Should You Take Antidepressants Forever?

[@kolimarie]

I’ve been on antidepressants for a while, but every time I come off them I relapse into a pretty severe depressive episode within a week or 2, but I’m comfortable knowing that I will likely need to be on antidepressants for the rest of my life (and yes I’m in traditional talk therapy).

[@MissBlueEyeliner]

Hey, I was on them for 11 years, I had that exact same problem so many times and I was getting no help on coming off them. Then I found out that the withdrawal symptoms from antidepressants are depression and anxiety! It’s brutal. It sucks. But if you can somehow hold on to it in your mind that the depression you’re feeling is a withdrawal and will pass, then you might make it out. It does suck though. But it’s so so worth it. Especially as you’re in talk therapy. (Ps: my psychiatrist told me I would be on them for the rest of my life. I am _never_ going to see that man ever again!)

[@ItsJadine]

@@MissBlueEyelinerI think it’s up to the person, like if a person is so depressed they are a risk to themselves (not saying that’s the case here), or they have bipolar and their moods are very unstable or psychosis. Then it might not be a temporary withdrawal symptom. Just like some people have panic disorder (not the TikTok version 😜) the SSRI long term would probably help to prevent panic attacks. I think that quality of life should be the main thing, theres a lot of people associate medication as a bad thing. It’s a tool, just like therapy. ❤

[@mariaradulovic3203]

I have no intention of coming off my AD. Why would I? They are keeping me alive.

[@ghostratsarah]

As long as they aren't causing you problems, there's no reason to go off them. A lot of people have this odd idea that being dependent on a pill is bad. That if you can manage without it, you should go off it. But, like, why?? I could manage walking around without an umbrella in the pouring rain, but, if the option is available to me, I'd be a nutter not to utilize it. Of course it's different if the wind is going to blow it out of my hand, but, in your case it sounds like the umbrella is providing sufficient protection from the rain with wind speeds at an acceptable rate. I'm not on ADs, but I'm on a lot of medications, that can be pried only from my cold rotting hands.

[@lachouette_et_le_phoque]

FWIW what you're describing sounds like you are having withdrawal instead of a depressive episode. Many doctors do not seem to understand that some people need to wean themselves off of antidepressants very slowly in order to be ok. This is how it worked for me, I got incredibly awful depressive symptoms to the point I was not able to do even move anymore, I don't recommend trying to tough it out! What worked for me to withdraw without getting any significant withdrawal effects was to calculate 95% of my current dose, take that for 5 days, then reduce by another 5% of that new dose and so forth, until I was down to a low enough dose (like eg 0.5mg when the full dose was 10mg) to quit entirely. If I still got symptoms, I stayed steady with my dose until the symptoms went away. It took more than a year to quit but I didn't have to suffer throughout the process. An easier slow withdrawal method would be to go 1mg lower every 3 weeks or so, but that was still too fast for me personally. I used a fine scale (20 bucks on Amazon) to weigh out the meds, and when I got too low for that to work I asked my doctor for a liquid prescription that I diluted in water and weighed out using a regular kitchen scale. Made a google spreadsheet to calculate the percentages and keep track of when to switch.

[@eyeseajujubee]

I really appreciate that you mentioned hypothyroidism. I’ve struggled with depression most of my life and recently realized that my thyroid levels have never been at a “normal” level. Not the case for everyone, but it was for me.

[@Hollyucinogen]

I also have hypothyroidism, and I also have depression (among a whole host of other symptoms). They just keep prescribing anti-depressants, anti-psychotics, therapy, and hospital stays. I've spent about a third of my life doing this, and they still haven't caught on that it's not working even though I've literally told them that to their face as recently as just a few weeks ago. I think that doctors are specifically trained to offer as many pills as possible to combat symptoms rather than the underlying problem. It's better to treat yourself whenever possible, in my opinion.

[@taramcflara]

Thank you for addressing the topic of psychiatric medication and treatment during pregnancy! This part of the specialty really gets overlooked, to the detriment of mothers and babies around the world; I've known a few friends with severe, lifelong depression enduring pregnancy without their medication because the effects on the fetus hadn't been studied 🤷‍♀️. They suffered so much because the pregnancy hormones increased the severity of their depressive symptoms. Those moms and kids are okay now, but it's heartbreaking that the women had to suffer so much simply because they'd been forgotten and overlooked

[@MissBlueEyeliner]

I’m 34, depression kicked in at 8, went on anti depressants at 22 and just got off then after 11 years a few months back. They will numb you enough for you to continue existing but I can confidently say now that for me at least, I wasn’t actually living. I tried to come off them so many times and my psychiatrist would always roll his eyes at me like I was a petulant child when I said I wanted to come off them. He failed to mention that the depression and anxiety at the half way mark was due to a withdrawal from the medication and not just a new onslaught of symptoms. It’s been a few months now and while it’s still really hard some days, I can feel ups and downs. I can cry from happiness as well as sadness. I have 11 turbulent years worth of tears to cry and I’m finally getting better now that I can feel the hurt I need to process. Do yourself a favour, avoid being on an SSRI long term if you can at all.

[@sircharlesmormont9300]

It's so weird how the experience is different for everyone. I honestly hope we get more research to help us to pinpoint root causes. I had a fairly severe episode of depression when I was 14-15. It went untreated and gradually dissipated by itself. Then, in my mid-twenties, I had a really bad episode. This one lasted for years, including a relapse that happened when I moved, had no money, had no health insurance, and had to ration my pills - and then I ran out. It was super fun to be mid-mental-health-crisis during the Great Recession. The next several years are a blur. I have few distinct memories from that time. It was a couple more years before I tapered off under medical supervision. Then, I honestly think it took me a couple more years to really get back to myself. There are parts of me that are gone forever. The difference between then and now, though, is like night and day. I don't know if I will ever be 100% recovered, but I think maybe I'm at somewhere in the 90% range. I pursued a career, earned an advanced degree in less than a year, read 100 or so books in a year, etc. I actually want to do things and, for the most part, I have the energy to do those things. My mind doesn't feel like it is clogged with molasses. For me, being on an SSRI long term got me through to the other side - and I am so, so thankful. I think it's really just different for everyone.

[@lachouette_et_le_phoque]

Your experience is valid, but not everyone will experience the degree of emotional numbing you've had to suffer through! They actually made me much happier. Individual experiences will vary widely with SSRIs! I'm sorry your psychiatrist did not support you, and failed at his job to protect you from withdrawal effects, and glad that you were able to reach your goal of withdrawing despite the lack of help.

[@marcopolo9569]

I started on tricyclics, switched to SSRI's when they became about. Went through most all of them and their iterations. Ended up on NDRI buproprion. I tried stopping it because I thought it wasn't doing anything, but soon found out it was indeed doing what it was supposed to be doing....

[@Classyferret]

Been on antidepressant for 7 years and Im slowly working to tapper them off with my doctor. Turned out to be a missdiagnosis of GAD and panic disorder when in fact I have POTS which is a autonomic nervous system issue causing inappropriate tachycardia and symtoms that mimick panic attacks and anxiety. Treated now with beta blocker, increased fluid and salt intake and Im feeling miles better.

[@joanna0988]

I keep wondering if this is what I have because my "attacks" happen when I'm exhausted, hungry or get too hot.

[@Classyferret]

@@joanna0988 Worth speaking to your primary doc about it. I ended up getting tested by a cardiologist and it was found my heart rate shoot up to almost double when I stand up (70 to 140) and also goes up when I eat or when Im too hot. I had near syncopes, dizziness, shaking, nausea, general feeling of being always Wired or Tired and cold sweats too.

[@bxstar5276]

They told me I had some major MH out of the blue. Tried to get me on pills so many times. I figured it’s POTs and it’s all confirmed now.

[@101kurtj]

I ❤ this man. His energy is perfect for this kind of work. Just makes me wanna pinch his cute little cheeks every time I see one of his videos. He has just a sweet, pure, and holistic understanding of what he's presenting. It's great. 😊

[@DoctorElliottCarthy]

☺️

[@lovel2940]

I've been on anti depressants (Citalopram) for about 7 years. I had been depressed most of my life and became suicidal so got diagnosed and treatment. Personally it has worked well for me. But along with general support from frie ds family and some therapy. I felt better but not happy most of the time. But only the past 2 years I can say Im finally in a good place and happy. My doctor have recomended staying on the medication for now as i could relapse. But i could try smaller doses. At the moment im not sure. 1 day last month i forgot to take my mediacation and i has to take a day trip. And i felt physically sick all day (not depressed) just suffering from vertigo. Even when i went back on the medication it took me 2 days to recover

[@randomname24680]

Just in case you don't know : the withdrawal symptoms are not representative of mid to long time effect of stopping the medication. Which is why it's important if you stop to do it progressively.

[@mysterionz]

Similar instance happened to me. I’ve taken Prozac on and off for my entire life for depression/anixety. I once went without it for two days bc I forgot to take it and I had withdrawal symptoms that consisted of dizziness, my stomach hurting, and nausea. I’m trying to taper off of it again now that im on a stronger anxiety medication I take 3x a day (buspirone). Last time I tapered to 10mg, my anxiety and dark thoughts became more severe, and I was in a bad mental state. I also take a mood stabilizer for bipolar disorder, but I have to be careful as SSRI’s can worsen my mood and make it unstable again.

[@PJPer-zs8uj]

Major depression . Ocd. Sad. Anxiety. Yea I think I'm a Lifer. Unfortunately.

[@ItsJadine]

You may be on medication but there’s nothing wrong with that. Being mentally well is one of the most important things we need! High five as a fellow lifer 🫶🏾

[@wheelofhands]

Hi! Much love to everyone. ❤❤ By the way, I quit weed right after I had commented about feeling like it helped my PTSD on another video a few weeks ago. I wonder when the weird, overly intense dreams will stop :⁠,⁠-⁠) . It's been hard to sleep, but I am feeling good in other ways.

[@taramcflara]

Congratulations! You worked hard for change, you should be proud ❤. I'm struggling with that, myself, and the weird dreams after you quit are part of the struggle. Still, they do tend to go away by the 21-30 day mark (in my experience); usually around the time your other circadian rhythms fully readjust 🤔. Hang in there ❤ however long it takes, it won't be forever; this too shall pass. You've got this 😄

[@jooleebilly]

Hey congratulations! It's always worth giving it a try. You never know how quitting may help you specifically. I just passed the 13-year-mark myself. Much to my surprise, it's been great! I never realized how nervous I was socially until about the six week mark without it. I almost never left the house, and when I did I was afraid. Not the standard "I can't have weed because it makes me paranoid" thing from people who never smoked on the daily, but just ambient anxiety I didn't realize was worse or maybe even caused by THC. I had very vivid dreams, but I liked those (as long as they're not nightmares) and used them to do more lucid dreaming. It was also a joy - that I hope you'll feel soon - of feeling myself fall asleep instead of getting high and then basically losing consciousness. I used to wake up with what I called "sticky brain" or "stoner hangover." I had some great times with cannabis, but at a certain point I was just ... done. So it wasn't easy, but when I was ready it wasn't hard - except for the physical withdrawal symptoms! For a while it was *harder* to concentrate and remember things, but as my brain readjusted to life without THC in the mix, it really bounced back. At first I thought, "Well, the shows I like and life in general won't be as funny anymore, but I can't "take a break" like some people can, so I need to totally quit, and just accept that life won't be as much fun anymore." Boy was I wrong! I'm enjoying things just as much, if not more now. I also have PTSD, anxiety disorder, ASD, and chronic pain. Weed seemed like it helped, but I realized after stopping that it hadn't helped as much as I'd thought, and it hurt in other ways. So overall, a good choice for me. Sounds like a good choice for you too!

[@malenixius]

When considering which antidepressant to prescribe, do prescribers ever consider family history of response to specific antidepressants (and if so, why so, and if not, why not)? For example, person presenting with their first major depressive episode, has had an adequate trial of fluoxetine and saw no positive effect, then tells you both their father and paternal grandmother also didn't respond well to fluoxetine or other SSRIs, but both saw good effect from amitriptyline. Would you consider jumping the normal stepped progression and offering amitriptyline? Now, if the patient hadn't offered that information but it was still the case - would you have taken a family history for antidepressant response and asked that question?

[@Chucanelli]

Mine did! I told my psychiatrist that my sister had had great luck with Prozac, so we tried that and it was a good match for me. It stopped working after a few years, but it allowed me to make progress in therapy and lifestyle changes that may have been impossible without it.

[@rhyliemasons7957]

I had a nurse practitioner try that with paxil (paroxetine) and it ended with a rather bad result. It definitely doesn't always work since our biochemistry is different.

[@AprendizdeLeitor]

As a Pharmacist, thank you for the shoutout 😁👍🏻 and thank you for this amazing video!

[@DoctorElliottCarthy]

Thank you for this and to your entire profession for having rescued me from too many mistakes

[@jenvampvegas4571]

I've been taking Lexapro for depression and anxiety for some time now and it has really helped. I would love to hear from you how it works.

[@SILENTWITNESS89]

Why is it that so many people who are neurodivergent end up misdiagnosed with mental illness? I was diagnosed as mentally ill till I was 30 years old when I finally got the proper diagnosis of autism and ADHD. I told them for years them of course being mental health system here in the US that I was not mentally ill and it took until I was 30 years old for a neuropsychologist to confirm it.

[@joanna0988]

From my understanding as a parent to neurodivergent children, the research on it is still limited and many kids get missed because they don't display the classic behaviors or they mask very well. It's more likely that girls get diagnosed with anxiety when really they have autism or ADHD and their nervous system is going haywire.

[@jenniferellis2275]

I was diagnosed with unnattentive adhd ar the age of 46. Until then I was treated exclusively for anxiety and depression. I believe I do have those conditions as well but they were exacerbated by the undiagnosed adhd. Like spending most of my life feeling like something wrong with me, like I wasn't a normal human doesn't help anxiety or depression.

[@joanna0988]

@@jenniferellis2275 ADHD is under diagnosed on a big level. I saw a study that said researchers estimate that 45% of inmates have ADHD. Not that ADHD makes you a criminal but the impulsivity can drive a lot of negative behaviours.

[@mothturtle7897]

I've never bothered to really bring it up because I'm so convinced I'll just be dismissed.

[@joanna0988]

@@mothturtle7897 Many family doctors here in Canada are now asking patients to take self reporting tests for ADHD (along with depression and anxiety) so I think they're realizing that ADHD is much more common.

[@TheCosmosprincess]

I am desperately trying to help two friends who are struggling and suicidal. I have been trying to help them in anyway I can, however, I am also desperately struggling myself. I have lost so many friends to themselves. I am at a loss at to what to do.

[@DasKlappital]

Please try to seek help for yourself, as well as those you care for. Don’t lose yourself by giving too much. If you can open your friends up to professional help to relieve the burden on yourself, and also provide them a wider, more diverse safety net. Put simply. Energy, mental and physical, is like a bank balance: you only have so much to give!

[@KayosHybrid]

I’ve been on Venlafaxine for about 15 years now, have had severe depression and diagnosed with complex ptsd just a couple year ago during a crisis and emergency psychiatric appointment during covid. Lived in the YMCA for 10 years, barely functional and suicidal. I don’t remember what it’s like to not be medicated and I do mourn that sometimes. But whenever I begin to do into withdrawal (can occur within 24 hours now) it’s such an intolerant level of instability that I’m kind of grateful to feel nothing at all

[@ItsJadine]

I hope you are well and supported. Sending all the positive vibes ❤

[@achuuz]

When I first started doing research on antidepressants with my neurologist all the suggestions he had where scrapped when I asked him if I can take them with ibuprofen which I take month when I'm on my period. I'm glad I asked, I didn't know that would be an issue😵‍💫 Now I'm on duloxetine and need to take omeprazole on days I'm going to be taking ibuprofen. So far i've only been doing for a year but so far so good.

[@mehlover]

On a side note, Dr. Elliot, can you please update thw timestamps in the description, cause I can't click on them to go to a section. I keep foegetting that if you're taking a medication and you feel better, you should still keep taking it. Of course there's some exceptions but keep taking your meds, even for long term, as long it's still helping your and your body

[@ebutblues]

One video question I'd love to see: Before (or after) we've proven that a psychotherapy is effective, how do we evidence the theory regarding how it works? Are we just guessing, or are there ways of testing? I have this problem with CBT: They say that automatic thoughts cause moods (ignoring intentional thoughts), but it seems plausible to me that maybe unconscious beliefs cause both automatic thoughts and moods, and that's why they're correlated. But it's hard to find evidence or even philosophical arguments either way.

[@heap_o_sheep]

I was joking about training us for the board exam 😅 Thanks for sharing your knowledge, really enjoy the channel and I always learn a lot.

[@jooleebilly]

Here's a long lead up to a short question: I've been taking antidepressants since 1995 but had never fully recovered. That is, I have been depressed almost every day since I hit puberty in the early 80s, and had never been in complete remission after at least 1/2 dozen antidepressants/mood stabilizer combos *until I fell backwards and sustained a minor TBI (concussion)* in 2022. From that moment, my depression was gone. Totally. Neurologists, psychologists, and occupational therapists aren't surprised when I tell them that my personality has changed from the brain injury, and that I have worse anxiety and insomnia, but surprised when I tell them my personality has also changed in that I have no depression. Is this as uncommon as they say?

[@suzannewakim7086]

Your videos are so helpful - thank you ❤ A question for a future Q&A. How do you decide if a medication is "working" given that there are so many factors in play. For example, a patient doesn't get better on a treatment but they also lost their job after starting the meds. Does one change the treatment or wait until life situations stabilize (if they ever do).

[@coffeecat086]

Oof, psych meds and seizures are fun stuff. I’ve ended up in status seizures more than once. 10/10 would not recommend. Can you do a video, if you haven’t on psychographic seizures? I have a friend with these, and they are sooooooo misunderstood. THEY ARE NOT FAKE.

[@megandmauiguidingpaws]

I loved this vid I am blind and autistic and have anxiety I have been taking Zoloft for long time now and it has really helped having it each time my vision continues to go especially after I had my white cane stolen on the light rail I have a guide dog now which helped

[@lunalovesnature]

I've got treatment resistant severe depression, I'm on lithium and venlafaxin now. People always talk about lithium as a treatment for bipolar, and I'm just over here in my corner wondering if I should tell them I take it as an antidepressant

[@malenixius]

7:30 Some treatment-resistance staging models (like the Maudsley Staging Model) only require lack of response to a single antidepressant!

