Everything You Need To Know About Antidepressants
Mental health issues are on the rise, what with the pandemic and the lockdowns, so here’s everything you need to know about clinical depression, and the drugs used to treat it — antidepressants.
Introduction
Certain events that take place in one’s life bring upon depressive episodes that can put people through some tough times. Depression has no single cause and can have a variety of reasons of different magnitudes. We’re sure you’ve spoken the words, “I’m so depressed” at least once in your lifetime, and it’s time to question if you really were depressed, or just sad. That’s right, they are not synonyms of each other.
Depression is not to be confused with sadness. Sadness is short-lived and is part of a collective human experience. Depression or rather, clinical depression, on the other hand, is a prolonged feeling of mental and thus physical energy drain. It is a mental illness, and not something to feel ashamed about. Depression causes feelings of numbness or extreme sadness for a prolonged time leading to a loss of interest in activities that were once enjoyed. Normal daily activities like waking up, brushing teeth, showering, can feel extremely exhausting. Fortunately, it is treatable, and here’s where antidepressants come to the rescue.
Did you think only humans undergo tremendous mental changes and thus only humans consume antidepressants? Well, turns out, that’s not true. All sorts of creatures fall mentally sick and need to be taken care of. In dire cases, creatures such as puppies and polar bears have been prescribed certain antidepressants for instance.
Did you know that before the pandemic hit, more than 14 percent of the total population in India suffered from variations of mental disorders? The majority of this share includes older adult females in India. We all know that COVID-19 has not been kind to people’s mental health. And to emphasize its importance, let’s look at some facts:
- Stats reveal that as of 2015, over 322.48 million people worldwide suffered from some kind of depressive disorder.
- According to National Centre for Health Statistics, more than 4 in 10 U.S. adults had developed symptoms of depression or anxiety by the end of 2020, a sharp increase from the first half of 2019.
- According to the UN, an estimated one in four people globally will experience a mental health condition in their lifetime.
Depression manifests itself in different ways for different people. Some of the common symptoms include sudden appetite changes (where people either eat too much or not at all) and/or sleep-schedule changes (where people either sleep too much or struggle falling asleep), and panic attacks, to name a few. It can be extremely hard for people with this affliction, to handle day-to-day activities, let alone normal situations (that they find extremely stressful). Some might need external help to pull them out of the vicious cycle of negativity and hopelessness and put their mind to ease. This is exactly what antidepressants are for.
What are antidepressants?
Antidepressants are a certain type of drug used to tweak the chemicals in one’s brain. We are sure you either know that or must have figured it out while going through the introduction part. To technically define them, antidepressants are designed to correct the chemical imbalance of neurotransmitters in the brain that cause mood and behavior changes. This is an example of what we call a “disease-centric” psychotropic drug action model.
Antidepressants can also be used for many conditions other than depression, such as Obsessive-Compulsive Disorder (abbreviated as OCD), Anxiety Disorder, and Post-Traumatic Stress Disorder (PTSD) among others. There are several categories of antidepressants that include:
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs).
- Noradrenaline Specific Serotonergic Antidepressants (NASSAs)
- Tricyclic Antidepressants (TCAs)
- Monoamine Oxidase Inhibitors (MAOIs)
If you notice, the antidepressant categories of drugs are focused on the happy hormone, serotonin, and noradrenaline (aka norepinephrine) — hormones responsible for emotions and blood pumping respectively. More about this later.
Are you wondering if you know of any antidepressant drugs? Chances are, you probably do. Zoloft (Sertraline Hydrochloride) is the most commonly used antidepressant worldwide. Elavil (Amitriptyline) is another major drug known to many. Celexa (Citalopram) is another commonly used SSRI drug. Let us know if you’ve heard of these in the comments down below!
How Antidepressants Work
The exact biochemistry of how antidepressants work with neurotransmitters is unfortunately unknown to man. The general idea is that these drugs upon consumption, increase serotonin and noradrenaline hormone levels. The increase in serotonin creates a mood change and makes a person happy (in a depressed person’s case, makes life bearable). The increase in noradrenaline, however, leads to more blood pumps, thereby increasing one’s physical energy. In some cases, antidepressants also alleviate long-term pain.
