Myth vs Fact: The Truth About Taking Antidepressants

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There are plenty of misconceptions about antidepressants. One is that you will never be able to stop taking them once you start. Another is that they will change your personality. Here are the facts about these medications, which, in many cases, have a profoundly positive effect and can be live-saving.

Depression is an illness not a mood state

Major depression is a serious illness characterized by symptoms such as insomnia, inability to concentrate, loss of joy in previously pleasurable activities, excessive guilt, and, in extreme cases, suicidal thoughts. It causes impairment in a person’s ability to function normally. Without treatment the consequences can be devastating both professionally and personally.

Depression is a highly prevalent illness that affects 21 million U.S. adults and about 5 million adolescents (National Institute of Mental Health, 2023). Antidepressant medications are widely prescribed, with more than 240 million prescriptions filled in 2018 in the U.S. alone. (Ahrnsbrak, R. Et al, 2021). The FDA has approved antidepressant use for children as young as 6 years old. The global market for antidepressants was valued at $11.67 billion in 2019 (Fortune Business Insights, 2025) and tremendous resources are allocated for pharmaceutical research and the development of novel medications.

As a psychopharmacologist I have treated thousands of patients over the past 25 years with antidepressant medications. Here are the answers to some of the most common questions that patients ask me.

How do I know if I should take an antidepressant?

Many patients ask ”Isn’t it normal to feel upset” about a particular situation such as job stress, the breakup of a relationship, or dealing with an illness? The answer is yes, of course it is normal to feel sad or stressed in such situations. But when does the level of distress reach a point where antidepressant medication is indicated? These are some signs that it may be time to consider a trial of medication:

Insomnia:

• Lying awake for hours trying to fall sleep or waking during the night for hours
• Obsessing over or feeling your heart racing or feeling dread during the night.

Stress overwhelms your ability to cope normally:

• Inability to concentrate or calling out sick from your job
• Avoiding responding to friends or family who reach out to you
• No longer engaging in self-care such as exercise, good nutrition, or basic hygiene.

Noticeable change in your appetite:

• Overeating or binging on sweets
• Poor appetite possibly with dry heaving or loss of weight.

No longer able to experience joy:

• No longer interested in activities you previously enjoyed such as reading, cooking, or spending time with friends
• Feeling like a burden to your family.

Pervasive feelings of hopelessness or despair about the future:

• In extreme cases, a person may develop suicidal thoughts and should immediately be evaluated by a doctor..

Will I ever be able to stop taking it?

Many people are able to come off of antidepressants. A typical course of treatment for an episode of depression lasts 6-12 months. People often feel better in a matter of weeks, but it is recommended to complete the full course of treatment to decrease the likelihood of a relapse. Each situation should be assessed individually, and there are cases in which longer-term treatment is indicated, typically when there have been more severe or frequent episodes of depression.

Will the medication change my personality?

Antidepressants do not change a person’s personality. They improve specific symptoms of depression, such as insomnia or inability to concentrate or excessive ruminating. They can increase a person's resilience in the face of stressful situations and bolster the ability to cope more effectively. They can enable a person to make better use of other supports, such as talk therapy.

Will it cause emotional numbing?

People often ask whether the medication will cause emotional numbing. The medication should not cause numbing and, if a person experiences numbness on an antidepressant, it may be an indication that the dose is too high. If numbing occurs, you should bring it to the attention of your doctor, who may lower the dosage slightly.

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Will I gain weight on it?

Antidepressants can sometimes cause weight gain or weight loss, but typically we can find a medication that does not cause significant weight change. If you have weight changes on a medication it is important to let your doctor know in order to consider other options.

Are antidepressants addictive?

Antidepressants are not addictive medications. They are not generally associated with tolerance, which means needing a higher dosage over time to achieve the same effect. After a course of treatment, antidepressant use should should be tapered slowly. Abrupt stoppage can cause discontinuation syndrome, marked by dizziness, irritability, or transient flu-like symptoms. Such a response can be prevented by gradual tapering under the care of an experienced clinician.

Will I have brain zaps or feel sick if I stop it?

There are stories on the internet about people experiencing terrible reactions from stopping their antidepressants. It is true that if someone stops their antidepressant abruptly after taking it for many months, they may experience a discontinuation syndrome. However if you taper the medication gradually under the supervision of a clinician, then this should not occur. Many people come off antidepressants fairly seamlessly.

Can I take antidepressants if I plan to become pregnant?

Antidepressant medications are widely used in women during pregnancy. There is extensive data on the effects of antidepressants in pregnancy as well as the effects of untreated depression on pregnancy. It is now considered the standard of care to consider antidepressants during pregnancy for severe depression.

If you are pregnant or planning to become pregnant you should discuss treatment with your doctor or a specialist in reproductive psychiatry. You should be informed about the potential risks and benefits of antidepressants during pregnancy and make the decision that is right for you. You can create an individualized program of non-medication treatments such as therapy and exercise, as well as determine whether an antidepressant should be included. The risks of untreated depression may be potentially greater to mother and baby than taking an antidepressant.