Antidepressant medications are much more common than you might expect. Recent surveys have found that about 13% of all adults in the United States are currently taking antidepressants, with women and older adults using these medications most frequently. If your healthcare provider is recommending that you begin taking an antidepressant, you’re far from alone.
Once you’ve struggled with addiction, it’s perfectly normal to be nervous about taking any sort of medication. While it’s true that prescription painkillers and sedatives can be highly addictive, there’s no need to worry about becoming addicted to your antidepressant. In fact, if you suffer from a substance use disorder and co-occurring depression, taking antidepressant medication can be a vital part of your recovery program.
Understanding the Difference Between Tolerance, Dependence, and Addiction
Antidepressants often get labeled as addictive by people who don’t fully understand the difference between tolerance, dependence, and addiction. Tolerance means that your body has adapted to the presence of a certain substance and now requires more of it to achieve the same effect, while dependence means that your brain only functions normally when the substance is in your body.
Tolerance and dependence can be warning signs of addiction, but they can also occur when a drug is being taken for a legitimate medical purpose and used as directed. Prolonged use of antidepressants can lead to tolerance and dependence. However, antidepressants are not addictive because they won’t cause cravings, interfere with your judgment, or lead to the destructive changes that are associated with a substance use disorder. Antidepressants correct a chemical imbalance in your brain to help regulate your mood. They don’t make you “high” like an addictive drug will.
If a person taking antidepressants starts to feel better or wants to pursue alternative treatments, they should work with their care provider to taper their medication dosage slowly to minimize any uncomfortable withdrawal symptoms. Quitting “cold turkey” is never recommended. In addition to the symptoms of withdrawal, abruptly discontinuing antidepressants may lead to a sudden increase in depression or suicidal thoughts.
Finding the Right Antidepressant
The term antidepressant refers to a broad class of medications used to treat mood and anxiety disorders, but there are many different types of antidepressants. For example:
- Selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft)
- Serotonin and noradrenaline reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq)
- Tricyclic antidepressants (TCAs) such as amitriptyline (Elavil), amoxapine-clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
- Noradrenaline and specific serotonergic antidepressants (NASSAs) such as Mianserin (Tolvon) and Mirtazapine (Avanza, Remeron, or Zispin)
- Monoamine oxidase inhibitors (MAOIs) such as Phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (EMSA M or Eldepryl)
Since each antidepressant works in a slightly different way, it can take time to find one that fits your needs. For example, if you are bothered by sexual side effects while taking an SSRI, you may find that NASSAs provide symptom relief without side effects. Be honest with your healthcare provider about the side effects you are experiencing and work together to find a solution. While many initial side effects go away as your body adjusts to the medication, there are lots of options to consider if you’re still having trouble after four to six weeks.
Building Your Recovery Toolbox
If you have a substance use disorder and co-occurring depression, you must treat both conditions to set the stage for a lasting recovery. If you focus on getting sober without examining the mental health issues that led to your substance abuse, you’re setting the stage for a relapse.
At Mountain Laurel Recovery Center, we work with our clients to develop individualized addiction treatment plans that focus on healing the mind, body, and spirit. For clients with depression, we may recommend antidepressants to help with general mood regulation, keep thoughts of self-harm under control, and make it easier to maintain a positive attitude when faced with stressful situations or unexpected challenges. When combined with a healthy diet, regular exercise, professional counseling, and 12-Step support, these medications can help you lead a wellness-focused lifestyle free from the burdens of addiction.