Do You Really Need an Antidepressant?

We've all seen a massive TV ad campaign encouraging us to try drugs for depression and anxiety. Over the last ten years it seems like everyone you know from your best friend to your mother's hairdresser's interior decorator has begun popping a little pill that has changed their lives. But is medication right for you? Here are four things to consider before you begin depending on drug therapy.

Consult the right health practitioner

Many people report that the initial prescription came from their general practitioner. Your family doctor is certainly the one to see for the flu, but is she specialized in treating mental illness? Reaganne, 22, spoke to her G.P. about depression following a breakup and was asked to fill out a checklist. "The quiz was produced by a drug company," she said. "It reminded me of those quizzes in women's magazines that determine what zodiac sign your dog's veterinarian should be born under. I can't base major life decisions on a quiz." If you are experiencing the familiar symptoms like sleeping too much or too little, or you just don't enjoy activities as much as you used to, talk to a licensed clinical social worker, a psychologist or even a psychiatrist. You should not only confirm that you are clinically depressed before you try antidepressants, you should see if talk therapy will work first. Besides, if you are experiencing anxiety, you may find that you have a medical problem such as a heart murmur which can mimic the symptoms of anxiety.

SSRIs can cause mania

The most common antidepressants prescribed in the United States are SSRIs, or selective serotonin reuptake inhibitors. Everyone knows the names of these popular drugs such as Prozac, Paxil and Zoloft, but what you may not know is that these drugs can cause mania in some people or unearth an existing propensity for mania. According to William S. Appleton, M.D. in his book The New Anti Depressants and Antianxieties, "If you are taking an SSRI and you suddenly feel extraordinarily happy, your thoughts begin to race, you sleep only a couple of hours a night, you have boundless energy, you start to spend money you do not have, and you begin to engage in business activities and romantic liaisons that horrify your friends and family, then use of the antidepressant must be stopped immediately and the doctor called right away." Jason, 31, had personal experience with this side effect. "I was depressed during my divorce and custody battle and my general practitioner prescribed quite a high dosage of Paxil. I felt euphoria all the time, similar to the feeling I had when I experimented with pot in college. Without knowing I was experiencing mania I burned through my savings and even moved to another state to be with a woman I met on the internet. I basically blew my custody case, but now that I am seeing a psychiatrist I am starting to get my life back in order."

SSRI discontinuation syndrome

Eventually, unless you have a personality disorder, you are going to have to wean yourself off of the medicine. Maybe your doctor told you to, maybe you can't afford the drug, your insurance will no longer cover it or maybe, as so many patients do, you are feeling so much better you think you don't need the drug anymore and you stop taking it. As the drug leaves your body you may experience a rebound effect which ranges from simple dizzy spells all the way to depersonalization. "I stopped taking my meds when I lost my job and no longer had insurance, "said Julia, 45. "I started out being dizzy and a little depressed, but soon I was feeling as anxious and uncomfortable as I had in high school when I was going through that awkward stage. I regressed to where I didn't want to talk to anyone and could barely look people in the eye!" Dr Appleton says, "A relapse is defined as a return of symptoms during an ongoing treated episode. This happens when drug therapy is stopped too soon."

Alternatives to drug therapy

Of course, people try all kinds of methods to combat long term depression. Talk therapy works for many because it actually helps you fight maladaptive thoughts consciously. Cognitive behavioral therapist A.B. Curtiss has this to say on the subject of meds in her book Depression is a Choice: "Depression and manic depression are not diseases to be cured by drugs. They are situations to be transcended by a process change in the way we direct our thinking." You may want to know that you have tried everything before you accept the fact that you need medicine. Many people find a combination of treatments keep them feeling the best way possible. "I have been depressed and anxious since my junior year in college," said Emily, 29. "I tried counseling, massage, herbs, tai chi, yoga, moving to different cities, phases in jobs and relationships, even experimental behavioral therapy and I came to the point that I had to try an antidepressant. But I also see a therapist, I have stopped binge drinking, continued yoga and massage therapy and I no longer date or befriend fundamentally unhappy people."

You will still get anxious and depressed no matter what solution you find; that is the human condition. If you end up going on an antidepressant after all your research, don't be ashamed. It may not be forever. At least you will know that you tried other solutions first. Don't let marketing decide your treatment options.