By Marise Alexander PsyD
Over the years, I have seen many individuals who have been prescribed antidepressant medications. I have also recommended that individuals consult their healthcare providers regarding the prescription of antidepressant medication to help manage their anxiety and depressive symptoms. In my experience, it is quite helpful to discuss with what they can expect to feel as the antidepressant starts to work.
It is really important to understand that there is no magic pill that starts working and cures everything. Antidepressant medications can be very effective but they are not perfect and optimally they should be taken in conjunction with psychotherapy. They take time to work but are worth the wait.
The most striking area that they seem to help are in the area of what I call non-productive worries. For example, the first three or four times you think about completing a task it is good because it motivates you to get started. The next 100 times you think about completing the task, it is no longer productive because it overwhelms and prevents you from even starting. These thoughts keep you stuck and your thinking clouded.
Antidepressant medications are great at reducing these non-productive worries. It is easier to let go of the things which are holding you back. One person described it as “putting on the best pair of glasses”. The antidepressant helped her to achieve emotional clarity.
Ideally, you should feel more like yourself not less like yourself! We certainly do not want someone to “feel like a zombie”. The zombie fear is a very common in individuals who are contemplating taking antidepressants.
At the point where a person is considering antidepressants they may be having more bad days than good days. The first day you take the medication you may notice a brief period where you feel a bit better. However, there is a good chance you may not notice any change. Some people expect immediate and dramatic improvement. It doesn’t work like that. It is not like a light that was turned off and is now on. Antidepressants feel like a light that flickers a bit before it turns on. Slowly you will have periods in which things don’t seem so bad or you can let go of things more easily and then you notice feeling badly again. Eventually the “feeling good” period will increase from minutes to hours to days. Changes may be quite subtle but add over time.
Look for changes in your functioning. Ask yourself the following questions throughout the first days and weeks after you begin the medication. You may even want to rate your mood or keep track of the answers to the following questions:
1) Is it easier to get going or maintain your energy throughout the day?
2) Is it easier to let go of things?
3) Does your day seem a bit brighter?
4) Is your concentration improved?
5) Do people comment that you look like you are feeling better?
6) Is easier to fall and stay asleep?
The more information you can give your healthcare provider the better we can help make any adjustments. Antidepressant medications take a bit of time to optimize and may even require a change to a different SSRI.
The key word here is patience. Patience with yourself and your healthcare team. Antidepressants can make a huge difference in people’s lives. Just give them a minute to work.
