An Expert Explains

Do I Need An Antidepressant? 8 Subtle Signs It Could Help

There’s no such thing as feeling “bad enough” when it comes to caring for your mental health.

by Arielle Tschinkel
The signs you could benefit from an antidepressant can be subtle and sneak up on you, say experts.
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Depression and anxiety don't always look the way they're presented in movies and on TV, with someone spending weeks in bed with the shades drawn or experiencing a panic attack every time they leave the house. Mental health struggles can present with telltale symptoms, but they're not a given for everyone, so it really can be difficult to know if you might benefit from professional care.

If you've been feeling a bit "off" lately — perhaps not quite like yourself, but you're still functioning relatively normally — you might not think you "need" treatment or that your symptoms are "bad" enough. Dr. Julian Lagoy, M.D., a psychiatrist with Mindpath Health, tells Scary Mommy that there's no such thing as "not enough" when it comes to caring for your mental health.

Sure, there are times when it might be more obvious, such as when you're coping with a sudden loss (either a friendship or relationship, a job, or the death of a loved one) or a big life change, such as a move, illness, or injury. But these acute circumstances aren't necessary for you to benefit from mental health care, says Lagoy.

Mental Health Care 101

The gold standard for treating anxiety and depression is through a combination of talk therapy and medication, notes research out of Harvard Medical School. But let's be real: Not everyone has time to devote to regular therapy sessions, and therapy isn't always financially accessible to those who need it most. In those cases, medication might just be the ticket to feeling better — though it's worth noting that it's rarely a quick or easy fix. More on that in a minute.

First, a quick refresher on the types of mental health medication options out there and how they work. According to the Mayo Clinic, antidepressants can relieve symptoms of anxiety and/or depression by targeting specific neurotransmitters in the brain (aka chemical messengers) that impact mood and behavior, such as serotonin, norepinephrine, and dopamine. First-line treatments typically include selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro) or serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), and others. There are also atypical antidepressants that work slightly differently, and options to augment first-line meds should you need additional support.

And yes, most of these meds take several weeks before you begin to feel relief, and plenty come with side effects. But the prospect of side effects shouldn't scare you away from trying medication; your doctor can and should work with you to choose the best med for your specific needs, starting on a low dose and titrating up slowly, if needed, as you monitor your symptoms.

Signs an Antidepressant Might Be Right for You

So, how do you know if you might benefit from an antidepressant? "Generally speaking, if somebody is having significant negative effects from their mental health that is affecting their day-to-day life in their work or with their families and loved ones, then they should definitely consider seeing a psychiatrist to get medication," says Lagoy.

But what about if things aren't so clear-cut? Lagoy notes that there are a lot of lesser-known or more subtle signs that something's amiss. Some subtle signs and symptoms, ays Lagoy, include:

  • Changes in sleep habits (such as trouble sleeping through the night, trouble staying awake during the day, or mental or physical fatigue)
  • Appetite or weight changes (which can happen slowly over time, making them less noticeable)
  • Negative thinking or self-talk
  • Being less optimistic
  • Having trouble concentrating
  • Feeling frequently short-fused (suddenly snapping at those around you or an inability to let things go)
  • Aches and pains that might feel random, such as backaches or headaches that come on for seemingly no reason
  • Low energy

These could all be signs you're struggling with something deeper, explains Lagoy, pointing out that shifts in your typical persona can serve as hints you may need to seek professional advice. Maybe you haven't felt like having sex with your partner in weeks, or even just texting your pal to say hi feels like too much effort. Perhaps you're struggling to make even small decisions — if you're snapping at your spouse when they ask what takeout you'd like to order, it might be a sign that you need some support.

Conversely, keeping yourself unsustainably busy with work, family, or social commitments could be a sign that you're avoiding facing feelings of sadness or anguish, as research has shown. If you're constantly chasing perfectionism or feeling frequent guilt, any form of perceived self-failure could set off strong negative feelings that are hard to shake, even though the hard truth is that not a single person on this planet is perfect, and we all make mistakes big and small every single day of our lives.

Of course, your emotions (or lack thereof) often offer a peek into your overall mental health. If you feel withdrawn or don't enjoy things that typically make you happy — if even a warm embrace from your kiddo or a thoughtful gesture from your SO elicits nothing — that apathy might be trying to tell you something. Or the opposite: Maybe you feel temporary happiness when you're doing something fun with family, but those sad feelings quickly creep back in again right after. This could mean you're struggling without realizing it.

Thankfully, medication options are safe and generally very helpful. Your doctor can work with you on finding the best fit or refer you to a specialist, such as a psychiatrist, who can better serve you based on what you're dealing with. Lagoy adds that many antidepressants are safe for use before, during, and after pregnancy, so you should be able to continue medication throughout.

Kick Shame to the Curb

Whether you're on medication for a short time to help you get through a particularly rough patch or stay on them for the foreseeable future, there's absolutely no shame in getting the help you need and trying many options to see what works best. You deserve to feel better, and support is available in many forms to help you get there.