It can be a long and complicated process to find the right antidepressant. If it’s time to change your dose or med, you’ve got this.
In an ideal world, you could press a button to find out exactly what medication would help you, how long you should take it, and how much. You wouldn’t have to go through trial and error, or intolerable side effects.
But in reality, finding the right antidepressant or depression treatments can be complicated, challenging, and exhausting.
If you’re about to change your antidepressant(s) or are on the fence, I’m here to tell you that it’s going to be OK. I’m doing it right now, too.
I’ve tried many types of antidepressants with varying levels of success. Sometimes the right med or combination have worked for a time, and other times I know instantly it won’t work out.
For some people, it can be easier. But for people with treatment resistance —
I’ve tried everything from going on “drug holidays,” where you take a break to find your baseline symptoms (it turns out my baseline sucks) to spending 5 nights a week for more than a month doing transcranial magnetic stimulation (TMS) therapy (results not as anticipated).
Still, in the past 2 years, I’ve been lucky enough to have had a fairly stable medication. It wasn’t until 3 months ago that I started noticing my depression symptoms returning full force. Without even a polite knock, it burst through, ready to destroy everything in its path.
But I’ve lived with depression for many years, so I know that with the right treatment combo, I can manage. I’ve made it this far.
Even so, it felt hard to reach out to my psychiatrist. Why? I didn’t want to recognize the signs that it was time to change medications again — to go through the process of tapering, trialing, and waiting.
Like for everyone I know, the pandemic has made everything feel 10 times more exhausting. And of course, depression makes everything feel 20 times more exhausting. So basically, I’m tired.
If you’re considering changing your antidepressant, you’re not alone. Whether you’re changing your dose or switching to a new type (or even stopping altogether), each small step takes you closer to the other side — if not to full recovery, at least to a safe and manageable spot.
If it’s time for you to make changes to your antidepressants, here are some tips that have helped me:
Be gentle with yourself
This is honestly the most important tip I can share with you, and one I often have to remind myself.
According to my depression, I have been a lot of things, and none of them were good. I am worthless, not good enough, too young, too old, too much.
If your depression symptoms are back, your negative thoughts might be louder and more obnoxious. You might be thinking “why bother?” when it comes to changing medications or getting out of bed… or anything.
But you’re here and you’re doing the dang thing. While you may not feel like it, celebrate the small wins — getting out of bed, working, taking a walk, running an errand, making an appointment.
And if you’re currently changing medications? Keep celebrating, because it’s not always an easy road.
You may have to deal with early side effects, discontinuation syndrome, or just finding the right medication when one (or five) aren’t a good match. Your mood and energy levels might feel all over the place as you go through this process.
So be gentle with yourself and give yourself a little grace. If you can take a day off work when you’re feeling bad, do it. If you need to stay in bed for an extra hour, don’t punish yourself for being kind to you.
It might also be a good idea to work with a mental health professional who can help and guide you through those “all over the place” experiences.
Be your own advocate: Research before your appointment
If you’ve made the appointment to change antidepressants (or a followup), you can advocate for yourself by coming prepared.
While my psychiatrist is the professional mental health expert, I’m the expert on me. So if my next appointment will be surrounding medication changes, I often do a quick search into any new medication options, different classes of antidepressants, and supplements that have shown evidence of improving symptoms.
Try to go into your appointment with an open mind and be prepared with questions or any concerns you might have about any new medication recommendations.
Take time to make decisions that work for you
I go over side effects, my concerns, and all of that when I talk with my psychiatrist, but if she’s given me new treatment options (especially more than one), I often ask to email her the next day with my decision. This gives me time to look up the information, side effects, and compare what she recommends.
Yes, you can give yourself permission to not have to make a decision RIGHT NOW in that 15-minute appointment. Most doctors have email set up and can send a prescription any time, so it’s worth advocating for that extra decision time.
Track your side effects and symptoms
You can jot it down on paper, in your phone, or use an app, but however you do it, it can help to track what you’re feeling.
Taking notes before your first appointment helps so you know what you want to bring up regarding your symptoms and how your current treatment is and is not working for you. The more information they have, the more they can help.
Once you’re in the midst of changing medications, notes (even brief ones) can help you figure out how you’re feeling about the medication changes.
Maybe you’re feeling lethargic every day at a certain time. Your doctor may recommend changing the time you take the med to compensate. Or perhaps you’ve noticed improvements in a few depression symptoms, but not with your sleep. This info can help your doctor figure out if you need an add-on medication or if something else is going on.
Ask for help if you need it
Depression often tells me to isolate, but we all need and deserve support, especially when we’re feeling at our lowest.
You can ask for help. You won’t be a burden.
You can reach out to friends or family for distractions, to remind you to take meds, just to talk or vent, or to help you make an appointment.
You can seek a mental health professional for finding the right tools to get you through each day and extra support if you’re having a hard time changing medications.
You can also find a support group of like-minded people who get just what you’re going through.
Take all the deep breaths
Research, symptom tracking — all the things — help me advocate for my health, but if I’m being honest, it can also be a one way ticket to panic, thought spiraling, worst-case scenarios.
You might know what I mean if you’re looking at that list of rare side effects and are waiting to pretty much implode.
When you go from reading to gain knowledge to reading yourself into a pure ball of anxiety, it’s time to step back and take some deep breaths. Maybe try emailing the info to your doctor to ask just how big that 1% risk really is.
Yes, it can be challenging to find the right antidepressant, especially if you live with treatment resistance like me. But no matter what your depression might tell you, you can do it.
You will find a treatment plan and support that works for you.
If you need a bit of help with the starting research, here’s some information from Psych Central that might help: