Most people suffering from depression are seeking treatments that are safe. Although many treatments such as medications are relatively safe, they can result in unwanted negative side effects and difficult withdrawals. In most cases, it is better to attempt treating depression with therapy and natural methods prior to trying antidepressant drugs.
It should also be noted that there are some relatively unsafe treatment options that people pursue. Many people turn to illicit drugs and alcohol to treat their depression because they either can’t afford to seek help or don’t know healthier ways to cope. Highlighted below are some safe treatment options for depression as well as some of the less safe options.
Safest Antidepressants: Top 3 Options
These rankings are based on the analysis of risk-benefit. CBT ranks in at number one on the list because the risk is relatively low, but the potential benefits of going to therapy are pretty high. Second on the list is lifestyle changes, which includes targeting diet, exercise, and social life. Finally if all natural options have been pursued,second-generation antidepressant medication can be considered.
1. Cognitive Behavioral Therapy (CBT)
If you are feeling depressed for no reason, a good first step is getting yourself in to see a licensed psychotherapist. The therapist will talk about what’s going on in your life, how you feel, and get some background information. Then you will talk about your feelings of depression, and the therapist will try to come up with some solutions to change how you feel.
Although this man not benefit people with major depression, it may provide significant benefit for those who are mildly depressed. Sometimes people are just going through a rough patch in life and need some qualified social support. Good therapists are highly-trained and highly skilled at their jobs; their goal is to make you feel better. In therapy you are completely safe to talk without judgment, which is very helpful to many with depression.
2. Lifestyle Changes
Often times people explore medications before they pursue natural options, and I think this is a mistake. Unless you have taken the time to evaluate your habits, you won’t know if your diet, lack of exercise, lack of socialization, lack of sunlight, etc. could be contributing to your depression. In most cases, pursuing cognitive behavioral therapy (CBT) and making lifestyle changes can result in significant mood improvements.
- Diet: The optimal diet for mental health is one that consists of fish, meat, fruits, vegetables, and whole grains. Minimize refined sugars, processed foods, and alcohol intake.
- Exercise: There are many psychological benefits of exercise that could improve your mental health. Getting sufficient cardiovascular exercise is thought to release endorphins and promotes neurogenesis – both of which are associated with an antidepressant effect.
- Social life: If you are isolating yourself from others, getting more social contact could improve your depression symptoms.
- Drugs / alcohol: Minimizing usage of illicit drugs and alcohol could improve your depression. Although they may help depression temporarily, they may lead to worsening of symptoms.
- Supplements: Various supplements have been shown to have some promise in treating depression. Specifically omega-3 fatty acids (EPA / DHA) are theorized to help those with depressive moods.
Take the time to explore all natural options and focus on improving one area of your life at a time. Making changes in diet, exercise, and social life all at once can be overwhelming and may be a recipe for failure. Gradually improve each area of your life that may be contributing to your depression. Over time, you may notice that your mood improves. For further reading check out: 10 Natural Cures for Depression.
3. Antidepressant Medications
For those who suffer from severe depression, taking an antidepressant medication is a valid option. Medications should only be explored once all natural non-medicinal approaches have been pursued. The drugs on the market today are far from perfect, but are clinically proven to treat depression. These drugs tend to fall into one of a few categories:
- Atypical Antidepressants
- SNRIs (Serotonin Norepinephrine Reuptake Inhibitors)
- SSRIs (Selective Serotonin Reuptake Inhibitors)
- TCAs (Tricyclic Antidepressants)
- MAOIs (Monoamine Oxidase Inhibitors)
Most newer antidepressant medications are relatively safe when used properly under the aid of a licensed psychiatrist. If you plan on trying a medication, it is recommended to first find a psychiatrist; these are doctors that specifically focus on treating mental illness. Many of the newer SSRI drugs, SNRI drugs, and atypical antidepressants (e.g. Wellbutrin, Viibryd, etc.) are considered safer than most.
When comparing the efficacy and ability to tolerate drugs, some research suggests that Lexapro and Zoloft are slightly better than the rest. Other research however suggests that all of the approved drugs are similar in regards to effectiveness. Drugs have different effects that are subject to individual variation. Unfortunately there is no list of “safest antidepressant” medications for practitioners to follow – most second-generation medications are similar in regards to safety.