[@Feehlo382]

How is it that memantine is seen to successfully augment other medications for various psychiatric issues?

[@JohnFallot]

Question about working memory, ADHD, and psychiatric treatment (and, full disclosure, I’m seeing a psychiatrist starting next week at a local LGBTQ clinic, which is just the bees knees) Are there any treatments that target working memory/cognitive inflexibility specifically? Or is poor working memory something that can only be managed with outside/environmental tools? Asking since, among other things, I’m on the spectrum, and (a bit like Temple Grandin, but not exactly) I’m very much a visual thinker: I can think in pictures, but my working memory is *absolutely* fried. I do take Effexor and Vyvanse, but the former has (in my view) made me a bit too complacent, and the Vyvanse is good for hunkering down to get computer work done, but that hasn’t really been the problem: it’s more mundane tasks and executive functioning stuff.

[@Finkeldinken]

It might be worth your time to ask about Wellbutrin or Atomoxetine when you see that psychiatrist. Or Intuniv. In other words, there are a number of options worth checking out for the issues you mention, so keep hope up! My own working memory is probably my most debilitating symptom, but for me, the above meds didn't work - maybe because part of my working memory issues might be caused by multiple brain concussions in childhood and adolescence, but I know other ADHD'ers who have had really good results! Best of luck! ❤

[@JohnFallot]

@@Finkeldinken Thanks! For my part, I’m very interested in atomoxitine (sp?). As for wellbutrin, I’ve tried it before and I remember it was always a mixed bag: my sleep quality worsened and I was quite anxious and irritable, but I also lost a ton of weight (positive) and it was much easier to take the initiative. I remember it also made me very eager to write stuff (another positive).

[@mfleuti]

As always, a great and informative video! Would you mind doing an edition on anti-depressants and pregnancy or on mental health and family planning in general? I have been trying to find more infos but I keep coming up empty... (even when searching the secondary literature, eg. scientific review articles)

[@TheOrthoglyph]

The only thing I've found that helps with my treatment resistant depression has been psychedelics. They've been an absolute life saver for me after 20 years of suffering no matter the medication they tried. I'm now not on any prescriptions and simply take a couple trips every 6 months and that seems to treat my depression and SI quite effectively. The only time in the last 5 years I've had an issue is when I couldn't find any and went around a year without self-medicating. I ended up in the crisis center and they tried another cocktail of medications that didn't help and the side effects were terrible. After coming off those I went back to my psychedelic routine and I'm back in remission. Obviously use at your own risk and not without doing a lot of research and talking to your care team. These substances can worsen symptoms in people with certain disorders.

[@ItsJadine]

Wow I’ve never heard of that self management. I hope you stay mentally well! Sending all the positive vibes ❤

[@sweet_t811]

I finally gave in & tried lithium (it sounded so scary to me). It was a miracle for me. I have tried every antidepressant/mood stabilizer but they weren't working. Lithium, at first, gave me my life back, I felt WONDERFUL. but it soon started making me incredibly tired, I'd sleep all day on my off days (caffeine kept me going for the rest of the week). My tiredness ended up getting in the way of normal life so I stopped taking it, before lowering my dose to half 150 mg. Short story long, what can I take in place of lithium?? & thank you for every single video you put out. It is not lost on us.

[@batbratsdesigns]

I was miss diagnosed with schizophrenia at the age of 11, forced on loads of medication that caused me physical illnesses that are permanent. I finally was given a choice when I was 29 after my mom stayed with me for a week because I told her I was having difficulty and I needed her to watch me and I needed her opinion. She helped me to get off all medication and my counselor requested me to get tested for autism. I was diagnosed with autism when I was 30 and I was also diagnosed with savant syndrome and PTSD. Medication doesn't help me plus I am capable of dealing with my mental health by meditating and brain storming to figure myself out. I force myself to do things when I am depressed that make me feel it and I accept the feelings and go meditate on myself to learn about what is going on. I don't know why I am different I just accept it and I use it to help others. My IQ is 200 and above because the autism causes me to be very focused on one topic until I know almost everything about it. My brain doesn't forget things causing the savant syndrome from unknown reasons. My intelligence makes me think I am stupid because I can't find a challenge in learning new things do to how quickly I learn. Also , I don't understand why people think they have to be like everyone else because I have tried but it's impossible to be anyone but myself. Like IQ, a person's IQ doesn't matter unless you need to be diagnosed with something like autism neurological handicaps and medical purposes. All my IQ got me is a master's degree in advanced science and engineering and I can't use it because of my handicaps. So what's the purpose of being so smart? It causes me more challenges. On top of that I have a low self esteem I have to work with. I thought I was a retard until I got my IQ tested, sometimes I still think I am. I have learned it's okay to not always be okay. I have to go through the hard times to get to the soft times. I have to remember the softness is always there when I get through the struggle and I rest once it's over. I have doctor's to talk to so if I need help again I am free to ask for it. Counseling helped me and I went through cognitive therapy and speech therapy through my school even in college they helped me too. I had job opportunities in highschool and I can't work. They could have given my opportunities to someone who needed it. Now I am 43 living on my own with assistance and I have had probably over forty different jobs and skills that I have no use for. The only things I do is crochet, blog and watch videos all day while suffering from chronic illnesses like pain epilepsy and possibly siff person syndrome. The autism is not a problem for me it is who I am so I never considered it a handicap. People tell me I inspire them and I teach them how to be aware of others who are unique like myself. That's a good thing because I am helping others including people like myself. We are all an example for each other. It's okay if you need a little help from medication it helps people through very tough times. It's very important to communicate with your doctor and people who care. To love yourself is number one priority so you can be part of the world in your own way. It can be scary too but I go through the fear shivering and then relax after I get through it and I learn from the experience. Fear is a normal response to lots of causes. It's up to you how you deal with it.

[@kelsiehogan576]

I LOVED how I felt on Wellbutrin!! I took it for 8 days, and everything was great. Day 9, I woke up completely covered in hives. Even inside my mouth and throat. Is there anything similar, that may not cause me an allergic reaction?

