Some people wonder how the medication should help them with a mental illness like depression, especially if they see stress at work, tensions in a relationship or another difficult life situation as the cause of the illness. Such problems, which are perceived as magnified in depression, are not eliminated by medication.
However, successful drug treatment of depression reduces the listlessness, hopelessness and joylessness, and the existing problems appear less large and manageable again or part of the often-bitter life.
It is very important to consider drug treatment possibilities because only if you are convinced of the treatment will you take the antidepressant drug regularly and sufficiently long.
Antidepressants are specifically approved for the treatment of depression. They are an important pillar of treatment and are by far the most commonly used. However, many of those affected are often skeptical about taking medication at first. The following pointers should help you better understand how antidepressants work and why they are an important part of treatment.
The Most Important Thing About Antidepressants:
- Antidepressants are not addicting.
- Antidepressants are not stimulants or sedatives and do not get you “high. “
- Antidepressants belong to the group of psychotropic drugs (drugs that are used to treat mental illness).
There are also two other groups of psychotropic drugs, the effects of which, however, differ significantly from the effects of antidepressants:
- Antipsychotics/neuroleptics for the treatment of schizophrenic diseases and delusional depression.
- Anxiolytics/hypnotics (sedatives/sleeping pills), for example, treat anxiety and sleep disorders.
How Do Antidepressants Work in The Brain?
In the depressive illness phase, numerous functions in the brain are changed. Here, messenger substances in the brain, which among other things, enable communication between different nerve cells, play an important role. The messenger substances serotonin and norepinephrine are regarded as important for the development and maintenance of depression. Antidepressants influence the mode of action of these messenger substances and could thus correct any malfunctions.
How Can Antidepressants Influence The Effect of These Messenger Substances?
In a healthy state, some of the chemical substances released by the nerve cell are returned to the nerve cell from the synaptic gap pumped. When taking most antidepressants, this pump is blocked, and the messenger substances’ return transport is reduced. The result is that more messenger substances are in the synaptic gap, and their effect is increased. This is the mechanism of numerous antidepressants (tri- or tetracyclic, selective serotonin reuptake inhibitors (SSRI)). So-called monoamine oxidase inhibitors (MAO inhibitors), on the other hand, work within the nerve cell by blocking a protein (enzyme) that is responsible for the breakdown of serotonin and noradrenaline in the nerve cell. This means that more messenger substances are released into the synaptic cleft.
Since our brain is a highly complex organ, the systems of which are in permanent interaction with one another, there are still more questions about the exact mode of action of antidepressants than answered.
Treatment with Antidepressants
Whether antidepressants are useful should be discussed with the attending physician. The decision for or against treatment with antidepressants depends, among other things, on the severity of the depression but also the patient’s preferences. In the case of mild depression, antidepressants can initially be dispensed with. If the depression does not improve despite other treatment attempts, or if there has been more severe depression, then treatment with antidepressants can also be attempted for mild depression. In the very mild but chronic form of depression, dysthymia, the effectiveness of antidepressants has been well documented.
Antidepressants do not work like pain killers or sleeping pills immediately after ingestion. As a rule, a decrease in depressive symptoms only becomes apparent after about one to two weeks of daily use. Antidepressants must not be discontinued immediately when they improve! It is important to keep taking antidepressants even if there is a significant improvement. Premature termination of drug therapy is associated with a high risk that the depression will come back, similar to how blood pressure often worsens again when stopping a blood pressure drug. To relapse in the long term to avoid, the antidepressants should continue to be taken in the same dosage for about six months after the depression has subsided. If the depression is very severe and there have already been several phases of depressive illness, it is often advisable to take medication for years to prevent relapse.
There are various antidepressants available, which differ less in their effectiveness than possible side effects.
The goal of treatment offered by a psychiatrist in Islamabad is always the same: to subside the depression while at the same time being well tolerated by the antidepressant. The patient and the attending physician decide together which medication is best. If an antidepressant is not tolerated, it can be switched to another with a different risk of side effects. Antidepressants are also used for other illnesses such as anxiety disorders or obsessive-compulsive disorders.
In addition to antidepressants, other medications can be prescribed for depression, such as medication to stabilize the mood or, at short notice, sedatives and sleeping pills at the start of treatment. However, the latter should not be taken for a long time because of the risk of developing an addiction. Medicines from the group of neuroleptics can also be useful for severe delusional depression.
People react differently to antidepressants. While many people experience no side effects or only experience slight side effects in the first few days, others suffer from side effects that are unacceptable in the long term. Since different antidepressants can have different side effects, switching to another antidepressant can make sense. It is important to report any side effects to the attending physician. The patient can discuss whether the side effects are serious and, if necessary, a change (e.g., reducing the dose, different medication) needs to be made. Since there is a larger selection of antidepressants, it is usually possible to find an antidepressant that works and is tolerated.