While the American Psychiatric Association (APA) supports more research and clinician training on how to prescribe antidepressants safetly, the organization says blaming this treatment for America’s mental health crisis is an oversimplification.
Psychiatrists and other mental health providers agree that antidepressants should be prescribed carefully, monitored thoughtfully, and stopped only with medical guidance. But stigma and misinformation can also keep people from considering treatment that may help them function, recover, and feel like themselves again.
Here are 10 common misconceptions about antidepressants and SSRIs, and how psychiatrists respond.
1. Myth: Antidepressants Will ‘Change Your Personality’
Psychiatrists Say: These Drugs Can Help You Feel More Like Yourself
Personality includes the way people feel, think, and react to the world, and those things can shift with SSRI treatment, just as they can with therapy or other mental health interventions.
Because of that, some people may feel subtle changes in how they experience themselves. But that’s not the same as becoming a different person.
“None of these treatments should feel like they change the essence of someone’s person,” says Allison Young, MD, a psychiatrist in private practice in New York City and a medical reviewer for Everyday Health. “Ideally, with any mental health treatment, someone feels like they are finding their way back to themselves or being reminded of something or someone they already knew — not being changed,” she says.
Some people experience a dampening of emotions on SSRIs, sometimes described as feeling “numb.” These medications can affect all emotions, so they might not just alleviate sadness or anxiety, but also tamp down excitement or energy, Dr. Young says.
This may be a side effect worth discussing with a prescriber, Young says, but not a sign that the medication has permanently altered who a person is.
2. Myth: You’ll Be Hooked on Antidepressants for Life
Psychiatrists Say: SSRIs Aren’t Addictive but Require Careful Tapering Before Stopping
SSRIs are not addictive in the way alcohol or opioids can be, says Young. “When you have an addiction to alcohol or opioids, you’re going to have cravings for the drug, and you’re going to have goal-directed behavior toward trying to use that substance again. That’s not what you experience with SSRIs,” she says.
But abruptly stopping or dropping the dose of an SSRI can still cause an array of symptoms, sometimes called withdrawal or discontinuation syndrome. “The brain adapts to an SSRI — when the medication is withdrawn abruptly, there isn’t time for the brain to adapt back,” says Young.
Symptoms of discontinuation syndrome can include flu-like feelings, insomnia, headache, dizziness, low mood, and “brain zaps,” or electric-shock sensations, she says.
That’s why it’s important to work closely with your psychiatrist or doctor to taper the medication slowly rather than stopping it on your own, says Young.
About half of people with major depression have long-lasting episodes or recurrence, says John Krystal, MD, a professor and the chair of psychiatry, neuroscience, and psychology at Yale Medicine in New Haven, Connecticut. “If we think of depression like other long-term or recurring conditions, like arthritis or asthma, then the situation of long-term treatment becomes a little clearer. We would never say that a person is hooked on their asthma medication because we know that these people need their medication to breathe comfortably,” he says.
Still, there’s a tendency to pass judgment on people who manage their depression effectively on a long-term basis, which could reflect a fear of depression in our society that creates stigma about treatment, says Dr. Krystal.
3. Myth: Antidepressants Are a ‘Quick Fix’ or ‘Happy Pill’
Psychiatrists Say: Antidepressants Take Time to Work and Don’t Create Fake Happiness
“I always like to tell people antidepressants are not a quick fix, because research shows these medications take up to six weeks to work for some people, so there’s definitely nothing quick about it,” says Young.
SSRIs also do not manufacture fake happiness. “Alleviating suffering is not the same thing as making people happy. Depression robs many people of the capacity to be happy,” says Krystal.
Antidepressant treatment can help restore the ability to feel happiness in situations where that would normally be possible, he says.
4. Myth: If the First Antidepressant Doesn’t Work, None Will
Psychiatrists Say: If One Antidepressant Doesn’t Work, Another Might
Finding the right antidepressant can take time, and a first try that falls short does not mean the whole category is off the table.
“Even two people who have very similar symptoms of depression may respond very differently to the same medication,” says Evita Singh, MD, a psychiatrist at the Ohio State University Wexner Medical Center in Columbus. Genetics, metabolism, side effect sensitivity, other diagnoses, and other health factors can all affect how someone reacts, she says.
If a first SSRI does not work, the next step may be raising the dose, switching to another SSRI, trying another antidepressant medication class such as an SNRI, or adding a second medication, says Dr. Singh.
“When a person does not respond to an SSRI or even several antidepressants, there are now treatment approaches that can help,” says Dr. Krystal. Options may include esketamine, transcranial magnetic stimulation, or electroconvulsive therapy, depending on the person’s symptoms and history, he says.
5. Myth: Medication Is the ‘Easy Way Out’
Psychiatrists Say: Antidepressants Are a Tool, Not a Shortcut
Depression is a medical condition that involves changes in brain functioning, stress, sleep, and emotion regulation, according to Singh. To treat this variety of issues, “Medication is one tool — it’s not a shortcut at all,” she says.
Medication can also help people pursue the other parts of recovery that depression or anxiety have made hard to access. “While some people can start with lifestyle interventions that can improve mood, others may need medication to get to a place where they can engage in those [interventions], whether that be therapy, behavioral activation, or exercise,” says Young.
For someone who used to run miles before depression made them feel sluggish, the ability to take a five-minute walk may not feel like a win, says Young. But whether through medication, psychotherapy, or both, the goal is to help people move beyond the shame and negativity that can make small steps feel pointless, she says.
6. Myth: Natural Supplements Are Always Safer Than Antidepressants
Psychiatrists Say: Supplements Pose Their Own Risks
“Natural” supplements are not automatically safer, better studied, or less likely to cause side effects than prescription medications, psychiatrists point out.
