> For these reasons I am completely shit-scared of them. I see them as my option of last resort but increasingly I feel my options running out.
I was in the same boat.
Don't listen to the haters. Anti-depressants are amazing. Most of the people who 'cured' their depression through some kind of cheap trick turn out to have been self-diagnosed.
Anti-depressants, if dosed and chosen properly, have basically no side effects. The only change is you get to experience life like neurotypical people. So like, exercise is fun, not a form of torture. Emotions are OK, not the harbringers of the apocalypse.
Living with depression is awful, and it almost never goes away. It's also extremely dangerous. Look at the stats: depression is a dangerous medical condition. Anybody telling you to take some herb or read a book is on the level of the people who prescribe smoothies to cancer patients. Get medical advice. Take drugs if they are prescribed. Depression massively increases your risk of death from all causes. Anti-depressants have like, a slight chance of causing dry skin.
This isn’t an accurate description of the possible side-effects. Anti-depressants can cause meaningful side-effects including changes to appetite, difficulty regulating body temperature, nausea, changes to sleep, and akathisia. They are also very, very not fun to quit abruptly if you run into an intolerable side-effect. That said, nothing that you said about depression is wrong and the effects of untreated depression can be far worse than the side-effects of anti-depressants. It can just be hard for people to tell what is normal and what is abnormal and potentially caused by their medication, so they should be informed so that they can switch medication if they run into side-effects. (And know if their doctor is not providing them with good information.)
Yeah, re-reading my post, I probably should have expanded on the 'if dosed and chosen properly' part. Obviously, if you take the wrong dose, or have an adverse reaction, it's going to not very fun. I recommend talking to a psychiatrist.
That said, my first go-around with anti-depressants was a hugely overdosed prescription of venlafaxine from an overenthusiastic doctor, which is pretty side-effect-tastic, so my eyes were rolling out of my head and I was falling off chairs for a week and it was still far superior to being depressed.
Not taking anti-depressants because you're worrying about the side effects is like not wearing your motorcycle helmet because there might be a scorpion in it. The risk of dying from depression is really high. The risk of suffering from anti-depressants is fairly remote.
Granted, I’m bipolar, but every person I know in my online support group has had significant side-effects from antidepressants. As well as a few friends with chronic depression.
Antipsychotics are even worse but I’ll take the side-effects over psychosis and paranoia any day.
For the first several months of drugs I had zero sex drive. I talked to the doctor about it and we both agreed that this was 100% tolerable compared to how I’d been without medication. Also that if my opinion on the matter changed, there were other options. Fortunately that side effect eased on its own.
I tried a whole host of anti-depressants including several SSRIs and an SNRI and all gave me many horrible side effects. At times they were necessary evils, but right now I'm doing pretty well on a low dose of gabapentin. In particular, they tended to both make me sleepy during the day and dramatically reduced the quality of my sleep at night. I also ended up getting tremors and RLS. In the end, I think most of these symptoms were due to the medications decreasing the effective amount of dopamine in my brain (they increase seratonin, but due to how seratonin and dopamine interact, this can decrease the effect of dopamine in the brain; they really need to be in balance with one another).
I also take methylphenidate (Ritalin) for ADHD and it is MUCH easier to stop stimulant medication in my experience compared to anti-depressants. And while stimulants affect sleep, I found the SSRIs to be much worse in this regard since they made me sleep poorly regardless of when I took the SSRI unless I skipped a day of the SSRI (and I was on the lowest possible dose).
Not only do these medications have side effects, they have severe side effects, at least for some people.
Depends on how you rate side effects. My experience of depression was feeling so physically awful I wanted to die, just to make it stop. In comparison, even the 'extreme' side effects from rapid anti-depressant withdrawal (shocks, vomiting, dizziness, etc) are very mild.
I get that's not everybody's experience. However, my feeling is that if you shop around until you can get the right dose and the right meds, the only side effect pain is when you start, and when you stop or draw down your dose.
The real danger of starting meds is that it can give a severely depressed person the motivation and wherewithal to commit suicide, so I do think it's worth starting them in a setting where you're not going to be alone. Still, I'd say that's less a 'side effect', and more just an effect of having severe depression and suddenly not feeling so debilitated that you can't do anything about it.
In general, I just find the conversation around anti-depressants completely unhelpful and baffling. People focus on the extremely long-tail side effects, and ignore the massive bump in the bellcurve that is a depressed person either committing suicide, or just living a totally miserable life until they die from some substance abuse problem. People who are diagnosed with depression do not live good lives without medication. The statistics for life expectancy, etc, are just awful (it's worse with stuff like schizophrenia or bipolar). So all the stuff about antidepressants making you fat or whatever is just totally irrelevant.
I was averse to anti-depressants as well. Ended up depressed and started self-medicating myself for a few years with weed and alcohol. Finally gave in and started taking the minimum dose of Celexa and, holy fuck, do I wish I had started taking them sooner. They changed my life. I took them for about 7 years and then went off them when I didn't need them anymore. Side effects were very minimal. Dampened sexual pleasure slightly. But it also made me more effective at work and better to get things done in my life.
My advice is try it. Talk to a psychiatrist and go on a minimal dose for a few months. Get therapy while you're going. If it doesn't work, it doesn't work. But it really could change your life.
> Anti-depressants, if dosed and chosen properly, have basically no side effects
WTF is that bullshit ?
SSRIs destroy libido and possibly permanently (see r/pssd)
MAOIs have many side effects
NRIs are not effective
NDRIs can cause tinnitus.
