Dr Michelle O'Driscoll: Antidepressants - what role can they play in treatment?

While antidepressants have their place for many individuals, they are rarely just a single bottom-line, so says Dr Michelle O'Driscoll
Dr Michelle O'Driscoll: Antidepressants - what role can they play in treatment?

"Your own personal treatment plan will be created in due course. A different drug, a different dose, trial and error may well be necessary to find the perfect fit." Picture: Stock, posed by model

ANTIDEPRESSANTS are a group of medicines that are prescribed for a wide range of conditions, some of which have been touched upon here in previous articles: the obvious diagnoses of depression and/or anxiety, as well as emotional symptoms of the menopause, pre-menstrual syndrome, and less considered issues such as pain management.

While it is important to acknowledge that they are not always warranted, antidepressants can play a very important role in treatment and in re-establishing a good quality of life for those who are suffering excessively for one or other of these reasons.

So if you have been recently prescribed an antidepressant, or are considering the need to start one, here are some things to bear in mind.

Individualised treatment

While it’s fantastic to talk to trusted family and friends about your medications, maybe swapping notes about past personal experiences with different treatment options, there can often be a misconception that (a) the treatment that suits one person will definitely work for another, and (b) that the higher the dose, the more severe your illness. Neither of these things are the case.

While stories of what has worked for others can certainly be heartening, it’s easy to then lose hope if what worked for your friend or family member is either not working for you, or is not deemed to be suitable for you.

There are many different categories of antidepressants, which all target different neurotransmitters in different ways. The choice of which one will work best is made by your doctor based on your specific symptoms and medical history. Each person’s response is unique to them.

Your own personal treatment plan will be created in due course. A different drug, a different dose, trial and error may well be necessary to find the perfect fit.

Not a quick fix

Once an anti-depressant has been started, the benefits for anxiety take two weeks to become evident, and for depression it usually takes up to six weeks. If you as a patient are not aware of this lag time, chances are you’re going to prematurely give up hope of them ever working, and stop taking them before they’ve been given the opportunity to act.

Another time-related issue is the experiencing of side effects. Like most medications, anti-depressants come with their own potential side effects, such as headache, fatigue or being hard on the stomach. The good news here is that these do usually tend to subside over time. The key is to wait out those initial discomforts for the initial few weeks. Often, that bit of time is all that’s required for your body to adjust accordingly and settle into the treatment. You are then in a better position to assess what problematic side effects (if any) you’re left with.

Part of a Bigger Picture

Despite their proven benefits in treatment plans across a spectrum of illnesses, antidepressants tend to work best as one piece of a sometimes complex puzzle, rather than being used as a quick cure, or a “pill for every ill”.

If your sleep routine is off, if you’re not fuelling your body with the right foods, if you’re not addressing the mental and/or emotional issues underlying your symptoms through talk therapy, then chances are you won’t reap the maximum benefits possible.

While antidepressants have their place for many individuals, they are rarely just a single bottom-line.

Similarly, you could make all the healthy lifestyle changes in the world and still be missing the key ingredient of the help of an antidepressant. Considering that bigger picture is key.

Struggling with stigma?

We have come a long way in terms of stigma around this topic, but we still have some way to go, particularly when it comes to our own personal journeys.

While we’re good at understanding, appreciating and respecting the need for others to take antidepressants, we can find it difficult to translate that into how we view them for ourselves and our own treatment options.

Often, there’s a fear that needing an antidepressant is a sign of weakness when, in fact, it’s the opposite. Reaching out for that help and making the decision to take action is one of the bravest, strongest things you will ever do for yourself.

Others fear that an antidepressant will make them feel different, or not like themselves. If anything, once that individualised treatment has been found and tweaked, taking that tablet may be exactly what is needed for you to feel normal once again, and to reclaim your quality of life, especially if you are at that point of needing more than just lifestyle adjustments.

Retrospectively, you will see the haze that you were under, the fog that was dulling everything. For those who need them, just like those who need heart or diabetes medications, antidepressants can restore order, give hope, and allow life to resume in colour and 3D once more. And wouldn’t that be amazing?

If any of the above points strike a chord, or prompt further questions for you, take the plunge and pick up the phone to schedule a conversation with your healthcare providers.

Discuss your options with your doctor, educate yourself with the help of your pharmacist, and use their expertise to make informed choices around your wellbeing and what is best for you and your health.

  Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally

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