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When to Take (and Not to Take) Antidepressants

A recent study found that about  one woman in three who went to a doctor’s office walked out with a prescription for an antidepressant, most without even a follow-up appointment to see how it would work. Today some 11% of American women and 5% of men are taking antidepressant medication.

The main reason these meds are so popular is that they work really well.  They resolve one of the causes of depression (chemical imbalance, most often serotonin), and relieve many of its symptoms: thinking, feeling and acting DOWN.

People with depression feel down on energy, sex drive, self-confidence and the desire to enjoy life.  They think negative thoughts about themselves, others, the world and their future.  They act down because they can’t work, sleep, eat or make love the way they’re supposed to.

Antidepressants would be much more effective if more people took them strictly as prescribed.  Since most of the bothersome side effects occur during the first 2-3 weeks, and as most of the symptom relief comes after those first 2-3 weeks, too many folks don’t give them a fair trial, and give up on them too soon.

A fair trial would be regular dosage for three or four weeks.  If the benefits are still being outweighed by the side effects, a second antidepressant should be tried for another 3-4 weeks.  But how do you know when you should take this medicine?

You should consult your primary care physician about antidepressants if you know what you need to be doing to make yourself feel better but you can’t make yourself do it.  Whe n making needed changes seems too difficult, you can level the playing field for yourself by trying medication.

Another way to tell if you need antidepressants is to give yourself the Beck Depression Inventory (Google it for a free copy of this quick 21-item test).  If your score is 14 to 19, you’d probably benefit from antidepressants.  But if your score is 20 or over, you might well be so depressed that efforts to cheer yourself up through counseling or willpower changes just won’t work without medication.

When you’re depressed, it’s a good idea to take that test (the BDI) once a week at the same time.  This not only measures your ups and downs, but the items that are elevated will also show you where you need to adjust your thinking and behavior.  Here are some signs that you are ready to cut back on your medication:

  1. When your BDI scores are consistently below 14 for 2-3 months
  2. When you are making the needed changes in your relationships, habits, and lifestyle
  3. When your losses (loved ones, health, job) have been resolved to the point you are now opening yourself to new experiences that seem likely to become fulfilling.

One final mistake people make with antidepressants is to take themselves off of them cold turkey.  Cutting antidepressants down and out should be done this way:

  1. Seek confirmation of your significant others and any professional counselor you are seeing.  These folks will make sure that the help you’ve been getting from your medication is going to be replaced by such mood lifters as lowered levels of alcohol, junk food, stress and conflict, and higher levels of appreciation, affection, inspiration, exercise, and fulfilling work to do.
  2. Consult your physician, tell him or her about the changes being made in your life from the previous paragraph, and follow doctor’s orders about exactly how fast to cut back on the medication.

Medicine can help you make significant changes in your relationships, habits, and lifestyle.  But don’t be foolish and lazy enough to think that medication alone will change your life. Antidepressants are only as helpful as the life changes they enable you to make.

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About Dr. Paul Schmidt, PhD

Dr. Paul Schmidt, PhD is a psychologist life coach with offices in Louisville and Shelbyville, KY, 502 633 2860.