Psychiatry News | Hee-Joo Jung, Specialist in Psychiatry
Why you need antidepressants
Medication is very important for depression. Perhaps there are many people who have the idea that ‘depression can be overcome with will instead of medicine’. However, depression is a condition that is accompanied by a combination of physical symptoms such as fatigue, insomnia and decreased appetite, decreased thinking and concentration, and negative cognitive distortion along with a depressed mood. .
especially moderate to high Depression can be treated most quickly and effectively when medication is combined with counseling.has enough scientific evidence. Unfortunately, psychiatric visits and medications are often delayed due to a lack of information and misunderstandings related to antidepressants. If treatment is delayed, the intensity or duration of depressive symptoms may increase, and even if recovered, the risk of recurrence in the future increases. Late treatment due to misinformation makes the ‘brain vulnerable to depression’.
Depression is an imbalance of neurotransmitters.
There are several types of neurotransmitters in our brains and receptors with the right shape for them. Neurotransmitters floating around in the brain work when they attach to their correct receptors, just like a light bulb turns on when a battery of the right size is inserted. Depression is a condition in which there is a shortage of neurotransmitters, especially those responsible for emotions, among various neurotransmitters, and it is caused by not being able to contact receptors and not functioning properly.you can see it does.
There are many reasons for a lack of neurotransmitters. If there is a genetic factor, improper parenting during growth, psychological trauma, etc., the neurotransmitter responsible for emotions can easily become insufficient. After becoming an adult, neurotransmitters are depleted when stressed from the outside. At this time, it becomes difficult to control positive and negative emotions, resulting in depression.
Neurotransmitters responsible for emotions – serotonin, dopamine, norepinephrine
The neurotransmitters responsible for emotions are serotonin, dopamine, and norepinephrine, which are the most important in the onset and treatment of depression. Depressed people experience two mood states: too few positive emotions and too many negative emotions.will do At this time, the lack of dopamine affects positive emotions, which reduces euphoria, pleasure, mental alertness, enthusiasm, and self-confidence. On the other hand, a lack of serotonin affects negative emotions, increasing feelings of guilt, fear, anxiety, aggression, irritability, and loneliness. Norepinephrine is known to affect both positive and negative emotions. As such, serotonin, dopamine, and norepinephrine have similar but different functions, and their combination determines our emotional state.
How antidepressants treat depression
There are two main mechanisms by which antidepressants treat depression. First of all, it protects serotonin, dopamine, and norepinephrine, which have been depleted due to stress, from breaking down any further, and restores their concentrations to their original state. An analogy is to put a new battery in a light bulb that has gone out due to a dead battery and turn it on again.
Taking antidepressants on a regular basis affects not only neurotransmitters, but also their receptors that pair with them, making them function more effectively when they come into contact with them. In this case, you can say that the bulb itself is upgraded so that it glows brighter even with the same batteries. Because the treatment of depression requires a process that affects receptors, it is important to take antidepressants regularly.do.
Types of antidepressants
Antidepressants are divided into first-generation and second-generation antidepressants according to their mechanism of action. Both first- and second-generation drugs are effective for depression, and several studies have found no significant difference in treatment effectiveness. However, the first-generation drugs tend to have side effects such as drowsiness and weight gain compared to the second-generation drugs. Nevertheless, depending on the person, first-generation drugs do not have side effects and are more effective in some cases, so it can be said that whether to use first-generation drugs or second-generation drugs differs depending on the case.
Second-generation drugs have relatively few side effects because they selectively act on the neurotransmitters responsible for emotions: serotonin, norepinephrine, and dopamine. Also, among the second-generation drugs, drugs that mainly act on serotonin and drugs that act mainly on norepinephrine or dopamine are divided depending on the type, so they are prescribed according to the symptoms of depression and individual preferences. There are various second-generation antidepressants such as SSRIs, SNRIs, and bupropion, so it is necessary to choose the drug that is right for you according to the diagnosis of a psychiatrist.
Duration of treatment with antidepressants
There are not many cases of recovery from depression immediately after taking antidepressants, and the full therapeutic effect begins to appear about 1 month after starting treatment. This is because antidepressants take about a month to affect the receptors of the neurotransmitters as well as the neurotransmitters. therefore It is important to continue taking antidepressants even if there is no immediate change.do.
When prescribing antidepressants, the most frequently asked question is ‘How long should I take the medication?’ It may vary depending on individual circumstances, but on average, it is recommended to continue administration for more than 6 to 9 months.It’s possible. If there is a family history of depression or recurrent depression, the treatment period is longer than this, and in some cases, continuous use for several years is required.
side effects of antidepressants
The biggest reason for reluctance to take medication for depression is probably the fear of side effects. As antidepressants are drugs, they have side effects. However, it is not that it damages the liver or adversely affects the brain when taken for a long time, as is often thought. In most cases, temporary side effects occur in the process of adapting to the drug.is to do Perhaps Even if side effects occur, most of them disappear within a few days if the dose is adjusted or the drug is stopped.So you don’t need to worry too much about it.
The types of side effects are very different depending on the individual and the characteristics of the drug, Drowsiness or insomnia, weight gain or weight loss, digestive symptoms such as nausea and vomiting, delayed ejaculation or decreased libido, etc.This can happen. There are many different types of antidepressants and they have different properties. Therefore, rather than giving up treatment right away if side effects occur, it is better to consult a psychiatrist and find a drug that is right for you.
Misconceptions about antidepressants – 1. Taking antidepressants makes you addicted to drugs.
Many people think that taking antidepressants is lifelong addiction and difficult to quit. not true at all Antidepressants are non-addictive drugsno see. In fact, some drugs in the psychiatric realm are addictive. Patients addicted to these drugs often visit the emergency room to get prescriptions or mimic the symptoms and beg for more prescriptions. But in my entire life, I’ve never seen a single patient ask, ‘Please, prescribe me more antidepressants.’ just There may be temporary withdrawal symptoms in the process of stopping antidepressants, but if you plan ahead with your doctor, you will be able to cope with it.You can.
Misconceptions about antidepressants – 2. Antidepressants damage the brain.
To put it more directly, it is a case of thinking, ‘I’m afraid that I will become a fool by taking antidepressants’. This is also not true. rather If depression is left unattended without taking antidepressants, stress hormones in the body increase and damage the brain.causes In fact, in a study using MRI, it was found that people with depression had a smaller area in the brain called the hippocampus, which is responsible for memory, compared to those who did not. so For brain health, it is necessary to quickly treat depression by taking antidepressants.do.
Since the invention of antidepressants, millions of people have been able to overcome depression and return to their daily lives. If you are suffering from depression, I hope that reading this article will help you get rid of the misinformation and misunderstanding about antidepressants and get effective treatment.
Gwanghwamun Forest Mental Health Clinic | Director Jeong Hee-joo