Unsafe Antidepressant Options
Below are some antidepressant options that either aren’t recommended or aren’t very good options. The risks of pursuing these treatments tend to be very high compared to the benefit. Illicit drugs and alcohol tend to produce immediate gratification, but the antidepressant effect wears off quickly and tolerance is established.
1. Illicit drugs
Many people turn to illicit drugs such as: opioids (e.g. heroin / pain pills), marijuana, amphetamines, etc. to treat depression. Although most of these drugs may provide an initial relief from depression, long-term use results in increased tolerance and dependence. Additionally many of these substances have a high potential for abuse. There is even some evidence that suggests certain drugs may further exacerbate symptoms or lead to additional problems.
In a controlled setting under supervision of a psychiatrist, some illicit drugs may actually work well for treatment-resistant depression. However, if you are not prescribed them specifically for the purpose of treating depression, they are typically not a good option. A person who takes an opioid like Oxycodone may feel euphoria when they initially begin using the drug, but as they continue, the effect wears off and the individual has dug themselves an even deeper hole.
List of illicit drugs that may be useful for depression.
- Adderall for depression – Specifically in cases of ADHD or motor-slowing with comorbid depression, this drug may prove to be useful. It is also a relatively popular augmentation strategy.
- Ketamine for depression – This is a newer option that is being researched to help those who aren’t able to get relief for their depressive symptoms.
- Psilocybin for depression – Many have touted the experience of using magic mushrooms as being “spiritual” and leading to significant improvements in mood and wellbeing.
- Suboxone for depression – Specifically in cases of opioid addiction with comorbid depression, this drug may be the ideal option. There’s a new drug in the works called “ALKS 5461” for depression that contains the active ingredient in Suboxone.
Understand that using these drugs recreationally for depression relief is not the same as using them under the guidance of a professional. Many have not yet been approved to treat depression because the FDA is still unsure about safety and long term effects. In most cases, it is best to stay away from these drugs as the risks (e.g. dependence, increases in depression, addiction, etc.) outweigh the benefits.
Many people that are depressed turn to alcohol as a cheap solution to deal with what they are experiencing. Alcohol is a depressant which means it slows down nervous system activity. In many cases, it can provide a relaxing effect, but it is certainly not a good option for depression. Most people with depression already have slowed processing in the nervous system and alcohol tends to make things worse.
Although it may serve to cover up unwanted depressing emotions, eventually a person is going to have to deal with them in a sober manner. The pain of depression may be significant, but attempting to drown out the feeling with alcohol is not a good solution. This will lead to further tolerance, dependence, and a nasty withdrawal when a person ends up stopping.
For the life of me I cannot seem to wrap my head around why people are so in favor of adding an antipsychotic drug to their depression regimen. If a person tries a bunch of second-generation antidepressants, doctors and patients alike are usually fine with adding an antipsychotic to help symptoms. The problem with antipsychotics is that the side effects and withdrawals can be extremely powerful.
Additionally, there is some evidence to support the idea that antipsychotics damage the brain over time. Unless you have schizophrenia or bipolar disorder, or don’t respond to any other medication, an antipsychotic should be a last-resort option. A life-threatening condition called neuroleptic malignant syndrome can be triggered by antipsychotics.
4. ECT (Electroconvulsive Therapy)
Although this is a proven technique to treat depression, many people who receive ECT report that the depression eventually returns. Additionally, it should be noted that memory loss and impaired brain functioning are sometimes permanent side effects. Unless you are willing to risk losing your memory, you may want to view this as a last-resort type option.
Safer Antidepressants in the Future?
It is hoped that technology will advance to the point that one day depression can be eradicated by gene therapy. Currently the trend seems to be that companies are following the same style of medications that are already on the market for depression, but are putting a safer spin on them. In most cases, the newer medications are thought to carry less side effects than the older ones.
Unfortunately most all psychiatric medications carry severe withdrawal symptoms. One improvement in treating depression would be finding a medication that offered a less severe withdrawal period. In regards to the health of your body, the safest antidepressant will always be one that doesn’t involve taking a pharmaceutical drug. That’s why therapies like low-field magnetic stimulation may be promising.
If you plan on going on a drug, do your own research and talk with a psychiatrist to determine what one you think is safest. For additional reading, you may want to check out the article I wrote entitled “What is the best antidepressant?” It sums up some proven ways to get out of depression without medication. It would be nice if the FDA eventually released a safety ranking of antidepressant drugs for consumers.