How do Antidepressants Work?

According to the Royal College of Psychiatrists, antidepressants were first created in the 1950s and have been used ever since to treat different forms of depression as well as some other mental problems like eating and anxiety disorders. Although there are around 30 different kinds of antidepressants available today, they all fit into four major categories: Trycyclics, MAOIs, SSRIs, SNRIs, and NASSAs, according to the Royal College of Psychiatrists.

Because they are so closely related to thought and behavior, antidepressants have long inspired questions wherever they have been used. Although they certainly impact the way an individual thinks and feels, they force individuals to look at the connection between nature and nurture and to ask if it is possible that a medication can alter a person's personality or sense of self. However, further study into what antidepressants actually do reveals that their role is entirely biological. They help to establish normalcy in the brain, which then positively affects the thoughts and feelings of most individuals.

Antidepressants are used to treat a wide range of psychological disorders, from controlling eating disorders to treating obsessive compulsive disorder and depression. According to Discovery Health, there are many different kinds of depression. For instance, the web site defines Major Depressive Disorder as a disease characterized by a person's intense feelings of sadness or disinterest in what he or she was once interested in. There are other degrees of depression. For instance, mild depression can be characterized by feelings of sadness, but antidepressants are generally not used to treat mild depression. Instead, persons with mild depression are typically treated with therapy alone.

The Royal College of Psychiatrists states that antidepressants seem to be more effective than placebos, as people given antidepressants improved significantly over those who were given the fake pills. Still, it is possible to attribute some of the positive effect of antidepressants to the so-called placebo effect, according to the Royal College of Psychiatrists. In other words, when people are treated for a disorder, they tend to believe they are getting better. Still, it is widely recognized that for most patients, antidepressants do weaken depression symptoms, though they may not be able completely cure the disorder. However, knowing that antidepressants works begs the question of how do they work? And that is still an issue of some debate.

The Royal College of Psychiatrists notes that antidepressants work through modifying the chemicals in the brain, suggesting that exactly how they work is still unknown. However, Discovery Health goes into much more detail. According to the web site, neurotransmitters are "messengers" that travel among the brain's neurons with all kinds of messages that not only describe what people are thinking, but also what they feel.

In a system that rivals the world's most advanced post offices, neurotransmitters travel from neuron to neuron via synapses, what Discovery Health lists as the formal name for the spaces between neurons. When neurotransmitters deliver their messages, they return to the sending neurons and can be absorbed by those neurons, no longer able to carry messages from neuron to neuron.

Because some neurotransmitters are connected to feelings, some of them are tagged as denoting sadness and depression, while others are tagged as being able to carry messages of happiness. Two neurotransmitters, serotonin and norepinephrine have been linked to depression. When people do not have normal levels of these neurotransmitters, they are more likely to become depressed. Many types of antidepressants remedy this situation by increasing the number of these neurotransmitters via different chemical processes, hopefully erasing the feelings of depression and sadness, according to Discovery Health.

One type of antidepressants, SSSRIs, work by stopping the process of reuptake -the formal name for when the sending neuron takes a neurotransmitter back and absorbs it. Medication increases the amount of serotonin and norepinephrine in the brain. Inhibitors that keep the sending neuron from re-absorbing the neurotransmitter ensure that more of the chemical is available in the brain. The intended result of this is fewer feelings of depression, according to Discovery Health.

But there is another way that drugs can increase the amount of neurotransmitters in the brain in order to decrease the likelihood of depression. This method is by stopping enzymes that break down these serotonin and norepinephrine. MAOIs stop an enzyme called MAO from destroying these important neurotransmitters, and because more of them are available in the brain's synapses, they can carry more messages that are not associated with depression.

MAOIs are also unique among antidepressants because of their connection to dopamine. John McManamy, an award winning mental health journalist, notes that dopamine has long been overlooked when it comes to depression and its treatment. However MAOIs, which were among the first antidepressants developed, are still among the few medications that focus on increasing levels of dopamine as well as the other neurotransmitters.

In addition to treating depression, antidepressants like SSRIs have also been used to treat other mental disorders, such as bulimia nervosa. In fact, PsychiatricDisorders.Com lists SSRIs among the common treatments for this disorder. When paired with therapeutic treatments, the web site states that SSRIs and other medications that are designed to prevent reuptake- thereby increasing the amounts of serotonin and norepinephrine in the brain-have been used successfully to treat patients suffering from this disorder. While anti-anxiety medications exist alongside antidepressants, some antidepressants have been generally given to patients suffering from anxiety disorders as well. Regardless of why a person is prescribed with an antidepressant, the medications act the same way, regulating chemical levels in the brain to impact behavior and feelings.

But while these medications are relatively successful at stopping depression and eating or anxiety disorders, they can also create side effects that are uncomfortable and potentially dangerous. Some of these side effects include nausea, sexual problems, fatigue, dry mouth, and constipation, as well as feelings of anxiety. However, the Mayo Clinic states that most side effects associated with antidepressants go away within a few weeks and those that don't can be managed through changing medication or lifestyle changes.

The side effects are one reason that so many different kinds of antidepressants exist. Although each essentially does the same thing-regulate the levels of neurotransmitter chemicals serotonin and norepinephrine (and sometimes dopamine)- they complete this task in different ways and create different side effects. For instance, MAOs and Tricyclic Inhibitors are the older forms of antidepressants, and the National Institute of Mental Health and Royal College of Psychiatrists agree that newer forms of antidepressants have fewer side effects.

However, the National Institute of Mental Health notes that antidepressant a person should choose is dependent on many factors, not just side effects. In fact, the National Institute of Mental Health writes that studies have shown patients who have switched antidepressant medication because the medication they were prescribed was not working, tended to respond favorably to a different kind of medication. This means that it is important for patients to continue taking their medication even if it seems that they are not improving. In fact, the National Institute of Mental Health recommends taking the medication for several weeks, as people generally don't see noticeable improvements until after this period of time.

Although antidepressants generally tend to be effective for patients suffering from major depression, generally these chemicals are not enough. Instead, the National Institute of Mental Health states that most patients receive treatments that include both antidepressants and psychotherapy, which involves talking to a trained clinician. According to the National Institute of Mental Health, including therapy with antidepressants teaches individuals to think differently, which can impact their ability to keep the positive effects brought on by medications. The fact that therapy is a standard part of the depression treatment helps to answer some individuals' questions regarding antidepressants. While they can help to correct chemical imbalances that have a direct result on feelings and emotions, they can't make a person act a certain way.

Thus, antidepressants have been around for around 60 years, and each function similarly. Each antidepressant aims to increase the availability of a certain neurotransmitter within the brains' synapses. The goal of the increased neurotransmitters is increased message delivery. In other words, with more carriers available to transmit positive or happy messages, it is more likely that the brain will absorb these messages, and the individual will feel normal. Antidepressants try to increase the availability of three specific neurotransmitters: serotonin, norepinephrin, and dopamine, with serotonin and norepinephrin deficiencies being the most often cited causes of depression. Antidepressants increase these transmitters in a couple ways: by destroying enzymes that seek to destroy the transmitters, or from preventing the absorption of the transmitters into the sending neuron. There are a variety of factors that determine why a certain person should take a certain antidepressant, and individuals who see no results after several weeks of taking one medication typically see results on another. Although they tend to help individuals suffering from depression, antidepressants are controlled substances, and are not given without a prescription. A doctor generally determines whether a person should be taking an antidepressant, engaging in therapy, or both.