[@kathleendavidson3316]

One thing I’ve discovered (as a female) to hang out with autistic women. They will tell you, point blank, if you’re autistic and usually right away. I don’t have any studies (longitudinal or otherwise) but so far it’s worked in my experience.

[@DoctorElliottCarthy]

The instant recognition of neurodiversity by neurodiverse people is def a thing

[@jazzheadsbop]

A truly wonderful channel! 🙌🏻

[@gthbtn]

How long on SSRI's? The No Help Service just kept upping the dose until I got the point I was a zombie on what I later found out was twice the maximum recommended dose and I was taking several medications to deal with the side effects... as for actual help there's nothing, just pills-a-plenty!

[@mothturtle7897]

I've been on antidepressants for about 18 years now. I've tried fluoextine, citalopram, venlafaxine and paroxetine. Might be forgetting some. Just sort of gave up and stuck with paroxetine for about 10 years. Antidepressants have made life tolerable and that's about as much as I can say. Unfortunately, depression makes it hard to really advocate for yourself and you certainly don't chase up things like medication reviews. Amazingly my GP surgery recently called me to arrange one and it looks like we'll be making some changes, although I won't know for another month because appointments are so hard to come by. Perhaps I'll eventually find "the one".

[@maggiemac765]

It would be really good if you could talk a bit about alternative non-pharmacological psychiatric treatments. For example, I guess I was probably labeled as having treatment resistant depression as i have tried so so many antidepressants and could never handle the side effects. Im now using transcranial direct current stimulation and it is one of the best things that has ever happened to me for managing my depression and anxiety (though unfortunately having to do it independently and privately as its not available on the NHS everywhere yet). My aunt also had electric shock therapy when she was younger and that helped her. It'd be interesting to learn more about how these non-pharmacological treatments work and what they are generally used for.

[@callummullen2538]

Great video! I have a couple questions: Why do doctors seem to avoid giving diagnoses? I've suffered with depression my whole life, and also have PTSD symptoms, and have been assigned to PTSD spefici therapy groups, but have not been given any official diagnosis? I think knowing the issue will help guide my recovery, even if it is just sticking a label on me. Do all antidepressants just numb your emotions? I dont want to be depressed but i dont want to be numb and never feel joy either.

[@FronteirWolf]

I have a feeling that's how they help. It's a good idea if numbing your emotions leads you to have a more normal level of emotions. Sometimes I've thought it numbs me from feeling joy, it certainly impacts my ability to feel grief, which I don't like, but then I do something I really enjoy and I think it must be my mental health making my mood so flat, as I now I feel great. I'm on a relatively low dose though. At times I haven't got down because my ability to ruminate and get lost in those emotions and thoughts isn't the same as it was, which obviously reduces my depression. It doesn't cure you though, you've got to make changes in your attitude, your environment, etc to really improve your symptoms. You aren't going to have much of a life relying on meds to make your depression better. You can manage symptoms and even recover without meds. I did that once, when I was too scared of meds to ask for any medical help, and it can improve naturally, I wouldn't recommend putting your family through months of severe depression waiting to see if that happens though, which I did. When I got to month 9 or 10 of crippling depression, I realised that wasn't going to happen this time.

[@charlotteburford2240]

Can you explain the use or idea of hypnosis as mental health treatment please

[@woodpigeonsong]

I know people hate the idea of being on antidepressants for long term, even life, but I take inhalers every day for my chronic asthma. I personally don't differ taking those to taking my 175mg sertraline for depression and OCD.

[@DennisBolanos]

Dear Dr. Elliott. Why do different brands of methylphenidate have different maximum doses (despite having the same active ingredient)? In Spain, the maximum daily dose of Concerta is 108 mg. Yet for Rubifen SR, it’s 60 mg.

[@tamarinmangold1414]

That SR means Sustained Release, so it's actually a different formulation of the medication, in that the medication is released over a sustained interval of time.

[@DennisBolanos]

@@tamarinmangold1414 Oh OK, thanks.

[@shrinkinglilac508]

Great video as always (had to listen only) but kinda bummed the hard coded subtitles are back 😥 I know how necessary they are for so many people but I genuinely can't watch any videos with subtitles - my brain just freaks out. Hope there's an option to turn on/off in the future again.

[@mangantasy289]

Thanks for the hint to you multiple choice question. Did not know but like it. Just out of interest. I'm a long-term patients with several comorbidities (and 3 meds by now. Alprazolam a Qietiapine on top of the anti-depressant). Including depressions. I'm female, my first diagnosed epidode was at age 15 (but in hindsght I defintely had issues long before that, first "I'd raher be dead"-thoughts around age 6). I was put on antidepressants, changing them a few times from age 15 to 19 (Fluoxetine, Mirtazapine, Sertraline. Not sure any more if there was a fourth one). After a very bad experience with Sertraline (my primary care doctor told me to take it in the morning. I ended up "stoned" in school the day I had to hold a speech before class. I felt more and more horrible but made it through, but felt so sick that I left shool eary (and got blame for it....). Then there was another episode gone bad. At the 18 bd of a peer and one of the girls wanted to play a little prank by adding red wine to my coke when I did not look. I obviously never drank. For reasons. She was mortified, but I'm not really mad at her. We were all just 18 and 19, there was no way she expected me being on antidepressants (honestly don't remember which one it was at that point) and what this means on regard to alcohol. Not clever, but forgivible teenage prank. The mother of a friend living in the same town as drove me home. My own was at my sister's uni and it was planned I sleepover at the friends party. Cancelled that plan quick). My mother returning the next day at 4 p.m woke me up. Needed quite some effort to do. I was still feeling really dazed, my pupils being wide open and unreactive to light . (2 for contexts: I was also dealing with anorexia and quite underweight. My parents are divorced, which made me be alone in the house). All this combined the sedating effects of Mirtazapine, which I hated so much, I refused to be switched back to that one and was so annoyed that I did not want any more at all. Then I went studying abroad, for 3 years. I was without any med and no psychiatric or just mental health at all. Simply unaffordable. It just went worse. At some point I had to give up studies due to all the issues and also financial situation. Back home I found socially founded ambulant service for mental health that is free for the patents/clients. It also is multidisciplinary, it's staff consisting of pysichatrists, counselors and social workers. I'm thankful every single day to be privilidged enough to live in a place where such an offer exists. But I'm digressing from my already lenghty story. (Just so hard to keep it short with the long history). I met my still actual psych through that, and it was a perfect match. I needed some time and persuasion before I was willing to give antidepressants a new try. (not only for the bad expierences, but my mother also had severe mental health issues, and abused her meds and alcohol.) We dicussed together which one might be good for me, the psych really taking my qualms into account, and landed on Escitalopram. That was when I was around 22, I'm 37 now and still on it without break. The dose as even hightened twice and is maximal by now. At first, as teenager, I got the diagnosis "recurring" depressive disorder. But by now, I feel like I'm depressed since at least 5 years, with maybe only very mild amelioratings for short times, but still classifiying as at least mildly depressed. And new issues added to it, getting more diagnoses. It's so bad I had to go into invalidity pension. Although I really really loved my job (arachnologist/entomologist in a scientific research center afilliated with a natural history museum), so much so that it felt more like a vocation than a job. Another big pain that this was not enough. So to come back the actual question. Afetr some years as a teenager with more chaotic and switched andidepressant use and 3 year break, I'm on constant Escitalopram since roughly 15 years and there is no way in sight to stop itat this point. (Also, the whole time I#m in talk therapy with my psych too. Once a week as of now, because I'm doing badly, but it was less often when I was a little better years ago) Sorry for my endless comment. Feel free not to read if it is too much. Thanks for your content. I really like it.

