Young Adults’ Experiences of Depression in the U.S.

Depression, medication, and treatment choices

People with depression may choose to take prescribed medications to help with depression symptoms. Some people we interviewed managed their depression with medication alone. Others used medication in combination with therapy, lifestyle changes and/or holistic and integrative treatments. Some did not use medication at all and only used other approaches to manage their depression. The ways that people manage their depression can change over time. Many people we interviewed described changing their thinking about medication – some growing more favorable, others less so – in response to personal experiences and growing self-knowledge. (For more about approaches to depression other than medication please see ‘Therapy and counseling’, ‘Depression and strategies for everyday life’ and ‘Holistic and integrative approaches to depression’.)
Deciding to go on an antidepressant – or not

People we talked with considered many factors before making the decision of whether or not they wanted to take medication. Some started therapy first, while others carefully weighed the benefits, expectations, and potential side effects of different medications. Pete knew he didn’t want to “be dependent on a drug to fix my problems.” He talked with his therapist about medication options in addition to “weighing the pros and cons.” He also used the internet for research, talked with “other people who are depressed” and sought out the opinions of friends with social work or clinical backgrounds. In contrast, a few people knew they wanted medication right away.
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Some people we interviewed were initially resistant to taking medication, but eventually decided to try it. Casey first thought that taking medication to feel better would be “cheating.” Joey said his family noticed that he didn’t seem like his “normal self”, and although he agreed to talk with a therapist, he was reluctant to accept that he was depressed because “everyone is unhappy.” Eventually, though he decided to try medication when “pharmaceuticals sounded like a better option than staring out my window with like nothing to do every day.”
Many people we talked with decided not to take medication because they were worried they would become dependent on it. Pete worried about the permanence of medication and having to take it “for most of the rest of your life until you are completely healed.” He also worried about dependence and future access to medications, saying, “what if that pill runs out, what if I, there is a situation where I can't get another one then I burst from the seams.” Ben, however, said his depression was severe and left him he no other option. He described, “I didn’t want to depend on the medication but now I have to.” A few other people expressed they only wanted to use medication as a “last resort”, if their depression became severe or if they were out of options. Kate felt “pretty functional without it.” She worried that medication “would carry a risk of undoing the work that I've already put in.”
Sophie, Julia and Crystal had family members who were against them taking medications. This led Sophie to choose to manage her depression through behavioral therapy. Julia, whose mother was against both medications and therapy, decided to take medication anyway because she “was just really desperate” and “couldn’t keep going with being as impulsive as I was.”

Others thought that antidepressants weren’t necessary or effective given their reasons for feeling depressed. Teddy said he doesn’t feel like he needs pills, and that, “it’s kind of more I need my friends and family to know that I’m there to support them and they’re there to support me when I need it most”.
Some, like Sophie and Tia, had other reasons for not taking medication. Sophie says, “quite frankly…I don’t like pills. I can’t take pills”. Tia says she used to use “prescription drugs and alcohol...as an outlet,” so she did not want to take antidepressants. (For more about depression and substance use, see ‘Depression, substance use and abuse.)

How medication can help

Medications were seen by many as something that eventually improved their lives. Shayne says it helped her neurochemical imbalance and allowed her to get better. Although some mentioned that medications took time to become effective, many people also said that medications helped them better cope with issues in their life and generally made them feel better. Frankie feels “like there are much fewer lows now, now that I consistently take it.” Elizabeth says, “It really helped calm down what I like to call the noise, it helped me focus on working with a therapist, working on behavior, working on coping skills, problem solving and it really was the key to me getting better and I don’t think that I would have if it weren’t for that.” Ben also says his thoughts are “much clearer” when on medication. Joey felt like on the medication he could “be more productive” and “get things done.”
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Medication helped a few people feel more sociable. Meghan says when she’s on medication she feels she is “more bubbly, more approachable.” Maya the medication helped her “deal with the amount of stress that my family caused me.” For Frankie and Jacob, the medication helped reduce irritability.

For Mara, medication helped alleviate her desire to self harm. (For more about self harming, see ‘Depression and self -harming’.)

Finding the right medication and dosage

Several people we interviewed said they tried multiple medications or multiple dosages before finding the right medication or combination of medications that helped their depression. For some people this was very frustrating. However, although it was time consuming, Shayne said she “recognized that medication could make me feel better and it was worth it to try to find the right medications.” People described needing to talk with their doctor about why a certain medication was or wasn’t working for them, and working with their doctors to develop the best treatment plan. Sometimes, this involved lowering the dose of medications. Maya, for example, realized that she needed a lower dose than what was prescribed so she could feel normal emotions, including the “highs.”
Side effects and other issues with antidepressants

All medications have potential benefits and side effects. Many people we talked to said they experienced side effects when taking antidepressants. These physical side effects included feeling “extremely sleepy,” gaining weight or nausea. Others reported having a change in personality. Several people said they felt numb or no emotion, or felt “foggy” after taking medication. Sara described “I didn’t feel like myself I felt like I was just, blah, very just, no emotions and I didn’t like that. I didn’t like that I couldn’t feel things, I didn’t like the way I acted. I wasn’t myself.” Joey felt like there was a “glass emotional ceiling” that limited his ability to feel. Devin said the medication “would…make me extremely angry” and realized this was not how he should be feeling. A few people switched medications or stopped taking some of the medications that were initially prescribed to them, due to side effects. Joey and Ryan said the medications made them feel “less creative,” which ultimately led to their decision to stop taking them. Some had other issues with antidepressants. Ben found it difficult to remember to take them daily. Brendan felt a “distrust” toward antidepressants after the medication he was taking suddenly seemed to stop working.
A few people, like Sierra Rose and Colin, experienced an increase in suicidal thoughts after being placed on a new medication. Although this is an uncommon side effect of antidepressants, it is serious and needs immediate help. The FDA has placed a “black box” warning label on antidepressants to alert people up through age 24 about this rare but serious possibility. For more information about suicide and depression, see ‘Depression and suicide’.

If you or someone you know is considering harming themselves, call 911 or The National Suicide Prevention Lifeline, 1-800-273-8255.

Deciding to discontinue medication or use medication long term

People we interviewed discontinued taking medication because of feeling better, experiencing negative side effects, or having difficulties affording the medication. Several people said they decided to stop taking their medication when they “felt better.” Elizabeth met and found social support in her husband and felt the combination of “medication and different changes in my life... really helped me get a lot better.” She has been off medication since then. Others, like Shayne, turned back to medication when experiencing another depressive episode. Sally also found it “unbelievable how hard it was for me to control my emotions again” after stopping her medication and ended up deciding to take them again. 

When some antidepressants are stopped suddenly, there can be side effects*. After feeling better, Joey decided to discontinue his medication “cold turkey.” This led to a “zappy kind of feeling, where it’s like almost like a twitch or something.” Marty, Teddy, and Sam said they discontinued their medication due to cost-related issues. Marty found the medications too expensive and instead self-medicated with substances. Teddy says he felt like the medication was not working and didn’t see why he should “keep paying for it.” Sam said medication did help him, but after taking a semester off, he no longer had access to student health insurance.



References
* Haddad, Peter M. "Antidepressant discontinuation syndromes." Drug Safety 24.3 (2001): 183-197.

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