I generally hear two major objections within the Christian community to antidepressants.
The first is that depression/anxiety is a spiritual problem, and I’ve addressed that damaging myth quite a bit.
The second is that antidepressants don’t work (study after study has proven they usually do), and along with that is the line that: “I took an antidepressant once, and it didn’t work, so none of them work, and the whole thing is a sham.”
I don’t doubt their experience, just their conclusion.
Everyone’s body is different and some antidepressants help some people, and don’t do anything for others.
Finding the right one often involves trial-and-error, patience, and trust in the process.
But there’s another important thing to remember. It’s important to give the antidepressant a chance to work.
You can’t take a new antidepressant for one week and expect rainbows.
If you’ve ever wondered why it can take a month or so for an Rx to work, Dr. Margaret Tsopanarias has a great, easy-to-read explanation over at Psychology Today:
“What we often see with depression is that the receiving cell is so hungry for serotonin, it increases the number of receptors reaching out for it. This is called upregulation.
When this happens, not only is there an increase in the overall number of serotonin receptors, but also an increase in the variety of serotonin receptors present. Though some of the receptor types added are related to mood, others are related to sleep, appetite, and sexual function, among other things.
This is why we don’t want to start with a high dose of an SSRI too quickly: If we give too high a dose, too fast, there will be a flooding of serotonin to all receptors types, including those involved in functions unrelated to mood, and this can lead to a dramatic increase in side effects.
When patients with depression are started on SSRIs, psychiatrists go low and slow to avoid side effects as much as possible, but they still occur to some extent.
That’s because there’s still an increase of serotonin meeting the overabundance of serotonin receptors present from the upregulation phase, caused by depression. Then, over the course of a few weeks, we start to see a reduction of serotonin receptors (of all types) in response to the abundance of serotonin in the synapse: this is called downregulation. At this point, both the positive effects and the side effects of the drug begin to diminish.
Downregulation occurs over the first two to four weeks after starting an SSRI, which is why there is often a delay in the efficacy of SSRIs for two to four weeks.
After the downregulation process stabilizes, psychiatrists then usually increase the dose of the SSRI slowly, and then we see a more consistent, positive effect of the drug on mood and more limited side effects if any.”
