hard time believing in themselves or the hope for progress. Unlike medication, therapy requires that a patient has faith in their therapist and the method of therapy they’ve chosen. It’s in cases like this where antidepressants can help make the difference between a long life well spent, or an untimely death.
Why Antidepressants Save Lives
Antidepressants are simple, rather than complicated. They increase the effectiveness of naturally-produced serotonin, keeping it available for longer. Some do more than that, also increasing the availability of norepinephrine and dopamine. But why exactly these drugs improve symptoms of depression is not completely understood. The hypothesis is that by increasing serotonin, a person is less likely to have depressive thoughts, and will have an improved mood. But with that comes a myriad of side effects, because serotonin and these other neurotransmitters do more than just control mood, and different antidepressants use different mechanisms to affect the brain.
I’ve known people who have taken antidepressants with no side effects. And I’ve known people who have struggled with weight gain and sexual dysfunction due to antidepressants. How and why side effects occur is not completely understood – but in the long-term, and on a societal level, one thing is undeniable: since antidepressants have been introduced, suicides have gone down. However, as with most prescription drugs, antidepressants have also been overprescribed, which is another issue altogether.
These drugs have risks. It takes time for the drug to take effect (about two weeks) and it takes time to switch to another drug (up to a month), and it may often take several attempts to find an antidepressant that works. However, they do have their place in treating certain cases of depression. And ultimately, it’s up to you if you want to risk using them. Natural or herbal alternatives exist, but there’s also no good way of knowing if they can be effective.
Never Rely on Medication
Antidepressants are not usually addictive, although some – especially SDRIs and NDRIs – have addictive properties. The most common antidepressants prescribed today are SSRIs and SNRIs, and these drugs do not elicit the same dopamine release as drugs like alcohol, benzodiazepines, opioids, and other problematic substances.
But that doesn’t mean you can’t get emotionally dependent on your medication. It’s important to recognize that antidepressants are not meant to be the key to living a life without sadness – they’re just meant to be a crutch to help you get walking. It’s a very long road from the wheelchair to the end of a marathon and getting out of the chair in the first place is the crucial beginning.
From there, medication helps you “walk” again, kickstarting the rest of your treatment. It’s how you approach your addiction through the help of therapies like cognitive behavioral therapy, dialectical behavior therapy, exercise, and art therapy, that determines how long it takes until you make it to the finish line – until you make it to a point where you no longer have to rely on medication to be happy and keep the depressive thoughts in check.
Then there are cases where therapy and medication doesn’t help – but alternative treatments do. From acupuncture to cutting-edge techniques like transcranial magnetic stimulation, “treatment-resistant depression” can still be affected by certain therapies not usually used or prescribed.
Moving Past Medication
Therapists and doctors do not want to keep you on your meds forever. While depression is not exactly something you can cure like the common cold, the most progress in managing a depression is done through lifestyle changes, regular therapy, and stress management, rather than medication. For professionals, medication is a means to an end to help a patient get to a better mental place before treatment can fully take effect in them.
It’s important to remember this when thinking about antidepressants and their effects. Ideally, a medical professional should prescribe medication to you with the intent of taking you off the meds once you’re ready.
It’s difficult to determine what “ready” means. It’s partially up to you and your therapist to find the right time to start weaning off the medication. If you’re beginning to feel comfortable in your own skin, comfortable with your life, and mostly free from depressive thinking, you may be at a point where you can continue to manage the symptoms of your condition with therapy and healthy lifestyle decisions, in perpetuity.
Remember: depression is managed, not cured. It can be driven into “remission”, wherein your symptoms don’t effectively show up anymore, but they could resurface in moments of extreme stress or when you’re confronted with a great challenge.