Antidepressants that treats anxiety and depression are widely prescribed – many people have been on or will be on antidepressants at some point in their lives. They are used by millions of people and have helped millions of people. There are people that are over-reliant on them and aren’t ready or willing to do the exploration with a therapist that is needed to get to the roots of their anxiety and depression.
However, there are also those who could greatly benefit from antidepressants who are hesitant to take them. They may feel that there is a stigma associated with these drugs. They may feel it’s taking shortcuts or that they won’t be themselves if they take them. Often they’re misinformed about how antidepressants actually work in the brain.
Quick Disclaimer: I am not a medical doctor or psychiatrist. As a therapist, I understand how medication works and have seen its impacts, but you should always consult with a medical doctor if you have questions given your particular situation.
Antidepressants and the Brain
I would like to share with you a metaphor that I think is particularly helpful in understanding antidepressants. The metaphor is one of a bridge that serves as a temporary connection between the synapses in your brain.
Think back to your high school biology class when you learned about the brain. You may have been told that the neurons in your brain look like two fists coming together. The fists don’t actually touch – there is space between them. And in this space, we have neurotransmitters facilitating impulses back and forth across the synapse (the space between 2 neurons).
When your brain is working properly and you experience stable moods, it is because your neurotransmitters are facilitating communication properly – making it possible for messages to go back and forth between neurons. And, of course, there are trillions of these impulses firing in your brain all of the time. This communication promotes the normal, healthy feelings of someone who is not depressed or anxious. But when we’re experiencing depression, anxiety, and other types of mood-disrupting disorders, the communication between our neurons is misfiring or not working correctly.
SSRIs (selective serotonin reuptake inhibitors) are the most common and likely the most prescribed form of antidepressant medications used to treat both anxiety and depression. Think Prozac, Lexapro, Zoloft, etc. As their name suggests, they inhibit or stop the neurotransmitter serotonin from being absorbed into the neuron, thus making more available to facilitate connections between neurons.
Antidepressants Can “Bridge the Gap”
Imagine a town with a river flowing through it, and a bridge over that river that serves as the connecting point between the two sides of town. If that bridge is out of commission, the entire town is disrupted — people can’t connect, the flow of commerce is stalled, and people can’t get to work, school, or appointments. All of the good things that happen when transportation flows normally just can’t happen.
Now imagine a similar disruption happening in your brain!
When neurotransmitters that are supposed to be facilitating connection aren’t working, it’s like the bridge is out in your brain. When you take an antidepressant for anxiety or depression, what it does is help rebuild that bridge, or at least create a temporary bridge in the brain.
Antidepressants can be tremendously helpful. But they are not meant to act alone. The best practice for using these medications is to combine them with psychotherapy to treat anxiety or depression, and, if necessary, address the underlying trauma, event, or stressful circumstances that contributed to the neurotransmitters’ disruption.
When it works, the medication can “clear out the fog” in the brain and boost motivation to do the work of therapy and experience its benefits. Other factors also can provide therapeutic benefits, such as quality sleep, regular exercise, reduction of alcohol and eating nourishing whole, minimally processed foods. When everything in your brain is working as it should, energy and impulses are flowing as they should. And when we are depressed or anxious, sometimes the bridges in our brain need a boost so that our moods can stabilize and energy can flow properly.
I hope that this analogy helps demystify and destigmatize the role that antidepressants can play in working through difficult times. If you think you could benefit from medication, I encourage you to talk to your doctor or psychiatrist. If you would like to discuss how therapy could improve your life, please feel free to contact me for a free consultation.