“I shut my eyes and all the world drop dead
I lift my lids and all is born again”—Sylvia Plath
The word “depression” is not a simple one; yet, it is often used too casually by people who are just feeling a shift in their mood. In fact, for a person to be considered depressed, it needs professional medical diagnosis to be able to prescribe the correct medications, known as antidepressants. So, what is depression and how do antidepressants work?
Depression is a serious mental disorder that affects how people feel, act, think, and perceive the world. The symptoms may vary from one person to another, spanning from mild to severe with respect to many affecting factors. Yet, the condition goes way beyond just feeling sad. The symptoms include feeling lost, losing interest in the activities you once enjoyed, significant changes in appetite, gaining or losing weight, significant changes in the biological clock, sleeping too much or too little. These symptoms may appear when one is exposed to a change in the brain chemicals, namely neurotransmitters, serotonin, dopamine, and norepinephrine.
To be able to diagnose depression and create a treatment plan that includes antidepressants, a patient must first undergo a thorough diagnostic evaluation. While treatment do help, the improvements are slow-paced and may not be recognizable until later into the treatment as antidepressants do not treat the cause directly.
Antidepressants work by increasing neurotransmitters, such as serotonin and noradrenaline to improve and boost the mood. However, increasing the neurotransmitters in the brain can disrupt brain signals, indicating why some antidepressants work only on the long-term.
Antidepressants are classified into four types. The most commonly used type is the Selective Serotonin Reuptake Inhibitors (SSRIs), which work by preventing the reabsorption of serotonin in the brain and thereby increase its availability. More serotonin in the brain translates into better mood regulation; however, it is not always as simple as it seems like. The unspoken issue with manipulating brain chemicals such as serotonin is that the effect ripple way far beyond the desired target.
Many patients report initial improvements and mood boosts, while others experience a wide range of side effects that are often underplayed, and no one warns them about. The side effects include fatigue, insomnia, and weight gain. Some patients report that their emotions—both good and bad—become blunted. The feelings that make us human and can connect with the world and nature become muted, leaving them depressed and in a state of emotional flatness, which makes the matter worse.
What is even more concerning is that some patients experience withdrawal symptoms when they stop using antidepressants. They face dizziness, brain fog, mood swings, among others. These side effects are raising the question about the long-term neurological impact of these drugs on the brain, thereby, they can affect hormonal imbalance.
Given the fact that antidepressants are more complex than a straightforward cure, a crucial question is: do these drugs treat the underlying illness, or do they merely mask its symptoms? Hopefully, future research would lead us toward a more comprehensive approach to mental health that addresses the root cause, not just the surface-level signs.
References
cambridge.org
my.clevelandclinic.org
nhsinform.scot
pmc.ncbi.nlm.nih.gov
psychiatry.org
Cover image by Freepik