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4 Signs Antidepressants Aren't Working for You
Jules Washington
Simply starting treatment for depression is an accomplishment worth being proud of. But as you've likely come to realize, the road to recovery isn't always smooth. Finding the best treatment for you can be a matter of trial and error, and you may encounter some setbacks along the way.
When you reach a setback, how do you decide which route to take next? Here, it's wise to take stock of the specific symptoms you're feeling in this moment. This includes your mood, physical symptoms, and any medication side effects you may be experiencing. This is especially important if you think your antidepressants aren't working.
Learning to recognize the signs your antidepressant is not working could help you understand how to get to your ultimate destination: a state of better well-being.
Signs Your Antidepressant Is Not Working
1. You Still Have Symptoms
It may sound obvious, but it's worth mentioning that if you still have symptoms of depression, your antidepressants are not working to their full effect. Many people experience only partial relief, but not full relief. If your remaining symptoms are impacting your quality of life, you may want to consider changing your treatment course.
Remember that everyone's experience with depression is different. Some people with
depression symptoms have a tendency to experience specific physical symptoms, such as muscles aches, joint pains, and stomach problems, for instance. This can be especially true for older adults. Men can (and do) experience the more common symptoms of depression, such as low mood and lack of energy, but they are also more inclined to angry, aggressive, and risk-taking behavior as well as substance abuse. If your mood has lifted a little but you're still experiencing some of the symptoms mentioned above, that may mean antidepressants are not a fully effective treatment option for you.
2. Your Sleep and Appetite Remain Disrupted
If you're finding that your sleep and appetite are still affected, it's possible your antidepressants aren't working as well as they could. Sleep disturbance in depression can manifest in a variety of ways: waking up early in the morning, oversleeping, sleeping restlessly, or feeling tired all the time. As for changes in appetite, you might have experienced unintentional weight loss or weight gain, with or without food cravings.
3. Your Initial Response to Treatment Has Tailed Off
Perhaps you felt energized soon after starting antidepressants, but now your symptoms have returned. Up to
34 percent of patients lose their initial positive response to their antidepressant, or they have a reduced response to it over time. This lost or reduced response is called tachyphylaxis.
This is called breakthrough depression. If you're beginning to suspect your depression is returning, ask yourself a few quick self-assessment questions. Have you lost interest in socializing, your hobbies, or your career? Are you less motivated and more tired—feeling that even small tasks take a good deal of extra effort? Do you feel anxious, restless, or irritable? Remember, you are the best judge of your own well-being.
4. You Are Experiencing Side Effects from Treatment
The most common antidepressant side effects
listed by the FDA include nausea and vomiting, weight gain, diarrhea or constipation, fatigue, and sexual problems. If you have persistent adverse effects, it may be best to seek a different form of treatment. Before making any changes, however, consult with your doctor. Suddenly stopping or even pausing your antidepressant can cause withdrawal-like symptoms or depression symptoms to worsen, so make sure to schedule an appointment to figure out next steps.
Stay Hopeful
If the signs suggest your antidepressants aren't working, talk to your doctor about optimizing the dose of your current medication or trying a different one. It's important to continue with your medication, even if you feel your antidepressant is not effective, until your doctor sets a new treatment course.
Even when there seem to be roadblocks in front of you, remember there are other effective options available. One of these is transcranial magnetic stimulation, or TMS. This is a treatment choice for when at least two medications have not been effective for depression. It is an FDA-approved,
non-invasive and non-drug form of treatment that applies highly focused magnetic pulses to brain regions that regulate mood.
Sixty-two percent of patients report a reduction in depression symptoms at the completion of the acute phase of TMS therapy, i.e., within just six to nine weeks.
If you still experience symptoms of depression after trying antidepressants, know that you deserve a treatment option that works—and you deserve to feel better. It is possible to get yourself back on track and follow those signposts toward healing.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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