CLOSE
iStock
iStock

8 Common Misconceptions About Antidepressants

iStock
iStock

Think you have depression, but feeling uncomfortable about the idea of treating it with medication? Each person’s treatment plan is unique, but if you feel like your life could be improved by antidepressants, you shouldn’t let the many common myths and misconceptions surrounding their use keep you from seeking the help you need.

Mental Floss spoke with Dr. David Mischoulon, director of research at Massachusetts General Hospital's Depression Clinical and Research Program, who set the record straight on some common misconceptions about antidepressants.

1. THE MYTH: ANTIDEPRESSANTS DON'T ADDRESS THE ROOT CAUSE OF DEPRESSION.

There are multiple factors that can contribute to depression, ranging from environmental or situational components to brain biochemistry. Medication can help when the underlying cause is partly biological in nature.

“For example, there are some people who may develop depression for no apparent reason,” Dr. Mischoulon says. “There is absolutely no particular stress in their lives. There hasn’t been any misfortune of any sort. In fact, they’ll often say, ‘I’ve got a life that most of the world would envy,’ and yet they’re depressed ... Those people often respond very well to antidepressants, and in that sense, [the medicine] is getting at the root cause [of the depression], which is a biochemical imbalance in the brain.”

At the other end of the spectrum, some people “may become depressed primarily because of situational problems,” Mischoulon adds. "They may be experiencing problems in the workplace, family problems, or a divorce, things like that. Those factors can certainly contribute to depression—perhaps in combination with a proclivity to becoming depressed, or because … the stress is just so, so tremendous that the person becomes depressed as a result.”

Sometimes these individuals may not respond to antidepressants because the root cause is situational. If their situations were to improve—say, they got a better job—they might start feeling better. Therapy might also help them develop better coping skills.

“There are certain kinds of therapies that have been carefully studied in clinical trials, and for many [depression] cases, they can work very well,” Mischoulon says. “For example, cognitive behavioral therapy is one of the better studied forms; it’s been shown in some studies to be as effective as antidepressants.”

That said, research also suggests that for many people, treating depression with a combination of therapy and medication can be the best course of treatment. “The two will work synergistically," Mischoulon explains. "By combining the two you can get a better result.” (If you're thinking about beginning therapy, here's a guide to figuring out which type is best for you.)

Mental health researchers are trying to pinpoint ways to differentiate between a biochemical depression and situational depression. But as of right now, "we’re not at a point where we can use what we've learned in a clinical setting," Mischoulon says.

2. THE MYTH: ANTIDEPRESSANTS ARE "HAPPY PILLS."

“If I give an antidepressant to a healthy individual—someone who’s not depressed—they’re not going to be happier, or more cheerful” as a result of taking it, Mischoulon says. “It only works to return the mood to the patient’s normal baseline. So if you’re depressed, the antidepressant can help you get back to where you were.”

3. THE MYTH: ANTIDEPRESSANTS ARE ADDICTIVE.

Antidepressants “aren’t drugs of abuse,” Mischoulon says. They may improve your depression symptoms, which can lead to increased energy levels and an improved mood, but they won’t get you high or make you crave additional or stronger doses—all hallmarks of addiction.

However, since your body grows accustomed to the drug, you may experience withdrawal syndromes—including headaches, dizziness, nausea, and irritability—if you stop taking it abruptly, “similarly to what you might have with a recreational drug,” Mischoulon explains. If you’re thinking about discontinuing an antidepressant, check with your doctor first. He or she will likely recommend that you taper your dosage over a period of days or weeks, depending on the medication.

4. THE MYTH: ANTIDEPRESSANTS WILL PERMANENTLY ALTER YOUR PERSONALITY.

Taking the right antidepressant can slowly help a depressed person return to his or her baseline mood, making them feel and act more like “themselves." That said, Mischoulon does say that some patients on antidepressants “report being emotionally numbed, like they can’t experience normal emotions.” There aren’t many prospective or systematic studies that examine this phenomenon, but Mischoulon estimates that maybe 10 percent of the patients in his practice have reported it. It's "a relatively small minority," he adds. 

If this happens to you, don’t worry: It’s usually "not a known cause for concern,” Mischoulon says. This won’t “cause permanent damage to someone’s personality, or their capacity to feel emotions … It’s simply a matter of discontinuing the antidepressant and trying another one.”

