12 Facts About Depression and Antidepressants Everyone Should Know
Key takeaways:
Depression is a common, treatable mental health condition.
For many people, depression can go away — either on its own or with a combination of medication, therapy, lifestyle strategies, and/or alternative medicine.
Therapy and medication are equally effective, especially for moderate to severe depression.
Taking an antidepressant can cause side effects that may increase feelings of depression.
If your life has been affected by major depressive disorder (MDD), you’re not alone. Over 8% of American adults experience depression every year. And for young adults between the ages of 18 to 25, it’s even more common — affecting almost 17% of people.
With this in mind, it’s probably no surprise that antidepressants are some of the most frequently prescribed medications in the U.S.
It’s likely that you’ve either taken an antidepressant yourself or you know someone who has. Antidepressants are used not only to treat depression, but also to treat other health conditions like anxiety, obsessive-compulsive disorder (OCD), and even chronic pain.
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Though you’re probably familiar with depression and antidepressant medications to some degree, it’s normal to have questions. You may be wondering about the side effects of medication, if certain medications work better than others, and if there are antidepressants that are more mild for those just starting to take them. You may even have some questions about MDD itself.
Here’s the good news: If you’ve got questions, we’ve got answers.
Read on to learn 12 key facts about depression and antidepressants, so you can feel confident in understanding some of the basics. And if you’re looking for more in-depth information, you can always find it in our complete guide to depression.
1. Depression isn’t forever — it can go away
When you have depression, it can feel like your symptoms will never go away.
But, according to the American Psychiatry Association, between 80% to 90% of people with depression “eventually respond well to treatment.” And almost 100% of people have at least some improvement in their symptoms.
There’s even evidence that depression can sometimes go away on its own.
In addition to therapy and medication, there are other ways you can treat your depression, including:
Practicing mindfulness
Seeing an acupuncturist
Exercising
Eating nutritious food
Exploring dietary supplements
Getting social support
Getting good sleep
You can read more about how to combine these strategies in our guide to fighting depression.
2. Both therapy and medication works for depression
Trying to decide between therapy or medication? You’re in luck: There’s evidence that both antidepressant medication and therapy are effective for treating depression. It’s OK to go with whichever treatment feels like the best match for you.
And there’s some evidence that combining medication and therapy might actually give you the best results — especially if you have moderate or severe symptoms.
3. There are 3 commonly used types of antidepressants
There are many different types of antidepressant medications. But there are three types that are used most often.
Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors (SSRIs) help your brain use serotonin more effectively. Examples include:
Serotonin-norepinephrine reuptake inhibitors
Serotonin-norepinephrine reuptake inhibitors (SNRIs) help your brain do a better job of using serotonin and norepinephrine. Examples include:
Pristiq (desvenlafaxine)
Atypical antidepressants
These are antidepressants that don’t fit into other categories. It’s not clear exactly how they work. Examples include:
There are also some older types of antidepressants, like monoamine oxidase inhibitors (MAOIs) and tricyclics, but these aren’t used as often anymore. Older antidepressants tend to have more side effects and don’t work as well for other mental health conditions.
4. The biggest differences between antidepressants are costs and side effects
Surprise! Multiple reviews have shown that the effectiveness of different antidepressants is generally comparable, both across and within classes. Side effects, along with cost, are what makes them different. Some of these drugs are very expensive, especially those that are brand-name only.
5. SSRIs or SNRIs are good first choices
Which medication is the best to start with? Healthcare providers often start with an SSRI or SNRI, as these types of antidepressants tend to work well and have fewer side effects.
If you also have chronic pain, SNRIs may be a better first choice, as they can sometimes help treat ongoing pain in addition to mood.
6. SSRIs are the most commonly prescribed antidepressants
SSRIs are the most frequently prescribed type of antidepressant, especially fluoxetine and sertraline. This is because they usually work well, are cost-effective, and don’t have a lot of side effects.
Another reason SSRIs are prescribed so often is that they work for other health conditions, too. These include anxiety disorders, chronic pain, and obsessive-compulsive disorder.
7. Antidepressants can have side effects, but they usually go away
Like all medications, antidepressants can have side effects.
