Volume No. 18 Issue No. 2 February 2021  

  Antidepressants: do they work?

     Antidepressants have been around since the 1950s; however, despite a long history of use for mental health disorders, misunderstandings still occur.
   In the article, “A Brief History of Antidepressants,” published Jan. 7, 2010, on time.com, writer Laura Fitzpatrick said researchers discovered the first antidepressants purely by chance in the 1950s while seeking a treatment for schizophrenia.
   According to the American Psychiatric Association, depression affects an estimated one in 15 adults (6.7%) in any given year, and one in six people (16.6%) will experience depression at some time in their life. They report that depression is among the most treatable of mental health disorders; between 80 to 90% percent of people with depression eventually respond well to treatment.
   The National Alliance on Mental Illness website explains that psychiatric medications influence the brain chemicals that regulate emotions and thought patterns; oftentimes they are combined with other therapies to be the most effective.
   NAMI encourages persistence in working with one’s doctor to find the medication or combination of medications that work. A few psychiatric medications work quickly, but it is not uncommon for it to take several weeks or months to see full improvement.
   According to the site, it is not recommended to suddenly stop the medication for any reason as this can result in problems such as headaches, dizziness and nausea. Instead, consult with the prescribing doctor to discuss possible adjustments, such as tapering off one medication to start another, which allows the brain chemicals to adjust to the change.
   Dr. Mitchell Liester, a psychiatrist in Monument, Colorado, said there is a lot of misinformation surrounding antidepressants. People think their personalities will change; they will have to stay on them forever; or they’re addictive — those are just a few of the misunderstandings, he said.
   “I try to educate people to help them understand that depression is a medical condition, it’s not a personality flaw or character defect. It’s like hypertension or diabetes, and it requires medical treatment,” Liester said. Antidepressants are often the first line of treatment because it is extremely difficult to get people to make the changes that are needed when they are depressed, he said. They often feel fatigued or have little to no motivation; medication can help them get out of the hole. Studies have proven that exercise can be as helpful as an antidepressant for people with mild to moderate depression. Once they start to feel better, they can make any necessary changes to diet and lifestyle as well, he said.
   One of the toughest emotions related to depression is the feeling of hopelessness, helplessness and thoughts of never getting better, Liester said. “Depression actually changes our thinking, our attitude and our perspective on the world around us and that’s what’s so difficult about it,” he said. “It’s not just a sad mood like people think it is,” Liester said. “Depressed people think they will always feel this way and won’t get any better.” He said people have told him if they had to choose between cancer and depression, they would pick cancer because at least they had the will to keep going.
   Liester said it is especially important to educate people who are suicidal. “Suicide is often called a permanent solution to a temporary problem, but it will get better and once treated, the suicidal thoughts will go away,” he said.
   Psychiatrists look at individual symptoms and choose a medication that treats those specific issues, but there is not one antidepressant that is better than another. He said when head-to-head trials have been done, scientists found they all work about the same two-thirds of the time; some individuals just do better with one medication than another. “I’ve had two people on the same medication and one will say, ‘that’s horrible, it’s poison, it should be taken off the market; and the other will say, ‘this is amazing, I feel great, it should be in the drinking water,’ so there’s an element of trial and error,” Liester said. “The bottom line is there are many to choose from, so don’t give up.”
   He also warned that there is no DNA test to indicate which antidepressant is the best for someone. “There’s some false claims out there that genetic tests will give an indication as to what medication will work for them, but it actually only reveals how the medication is metabolized in one’s body,” Liester said. “Unfortunately, people are spending hundreds of dollars for a test that isn’t providing what is promised.”
   A recent survey reported more than 50% of Americans are currently either depressed or anxious because of COVID-19 or other ongoing stressors in the world, he said. “It’s unfortunately the new normal right now that people in our country are depressed more than not,” Liester said.
   He said the field has changed dramatically in the last 34 years since he started his practice; there are many more options, medications and treatments that are effective. “People don’t have to suffer with depression anymore, they can get help; they will have hope and joy again,” Liester said.
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