Depression: Should I take an antidepressant?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Depression: Should I take an antidepressant?

Get the facts

Your options

  • Take antidepressants to treat depression.
  • Don't take antidepressants.

Pregnant women need to be more careful about taking antidepressants. For more information, see:

Click here to view a Decision Point. Depression: Should I take antidepressants while I'm pregnant?

Key points to remember

  • Taking medicine for your depression can help you get your life back to normal, especially if you also get counseling. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
  • You don't need to be ashamed about taking antidepressants. Depression is a health problem, not a character flaw or weakness. The medicines won't change your personality.
  • Antidepressants don't work right away. And you may need to try a few before you find one that works.
  • Side effects are one reason that people stop taking antidepressants. But talk to your doctor. There are many ways to manage side effects. And lowering the dose or changing medicines may also help.
  • The thought of needing to take medicine for a long time can be scary. But many people are able to slowly stop taking antidepressants after a while.
FAQs

Are you depressed?

The symptoms of depression include a loss of interest in daily activities or feeling sad or hopeless and having at least four of the following symptoms:

  • A change in eating patterns that causes either weight gain or weight loss
  • Sleeping too much or not enough
  • Feeling restless and unable to sit still, or feeling that moving takes a great effort
  • Feeling tired all the time
  • Feeling unworthy or guilty without an obvious reason
  • Having problems concentrating, remembering, or making decisions
  • Thinking often about death or suicide

What are antidepressants?

Antidepressants are medicines for treating depression. They work by helping to balance certain chemicals in your brain. They can make your symptoms better or get rid of them completely.

There are several kinds of antidepressants. There is no evidence that one works better than another. But the side effects are different.1

Antidepressants don't change your personality. They help your symptoms.

You don't need to be ashamed about taking antidepressants. Depression is a health problem, not a character flaw or weakness.

How well do antidepressants work?

Most people are able to find an antidepressant that helps their depression. But you may have to try a few before you find one that works for you. The right medicine is one that helps your symptoms and has the fewest side effects.

You may start to feel better within 1 to 3 weeks after you start taking an antidepressant. But you may need to take it for as long as 6 to 8 weeks to see more improvement.

It's best to keep taking your medicine for at least 6 months after you feel better. If this is not the first time you have been depressed, your doctor may want you to take these medicines even longer.

The thought of needing to take medicine for a long time can be scary. But many people are able to slowly stop taking antidepressants after a while.

Antidepressants can change how you feel and respond in certain situations, but they don't change who you are. You may feel more relaxed, more social, more assertive, or more outgoing when you are taking an antidepressant.

What side effects can antidepressants cause?

Most antidepressants cause minor side effects that go away or improve in the first few weeks of treatment. If you keep taking your medicine, there is a good chance that you will start to feel less depressed and that the side effects will decrease. Most people feel that the benefits of antidepressants are well worth the price of living with some side effects.

Side effects may vary depending on the medicine you take, but common ones include:

  • Nausea.
  • Dry mouth.
  • Loss of appetite.
  • Diarrhea or constipation.
  • Sexual problems (loss of desire, erection problems).
  • Headaches.
  • Trouble falling asleep, or waking a lot during the night.
  • Weight gain.
  • Feeling nervous or on edge.
  • Feeling drowsy in the daytime.

Some side effects may not go away, but usually there are ways to manage them. See:

Click here to view an Actionset. Depression: Dealing with medicine side effects.

Problems with sexual arousal and a lack of interest in sex are common side effects. If this happens to you, talk to your doctor. There are other medicines that may help with these problems.

Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

What are other treatments for depression?

Counseling

Counseling is an important part of the treatment for depression. The types of counseling most often used for treatment of depression include:

Lifestyle changes

There are also lifestyle changes you may be able to make that may help your depression symptoms:

Other treatment choices

Besides counseling and lifestyle changes, there are some other treatments you can try:

  • Alternative treatments such as massage therapy and yoga may help you get better faster and make your life better.
  • You can try relaxation exercises at home to lower your stress.
  • The herb St. John's wort may help if you have mild depression. But it can cause problems with other medicines you may be taking, so talk to your doctor before you try this herb.
  • Electroconvulsive therapy may be used to treat severe depression or depression that hasn't responded well to other treatment. It also may be a treatment choice for someone who cannot live with the side effects of antidepressants.