[@pantherinae_art]

I've been on one anti-depressant or another for about twenty years, and been on my current dose of venlafaxine for over a decade of that. 🤔 It was a psychiatrist that put me on it initially for severe PTSD, chronic depression and anxiety including multiple un-aliving attempts and a history of SH (sorry to censor language. I'm not ashamed, but I don't want YT to penalise the channel or me!) I don't envisage coming off my ADs any time soon. I regularly discuss things with my GP and pharmacist, and we generally think it's not worth rocking the boat on that one as it appears to be helping me a lot. I'm currently on a waiting list for more therapy too (let's see how many years that takes!!) If I have to take it for the rest of my life, I'm ok with that, because if you can't produce all the correct chemicals in the right quantities, in your brain yourself, store bought is fine ☺️

[@thegreenmanofnorwich]

Hmm. I take antidepressants (sertraline), and also took fluoxetine for years. I'm still hideously depressed, but not debilitatingly so. If I up the dosage, I'm too tired to function. Not really a question, but ive had counselling and CBT - have you ever seen anyone recover?

[@malenixius]

Hey! I'm not a doctor (just a student mental health nurse and long-time taker of a few different classes of antidepressant) so please don't take this as advice or guidance, but you do have the option of speaking with your doctor about switching to a different class of antidepressant (or another antidepressant in the same class as fluoxetine and sertraline, if you prefer, with citalopram being the other popular SSRI). People who don't experience more than 50% remission on one class of antidepressant can have a far different response to others. Some common ones that GPs feel comfortable prescribing include mirtazapine (which can also cause drowsiness, but that side effect actually gets better at higher doses instead of worse!), SNRIs like duloxetine and venlafaxine, or occasionally a GP may consider a tricyclic antidepressant like amitriptyline, although they also have higher risk of side effects. Just speaking personally, I never had a positive response to SSRIs and had less than 50% response to mirtazapine, but stayed on mirtazapine for a long time because at least it was doing something! However, after some time I switched onto bupropion, which I'm still on now, and it's far better. I still meet criteria for mild depression but compared to how I was before, this is worlds better. Not specifically recommending any of these, just saying this to demonstrate how differently we can react to different types of antidepressant!

[@mangantasy289]

Grapefruit juice: wow, I did not know that. (or did not even register in my med risks when readng. I hate grapefruits). My mother had severe mental issues as well, she took lots of meds. And loved grapefruit juice. I told her to be cautious with that when she had to take meds for hearth issues (alcoholic cardiomypathy), because there I knew of possible interferences, but not before. She did not listen any way.... Just makes me wonder looking back. She died last november.

[@TsukiNoInu93]

I have depression(recurring) and ADHD and I take bupropion but I don't think it's doing much. I went up from 150 to 300, is it a matter of going higher or should I try a new medication at this point? Been on them for almost 3 months. ^^ Love your videos btw!

[@nanajiloh]

I was told I have dysthymia. It doesn't feel like I'll ever be able to get off antidepressants. I feel good with them, it's just a little sad (and expensive).

[@cassandraj1822]

I’m so afraid to go off of my psych meds that I never plan on getting pregnant. It’s sad but also it was so bad before.

[@cutienerdgirl]

I take Wellbutrin too because it treats my executive dysfunction and lethargy.

[@IAmFJ1]

My doctor had me stop Mirtazapine which I've been taking for yeeeears. I'm fine generally but I want them back because my allergies are killing me. I remember the many miserable years of trying all the medication there's and none of them had a good enough result. Then I was suddenly cured. Then the last time I stopped the pill because I didn't have access to my doctor and therefore the pills, the allergies came back. I told myself it's the antidepressant. Wasn't completely sure tho. And this time I am. I'm itching as I'm typing and now I know shrimp is not my friend anymore. It's like forfeiting friends in a breakup.

[@Tman001100]

I've been suffering from clinical depression for about 24 years now, off and on but it is definitely chronic. I've been avoiding even the topic of antidepressants that entire time though, partially due to stigma, partially due to not being able to consistently afford it and the rest is just being worried about side-effects and the possibility that I might need to be on them for the rest of my life, which I'd rather not be. However, I'm finally going to talk to my next therapist about it and talk about which one/s would be right for me because my depression is still leading to severe sleep issues and thus problems at work, in addition to other aspects of my life. Anyway, thank you, Doctor Elliott for breaking down some of the finer details about antidepressants.

[@TeeKing]

I haven't been to the doctor in almost five years now; living with lupus for decades, I just got sooo tired of always being at one clinic, hospital, or other medical facility. And so, I checked out of that loop permanently. I don't take any prescription medications as a result, like the many various antidepressants I took for years. While they elevated my well-being, the side effects were often abysmal. Honestly, my depression will probably be what kills me. That's on me.

