In an ideal world I guess we wouldn’t get sick at all, but we have to settle for the fact that we do. Therefore, the next best scenario is we get sick, we get diagnosed, we get medicated, we get well. The good news is that this sometimes works. The bad news it may not, or it may stop working, and so we turn to the antidepressant.
Even assuming you are one of the people for whom antidepressants have a therapeutic effect, it can, as you probably know, take quite a period of trial and error to find the antidepressant that works for you. Having finally found one it comes as something of a low blow to discover its effects are wearing off. In this Sharepost I’m exploring some of the possible reasons why your antidepressant appears to have stopped doing its job.
If only antidepressants could be taken like a course of antibiotics. Seven to 10 days and it’s done with. Sadly, antidepressant use can go on for years at a time, so it’s incredibly frustrating for patient and doctor to discover that its effects are diminishing or have stopped entirely. This is rather grandly termed tachyphylaxis but why it occurs with some people and not others remains a puzzle.
Some experts have speculated that the brain may build up a tolerance to antidepressants. Yet if this were always the case a simple increase in the dosage should demonstrate some level of improvement. Others suggest that blood levels of medication can start to decrease as the enzymes that regulate their metabolism increase. It is true that in some cases a simple adjustment to dosage can have a positive effect, but this isn’t the case for everyone.
Then again, how much do we really know about the nature of depression and its ability to adapt? Depression is certainly a progressive disease and what worked when symptoms were first treated may not be effective some months or years later. When this happens it points to the disease worsening rather than the antidepressant becoming less effective and this is a common reason why your antidepressant may appear to have stopped working.
After a period of feeling well it may be agreed that it’s a good time to come off antidepressants. Unfortunately if depressive symptoms return it may point to a need to take medication once more. This is the point when some people find the antidepressant that had previously served them so well no longer has the same effect. Again, there is no clear answer as to why this happens to some people and not to others. Perhaps the nature of depression does adapt or worsen in some people and not others?
Finally, the fact that you have depression doesn’t prevent you from having other conditions that come with depressive-type symptoms. Usually, one of the first thing a doctor will do when first being told about depressive symptoms is to take blood samples in order to check for physical problems such as underactive thyroid. Once ruled out, antidepressants may be prescribed. If the patient responds positively there’s a danger that later testing might be overlooked if depressive symptoms return.
These are some of the main reasons your antidepressant might stop working but there are still others besides. All drugs can interact with other substances or medications, so changes in lifestyle, habits or medications have to be taken into account.
Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.