5. THE MYTH: ANTIDEPRESSANTS ARE A SHORT-TERM FIX.

If you were successfully treated with antidepressants, you may want to speak with your doctor about continuing to take them as a preventative measure, even if you now feel fine. Research shows that experiencing just one episode of depression puts a person at a 50 percent risk for experiencing another episode, and increases their chances for future relapse.

Some doctors suggest treating conditions like major depression in the same way that you would a chronic illness—with lifelong management. “The good thing is that most antidepressants are very safe to take over the long term, so if a person had to take one indefinitely, it’s not the worst thing in the world,” Mischoulon says.

That said, if you’ve responded well to treatment and don’t have a prior history of depressive episodes, there’s a chance that you’ll be OK if you come off them under a doctor’s supervision.

6. THE MYTH: IF YOU TRY ONE ANTIDEPRESSANT AND IT DOESN'T WORK, MEDICATION ISN'T FOR YOU.

Once you begin taking an antidepressant, it can take weeks, if not months, to feel the full effects. And since there’s currently no good way to predict which antidepressant will work for any one individual, there’s always the chance that the one you’re trying may end up not being the right one for you. If this ends up being the case, you’ll have to begin the cycle anew—this time, with a different pill.

This trial-and-error process can be discouraging for some patients. Keep in mind, however, that there are more than two dozen antidepressants on the market—meaning there’s a good chance you’ll find something that alleviates your symptoms.

“There are antidepressants from different families that differ biochemically,” Mischoulon explains. “What we find is that a lot of people will take a particular type of antidepressant and it may not work, and then they’ll try an antidepressant from another family, and that one will work better for them.”

7. THE MYTH: ALL ANTIDEPRESSANTS HAVE AWFUL, LONG-LASTING SIDE EFFECTS.

From insomnia to blurred vision to fatigue, the long checklist of potential side effects included in your medicine packet can be intimidating, if not downright frightening. Don’t worry: The likelihood that you’ll experience every single one of them is slim, Mischoulon says. Most people only encounter one or two; common side effects include upset stomach, headaches, weight gain, and sedation, but side effects vary from one medication to the next. (For example, on average, Mischoulon estimates that about 15 percent of his patients report weight gain.)

These side effects are sometimes short-term, popping up during the initial stages of treatment and tapering off as the patient’s body gets used to the medication. Still, in other cases, they persist. In the latter instance, you may want to talk with your doctor about switching to another medication or the best way to treat your side effects.

8. THE MYTH: DOCTORS OVERTREAT AMERICANS FOR DEPRESSION.

According to the National Center for Health Statistics, antidepressants were the third most commonly prescribed drug taken by Americans of all ages between 2005 and 2008. (Though not all patients take antidepressants for depression and anxiety; they can also be used to treat other issues, including insomnia and chronic pain.) Are these medications overprescribed to patients?

“I think in certain circles they may be overprescribed, and in others they may be underprescribed,” Mischoulon says. “What we do know is that there are a lot of people with depression out there who are not being adequately treated … This could apply to antidepressants, as well as psychotherapy. A lot of people are not getting treatment at all who should be getting some treatment.”

People with depression don’t receive care for a variety of reasons, Mischoulon points out: Stigma, a lack of education, limited economic resources, or not living near a health care professional for treatment are just a few examples. That said, there can be dire repercussions for those who don't seek treatment, including suicide and worsened outcomes for concurrent medical conditions, like cardiovascular disease.

If you think you have depression and have the means to see a doctor, "get a professional evaluation," Mischoulon advises. "Don’t try to self-diagnose. Don’t try to treat it yourself with over-the-counter supplements. Speak to your primary care doctor, and maybe speak to a psychiatrist ... If not treated properly, depression can have devastating consequences."

nextArticle.image_alt|e
iStock
arrow
science
Here's What Actually Happens When You're Electrocuted
iStock
iStock

Benjamin Franklin was a genius, but not so smart when it came to safely handling electricity, according to legend. As SciShow explains in its latest video, varying degrees of electric current passing through the body can result in burns, seizures, cessation of breathing, and even a stopped heart. Our skin is pretty good at resisting electric current, but its protective properties are diminished when it gets wet—so if Franklin actually conducted his famous kite-and-key experiment in the pouring rain, he was essentially flirting with death.

