Depression: Getting Started with Getting Better

Depression: Getting Started with Getting Better.

Diane Skolka, PMHNP, Atlantic General Behavioral Health

Depression has many causes and talking to a mental health professional can help you identify factors causing and worsening depression. If your healthcare provider suggests taking an antidepressant medicine, you may have questions—and there's nothing wrong with that. After all, the more you know about your medicines, the more likely you may be to use them in a way that's safe and effective. Your provider is a great resource to turn to for answers. But in the meantime, here's what you should know about a few of the questions that might be on your mind:

How will my doctor decide which antidepressant to prescribe? Several types of antidepressants are available, and they work by regulating certain brain chemicals that affect your mood, such as serotonin, norepinephrine and dopamine. Based on your symptoms, health history, age and other medications, your doctor will recommend a medicine to start with based on your symptoms and response.

When will my medicine start working? Antidepressants can take time to build up in your system. Some people might begin to feel better as soon as one week after starting their medicine. But you may not feel the full effects until 8 to 12 weeks later. If you take your medicine for several weeks and you don't think it's helping, let your provider know. He/she may change the dose of your medicine—or suggest adding or switching to a different antidepressant.

What about side effects? All medicines can have side effects, and antidepressants are no exception. Some side effects are the body adjusting to the medication and can be helped by taking the medication with food or adjusting when it is taken. Ask your provider what problems to watch for—and what to do if you notice any of them. The good news is that side effects often ease up after a few weeks. If your antidepressant causes too many side effects, such as worsening depression, call your provider who may suggest a medicine that causes fewer problems. Common side effects of antidepressants include:

• Nausea and vomiting.
• Weight gain.
• Diarrhea.
• Trouble sleeping.
• Sexual problems.

But antidepressants can also have more serious risks. Reach out to your doctor if you have panic attacks or experience angry or aggressive behaviors. And call your provider or 911 right away if you have thoughts of hurting yourself or others.

How long will I need to take it for? Some people only need antidepressants for a short time. Others may need to take them indefinitely. But in either case, don't stop taking your medicine without talking to your provider first—even if you feel better. If you stop taking your medicine too early, your depression could return. Stopping suddenly could also cause unpleasant side effects, and most antidepressants should be tapered.

Antidepressants are not habit-forming, so you can't get addicted to them. But if you quit all at once—as opposed to gradually cutting back with your provider's help—you could have withdrawal symptoms. For instance, you could feel anxious or angry.

What other treatments might help? For many people with moderate to severe depression, combining medicines with psychotherapy is often the approach that works best. Your provider can help you find a mental health therapist if needed. In addition, focusing on healthy habits may lift mood. That includes being active, getting enough rest, sleep, following a healthy diet, and avoiding drugs and alcohol. Be sure to keep following your medication and therapy schedule even when you feel your best. The most important thing to keep in mind is this: You don't have to live with depression. Talk with your provider about a treatment plan that's right for you.