Why might your doctor recommend antidepressants?

Your doctor might suggest that you try antidepressants if:

  • You have tried counseling and lifestyle changes, and they haven't worked.
  • Your symptoms are bad enough that they interfere with your daily life.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take antidepressants Take antidepressants
  • You take a pill or liquid medicine one or more times a day for months or sometimes years.
  • Antidepressants can improve or completely relieve symptoms.
  • Antidepressants usually help when counseling and lifestyle changes haven't worked.
  • It takes weeks, and sometimes months, for the medicine to start working.
  • You may have to keep taking antidepressants for a long time.
  • Side effects—which can include nausea, diarrhea or constipation, sexual problems, weight gain, and trouble sleeping—cause many people to stop taking the medicine.
Don't take antidepressants Don't take antidepressants
  • You use counseling and lifestyle changes to help your depression.
  • You may try alternative treatments, such as massage and relaxation techniques.
  • Counseling works well for people whose symptoms are mild to moderate.
  • You avoid the side effects of the medicine.
  • Counseling may not be enough if your symptoms are severe.
  • Untreated depression is likely to get worse.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about deciding whether to take antidepressants

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I didn't even realize that I was depressed for a long time. I thought everyone felt this way; at least everyone in my family seemed to. I probably would have just gone on like that if my doctor hadn't asked one day if I had ever considered taking an antidepressant. I was relieved to find out that it isn't normal to feel like I do and that a lot of people are helped by medications. I know it might take a while to find the right one, but I'm in no hurry; I've spent my whole life feeling sad.

Jackie, age 62

I tried antidepressants about a year ago. I really was not prepared for the first few weeks, when the side effects seemed to get me down even more than the depression did. So I stopped taking them. It took me about 3 months, but I eventually started to feel better without any medicine. Then last month, I started to feel depressed again. I don't want to wait so long to feel better this time. So I'm going to try the antidepressants again. This time, I know what to expect and am better prepared for it.

Tyrone, age 43

I guess I'm just not comfortable with taking medicine for my depression. I feel like I ought to be able to manage this on my own without needing medication. It seems too much like taking the easy route. But maybe I just don't feel bad enough yet.

Bob, age 50

I recently began going to counseling. I know that if I took an antidepressant, I might feel better sooner, but I don't like the sound of the side effects I could have. My therapist and I have set some goals for me to work on, and we agreed to revisit my decision in 3 months. I want to wait and see how the counseling goes before I take medicine.

Joslyn, age 28

For more information, see the topic Depression.

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants

Reasons not to take antidepressants

My symptoms are keeping me from living my normal life.

My symptoms aren't bad enough to get in the way of my life.

More important
Equally important
More important

I'm willing to take medicine every day for at least 6 months, and maybe longer.

I don't like the idea of taking medicine for a long time.

More important
Equally important
More important

My symptoms are worse than the possible side effects of the medicines.

I think the side effects will be worse than my symptoms.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking an antidepressant

NOT taking an antidepressant

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Are antidepressants right for everyone with depression?

  • Yes Sorry, that's wrong. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
  • No You're right. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
  • I'm not sure It may help to go back and read "Key points to remember." Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
2.

Is it possible to manage the side effects of antidepressants?

  • Yes That's right. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.
  • No Sorry, that's wrong. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.
  • I'm not sure It may help to go back and read "What side effects can antidepressants cause?" There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.
3.

Will you start to feel better right away?

  • Yes No, that's wrong. Antidepressants don’t work right away. And you may need to try several before you find one that works.
  • No That's right. Antidepressants don’t work right away. And you may need to try several before you find one that works.
  • I'm not sure It may help to go back and read "How well do antidepressants work?" Antidepressants don’t work right away. And you may need to try several before you find one that works.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision  

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts  

Key concepts that you understood

Key concepts that may need review

Getting ready to act  

Patient choices

Credits and references

Credits
Author Jeannette Curtis
Author Paul Lehnert
Editor Katy E. Magee, MA
Associate Editor Terrina Vail
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Primary Medical Reviewer Catherine D. Serio, PhD - Behavioral Health
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Specialist Medical Reviewer Peter Hauser, MD - Psychiatry

References
Citations
  1. Butler R, et al. (2007). Depression in adults (drug and other physical treatments), search date April 2006. Online version of Clinical Evidence: http://www.clinicalevidence.com.

