Words Lim Teck Choon

All About Antidepressants 

Wait… medications?

Yes, sometimes medications are helpful in overcoming moderate-to-severe depression. Dr Amer explains that these medications, called antidepressants, are prescribed by psychiatrists, who are medical doctors specializing in mental healthcare or psychiatry.

Malaysia Has Good Psychiatric Care

Some of us may not know this, but Malaysia actually offers some of the best psychiatric care in this region. Dr Amer points out that many of the commonly prescribed and effective antidepressants used worldwide are available in Malaysia. Therefore, people with depression can find a good level of medical care in both government and private hospitals. It is only a sad kind of irony that awareness of both depression and its treatment is not widespread enough, causing a number of people with depression to either deliberately or unknowingly miss out on getting treatment.

Thus, if you suspect that you have depression or you believe someone close to you has this condition, Dr Amer gently recommends that you seek appropriate advice and help from a qualified mental health professional. The earlier the treatment, the better are the chances of recovery.

5 Things to Know about Antidepressants

1. Dr Amer stresses that antidepressants are not the be all and end all of depression management. They work to reduce the symptoms of depression instead of curing the condition, and are only prescribed when necessary. Some people with depression may be able to overcome it without any need of medication at all.
2. It may take a couple of weeks before you see the beneficial effects of the antidepressant you are taking. If you believe that you are not getting better even after taking the medication, don’t be too quick to assume that it does not work. Instead, talk to your psychiatrist about your options.
3. It is, however, possible that certain antidepressants don’t work on you. The psychiatrist will prescribe another type after he or she has performed the necessary evaluation to confirm that your current medication is ineffective.
4. Take your medications based on the recommended dosage and frequency, and do not stop without consulting your psychiatrist first. Some people stop on their own when they believe that they are getting better, and as a result, their depression comes back, sometimes more severely than before.
5. Avoid drinking alcohol or taking illegal drugs while you are on medication. Some people believe that the ‘high’ from alcohol or drugs helps them feel better, but research has shown that these substances actually negate the benefits of your medications and can even worsen your depression.

How Antidepressants Work

There are different types of antidepressants available, and each type has its own unique ways of reducing the symptoms of depression. Generally, however, they all work by influencing the way the brain works.

Our brain cells, or neurons, form a closely connected network called the brain circuit. All information is passed from one neuron to another, carried by substances called neurotransmitters. There are many different types of neurotransmitters, and some of them carry information that affect our mood – for example, serotonin, dopamine and norepinephrine. 

Generally, antidepressants help reduce the symptoms of depression by interrupting the transmission of specific neurotransmitters that trigger a depressive mood. Some work on a single neurotransmitter, while others may work on two or more.

The type of antidepressants prescribed depends on the symptoms and severity of your depression, other health conditions already present and whether you are pregnant or breastfeeding. Sometimes, a psychiatrist may prescribe a combination of two antidepressants for enhanced beneficial effects. If the need arises, additional medications such as mood stabilizers, anti-anxiety medications or antipsychotic medications may also be prescribed to help you better manage your symptoms.

Also, if you experience bothersome side effects, your psychiatrist may switch you to a different kind of medication. If you are also on medications for other health conditions, you should share them with your psychiatrist, as there is a possibility that these medications can react with an antidepressant to create potentially dangerous complications.

But Aren’t Antidepressants Addictive?

No, not at all, says Dr Amer. Some patients experience withdrawal-like symptoms when they stop taking antidepressants, but this is not a sign that they are addicted to those medications. Rather, it is more likely due to the body needing some time to adjust once the medication is stopped, especially if it is stopped abruptly. These symptoms usually go away on their own. If you experience bothersome side effects, you should let your psychiatrist know. He or she will either offer options to address these side effects or switch you to another type of antidepressant.

Is It True that Taking Antidepressants Will Ruin My Sex Life?

Because antidepressants work by calming your mood and reducing your anxiety, one possible unwanted side effect is that you also become too ‘calm’ to respond in intimate situations. Some people (both men and women) find that their libido is decreased. There are men who also experience erectile dysfunction, while women may experience discomfort during sex due to reduced lubrication. Delayed orgasm may also be experienced by both men and women.

Fortunately, this does not mean that your sex life is ruined if you are on antidepressants. Sometimes these side effects go away on their own, after your body has become used to the medication. If they persist, there are ways to manage these symptoms, such as reassessing the dosage or, if you anticipate having an intimate moment with your partner, taking your antidepressants only afterwards. Switching antidepressants might also be an option if the above doesn’t work.

Don’t stop your medication because it is affecting your sex life, as this may cause your depression to worsen. Instead, talk to your psychiatrist about the issue; he or she will be able to help you in this matter.

Don’t Give Up!

Medication alone is often not enough to help the person overcome his or her depression. Overcoming depression is a day-to-day process, often requiring a lot of energy and focus. Recovery may not be as quick as the person wishes, and in the meantime, he or she may experience broken relationships, loss of jobs and other heartbreaking disappointments.

In such situations, some people may become overwhelmed and feel that they will never become better. They choose to give up instead, thus succumbing to their depression.

It does not have to be this way. While depression is often portrayed as a lone person’s struggle, Dr Amer points out that the road to recovery is often easier with support from the people around that person.

This is why, while he respects a patient’s desire for confidentiality, Dr Amer would advise the patient to let at least one trusted person in on the fact that he or she is trying to overcome depression. This person can provide a listening ear and a shoulder to cry on when the going gets tough for the patient. Additionally, that confidante is welcome to ask for advice from the patient’s mental health professional if the need arises.

Furthermore, support can be obtained from various support groups (either in real life or online at places such as Facebook and Reddit) as well as from various non-profit organizations dedicated to helping people with depression and other mental issues heal.