You’ve probably heard, seen, or read about people taking medications to treat depression. You might not realize the difference between antidepressants purchased at a store and those recommended by a doctor. The common misconception is that “store-based” pills – also known as over-the-counter (OTC) medicines – should be used instead of antidepressants prescribed by a medical professional. This article will discuss the differences between short-term depression medication and long-term depression medication.
One of the things people learn when they take antidepressants is that, while it doesn’t do much for their depression, it does make them feel better. This has led some people to dismiss the pills as a placebo. But they don’t dismiss them because they want their money’s worth, or because they believe the pills are harmless, or because they believe the pills are unimportant. They don’t believe they’re depressed; therefore, they ignore them.
Here’s the problem. Very few people know what depression is. When people say “I feel depressed,” they usually talk about something very specific: sad, unmotivated, anxious, or angry. Most people know the difference between being sad and being depressed, and when those feelings are the result of a legitimate problem, they treat it. But few people understand depression.
Depression is a monument, not a flaw. Depression is a monument, not a flaw. Our brains evolved to deal with adversity, so depressive symptoms are a direct product of that evolution. If we didn’t experience adversity, we wouldn’t need the symptoms of depression. The way our brains evolved to deal with adversity is by making us feel sad, not wanting to do anything, not wanting to see anyone, and not wanting to live.
Because depression is a feature, not a flaw, doctors usually treat depression by getting rid of it. But you can’t get rid of it. When you take antidepressants, your brain learns to stop making those symptoms of depression. However, you will be unable to eliminate it. Because depression is a feature, they can’t get rid of it.
What are the threats of using antidepressants for a limited time?
A period of one week to one month is cited as “short term.” (For convenience, I will call it “Meds” rather than “depression medication.”)
The term “long-term” cites the fact that the therapy will be taken indefinitely. (For convenience, I will call it “depression medication” rather than “long-term depression medication.”)
Short-term adverse effects are minor, comparable to depressive symptoms, while long-term side effects are far more harmful.
However, short-term depression medication does have its risks.
1. Short-term depression medication often causes people to become dependent on it.
2. Short-term depression medication causes a person to feel much worse for about a month due to the drug wearing off.
3. Short-term depression medication, without active intervention, can lead to a relapse of depression.
4. People on short-term depression medication often attend therapy sessions, and this helps, but therapy alone is not a long-term solution.
5. Short-term depression medication often causes a person to abuse other substances, including alcohol.
The short-term drugs do work by putting up a shield against depression — but they don’t offer much beyond that. They may not help much with sleep, and they are not much help for thinking clearly.
Long-term medications are used to treat other things — like bipolar disorder, schizophrenia, and Alzheimer’s. They work by changing the way the brain works.
Short-term medications are more effective for treating depression brought on by a stressful event, such as the death of a loved one. Long-term medications, on the other hand, work better in the long run.
Depression is a real problem. It kills people. And It kills them much more by interfering with their work. Depressed employees are twice as likely to be fired.
So there is real value in developing new medications to treat depression. But before we start spending billions of dollars, we should ask what the side effects might be.
One side effect is short-term depression itself. I’ve heard this described as a car with a flat tire. The tire blows out as you press down on the gas pedal, and the car is stuck in first gear.
Weight gain is another negative effect. The antidepressants feel so good that they make you eat more. And, of course, if you don’t eat enough, your depression will worsen.
A third side effect is the “anticipatory nausea” that is often associated with chemotherapy. But perhaps the biggest side effect is suicide. Although antidepressant medications do not cause suicide, they raise the risk of suicide in people who already have the problem.
So there are real risks, not just to the people who take the drugs, but to society. Besides, there is no substitute for changing the way the brain works.
For most people, antidepressants are only a temporary solution. Many people get better on them, but after a while, the antidepressant stops working. Some psychiatrists say that after a year or two, you should switch to a different antidepressant, but, as we’ll see, that’s not always true.
Some people improve for the rest of their lives while on antidepressants, but the average is roughly five years. Most people will need to switch antidepressants after that. And switching to a different antidepressant isn’t always easy.
The problem is that antidepressants affect everybody differently. Some people get better right away, and some take longer. Some people get better on one antidepressant but not on another. Some people do better on one antidepressant, but not after another.
Suppose you were taking an antidepressant that worked well for you for about a year. But then you think to yourself, “This antidepressant bothers me. I want to try something different.” Let’s say that after a year, you decided to try a different antidepressant, but you felt lousy and went back to the original antidepressant. You thought the first antidepressant wasn’t working; it turned out to be the antidepressant that worked best for you.
Suppose you were taking an antidepressant that worked well for you for about a year. But then you think, “I don’t like this antidepressant. I want to try a different one.” Let’s say that after a year, you decided to try a different antidepressant, but you felt lousy and went back to the original antidepressant. You thought the first antidepressant wasn’t working; it turned out to be the antidepressant that worked best for you.
The problem is, sometimes antidepressants work for a while and then stop working. When this happens, your doctor may recommend switching to a different antidepressant, which may or may not work as well for you as the first one did.
Depression is a chronic, not a fatal, illness. That means you’ll have to deal with it indefinitely. Medications for depression have to be taken long-term to be effective, but any long-term medication has side effects. When you are depressed, the side effects can seem worse than the depression, so you might think that taking medication to treat depression is doing more harm than good—but that’s just what your depression wants you to think.
There is an interesting problem with depression, however. Most people with depression get relief from medication, but for a minority, the relief only lasts a short time. So, although taking antidepressants does help some people, it also has the perverse effect of making depression worse.
For these people, antidepressants are not just ineffective: they are harmful. If depression is like a broken leg, then these medications are the equivalent of putting a cast on it and then yanking it off. The leg, instead of being fixed, is twisted.
The solution to this problem is obvious: don’t use medications to treat depression that you can’t live with. But people who are not depressed can have a hard time grasping how bleak life can be for someone who can’t function on a day-to-day level.
Read our series of mental health articles here
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