Three doctors outline how antidepressants actually work and what to ask before starting

Antidepressants do not remove sadness, and they are not a standalone solution for persistent low mood, three medical experts said in a recent broadcast. Instead, the medication aims to adjust chemical imbalances in the brain to help patients function while they address underlying causes such as stress, thyroid issues, or nutritional deficiencies.

Dr. Rhea Rogers, a board-certified physician, noted that the decision to take medication is individualized. She advised patients to evaluate whether symptoms like lost sleep, energy, or motivation are affecting their quality of life. If a triggering event creates a downward spiral that a person cannot escape, Rogers said, it may be time to consider antidepressant therapy. She stressed that the drug is a tool to help a person work on how they got there, not a way to erase the emotion.

Gerontologist Sam Cradduck echoed this view, stating that medication changes the brain's chemistry but does not change the external circumstances. Cradduck emphasized that talk therapy is a necessary part of the process. The conversation does not always need to involve a licensed therapist, but the patient must be willing to face the issues that led to the low mood. Cradduck warned that without addressing the root causes, the condition will likely continue in a cycle.

Aging expert Amy O'Rourke recommended that patients find a psychiatrist who can provide a thorough assessment. This evaluation helps determine whether medication is appropriate, which specific drug to use, and the correct starting dose. O'Rourke also advised patients to track how the medication affects them after beginning treatment. She cited a client who experienced racing heartbeat and sweating, symptoms resembling a panic attack. In that case, the psychiatrist switched the medication, a process that highlights the importance of monitoring side effects.

O'Rourke said she wants patients to know the withdrawal symptoms before starting any antidepressant. Dr. Rogers agreed, noting that there are many withdrawal symptoms and that patients cannot simply stop taking the medication abruptly. Rogers also suggested that if patients can afford it, testing for genetic variations can be a worthwhile investment. This testing can help predict how a patient will respond to specific drugs, as not everyone reacts to the same medications in the same way.

Katherine Ambrose, an aging well coach, suggested combining medication with other support systems. She recommended talk therapy, journaling, and seeking support from medical professionals. Rogers added that patients should not forget to check their thyroid, hormones, and nutrients. Ambrose encouraged patients to talk to their doctors, seek answers, and try everything possible to bring themselves back to a better state. The experts stressed that the goal is to support the patient, not just treat a symptom.