Depression: Should I take an antidepressant?

You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the facts

Your options

  • Take antidepressants to treat depression.
  • Don't take antidepressants.

Pregnant women need to be more careful about taking antidepressants. For more information, see:

Click here to view a Decision Point. Depression: Should I take antidepressants while I'm pregnant?

Key points to remember

  • Taking medicine for your depression can help you get your life back to normal, especially if you also get counseling. But if your symptoms are mild, lifestyle changes and counseling may be all you need.
  • You don't need to be ashamed about taking antidepressants. Depression is a health problem, not a character flaw or weakness. The medicines won't change your personality.
  • Antidepressants don't work right away. And you may need to try a few before you find one that works.
  • Side effects are one reason that people stop taking antidepressants. But talk to your doctor. There are many ways to manage side effects. And lowering the dose or changing medicines may also help.
  • The thought of needing to take medicine for a long time can be scary. But many people are able to slowly stop taking antidepressants after a while.
FAQs

Are you depressed?

The symptoms of depression include a loss of interest in daily activities or feeling sad or hopeless and having at least four of the following symptoms:

  • A change in eating patterns that causes either weight gain or weight loss
  • Sleeping too much or not enough
  • Feeling restless and unable to sit still, or feeling that moving takes a great effort
  • Feeling tired all the time
  • Feeling unworthy or guilty without an obvious reason
  • Having problems concentrating, remembering, or making decisions
  • Thinking often about death or suicide

What are antidepressants?

Antidepressants are medicines for treating depression. They work by helping to balance certain chemicals in your brain. They can make your symptoms better or get rid of them completely.

There are several kinds of antidepressants. There is no evidence that one works better than another. But the side effects are different.1

Antidepressants don't change your personality. They help your symptoms.

You don't need to be ashamed about taking antidepressants. Depression is a health problem, not a character flaw or weakness.

How well do antidepressants work?

Most people are able to find an antidepressant that helps their depression. But you may have to try a few before you find one that works for you. The right medicine is one that helps your symptoms and has the fewest side effects.

You may start to feel better within 1 to 3 weeks after you start taking an antidepressant. But you may need to take it for as long as 6 to 8 weeks to see more improvement.

It's best to keep taking your medicine for at least 6 months after you feel better. If this is not the first time you have been depressed, your doctor may want you to take these medicines even longer.

The thought of needing to take medicine for a long time can be scary. But many people are able to slowly stop taking antidepressants after a while.

Antidepressants can change how you feel and respond in certain situations, but they don't change who you are. You may feel more relaxed, more social, more assertive, or more outgoing when you are taking an antidepressant.

What side effects can antidepressants cause?

Most antidepressants cause minor side effects that go away or improve in the first few weeks of treatment. If you keep taking your medicine, there is a good chance that you will start to feel less depressed and that the side effects will decrease. Most people feel that the benefits of antidepressants are well worth the price of living with some side effects.

Side effects may vary depending on the medicine you take, but common ones include:

  • Nausea.
  • Dry mouth.
  • Loss of appetite.
  • Diarrhea or constipation.
  • Sexual problems (loss of desire, erection problems).
  • Headaches.
  • Trouble falling asleep, or waking a lot during the night.
  • Weight gain.
  • Feeling nervous or on edge.
  • Feeling drowsy in the daytime.

Some side effects may not go away, but usually there are ways to manage them. See:

Click here to view an Actionset. Depression: Dealing with medicine side effects.

Problems with sexual arousal and a lack of interest in sex are common side effects. If this happens to you, talk to your doctor. There are other medicines that may help with these problems.

Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

What are other treatments for depression?

Counseling

Counseling is an important part of the treatment for depression. The types of counseling most often used for treatment of depression include:

Lifestyle changes

There are also lifestyle changes you may be able to make that may help your depression symptoms:

Other treatment choices

Besides counseling and lifestyle changes, there are some other treatments you can try:

  • Alternative treatments such as massage therapy and yoga may help you get better faster and make your life better.
  • You can try relaxation exercises at home to lower your stress.
  • The herb St. John's wort may help if you have mild depression. But it can cause problems with other medicines you may be taking, so talk to your doctor before you try this herb.
  • Electroconvulsive therapy may be used to treat severe depression or depression that hasn't responded well to other treatment. It also may be a treatment choice for someone who cannot live with the side effects of antidepressants.

