Antidepressants are supposed to help treat depression, right? In cases where nothing else has worked for a person to manage their depression, an antidepressant is considered a clinically effective treatment option. Millions of people are put on antidepressants and in the United States, it is estimated that one out of every five people or so are on a psychiatric medication.
Although these can drugs prove to be a life saver for many, other people do not respond very well. In some cases people actually experience drastic increases in their depression as opposed to relief from it. When depression is increased as a result of taking a drug designed to treat it, this may leave the individual hopeless in their quest to manage their symptoms.
Can Antidepressants Cause Depression?
Antidepressants can cause depression a couple of different ways: while you are taking them and after you have come off of them. The depression that you experience while taking them is a result of your brain chemistry being altered from the drug. In some cases, a surplus of serotonin (from the medication) could cause your depression to become worse.
Most major pharmaceutical companies market the fact that people with depression have low serotonin, but they don’t really know for sure. They just make that claim because many people respond well to SSRI’s. The depression you experience after your treatment is a result of abnormally low levels of neurotransmitters (e.g. a chemical imbalance) as a result of the treatment.
Can antidepressants cause a person to become increasingly depressed while taking them? Ironically the answer to that question is “yes.” I know this not only from other people’s experiences, but from my own personal experience. I only experienced antidepressant relief from a couple of medications that I was on in the past. All other medications made my depression increase in severity.
Following treatment with an SSRI, you may notice that you become increasingly depressed. When you withdraw from the drug, your serotonin (and other neurotransmitters) are imbalanced. I wrote an article about antidepressants causing a chemical imbalance – which further increases depression. Some people are shocked that a drug used to treat depression can result in a person feeling even more depressed after treatment than they did before they were treated.
Antidepressants Cause Suicidality
There is clear evidence that taking antidepressants can lead to increases in suicidal thoughts and behaviors. This was found to be especially prominent among children and adolescents. Further research indicated that adults taking these drugs had just as much of a risk as younger populations to experience suicidal thoughts. Additionally it has been discovered that class of antidepressant drug does not play a role in increasing suicide risk.
In other words, people taking SSRI’s have the same risk of developing suicidal thoughts as individuals taking TCA’s. Another problem associated with antidepressants is that in some cases, they take a long time to work. The fact that people may experience increases in suicidal thoughts before the drugs “work” can further complicate this form of treatment.
Despite the fact that antidepressants causing a person to develop suicidal thoughts is “up for debate,” my personal experience and countless others are not “up for debate.” I have taken nearly every SSRI medication available as well as SNRI’s and TCA’s and in my experience, most of them that didn’t work, lead me to develop suicidal thinking. It is just a fact that these drugs can cause people to become increasingly suicidal.
In 2006, researchers brought up whether suicidality as a result of antidepressant treatment outweighed any beneficial effects of the drug. Although this suggested that doctors provide better information for patients regarding risk of suicidal thoughts, most doctors do not inform people about this possibility. Most people find out about this effect when they notice that they actually feel more suicidal on antidepressants than being off of them.
Keep in mind that nearly all of these drugs have a “black box” warning – meaning an extreme word of caution regarding the fact that antidepressants may lead you to become increasingly suicidal. This warning was applied to all adolescents and young adults up to the age of 24. With the evidence demonstrating that suicidality as a result of antidepressant treatment affects adults just as much as adolescents, this warning should also apply to them.
How do we know the antidepressants cause increased depression and suicidality? Because people have committed suicide with no prior history of mental illness just participating in “trials” for various antidepressants. In other words, it is the drugs that have lead people to take their own life.
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1198229/
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC557941/
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453113/
- Source: http://www.ncbi.nlm.nih.gov/pubmed/17143567/
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824975/
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799109/
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC193979/
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195160/
What to do if antidepressants make you feel more suicidal?
The best thing you can do for yourself if the medication you are on is making you feel more suicidal is to gradually stop taking it. It isn’t rocket science that people have adverse reactions to medications. Some people respond well to antidepressants, others don’t. There have been cases of people committing suicide after taking less than a week’s worth of doses with no prior history of mental illness.
Consult your psychiatrist and/or pharmacist to talk about what you are experiencing while taking the drug. Most of them know people have adverse reactions and cannot cope with various side effects of these drugs. If you are feeling more suicidal than before you started taking the drug, it’s obvious that you aren’t responding well. What makes these medications difficult is the fact that they sometimes make people feel worse before they become beneficial.