That's right, death: Had Franklin actually been electrocuted, he wouldn't have had only sparks radiating from his body and fried hair. The difference between experiencing an electric shock and an electrocution depends on the amount of current involved, the voltage (the difference in the electrical potential that's driving the current), and your body's resistance to the current. Once the line is crossed, the fallout isn't pretty, which you can thankfully learn about secondhand by watching the video below.

nextArticle.image_alt|e
iStock
arrow
Big Questions
Does Einstein's Theory of Relativity Imply That Interstellar Space Travel is Impossible?
iStock
iStock

Does Einstein's theory of relativity imply that interstellar space travel is impossible?

Paul Mainwood:

The opposite. It makes interstellar travel possible—or at least possible within human lifetimes.

The reason is acceleration. Humans are fairly puny creatures, and we can’t stand much acceleration. Impose much more than 1 g of acceleration onto a human for an extended period of time, and we will experience all kinds of health problems. (Impose much more than 10 g and these health problems will include immediate unconsciousness and a rapid death.)

To travel anywhere significant, we need to accelerate up to your travel speed, and then decelerate again at the other end. If we’re limited to, say, 1.5 g for extended periods, then in a non-relativistic, Newtonian world, this gives us a major problem: Everyone’s going to die before we get there. The only way of getting the time down is to apply stronger accelerations, so we need to send robots, or at least something much tougher than we delicate bags of mostly water.

But relativity helps a lot. As soon as we get anywhere near the speed of light, then the local time on the spaceship dilates, and we can get to places in much less (spaceship) time than it would take in a Newtonian universe. (Or, looking at it from the point of view of someone on the spaceship: they will see the distances contract as they accelerate up to near light-speed—the effect is the same, they will get there quicker.)

Here’s a quick table I knocked together on the assumption that we can’t accelerate any faster than 1.5 g. We accelerate up at that rate for half the journey, and then decelerate at the same rate in the second half to stop just beside wherever we are visiting.

You can see that to get to destinations much beyond 50 light years away, we are receiving massive advantages from relativity. And beyond 1000 light years, it’s only thanks to relativistic effects that we’re getting there within a human lifetime.

Indeed, if we continue the table, we’ll find that we can get across the entire visible universe (47 billion light-years or so) within a human lifetime (28 years or so) by exploiting relativistic effects.

So, by using relativity, it seems we can get anywhere we like!

Well ... not quite.

Two problems.

First, the effect is only available to the travelers. The Earth times will be much much longer. (Rough rule to obtain the Earth-time for a return journey [is to] double the number of light years in the table and add 0.25 to get the time in years). So if they return, they will find many thousand years have elapsed on earth: their families will live and die without them. So, even we did send explorers, we on Earth would never find out what they had discovered. Though perhaps for some explorers, even this would be a positive: “Take a trip to Betelgeuse! For only an 18 year round-trip, you get an interstellar adventure and a bonus: time-travel to 1300 years in the Earth’s future!”

Second, a more immediate and practical problem: The amount of energy it takes to accelerate something up to the relativistic speeds we are using here is—quite literally—astronomical. Taking the journey to the Crab Nebula as an example, we’d need to provide about 7 x 1020 J of kinetic energy per kilogram of spaceship to get up to the top speed we’re using.

That is a lot. But it’s available: the Sun puts out 3X1026 W, so in theory, you’d only need a few seconds of Solar output (plus a Dyson Sphere) to collect enough energy to get a reasonably sized ship up to that speed. This also assumes you can transfer this energy to the ship without increasing its mass: e.g., via a laser anchored to a large planet or star; if our ship needs to carry its chemical or matter/anti-matter fuel and accelerate that too, then you run into the “tyranny of the rocket equation” and we’re lost. Many orders of magnitude more fuel will be needed.

But I’m just going to airily treat all that as an engineering issue (albeit one far beyond anything we can attack with currently imaginable technology). Assuming we can get our spaceships up to those speeds, we can see how relativity helps interstellar travel. Counter-intuitive, but true.

This post originally appeared on Quora. Click here to view.

SECTIONS

arrow
LIVE SMARTER
More from mental floss studios