“Unfortunately, supplements are less regulated than our prescription medicines, and the amount of the active ingredient may vary based on the brand,” says Singh.
If you’re looking to enhance the effect of prescription antidepressants, Young recommends maximizing nutrients through food — such as omega-3s or B vitamins — rather than adding more pills. “A lot of people who have a long history of mental illness are kind of sick of taking pills,” she says.
“I always encourage people to talk to their healthcare professionals about supplements, so there can be a conversation about how safe this is, how regulated this is, and how much it could benefit versus an antidepressant.”
7. Myth: Antidepressants Will Always Ruin Your Sex Life
Psychiatrists Say: Sexual Side Effects Are Common but Not Inevitable — and They May Be Treatable
The words “always” and “ruin” are overstatements, Young says, “but sexual side effects are absolutely very real.”
“Unfortunately, this is probably the side effect that people tell us the least about — and then stop taking their medicine,” says Singh.
While some people experience reduced libido, delayed orgasm, difficulty with arousal, erectile issues, or genital numbness, others notice no change, says Young.
“There are also some people who have improved sexual function because depression or anxiety gets better. Those conditions can also strongly affect sex drive and arousal,” says Singh.
In rare cases, sexual dysfunction may continue after someone stops an SSRI, and right now it’s not clear who’s at risk for this longer-term side effect, says Young.
“If the antidepressant seems to be causing sexual side effects, options may include adjusting the dose, changing the timing of the medication, switching medications, adding another medication, or looking at nonmedication contributors such as stress, sleep, or relationship strain,” says Singh.
8. Myth: You Can Stop Taking Antidepressants as Soon as You Feel Better
Psychiatrists Say: Quitting Too Early or Too Suddenly Can Raise Relapse Risk
Feeling better is a sign that treatment may be working, not necessarily a signal that it is time to stop, says Singh. “Stopping too early can increase the risk of relapse, especially if symptoms have only recently improved,” she says.
For a first episode, guidelines often recommend staying on medication for 6 to 12 months after remission and then tapering slowly, says Young.
With any stopping of antidepressants, relapse or recurrence risk increases, especially in the first six months.
Singh says tapering slowly also gives the prescriber a chance to watch for discontinuation symptoms and for any signs that depression or anxiety symptoms are returning.
9. Myth: Antidepressants Are Only for ‘Severe’ Depression
Psychiatrists Say: There’s No Need to Wait Until Suffering Becomes Extreme
“There is absolutely no need to wait until suffering becomes extreme in order to get treatment,” says Krystal. If depression is negatively affecting your quality of life, even somewhat, he believes, “it’s time to start having a conversation about antidepressants.”
That doesn’t mean medication is always the first step. For mild to moderate first-episode depression, psychotherapy and lifestyle approaches are often first-line, says Young.
Medication may become part of the conversation when symptoms are more impairing, or when someone has tried other strategies and is still struggling.
10. Myth: Antidepressants Increase the Risk of Suicide in Everyone
Psychiatrists Say: Children, Teens, and Young Adults Are Most at Risk Early in Treatment
Federal health agencies require antidepressant packaging to carry a black box warning that the medication can increase the risk of suicidal thoughts and behaviors. This information is important but often misunderstood.
The warning focuses on children, adolescents, and young adults, especially early in treatment or after dose changes. An analysis by the U.S. Food and Drug Administration (FDA) found a greater risk of suicidal thinking or behavior in children and adolescents during the first few months of antidepressant treatment; the average risk was 4 percent on medication compared with 2 percent on placebo, and no suicides occurred in those trials.
“This black box warning is something I bring up to every person I see who I’m starting on an antidepressant — I want to make sure people don’t get scared when they see it on the label,” says Singh.
It’s also worth noting that untreated depression itself carries a major risk for suicidal thoughts and behavior, he adds.
Young tells patients who’ve just started an antidepressant to contact her right away if they feel worse, irritable, unable to sleep, restless, unable to stop moving, or like they have more thoughts racing through their head. “That’s a red flag — call your doctor or psychiatrist right away. This is not the medicine for you,” she says.
Close communication can help manage these risks, says Krystal, especially in the first few weeks, when some patients may have more energy but their mood remains low.
When to Talk to Your Doctor About Medication Issues or Switching Treatments
If you’re taking an antidepressant, talk to your doctor if symptoms are not improving, side effects are hard to tolerate, or you’re thinking about stopping medication, says Singh.
Before assuming it’s not working, consider how long you’ve been on a therapeutic dose (the dose that’s been found to effectively treat the condition the medication was prescribed for), she says.
“If patients are taking the medicine regularly every day at a therapeutic dose for about four to six weeks, and symptoms are still impacting day-to-day life quite a lot, that’s when we talk again: Do we need to switch it? Do we need to add something else?” says Singh.
Some common side effects, such as nausea, stomach pain, or diarrhea, may improve after a week or two. “The worst thing is when people feel like, ‘These medicines are making me feel so bad, I’m just going to stop,’ and then they lose hope in treatments that may actually be really beneficial,” says Singh. “We just need more monitoring and an open conversation.”
If it’s hard to remember how a medication is affecting you, notes on your phone or a running list of questions can help, she says.
You don’t have to wait until the next appointment if something feels wrong, says Singh. “I don’t want people suffering by themselves or overthinking the side effects before talking to us,” she says.
The Takeaway
- Antidepressants are not “happy pills,” personality changers, or “the easy way out” — but for some people, they can reduce symptoms enough to help them function and feel more like themselves.
- SSRIs are not addictive, but stopping them suddenly, without tapering or medical guidance, can cause withdrawal-like symptoms and raise the risk of relapse.
- Discuss side effects, including sexual problems, with your doctor rather than stopping medication on your own.
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