Why might your doctor recommend antidepressants?

Your doctor might suggest that you try antidepressants if:

  • You have tried counseling and lifestyle changes, and they haven't worked.
  • Your symptoms are bad enough that they interfere with your daily life.

2. Compare your options

  Take antidepressants Don't take antidepressants
What is usually involved?
  • You take a pill or liquid medicine one or more times a day for months or sometimes years.
  • You use counseling and lifestyle changes to help your depression.
  • You may try alternative treatments, such as massage and relaxation techniques.
What are the benefits?
  • Antidepressants can improve or completely relieve symptoms.
  • Antidepressants usually help when counseling and lifestyle changes haven't worked.
  • Counseling works well for people whose symptoms are mild to moderate.
  • You avoid the side effects of the medicine.
What are the risks and side effects?
  • It takes weeks, and sometimes months, for the medicine to start working.
  • You may have to keep taking antidepressants for a long time.
  • Side effects—which can include nausea, diarrhea or constipation, sexual problems, weight gain, and trouble sleeping—cause many people to stop taking the medicine.
  • Counseling may not be enough if your symptoms are severe.
  • Untreated depression is likely to get worse.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topic Depression.

Personal stories about deciding whether to take antidepressants

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I didn't even realize that I was depressed for a long time. I thought everyone felt this way; at least everyone in my family seemed to. I probably would have just gone on like that if my doctor hadn't asked one day if I had ever considered taking an antidepressant. I was relieved to find out that it isn't normal to feel like I do and that a lot of people are helped by medications. I know it might take a while to find the right one, but I'm in no hurry; I've spent my whole life feeling sad."

— Jackie, age 62

"I tried antidepressants about a year ago. I really was not prepared for the first few weeks, when the side effects seemed to get me down even more than the depression did. So I stopped taking them. It took me about 3 months, but I eventually started to feel better without any medicine. Then last month, I started to feel depressed again. I don't want to wait so long to feel better this time. So I'm going to try the antidepressants again. This time, I know what to expect and am better prepared for it."

— Tyrone, age 43

"I guess I'm just not comfortable with taking medicine for my depression. I feel like I ought to be able to manage this on my own without needing medication. It seems too much like taking the easy route. But maybe I just don't feel bad enough yet."

— Bob, age 50

"I recently began going to counseling. I know that if I took an antidepressant, I might feel better sooner, but I don't like the sound of the side effects I could have. My therapist and I have set some goals for me to work on, and we agreed to revisit my decision in 3 months. I want to wait and see how the counseling goes before I take medicine."

— Joslyn, age 28

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants

Reasons not to take antidepressants

My symptoms are keeping me from living my normal life.

My symptoms aren't bad enough to get in the way of my life.

More important
Equally important
More important

I'm willing to take medicine every day for at least 6 months, and maybe longer.

I don't like the idea of taking medicine for a long time.

More important
Equally important
More important

My symptoms are worse than the possible side effects of the medicines.

I think the side effects will be worse than my symptoms.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking an antidepressant

NOT taking an antidepressant

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Are antidepressants right for everyone with depression?

  • Yes
  • No
  • I'm not sure
You're right. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.

2. Is it possible to manage the side effects of antidepressants?

  • Yes
  • No
  • I'm not sure
That's right. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.

3. Will you start to feel better right away?

  • Yes
  • No
  • I'm not sure
That's right. Antidepressants don’t work right away. And you may need to try several before you find one that works.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
Author Jeannette Curtis
Author Paul Lehnert
Editor Katy E. Magee, MA
Associate Editor Terrina Vail
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Primary Medical Reviewer Catherine D. Serio, PhD - Behavioral Health
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Specialist Medical Reviewer Peter Hauser, MD - Psychiatry

References
Citations
  1. Butler R, et al. (2007). Depression in adults (drug and other physical treatments), search date April 2006. Online version of Clinical Evidence: http://www.clinicalevidence.com.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Last Updated: March 26, 2009

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