Stims are cardiotoxic and usually not prescribed for depression.
TCAs are not an action mechanism and therefore fall in the above categories.
Atypical mechanisms are not better either.
The only ones with low side effects either cause some sedation (mirtazapine, agomelatine) or have dubious effectiveness.
The only one that stands out is moclobemide and maybe bifemelane. The latter is only available in japan. The former has low efficacy.
hence for someone that don't want side effects, only moclobemide make sense, or ultra atypical stuff that has probably low efficacy. One of the only atypical that might be potent is SAM-e but who wants to play with his DNA methylation ?
9 mebc is phototoxic unfortunately as it is very promising otherwise.
edit: it's true though that testosterone is apparently as effective as SSRIs and with less side effects.
What should be said though is that there are some great anxiolytic out there, it's just that no one knows them, e.g opipramol, emoxypine, etifoxine
This is the reason why some people suggest not to listening to any comments. A lot of stuff here are factually incorrect:
1) MAOIs are safe, and Parnate specifically is extremely effective. However, requires a special diet to adhere.
2) Stimulants ARE prescribed very frequently to augment antidepressants in difficult cases, especially in people with serious illness.
3) Moclobemide has every effect of an MAOI in effective dosages, including diet restriction. There are no effective drugs without side effects. Moclobemide is not thought to be particularly effective(mostly because on-label dosage is far too low), there is a reason why it's used infrequently.
4) Etifoxine might be great for some, but it has significant risks of liver injury. There is a reason why Valium is still one of the most common anxiolytics prescribed worldwide.
Dangerous advice. Anti-depressants are band-aid solutions. Depression isn't an imbalance of "chemicals", it has been marketed that way for decades to sell pills.
As soon as you are off them, you will likely relapse back into depression. While it can help someone that is in immediate risk, it does not solve the core issue of what depression is which requires a holistic, non-conventional view that Western medicine shuns, and is doomed to never address.
Stop treating it like a medical issue and it will open doors. There's a reason Western society is riddled with drug abuses, addiction, mental health issues while other societies is riddled with war, poverty, and diseases.
Everyone experiences depression differently. SSRIs made a tremendous difference to me and my mom where therapy and various other treatments did not.
Please be careful; this attitude places the blame on the person experiencing depression, and feeling guilty about being depressed is a vicious cycle that can have catastrophic effects.
There are some for whom depression is a product of their environment. For some of those, a "tough love" approach may work. But there are also those for whom depression is a physical condition that requires medical treatment
I'm glad it is working for you but my point is that because SSRI and Western medicine largely addresses the observed biomechanical process, it is never going to be a complete solution, and hence I use the term band-aid. Addressing why through therapy can work but obviously if that was true we wouldn't need SSRIs in the first place. My point was that the Western approach to mental health has largely been the opposite of holistic and trauma-phobic. How do we know the wounds heal with SSRI and whatever popular politically correct therapy methodology is approved by academics at the time?
I did not put blame the person experiencing depression, like OP described, he finds SSRI questionable and is open to be without it and he is justified in doing so. He is completely in his right to question and trust his intuition by seeking second advice on here, most of which I'm appalled to say reads more like logical, academic explanations.
I simply described an alternative that has been increasingly viewed positively by the scientific community lately and there is nothing in that suggests I am guilt tripping them for being depressed.
Coming from SSRIs, I can tell you that the alternative I suggested that has already been downvoted into oblivion created a lasting change and it is consistent with other people who have previously been exposed to SSRI.
If depression was the product of their environment then there really is no need for any SSRI, the external situation can be changed. Doctors would be prescribing plane tickets to Bangkok but instead they hand you out pills. It does not appear to be what OP is describing and your argument is shaky at best.
Finally I will add, go ahead and try SSRI but it is not something you go on and off on without paying penalties for it. You don't know what you will be like weeks, months, years after it. You don't know what habits, lasting side effects you might develop during and after. It's not the job of the drug to know or care, it does what it is described as.
Just remember at the end of the day, your doctor is more than happy to prescribe you whatever anti-depressants sales rep incentivize them to. It's not his job to care nor is he is trained to by profession.
Usually when you change your environment ("tickets to Bangkok" as you say) the depression comes along with you.
If you have a specific stressor like a horrible job or abusive family member, leaving that situation can vastly improve your mental health. But otherwise, just flying somewhere else won't do much.
> Depression isn't an imbalance of "chemicals", it has been marketed that way for decades to sell pills
Medical professionals have been finding that in cases of clinic chronic depression, the patients brain doesn't produce nearly enough endorphins compared to others. Also, antidepressants are from a time where we didn't yet produce problems to sell the solution and they have helped millions of patients.
I was in the same boat.
Don't listen to the haters. Anti-depressants are amazing. Most of the people who 'cured' their depression through some kind of cheap trick turn out to have been self-diagnosed.
Anti-depressants, if dosed and chosen properly, have basically no side effects. The only change is you get to experience life like neurotypical people. So like, exercise is fun, not a form of torture. Emotions are OK, not the harbringers of the apocalypse.
Living with depression is awful, and it almost never goes away. It's also extremely dangerous. Look at the stats: depression is a dangerous medical condition. Anybody telling you to take some herb or read a book is on the level of the people who prescribe smoothies to cancer patients. Get medical advice. Take drugs if they are prescribed. Depression massively increases your risk of death from all causes. Anti-depressants have like, a slight chance of causing dry skin.