I am a psychiatrist in Austin, Texas specializing in the treatment of adults, including adults with depression. Sometimes people with depression are reluctant to take an antidepressant. Common concerns include being worried that the antidepressant will have intolerable side effects. It is certainly true that antidepressants, like all medications, have many potential side effects. However, not all patients will experience adverse effects; generally only a minority of patients taking a particular agent will experience adverse effects to that drug. Some side effects, such as headache or nausea, occur early in the treatment course and tend to resolve after one to two weeks. The goal is to find an antidepressant that has minimal side effects for that person and to match any likely side effects to the symptoms the patient is experiencing. For instance, a patient who has a decreased energy level during the day may do better with an antidepressant that tends to be more activating; whereas, this may be a poor choice for someone with anxiety. Sometimes a patient may have to try a couple of medications before finding one that is a good fit. What I tell people is that you cannot tell whether any side effects that you might experience are worse than your depression until you try the medication for a month. If you do find that the side effects are intolerable, you can stop the medication. If you find the medication gives you relief from your symptoms of depression but causes side effects, we can work together to manage that side effect. But if you never try the medication, you won’t have the information you need to make an informed decision.
Another concern that I hear from patients is that they worry that taking an antidepressant will decrease their motivation to change situations in their life that they are unhappy with. I suppose that is possible, but on the other hand, the symptoms of depression often prevent people from being able to address problems in their lives. One example might be a woman who is depressed and has a boss at work who is critical and difficult to work with. During her depression, she might feel worthless and feel the boss’s criticism is accurate and that she would never be able to find another job anyway. After her depression is treated, she might feel more positive about herself and have the energy and motivation to find another job or to address her boss in a manner which improves her ability to work with him. I also recommend that people with depression utilize a combination treatment of therapy and medication because therapy can also help people start to explore and change factors in their lives that are contributing to their depression.
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Disclaimer: The information in these posts is not guaranteed to be accurate or complete. It is not meant to serve as medical advice, and your reading of it does not establish a physician-patient relationship with Dr. Cynthia Benton. If you have any questions about this information, please contact your doctor.