Antidepressants: myths and reality Notes from a psychiatrist One of the common reasons for turning to a psychologist or psychotherapist is anxiety and depressive disorders of varying severity and duration. If, during therapy, severe symptoms of depression persist, feelings of anxiety, apathy increase, or suicidal thoughts appear, then there is a need to consult a psychiatrist and prescribe psychotropic medications, including antidepressants. People are often afraid to turn to psychiatrists, and the possibility of being prescribed antidepressants is simply terrifying, because... There are a huge number of myths around psychiatry and psychotropic drugs, and most of them are far from reality. So what is fact and what is fiction? Myth one: Antidepressants are drugs for “weaklings”; any depression can be overcome by willpower. Reality There are three degrees of severity of depression: 1. Mild degree of depression – symptoms of depression are mild and do not interfere with a person’s social adaptation . For mild depression, there is no need to prescribe psychotropic drugs; psychotherapeutic intervention is quite sufficient, and sometimes such depression goes away spontaneously and does not require contacting a psychologist/psychotherapist. 2. Moderate degree of depression - the symptoms of depression are more pronounced, the feeling of apathy and anxiety, insomnia are so strong that they lead to a decrease in performance and literally “do not allow a person to live a full life.” With this degree of depression, a person needs not only the help of a psychologist/psychotherapist, but also consultation with a psychiatrist and the prescription of antidepressants. 3. Severe depression - symptoms of depression reach their maximum severity, suicidal thoughts and psychotic disorders (delusions and hallucinations) may appear. Psychotherapy cannot cope with severe depression, and the prescription of antidepressants can save a person’s life. Myth two: Antidepressants include St. John’s wort, lemon balm, hawthorn, motherwort and other herbal infusions. Reality All of the herbs listed are herbal “antidepressants”, but they do not eliminate the underlying cause depression - impaired metabolism of serotonin and norepinephrine. Herbal antidepressants help cope with increased anxiety, and are largely adaptogens. They are only effective for mild depression. Myth three: Antidepressants are addictive, “it’s hard to get off them,” “you can prescribe or stop an antidepressant on your own.” Reality When prescribed correctly, antidepressants do not cause addiction or dependence, because they do not produce a “high” or feelings of “euphoria.” People with personality disorders and character accentuations may only develop psychological dependence. Antidepressants, like any medicine, cannot be abruptly discontinued, because the body does not have time to rebuild itself and a sharp increase in side effects is possible. With gradual withdrawal, such serious effects do not occur. Self-prescription of antidepressants is ineffective and even dangerous, because Without knowing the effect of the drug and the required dosage, you can only harm the body. The doctor selects antidepressants strictly individually! Stopping antidepressants on your own can also be a dangerous experiment for your body. Myth four: When taking antidepressants, a person becomes a “zombie” and cannot experience normal feelings and live a normal life. RealityAntidepressants do not affect a person's feelings, thinking or behavior, except for those feelings that are caused by pathological depression and anxiety. There are “strong” antidepressants that are used mainly for severe depression and in small doses for the treatment of moderate depression. In large doses and at the beginning of treatment, they can cause drowsiness, apathy, and fatigue. Over the course of several weeks, these sedative (calming) effects become less pronounced. Antidepressants that are used first