How Do Antidepressants Work?

Depression is a complex psychiatric condition that affects millions of people worldwide. It can lead to persistent feelings of sadness, hopelessness, and a loss of interest in things you used to enjoy. These symptoms can be overwhelming and impact the way you live your life. They can make it feel next to impossible to function as you would like at work and at home as well as in your relationships. For many, finding a psychiatrist and a counselor can make a world of difference. 

Understanding Depression and How It Effects You

Major Depressive Disorder (MDD), is a mood disorder that can greatly impact your ability to live your life as you see fit. Symptoms can include; 

  • Persistent sad mood or feelings of emptiness
  • Loss of interest in activities once enjoyed
  • Difficulty concentrating or making decisions
  • Sleep disturbances (either sleeping too much or too little)
  • Appetite changes and/or weight fluctuations
  • Feelings of worthlessness or guilt
  • Thoughts of death or suicide

For many individuals, depression is caused by a combination of things such as stressors, genetics and chemical imbalances in the brain. Neurotransmitters in the brain (chemicals that help transmit signals between nerve cells) are essential in regulating mood. An imbalance in these chemicals can contribute to the onset of depression. Medication can help with this.

How Can Medication Treat Depression? 

Medications for depression primarily aim to address and correct chemical imbalances in the brain. By influencing neurotransmitters such as serotonin, norepinephrine, and dopamine, antidepressants can help regulate mood, improve energy, restore healthier sleep patterns and improve overall functioning.

There are several types of antidepressant medications, each unique in the ways that they work. The most common include:

a. Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are among the most widely prescribed type of antidepressants. They work by increasing the levels of serotonin, a neurotransmitter associated with feelings of well-being and happiness. SSRIs block the reuptake (absorption) of serotonin in the brain, allowing more of it to remain in the synaptic space between nerve cells, which helps improve mood and reduce depressive.

Common SSRIs include:

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)

SSRIs generally have fewer side effects compared to older antidepressants, making them often a first choice in the treatment of depression.

b. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs work in a similar way to SSRIs, but they also increase the levels of norepinephrine, another neurotransmitter that plays a role in mood regulation and energy levels. By boosting both serotonin and norepinephrine, SNRIs can help treat symptoms of depression and anxiety.

Common SNRIs include:

  • Venlafaxine (Effexor)
  • Duloxetine (Cymbalta)

SNRIs can be particularly helpful for individuals with depression who also experience chronic pain or fatigue.

c. Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants were among the earliest medications used to treat depression, though they are now less commonly prescribed due to their potential for more severe side effects. TCAs increase the levels of serotonin and norepinephrine in the brain but also affect other neurotransmitters and receptors, leading to a greater chance of side effects such as dry mouth, dizziness, and weight gain.

Despite their side effects, TCAs can be effective for individuals who have not responded well to other medications.

Common TCAs include:

  • Amitriptyline (Elavil)
  • Nortriptyline (Pamelor)

d. Monoamine Oxidase Inhibitors (MAOIs)

MAOIs are another older class of antidepressants that inhibit the activity of an enzyme called monoamine oxidase. This enzyme breaks down neurotransmitters like serotonin, dopamine, and norepinephrine, so inhibiting it allows these chemicals to accumulate in the brain, thus improving mood and reducing depressive symptoms.

MAOIs can be effective but are typically prescribed as a last resort due to their interaction with certain foods and medications, which can lead to dangerous side effects. Patients taking MAOIs must adhere to a strict diet to avoid foods containing high levels of tyramine, such as aged cheeses, cured meats, and fermented foods.

Common MAOIs include:

  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

Finding the Provider That is Right for You

Every person is unique. The way you experience depression may be different from others. It is important to find a prescriber that will address your symptoms and your needs. Developing a medication management plan that is right for you is essential to successful treatment. 

Many think that the only provider they can see for medication management is a psychiatrist. While psychiatrists are highly skilled, Physician Assistants (PAs) and Psychiatric Nurse Practitioners (NPs) are often a wonderful option. They have advanced medical training and are able to prescribe psychiatric medications. 

Carolina Counseling Services in Sanford, NC contracts with knowledgeable PAs and NPs who care about you and your needs. They will complete a thorough assessment and make recommendations to best address your symptoms. Call CCS today to get started. Online appointments are available making getting the treatment you deserve easier than ever before!