How Do Antidepressants Work, and When Are They Not Enough?

woman holding anti-depressants

By Bobby Shriver

Depression has become a widespread condition in America today. Consequently, more and more people are being prescribed antidepressant medications. In fact, the number of antidepressant prescriptions in the US rose 18.6% in 2020, according to FierceHealthcare.com.

With the rise of depression medications, depression and its treatment are increasingly under the microscope. If you or someone you know struggles with depression, it’s easy to wrestle with a number of questions. Exactly how do antidepressants work? How do I know if my antidepressants are working properly? Should I use my medication in conjunction with other efforts to overcome depression?

To answer these questions, it’s important to understand how depression is treated, the different types of antidepressants available, and how to determine what treatment is right for you or your loved one.

How Do Antidepressants Work

When you’re struggling with depression, your brain’s available neurotransmitters are drastically reduced. This is where antidepressants come in.

Your brain contains the chemical molecules dopamine, serotonin, and norepinephrine. These molecules, called neurotransmitters, help regulate your mood, motivation, pleasure, decision-making, social behavior, and more. Yet when you’re struggling with depression, your brain’s available neurotransmitters are drastically reduced.

This is where antidepressants come in. Antidepressants increase the presence of neurotransmitters by helping your brain’s cells form new connections with these molecules. There are a number of different types of antidepressants that boost the presence of neurotransmitters, including:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)

More commonly prescribed, SSRIs prevent the reabsorption of serotonin into the body, keeping it active in the brain. The well-known antidepressants Paxil, Prozac, and Zoloft are SSRIs.

  • Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

Functioning similarly to SSRIs, SNRIs prevent reabsorption of both serotonin and norepinephrine. Typical prescriptions include Cymbalta or Effexor.

  • Monoamine Oxidase Inhibitors (MAOIs)

First discovered in the 1950s, MAOIs such as Serzone and Marplan block the effects of an enzyme called monoamine oxidase, so that neurotransmitters can function properly.

  • Atypical Antidepressants

Broadly described, these newer, uncategorized medications help neurotransmitters in unique ways. For example, Wellbutrin is a dopamine uptake inhibitor that both reduces depression and helps with smoking cessation.

Finding the Right Antidepressant for You

With so many antidepressant medications out there, it can be intimidating to know where to start. That’s why it’s key to work with a medical professional to find a prescription that works best for you. Your physician will consider a number of factors, including your specific symptoms, current medications, health conditions, and family medical history.

anti-depressantsAntidepressants can also have various side effects, so your physician will assess which of these could impact you the most when prescribing. And your tolerance to certain side effects may require you to change your antidepressant as well.

Once you have your prescription, you may be thinking, How do I know if my antidepressants are working? As you begin your antidepressant regimen, it’s important to be patient. You may see improvement in your symptoms after a few weeks, but it can sometimes take at least six weeks or more for the medication to become fully effective, according to the Mayo Clinic.

After this time period, you should start seeing results, such as feeling less depressed, having more energy, enjoying better sleep, and performing daily activities more easily. If you’ve been experiencing side effects from your medication, they should gradually improve over time, which is another sign your medication is working.

Antidepressants Not Working? Don’t Stop Taking Them … Yet 

If you aren’t seeing improvements, it could be tempting to stop your medication altogether — but don’t. Some antidepressants can cause significant withdrawal symptoms and may even increase your depression if stopped immediately. These withdrawal symptoms do not indicate you’re addicted to your medication, however; and despite popular misconceptions, they should not be compared to opioid addiction withdrawal, advises Psychiatric Times. Continue your dosage and share your experience with your doctor, who may want you to slowly taper your dose while you find better alternatives.

What to Do for Depression When Antidepressants are Not Enough

If you’re several weeks into your antidepressant medication and it doesn’t seem to be working, don’t lose heart. It can take time to find the medication that works best. Your doctor may even advise adding a second antidepressant on top of your current prescription, as a combination of medications can sometimes work better.

As you are exploring options, it’s good to know that it’s also possible to overcome your depression without medication. Some psychiatrists have started to recommend non-pharmaceutical treatments, reports The New York Times. Instead, they suggest paying attention to sleep habits, diet and exercise, and other behavioral changes.

VeryWellMind.com provides a number of alternative tactics for fighting depression without medication, including:

  • Getting better sleep
  • Reducing caffeine intake
  • Managing stress
  • Exercising
  • Joining a support group
  • Meditating

Overcoming depression is a process, but you can do it

Your doctor may even recommend a combination of psychotherapy and/or any of the above tactics in conjunction with a prescription antidepressant if your medication alone isn’t enough. Keeping this in mind, it’s clear you have a number of possibilities to find what fits your needs. Overcoming depression is a process, but you can do it.

Bournewood Is Here for Those Battling Depression

For anyone struggling with depression or other mental health issues, we at Bournewood Health Systems are here to help. Specializing in individualized care in a highly structured environment, our compassionate, expert team helps patients overcome the challenges they’re facing. Contact us today to learn more about the journey of hope and recovery that Bournewood can offer.