Hope you’re all doing well!
As someone who has studied psychology in college I have read and heard quite a lot about depression. I am a firm believer that antidepressants should not be the first option in treating depression. However, I hope that by the end of this quick post I can convince you that antidepressants should not be completely avoided either.
First of all, a person is diagnosed with major depression when they have been in a depressed mood for more than two weeks. Specific symptoms of major depression include some of the following:
- loss of interest in activities they normally enjoy
- weight loss/gain
- trouble concentrating
- suicidal ideation
Depression can impact a person’s social life, career, and/or performance in school. A family history of depression can slightly increase one’s risk of depression. However, there are a number of environmental factors that can contribute to depression as well:
- history of physical, sexual, or emotional abuse
- major life events such as the death of a loved one, or the loss of a job
- other mental illnesses or other physical ailments
- history of, or current, substance abuse.
Of course, taking antidepressants is not the only effective treatment option for depression. Effective alternatives include physical exercise, psychotherapy, and in extreme case electroconvulsive therapy or ECT.
Physical exercise can increase endorphins, which can counteract the symptoms of depression. Research has shown that physical exercise can also improve overall brain health by promoting the birth of new neurons.
Psychotherapy, where the depressed person talks to a mental health professional, can help the depressed person change their negative thoughts and actions and replace them with positive ones. Psychotherapy can also help people find better ways to cope and solve their problems. Research has shown that psychotherapy can be just as effective as antidepressants for people with moderate to severe depression. Overall, psychotherapy is especially beneficial to people who experience depression due to the challenges or difficulties they’ve faced in the earlier days of their life.
In extreme cases where no other treatment option including antidepressants, has worked Electroconvulsive therapy or ECT can be used. During the ECT procedure, the patient is given general anesthesia and then a series of small electrons are passed through their brain and this purposefully triggers a seizure. ECT impacts the neurotransmitters in the brain to help relieve symptoms of depression. For many patients this is only a temporary option.
What some people may not know about depression is that aside from affecting our moods and behaviors it also negatively impacts the biology of our brain. Cortisol is a stress hormone that is released by the body during times of physical and mental stress. However, in people with major depression excessive amounts of cortisol are released and sent to the brain.
In the long term excessively high levels of cortisol in the brain can lead to a wide range of problems. Some of these include:
- slowing down the birth of new neurons
- memory problems
- shrinking the prefrontal cortex (which is responsible for regulating emotions and making decisions)
- High cortisol levels also increase the size of the amygdala which is responsible for emotional responses. This can lead to sleep disturbances and it can cause the body to release irregular amounts of hormones and other chemicals.
- High levels of cortisol also decrease the brains structural plasticity (which is the brains ability to adapt to different situations).
The reality is that for many people depression is not limited to constantly feeling sad. For some people depression is caused by biological changes in their brain and for many people if depression is left untreated, in the long-term it can cause potentially irreversible damage to the brain.
Unfortunately, physical exercise, psychotherapy and ECT cannot prevent or improve the biological causes and the long-term biological damage that is associated with untreated major depression.
Once again, if someone is diagnosed with depression they should most definitely try physical exercise, psychotherapy, or any other non-prescription remedy. However, after a certain period of time if these other remedies don’t work it might be time to try an antidepressant.
For those that are wondering about the effectiveness of antidepressants, the latest research has shown that compared to a placebo (in a scientific experiment a non-drug sugar pill that is presented to the patient as an antidepressant) the actual antidepressant are significantly more effective in treating depression. Of course, some antidepressants are more effective than others and only a doctor can correctly prescribe the right medication for you.
Unfortunately, statistics show that most people with depression do not get the help and treatment that they need. In developed nations only one in six people receive treatment for depression and in the developing nations its only one in twenty-seven people. If you do suffer from depression, please make sure to reach out for help regardless of which treatment option you choose, never leave depression untreated.
I know that for many people this is much easier said than done because unfortunately, here in the United States not everyone has access to a mental health professional and going to visit one can be very expensive. These are systemic problems that the government and those with power have the responsibility of fixing.
Aside from exercise here are some free mental health resources.