Should you hire an Antidepressant?

Although the question of whether we are becoming a more depressed society or are simply getting better at identifying and acknowledging depression is open for debate, what’s clear is that the rate of prescription of antidepressant medications has dramatically increased since their introduction into the market place some 60 years ago. Today, there are over 30 types of antidepressant formulations available, and they have become the most commonly prescribed class of medications, outdistancing the second most commonly prescribed (blood pressure medications) by 5 million prescriptions per year (US figures for 2008).

In my counselling practice it’s not uncommon to hear clients say they were offered a prescription for an antidepressant by their family doctor or walk-in clinic physician, often after only a brief discussion of their symptoms and concerns. So if antidepressants are more available in general, and can or have been made available to you specifically, what do you need to know to determine if they are the right approach for you?

It’s a multi-faceted question, but to help start to answer it, I often ask clients to use the analogy of hiring an antidepressant, the way they would consider hiring an employee. That means working through several steps:

     1. Getting clear on the job you’d like the antidepressant to do. What are the symptoms of depression you’d like it to relieve? For example, “I’d like to sleep better, I’d like to get through the day without crying every 5 minutes, I’d like to have some energy and not feel like everything was a chore” are all good job descriptors for an antidepressant. “I’d like my partner/parents/children to be less annoying” is not.
    

     2. Giving the antidepressant a fair trial at the job. This means taking the medication at the dosage prescribed, and for the duration (typically 6 to 8 weeks) necessary to assess its effectiveness. It also means not mixing antidepressants with other medications or excessive amounts of alcohol, or with other mind or mood altering drugs.
    

     3. At the end of the trial period, evaluating the antidepressant’s performance. That is, assessing how well it did the job you hired it to do, and also determining its cost to you (both the financial cost, and any cost paid out in side effects).

You can – and I would suggest, should – research an antidepressant’s ‘qualifications’ by reading about its track record of effectiveness and its history of results and side effects, but that’s not sufficient information to know whether it works for you. Ultimately, you yourself are the best resource to determine whether something is helping or not, and that’s a power (and responsibility) you don’t want to outsource.

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