Should You Take Antidepressants Forever?

#askadoctor #drelliott #Q&A #psychiatrist #mentalhealth

This is an ask a doctor or Q&A video all about mental health, mental illness and depression.Thank you to those of you who sent your questions in on the channel as there is a great variety and I hope you learn something. I also talk about what psych wards are like, how Wellbutrin works, taking antidepressants in pregnancy and much more.

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00:30 What is a psychiatric hospital like?
02:18 the board exams
03:00 Wellbutrin
03:58 How long should you take an antidepressant?
05:43 Psychopath or narcissist?
07:12 Treatment resistant depression
08:04 Are you autistic?
09:05 Psych meds in pregnancy
09:56 Grapefruit juice and antidepressants
10:33 Lithium

[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).

[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.

[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

[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.

[kurtj]

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. 😊

[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.

[AprendizdeLeitor]

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

[marcopolo]

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....

[lovel]

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

[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.

[kathleendavidson]

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.

[SILENTWITNESS]

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.

[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.

[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?

[banditjourno]

Fascinating. I've been on Sertraline for coming up on seven years now, after suffering terrible post-natal depression stemming eventually into suicidal feelings. (Yes, men get PND too).
I honestly prefer myself on antidepressants than off. I'm less temperamental, less moody and prone to dark thoughts. I can be better as a husband and father. I'm honestly scared to come off them.
I think perhaps once both my kids are a little older, I'll be able to taper off.

[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

[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.

[jenvampvegas]

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.

[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

[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.