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For many people with anxiety or depression, a common barrier to treatment can be resistance to medication. They may make statements such as, “I don’t want to take antidepressants,” or “I don’t want to take medication.” Sometimes they may have tried an antidepressant medication before, and it did not work or caused unpleasant side effects.
This reluctance to try or continue taking antidepressants is understandable. Here you’ll learn more about the benefits, risks and side effects of antidepressants, so you can hopefully make a more informed decision about whether or not they may be right for you.
Understanding Side Effects of Antidepressants
As with most medications, the list of side effects can be lengthy and intimidating. Even over-the-counter medicines such as aspirin have side effects, so it’s no surprise that antidepressants’ side effects run a gamut from merely unpleasant to more concerning. Some of the major side effects of antidepressants can include nausea, fatigue, weight gain, insomnia, dry mouth, dizziness, constipation, anxiety and sleep problems.
Decreasing antidepressants gradually still can cause withdrawal symptoms to occur. These may include:
- Abnormal involuntary movements
- Blurred vision
- Memory and concentration problems
- Muscle pain and stiffness
- Panic attacks
That’s not all. When antidepressants are taken with opioids, the risk of side effects increases. These include severe and life-threatening reactions such as psychosis, hallucinations, suicidal thoughts and behaviors, homicidal thoughts, seizures, delirium and catatonia.
One of the common medications prescribed for treating depression and anxiety is SSRIs (selective serotonin reuptake inhibitors). Benzodiazepines (BZDs) are SSRIs that are often prescribed. Of note, however, is that about 15 percent of people with depression don’t respond to antidepressant treatment. Interestingly, a study at the University of Chicago and Washington University at St. Louis found a single treatment with low-dose nitrous oxide (laughing gas) was able to quickly relieve symptoms of treatment-resistant depression.
Some of the adverse side effects of BZDs include:
- Attention and concentration issues
- Slowed breathing
- Developing dependence
Benzos cause calmness and drowsiness by slowing activity in the brain. According to research, being female is a known risk factor for long-term benzo dependence. Females also have more pessimism about dose reduction, which tends to increase their risk for dependence after long-term benzo use.
Understanding Your Current State
Consider your current well-being. When doing this, take an objective account of what your life is like now. Is it sustainable the way it is? Does having depression preclude you from enjoying life fully? Is a mental health issue or diagnosed mental health disorder interfering with your relationships, job, sleep, overall health, ability to concentrate, happiness, sense of accomplishment or productivity?
The more negatives tallied when looking dispassionately at your current state, the more you’ll want to do something to overcome them. Wanting a better life is not just a dream. It can be a reality. Getting professional help, which may include taking antidepressant medication for a brief time, can help achieve that reality.
Suppose you’re plagued with the nagging question, “Should I take medication?” Instead of fretting unnecessarily, talk with a treatment professional. Find out what options exist for treating depression or anxiety, including any potential recommendations to take antidepressants. Try to keep an open mind about what can help you. While your concerns are legitimate, not knowing the facts may prevent you from alleviating issues that are causing problems.
How to Make Taking Antidepressants Better
Okay, even if you’re adamant that you don’t want to take antidepressants, your doctor and therapist may still strongly recommend that you take them. Remember that the main purpose of taking antidepressant medication is to make your life easier, less stressful and freer from debilitating depression, anxiety or another mental health disorder. If you end up grudgingly following the doctor’s recommendation, be sure to discuss your concerns upfront and have answers to all of your questions ahead of time.
Do I Need to Take Medication for Depression?
It’s also important to understand that there are going to be some adjustments necessary when taking certain antidepressants. Not every medication type or dosage works for every person. A recent study looking at attitudes toward treatment with benzodiazepines found that there’s no evidence of the effectiveness of antidepressants and BZDs for anxiety symptoms. The same researchers found that within weeks of antidepressants and BZDs, there was moderate qualitative evidence that the combo reduces severe depressive symptoms.
The doctor needs to carefully monitor what’s happening and how symptoms decrease, increase, or get worse when taking the medication. This is apart from any side effects that may occur. There’s no need to be miserable or to think you must tolerate extremely unpleasant side effects.
Here are tips that may be useful to counteract some of the common side effects of antidepressants:
- Being prepared for side effects (knowing what they are) can be helpful in itself.
- Stay in close contact with your doctor, so that side effects can be addressed promptly. This is especially important if more severe side effects appear out of nowhere, or a cluster of side effects becomes unmanageable. Adjusting the dosage may be what’s best, or even changing to a different medication.
- Exercise can help alleviate some of the side effects experienced with antidepressants.
- Some form of meditation can make certain antidepressants’ side effects less bothersome and more tolerable.
- Other therapies may ease side effects from antidepressant medication, including massage, yoga or cognitive-behavioral therapy (CBT).
- Individual and group counseling can be instrumental in overcoming or counteracting common antidepressant side effects.
- To decrease nausea, take the medication with food. Increase intake of fluids. Eat smaller meals. Talk with the doctor about a medication dosage change.
- For insomnia, take antidepressants in the morning. Avoid caffeinated food and drink, especially late in the day.
- To combat fatigue, take antidepressants at bedtime (with the doctor’s approval). A short daytime nap may also help. Avoid driving when drowsy. Walking is a good exercise that can be beneficial.
- Address dry mouth by chewing sugarless gum, brushing teeth twice a day, sipping water throughout the day and breathing through the nose instead of the mouth. Avoid caffeine, alcohol, and tobacco. Ask the doctor about a prescription for dry mouth.
- Constipated? Drink lots of water. Eat high-fiber foods. Get plenty of regular physical exercise. Take a stool softener if the problem persists.
- To deal with dizziness, get up slowly from a sitting position. Use handrails on stairs. Avoid alcohol, caffeine and tobacco. Be sure to drink plenty of fluids. Avoid driving and operating heavy machinery. Take antidepressants at bedtime with the doctor’s approval.
- Agitation, anxiety and restlessness can be alleviated with regular exercise. Also, incorporate deep-breathing techniques such as yoga and progressive muscle relaxation into a daily routine.
Will It Be a Life-Long Prescription?
Many people wonder whether they’ll have to take this medication forever. This is particularly true if someone strongly feels that “I don’t want to take antidepressants.” You don’t have to view it that way. Think of taking prescription antidepressants just for now. Who knows what innovations will come along? The nitrous oxide pilot study is one example. With millions of people suffering from major depression and anxiety, there are growing interest and momentum in finding effective, long-lasting treatments that don’t include the need to take antidepressants.
For some people, therapy may be an effective alternative to antidepressants or may allow them to take a lower dose of a prescribed antidepressant. (As always, consult a doctor about these options.) There is empirical evidence that therapy (counseling, behavioral and other types of therapeutic approaches) is extremely beneficial when someone is easing off medication.
Be kind to yourself and practice good self-care. Seek the advice of medical professionals who can give you sound guidance on potential avenues to explore regarding effective treatment. Don’t be scared off by the fear of taking medication. Know that these concerns are common. Voicing them aloud is the first step in opening a constructive dialogue that can lead to a workable and beneficial treatment plan.