[@Peacock2223]

Hi Doctor Elliot. I have a question for you about treatment resistant depression and lithium. I have been on medication for a number of years. I'm currently on 4 medications and have tried others before. I have not found them to be very helpful. Today my psychiatrist suggested going on lithium for treatment resistant depression but he was also asking me if I had anyone in my family with Bipolar disorder. Could that mean that he might be thinking I have bipolar or have you heard of lithium being used much to treat depression in this way.

[@csharpmajor4810]

Can you explain the default mode network (and maybe how it relates to different pathologies)? It wasn't a thing we covered when I was studying psych, and I haven't been able to wrap my head around it (pun not intended). Also, why is the fMRI machine called the wonder machine (I'm assuming it's because it fills people with a sense of wonder - or because it lets doctors watch people's brain wondering, idk)?

[@twiddle7125]

Not a question, but a request: please do a react to the Gloria 3 part therapy videos. I think it would be really interesting to hear a modern perspective on how things have changed since those videos took place.

[@SILENTWITNESS89]

I really would love to get a response from you. You are one of my favorite KZbinrs and I absolutely love your channel❤

[@tjtj7161]

I've tried hopping off multiple times and I've done it for a year, but my anxiety goes through the roof and i feel like im a burden to others and myself. I'm just a better person on a low dose.

[@AnneSchumacher-no]

Just a few weeks ago I tried to stop taking sertraline. When I was on half of my original dose, I started to fall back into some pretty gnarly anxiety and depression. I’m now back to 3 quarters of my original dose, and people keep telling me that it’s great, because I still lowered my dose by a little bit. It sucks, and my psychiatrist told me it’s just bad luck. Also, I hate it when people tell me that I did good, because I just feel like I failed, and hate thought that I might have to take the medicine forever.

[@nobodyimportant7804]

I have had constant depression since 1995 and no med has ever helped me(plenty of them have caused serious problems), so I don't take them anymore and am hoping to get approved for either ketamine infusion or rTMS. I have minor contraindications for both. I think I am about done if I can't qualify or they don't work.

[@sammjaisais7135]

I've been on sertraline for maybe three years. I was diagnosed with depressive disorder during medical school and I've been on and off ever since. The reason I say on and off is that I'm autistic and have ADHD, so I would forget to take my meds for weeks and then wonder why I went into a depressive episode again. Then I get back on them again, and everything goes back to normal in a couple of months.

[@ItsJadine]

I found this video really interesting, as a fellow Brit I wish mental health support was more accessible. It tends to be a post code lottery as to how much support and treatment a person can get. It’s very sad how many mentally unwell people (not yet in a crisis but have an impacted quality of life) are in a constant cycle of seeking the GP surgeries, starting meds, but are left to seek support like talking/behavioural therapies. I think a GP type service for mental health would be a great resource. It would be better than the “crisis team” telling a person they’ll have an appointment in 4-8 weeks, when they’ve already ended up in A+E after trying to take their life. 😩

[@littleflick]

I’ve been on antidepressants for 20 years now. Zoloft then Lexapro then Cymbalta then Zoloft again and now Effexor. Tried to come off them multiple times. Every time I crash after about two weeks and end up a crying mess. I may need to be on them the rest of my life, and I’m totally ok with that. I have been diagnosed with major depressive disorder, but my psych and I agree that what I have is probably closer to dysthymia. I also have generalised anxiety and some phobias. My anxiety is SO MUCH worse when I’m not on medication.

[@DoctorElliottCarthy]

Thanks for sharing and hope you find the right balance with what treatments work for you

[@littleflick]

@@DoctorElliottCarthy thank, the Effexor is going great. And I’ve got a great psychiatrist.

[@nellieharper2572]

How long does it take to become certified and ready to help real patients? Would you reccommend all mental health proffessionals also consider themselves doctors first and mental health proffessionals second? (When applicable.) I ask because I am seriously considering going into the career because I want to help people. I'm just scared that I'm not the type of person who could sit with patient's problems well. I'm good at helping people take perspective and learn new coping mechanisms, would those skills help me in the field or should I keep looking for other opportunites to help? Love your videos and I'm glad yellow lego man is back!

[@deancontiwriter13]

At the grapefruit juice question I panicked cuz I drinked Monster Ultra Rosa yesterday which tasted like grapefruit and I'm on duloxetine and I panicked that I was dumb. Turns out it does not have actual grapefruit juice in it, so I'm fine😅

[@amynehls4175]

After my 3rd relapse the drs said " you're probably just someone who needs to be on medication at all times now" I've been on a max dose for 10 yrs since .

[@jdemd1977]

Have you any knowledge or experience in treating patients with LDN (low dose naltrexone ) for various disorders, and if so, has it been effective?

[@crmn_hwr]

If you had a depressive episode, does that mean you have depression? As the disorder? Like forever? Or can you have just an Episode without actually having chronic depression? And if so, what are the Chances of getting another Episode later in life?

[@Leopardeye]

PTSD, ADHD, Chronic Depression here. I rely on antidepressants to sleep, nightly. 🥴😭 Not proud of it but I do feel like it’ll need to do this for a very long time.

[@boredutopia]

