Are Antidepressants the Right Choice for Me?

The decision about whether or not to take antidepressants is one that many people find understandably complex. It tends to happen in a ten-minute GP appointment, under conditions of distress, without much opportunity for the kind of considered thinking that the question actually requires.

This post is not a substitute for medical advice, and it is not going to tell you what to decide. It offers a framework for thinking about things carefully.

 

What antidepressants can offer

The evidence base for people with moderate to severe depression using antidepressants (particularly SSRIs) is quite solid. They may experience a reduction in the intensity of depressive symptoms (the flatness, inability to feel pleasure, physical heaviness, and hopelessness) to a degree that makes it possible for them to: function, engage in therapy, everyday life, and begin to find a way forward. For some people living with severe depression, they can be life-changing.

What antidepressants cannot offer

Antidepressants do not address the underlying causes of depression. They work on neurochemistry rather than changing relational patterns, life circumstances, personal history, or ways of thinking that contribute to the depression in the first place. For many people, this means that coming off antidepressants without also addressing those underlying factors tends to result in a return of symptoms.

For many, antidepressants are most usefully understood as a support that may help to create conditions in which other work (therapeutic, relational, or practical) becomes possible, rather than as a solution in themselves.

 

The side effects are worth taking seriously

The side effects of antidepressants are important to consider. Common side effects include nausea, disrupted sleep, sexual dysfunction (including reduced libido and difficulty reaching orgasm), emotional numbness, weight changes, and in some people, an initial increase in anxiety before any improvement is felt.

Some of these side effects resolve over time and some may not. Some people find that the side effects are significant enough to affect their quality of life in ways that outweigh the benefits of the medication, others are able to manage them. This is useful information worth monitoring carefully and feeding back to the prescribing GP or psychiatrist rather than simply tolerating side effects.

 

The decision is yours to make

What tends to get lost in the conversation about antidepressants is that it really is a decision for you to make. The decision involves taking time to weigh up the severity of your current symptoms, the likely benefits of medication for your particular circumstances, the possible side effects, your own values and preferences, and what else is available to you in terms of support.

Some people try antidepressants and find them helpful. Others try them and find the side effects intolerable. Another group of people find that therapy alone is sufficient. Others still find benefit in both. There is no singular 'one size fits all' approach.

What therapy can offer

If you are in the process of thinking through whether or not to consider medication, therapy can offer a helpful space to explore your decision-making. Therapy can also offer a safe space to unpack your low mood or depression, helping you to do the deep work to improve your mood.

Therapy is about helping you to think carefully about what you actually need rather than steering you towards or away from medication.

If you are currently experiencing low mood or depression and you are considering different treatment options, and would appreciate a safe place to explore, you are welcome to be in touch.

Dr Erin Reid is a counselling psychologist offering online therapy to individuals, couples, adolescents, and families across the UK and internationally, and 'Walk and Talk' therapy in Northwest London green spaces. Visit drerinreid.com to find out more.