Your 12 biggest antidepressant problems, solved

Have you started treating your depression with antidepressant medication, only to find that youre still wrestling with a number of tricky-to-treat symptoms or experiencing annoying side effects? If so, youre in good company.

Some people are exquisitely sensitive to antidepressant side effects, says Heidi Combs, MD, an associate professor of psychiatry and behavioral sciences at the University of Washington and the medical director of inpatient psychiatry at Harborview Medical Center in Seattle. Others can take just about any medication without running into problems.

The good news: If youre experiencing problems, most of them can be easily managed or reversed. Here are the most common reactions and concerns you might run into while taking antidepressants and how to resolve them.

1. Ugh Suddenly My Head Hurts

During the first few days of taking your new prescription, you might find that you have a headache. All antidepressants have the potential to produce this side effect for a few days, says Boadie Dunlop, MD, an adjunct professor of psychiatry and behavioral sciences and the director of the mood and anxiety disorders program at the Emory University School of Medicine in Atlanta.

He suggests taking acetaminophen (Tylenol) to help, adding that this symptom usually gets better within the first week or two.

2. My Stomach Is Upset, and I Have Diarrhea

3. I Have the Shakes

4. I Have a Dry Mouth and Really Bad Breath

In the meantime, Dr. Lim suggests sipping on water routinely, sucking on ice chips and sugarless candies, popping mints, and chewing sugarless gum.

If dry mouth persists beyond your first few weeks on an antidepressant, or if it is particularly severe, I would speak to your doctor as soon as possible, says Lim, adding that your dentist may also be able to help.

5. Im Still Sad

Of all antidepressant problems, this may be the thorniest to untangle. If youre continuing to experience depression symptoms despite taking an antidepressant, there are a number of possible explanations to consider:

• You got the wrong diagnosis. When someone has depression that doesnt respond to treatment, the first thing you do is step back and make sure you have the right diagnosis, Dr. Combs says. Your psychiatrist might do more tests to make sure some important clues werent missed the first time around. Medical conditions, including stroke, heart disease, hypothyroidism, and certain nutritional deficiencies, as well as some medications, can be the underlying cause of depression.
• Your medication hasnt kicked in yet. It takes time for an antidepressant to become effective typically a few weeks, but sometimes as many as eight weeks or more. Check with your doctor to find out whether you need to wait a bit longer.
• Youre drinking alcohol or using recreational drugs. These substances can interfere with the effectiveness of your depression treatment, so youll need to quit if you want complete success.
• Youre not in therapy. Although medication can help, you might also need to talk with a therapist to help you figure out how to cope with issues in your life that are causing you to feel sad or anxious. Some evidence suggests that the combination of medication and psychotherapy is more effective than either method alone.
• Youre taking the wrong medication. You might find relief by switching antidepressants or adding another medication, such as a thyroid drug or a mood stabilizer. Talk about this with your doctor.
• You need to try something new. Ask your doctor whether you might benefit from other approaches; even unconventional ones. For example, dance movement therapy and other dance-based therapies have been shown to help manage depression in adults, according to research.

6. Im Not Sad, but Im Not Happy Either

You dont have to lose your ability to feel joy in order to manage depression: Emotional blunting is best addressed by switching to a different class of antidepressants, adding a second medication, or talking with a therapist, Combs says.

7. My Antidepressant Is Making Me Gain Weight

8. Sex Tonight? No Way!

9. Im Up All Night

Some antidepressants are identified as activating, and some are sedating, Combs says. Finding the right match for you is key. A sedating antidepressant, for instance, might be a good bet for someone who is having problems falling asleep.

10. I Want to Stop Taking My Meds, but Im Afraid My Depression Will Come Back

Once you start feeling better, youll likely want to quit taking antidepressants. But Dunlop says that you need to be stable on antidepressants for at least six months first, to reduce the risk of experiencing another bout of depression in the future.

11. Now I Have Anxiety

Some antidepressants can have stimulating effects, resulting in restlessness, anxiety, and agitation, says Indra Cidambi, MD, the medical director and founder of Center for Network Therapy, a New Jerseybased outpatient addiction and mental health treatment facility.

One of the goals of antidepressants is, after all, to give you more energy to accomplish your daily tasks, Dr. Cidambi says. But sometimes people taking certain antidepressants just cant relax or even sit still when they want to. If this is the case, it needs to be addressed, she says.

Depending on the cause and severity of the restlessness or anxiety, your doctor may have different suggestions. Working out, yoga, or meditation is usually enough to drain away the excess energy, but if that does not work, you could ask [your] doctor to prescribe nonaddictive sedatives or adjust the dosage of antidepressants, Cidambi says. Sometimes, this may mean a different form of treatment is needed.

If youre having high energy levels accompanied by racing or impulsive thoughts, it may be a sign of a more serious condition, such as bipolar disorder, says Cidambi. She recommends talking to your doctor if you have these symptoms.

12. I Want to Die

Regardless of what might be prompting the suicidal thoughts, call your doctor immediately if you start to experience worsening depression symptoms, including suicidal thoughts or thoughts of harming yourself or others, Dunlop says. You can also get help at any time by calling or texting the 988 Suicide & Crisis Lifeline.

If youre running into a problem with your antidepressants, theres likely a solution so dont ignore it. Get to the bottom of it.

The Takeaway

Additional reporting by Michelle Pugle.