The brain is a well-defined collection of neurons and works on the principle of generating responses by a feedback mechanism. Every day we acquire different emotions as responses. Neuroplasticity, the power to form new connections between neurons, is impaired in patients having depression. The theory is that this prevents the brain from responding “correctly” to unwanted stimuli and stress. Antidepressants also gradually increase neuroplasticity.
It is important to note that antidepressants do not cure depression or other mental illnesses. Antidepressants can treat the symptoms of illnesses, but they do not always address their causes. These are usually used in combination with therapy (one-on-one sessions with behavioral experts to overcome the challenges one faces in their life), to treat illnesses like depression and anxiety.
Effects on a non-depressed brain
Have you ever wondered why antidepressants are not prescribed to non-depressed people to “create happiness” in their brains? It is not just because antidepressants are targeted drugs, but also because these alter the brain architecture permanently. Antidepressants can have unexpected and unwanted effects on a non-depressed brain. Let’s learn more about the specifics.
Two important regions in the brain are generally smaller in depressed people when compared to the non-depressed — anterior cingulate cortex (where regulation of mood takes place), and the hippocampus (where the consolidation of memory takes place).
Here’s an account of an interesting study conducted by UNSW, Sydney:
This study was not conducted on humans, because there were just too many variables at play — people have different underlying illnesses, varied types of depression, different treatment methods, etc. So, the primates used were monkeys. You know how extrapolation is widely prevalent in the scientific community! Anyway, the selected were segregated into two — male and middle-aged female monkeys (depression is twice as common in women than men). Both groups were given a diet that replicated a typical American diet for 18 months along with daily shots of sertraline.
The results were astonishing. In the depressed monkeys, the drug significantly increased the volume of the anterior cingulate cortex. In the non-depressed monkeys, it decreased the size of both the anterior cingulate cortex and the hippocampus! Intriguing right? Could this be applied to humans? That’s a question to ponder about. But in the 25 years of SSRI consumption, human brains have never shown brain damage or a decrease in intellectual capacity. So far, so good huh?
The negative side of antidepressants
Sometimes, using antidepressants could potentially be harmful to human beings like we saw in the previous section. Antidepressants may also cause adverse effects to some and therefore must be used with caution and never without a prescription. The side effects that these drugs cause vary from person to person. A recent survey conducted by some health officials says that people who take antidepressants have a 33 percent higher risk of dying prematurely than people who don’t.
While antidepressants are designed to reduce symptoms of depression, they increase the brain’s sensitivity to future incidents after discontinuation. They also cause neuronal damage and make neurons revert to an immature state. In some people, the consumption of antidepressants affects sexual life and can cause developmental problems too. The common side effects include dizziness, anxiety, insomnia, and weight gain. Though it is rare, some severe side effects include serotonin syndrome caused by dangerously high serotonin levels in the brain, and hyponatremia, a condition that has the potential to lead to coma.
If you or someone you know is depressed, please seek medical help. The doctors know what’s best for you, and if they prescribe antidepressants to you, there’s no harm in consuming them. Continuing consumption after the course period of antidepressant drugs is extremely harmful as they have addictive properties because of the happy hormone induction.
Conclusion
Now that we are at the end of this article, it is safe to say that resorting to antidepressants is generally the last resort, and should never ever be self-medicated. Physical activities like yoga, meditation, sports, etc. help one stay sane during tough times. The surrounding always has an impact on our thought processes, so being surrounded by positive people and having positive thoughts is crucial for one’s mental well-being. Always remember, depression can be fought back! It can be fought back more efficiently if we have the support of our loved ones; so never shy away from opening up about your mental state. Lastly, if you struggle to wake up in the mornings because you don’t find the will to, please please seek medical help.
So that, dear readers, brings us to the end of yet another interesting write-up from Daksh, the official techno-management fest of SASTRA Deemed to be University. To have a better perspective about mental health issues, here are a few movies you can watch (if you haven’t already) to get you through the lockdown days:
Manchester by the sea
Room
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