The most common side effects with SSRIs and SNRIs are:
Upset stomach
Diarrhea and constipation
Feeling tired
Sleep problems
Low sex drive
Problems having an erection
Problems having an orgasm
Appetite changes
Headaches
For most people, these side effects usually go away a couple weeks after you start taking the medication. Of all the different side effects, sexual problems are the most likely to continue.
If your side effects don’t go away — or they’re causing a lot of problems for you — talk to your healthcare provider. They can help you transition to another medication, if needed.
Remember: You may need to try a couple of different antidepressants before you find the one that’s right for you.
8. There are ‘mild’ antidepressants
Some of the SSRIs and SNRIs have a reputation for being more “mild” than other antidepressants. This just means that they are less likely than some other antidepressants to cause side effects, though they work just as well.
In research studies, people seemed to have the most benefits — and the fewest side effects — from these four antidepressants:
Escitalopram (Lexapro)
Paroxetine (Paxil)
Sertraline (Zoloft)
Mirtazapine (Remeron)
9. Antidepressants may work best for moderate to severe depression
Antidepressants seem to work well for many people with depression — especially if you have moderate to severe symptoms.
In research studies, most antidepressants worked better than a placebo (sham treatment). There’s evidence that up to 65% of people will get better when treated with medication, compared to up to 30% with a placebo. But there’s also some evidence that antidepressants might not work as well in people with mild depression.
10. Two antidepressants aren’t better than one
Taking two medications to treat your depression is not necessarily better than taking one.
In some cases, your provider might add on a second medication if your symptoms aren’t getting better. But it’s usually best to start with one medication at a time. If you start two medications at once, it can be hard to know which — if either — is helping and which is causing side effects.
11. Antidepressants can make you feel worse at first
Starting an antidepressant can’t actually make your depression worse. But it can cause side effects that are very similar to depression. Antidepressants can make you feel tired, cause concentration problems, and lead to changes in sleep and appetite.
These side effects can make you feel like your depression is getting worse, instead of getting better. You may even wonder if your medication is making you more depressed, especially since you have to take an antidepressant daily for several weeks before you see any benefits.
If you’re feeling this way, hang in there. And definitely check in with your doctor. For most people, antidepressant side effects get better in a few days. And, if they don’t, you can always talk to your provider about whether or not you should switch to another medication.
12. Depression takes time to go away
Patience is a virtue. You may find it hard to stay on your antidepressant, and side effects can be a huge factor in that. But they’re at their worst during the first few days and will likely get better, regardless of the medication you’re taking.
And keep in mind: While antidepressants may seem like they aren’t working or making you more depressed, it can take up to 6 weeks before they start to take effect. That’s why it’s important to hang in there and take your medication every day, so that it has a chance to start working in your body.
The bottom line
Facing depression can feel overwhelming, especially when you’re dealing with daily symptoms. But remember: Depression can go away, especially with treatment.
If you’ve been feeling depressed or hopeless for more than a couple of weeks, talk to your healthcare provider. They can help you understand whether you have MDD and, if needed, put together a treatment plan that’s a good fit for you.
Why trust our experts?
References
American Psychiatric Association. (2010). Practice guideline for the treatment of patients with major depressive disorder.
American Psychiatric Association. (2020). What is depression?
Brody, D. J., et al. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013-2016. Centers for Disease Control and Prevention.
Brody, D. J., et al. (2020). Antidepressant use among adults: United States, 2015-2018. Centers for Disease Control and Prevention.
Healthtalk.org. (2016). Antidepressants.
Luo, Y., et al. (2020). National prescription patterns of antidepressants in the treatment of adults with major depression in the US between 1996 and 2015: A population representative survey based analysis. Frontiers in Psychiatry.
MedlinePlus. (2021). Antidepressants.
National Alliance on Mental Illness. (2017). Depression.
National Institute for Health Research. (2018). The most effective antidepressants for adults revealed in major review.
National Institute for Health Research. (2020). Combined drug and psychological therapies may be most effective for depression.
National Institute of Mental Health. (2022). Major depression.
NIH MedlinePlus Magazine. (2020). Commonly prescribed antidepressants and how they work.
NHS Inform. (2022). Antidepressants.
Whiteford, H. A., et al. (2012). Estimating remission from untreated major depression: A systematic review and meta-analysis. Psychological Medicine.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