they put me on anidepressants with some other meds only once a year, thru october to mid january coz i cant function,i relapse and my c ptsd kicks so hard coz i cat avoid any triggers and i start to go deep, very deep and it becomes very very dark, also in past i had episodes where i spontanously was doing unaware of it, depersonalisation and deasosiation ( sorry if i missed proper term, english is not my first language and often some medical and tehnical terms makes me a problem), and around 15 i realised it happens and i liked that state and i started to drink a lot, on purpouse just to achieve that state. but in same time my dad's alcholism start to take very dark and violent turn and after an incident when i was 17 or 18 maybe even 19, cant be sure, that period is blurred ( no idea how i manaed to graduate and finish high school with good grade), it had to be 17, coz as soon as hit 18 i went back to icelan and finished high school there and went to universety. anyway long story short i stoped drinking, completly, i dont rink at all. but once i seeke dprofessonal help, at fi it was in iceland an how they had a lot of refugees from former yugoslavia, some sudanees from before and some kongoans they kinda, by the time i seeked help there had a knowedge and had shrinks from those areas to kinda set up good enviroment, coz war caused cptsd is different than other c ptsds. it is different. there i was put on anti depressants, but when i got back to homeland coz of complex family situation i realised the professional help treating that type of ctsd was way better and more helpfull, coz whole countrx actually suffered from some form or war casused ptsd. in homeland thru therapies my shrink realised i actually dont need meds all the time, what i need is mostly group therapy, individual therapy with a therapist, daily hospital from time to time and medications i need during certain times during year. so most of year i am mor eor less of the meds, but i learn to recognise signs of psychosis ( others around me warn me) , when i see i star to have deasosiuation episodes or depersonaisation, or i am more agitated, irritated i go to urgent mental care unit, they addmit me, i spend some time usualy 3 months there then go to daily hospital and i am fine. i did not need to be addmited for almost 10 years now and had no need for daily hospital in 5 years. i only need meds and help and support now only during mid to late october to early to mid january and i am fine after that.. cant explain it is strange but it took me long time to come to that point. i know i never ever be meds free andthat i will relaps every year in certain time. so some people i guess need them for rest of their lives, some dont, some can patch it up with mood stabiliztors in between, some with hospitaliaion or therapies, but i am somehow in between. cant quite explain to be honest..

[@oliverbennett8501]

I was diagnosed with depression about 15 years ago, and then anxiety and PTSD (from SA) a few years later. Tried various types and doses of different classes, no luck. Tried talk therapy, no luck. A few years back i asked my gp if i could trial bupropion for ADHD (i was trying to avoid paying $1.5k i couldn't really afford to see a psychiatrist, ended up doing so anyway). It didnt work for the adhd, but one day i woke up and thought "huh, i dont want to die anymore". Thought id be on them forever, but now im wondering if ill be able to come off them as i think a lot of it stemmed from gender dysphoria, which is very much reduced since I had top surgery last year. Might be time to talk to my GP.

[@SoupyGal]

I’ve been on them since I was 11 (I’m 24 now)

[@rosebroady6618]

I'd like to know why I've been different diagnosis by different doctors. The only constant seems to be depression. Is it normal for different doctors to disagree? Basically because depression is the only thing they agree on thats what I'm going for, but some of these diagnosis seem very extreme and very different

[@foolishlyfoolhardy6004]

I don't want to take them forever, especially because I'm on a tricyclic which can do all sorts of things, but this time I only just escaped ECT and I'm always barely escaping hospital. And honestly I don't think I would survive another episode.

[@janvierr9906]

OMG THE YELLOW LEGO PERSON HAS BEEN FOUND!

[@Mariosoa.]

I want to suggest you a game that in terms of childhood trauma o how people in different ways deal with it, when I first play it, it scared me, but at the same time I felt a bit of a connection to one of the characters, I heard other psychiatrist play it and had a lot to analyze, this game is called Omori and despite being a horror game it is insanely emotional in a good way because of the story it made me cry a lot, despite the scares of the game I felt a sense of relief when I finished it. You should give it a try, I also like how it portrays the problem of hikkikomori people.

[@aimeerat.]

my doctor wants to prescribe me SSRIs but im terrified of the weight gain side effects. Is there any medication that will 100% not do that

[@scriptorpaulina]

Can I be in therapy forever? Because while I’m getting better, I think I’m probably going to be emotionally disabled by my depression, c-PTSD, and ASD forever 8/ If that isn’t a good question, what’re your thoughts on BDSM as an alternative to self-harm Edit: Bupropion has fucking CHANGED MY LIFE with ADHD. I can sit still for the first time in my life and it’s crazy. It’s technically my third antidepressant (because psychotic depression) but I’m so happy with it.

[@noelleirina5628]

You're supposed to recover on antidepressants??? I've tried like 4 or 5 different ones and they never worked

[@Sophia-cd2ci]

How can someone (regular jon medival human) go about researching their medications and/or diagnosises? I would love to be able to understand what medications I am prescribed are doing, and why. My doctor talks alot about making sure any new meds don't interfere with other meds or with other present medical issues. I would love to be able to understand this stuff for myself as far as I am able, but i get so overwhelmed by pages of chemistry when i try to learn. Beyond the little fact sheet I can request on a medicatio from the pharmacist, are there any good ways a normal person can approach trying to understand what we are prescribed to put in our bodies and why?

[@ArashZarneshan]

I'm a med student in Iran and have been for 9 years (I took a lot of time off). I have attempted suicide 6 times now and aside from my toxic relationship with my father, I blame most of it on the toxic culture in our hospitals here. I have intentions of quitting medicine altogether. Do you think I should go on with that decision?

[@sarahemf]

I would suggest getting ride of any names, and faces. As the internet can be a cruel place.

[@Emma-LynnDavis]

You should react to shameless u.s.

[@Emma-LynnDavis]

Omg he hearted it❤

[@AsterDis-oq5rp]

Could you do a video on the movie the challengers, there's this weird polygamous love triangle with 2 guys and a woman and it's in a tennis centered world, it could be great to analyze

[@iisotter8944]

What if your mental state is as a result of the reality you are living? How ethical is it to medicate those on mass whose lives are just plain miserable. Medicating on mass people who live in poverty, abusive situations, working 3 jobs, unable to have time with family, and so on. Medicating 'reality' is just plain awful, sedating them from their lived reality rather than tackling the issue that is causing their mental distress. Changing someones biology long term just to cover up severe social issues is ethically questionable.

[@lm-rh3qo]

If you're in treatment for disability you will take them forever and if you don't you will have trouble.

[@sadem1045]

If I don't want to off myself, yes.

[@ceciliagialdini7695]

I love your videos, they are so interesting. But also... the key in the background

[@albertnulsen1855]

I took Zoloft for over 20 years. I quit taking and I’m glad I did. Therapy helped with handling the things Zoloft was prescribed for.

[@StanWatt.]

Is that dimple natural or were you shot? :)

[@lilmisou]

Great video as always! 🫶🏼 I also have a question for you: I am a woman in my early 20s on anti-depressants struggling with many symptoms of the inattentive adhd type. A big part of the diagnosis is going over preschool certificates to make sure the symptoms have been occurring since then, but mine don’t indicate any of that since I was a well-behaved quiet child. Is it even possible I have adhd?