However, in the experiences of many people (including myself), the antidepressants that work tend to work pretty quickly. When I was taking Paxil, I noticed it working within a few days of taking it. Additionally, I had no increased suicidal thoughts during the period in which the drug worked. When the effect wore off and Paxil pooped out, I began feeling more suicidal than I had ever felt in my entire life.
The bottom line is that if you are feeling suicidal, you need to get help. This is a temporary feeling, likely exacerbated by the usage of your antidepressant medication. Know that you will recover from this feeling, and work towards trying to think positive about your future.
Antidepressants often require experimentation
The problem with antidepressant treatment is that you really don’t know how someone is going to respond. One drug class may be very effective for some people, but may have absolutely zero effects in other people. For this reason, it is important to test a variety of medication “classes” so that you know what works best for you. Since most people respond best to SSRI’s, these are the drugs typically prescribed first.
If you clearly experience increases in depression while on these drugs, your psychiatrist will likely switch medication classes. Depending on comorbid symptoms, your psychiatrist may consider trying a drug like Wellbutrin or Viibryd. They may also want to test out an SNRI or TCA (older antidepressant). Everyone responds differently to different classes of medications – each drug is unique in the way that it works.
Rules of thumb – Assuming you have explored all natural treatment options such as therapy, exercise, and socialization, there are a variety of drugs that will be thrown your way by psychiatrists. Most of the drugs will be prescribed in a similar order to that outlined below.
- SSRI’s – This is the first line of treatment for depression in the United States. You will try multiple SSRI’s to determine if you respond to this class of drugs. Many people end up responding to one of these medications.
- Wellbutrin – If you don’t respond to an SSRI, the problem may not be low serotonin. You may have a better response by targeting low norepinephrine and dopamine instead of serotonin. Wellbutrin is a NDRI which means it targets neurotransmitters other than serotonin.
- SNRI’s – If you don’t respond well to an NDRI, a doctor may see if serotonin and norepinephrine reuptake inhibition is a better bet. In this case you may try a drug like Cymbalta, Effexor, or Pristiq to determine if either works.
- Viibryd – This is a newer medication that works on serotonin, but differently than most SSRI’s. If this medication doesn’t work well, you may end up getting put on a different class of medications altogether.
- TCA’s – Another class of antidepressants that can be explored is that of the Tricyclic class. These are older antidepressants, but have been proven to be effective in treating depression. Drugs in this class can range from having primary effects on serotonin to norepinephrine and in some cases, dopamine.
- MAOI’s – This class of antidepressants is least likely to be prescribed, but if all other drugs fail, this is the class that you may turn to. It is usually one of the last resort options, but worth checking out if your depression is refractory.
- Augmentation strategies: There are a variety of antidepressant augmentation strategies that can be used to help treat your depression. These strategies include hormone therapy, adding a psychostimulant (e.g. Adderall for depression), and/or something like an antipsychotic drug. Augmentation is typically used when all other monotherapy options (e.g. single drugs) have been explored.
Note: Although I am not a psychiatrist, I recommend always starting at the lowest possible dose of an antidepressant. Many times, these drugs are prescribed and/or found to be therapeutically effective at high dosages. If you are responding well to a medication at a low dose, it makes very little sense to further increase the dosage.
Antidepressants should always be considered a “last resort”
I have preached this consistently: antidepressant drugs should only be used after all other valid treatment options have been explored. Other treatment options include things like daily exercise, psychotherapy, dietary changes, supplementation, etc. If a person has gone through the ringer of natural cures for depression and has had no success, then tweaking neurotransmitters with psychiatric drugs is really the next best option.
These drugs are marketed as though they are always going to help someone who is depressed and/or struggling with suicidal thoughts. Clearly in some cases, they actually increase suicidal thinking and depression. Due to the fact that you risk feeling even more suicidal and more depressed on an “antidepressant” (the irony), you should not use one of these medications unless it is truly a “last resort.”
As someone that has been on these medications, I know exactly what it’s like to feel even more suicidal while on these drugs. Additionally, I fully understand how suicidal thoughts can plague people for extended periods of time even after they have been off of the drug. These create chemical changes in the brain and even though they are effective for about half the people that take them, many other people are left feeling even worse.