The Real Problem With Antidepressants

Prescriptions are rising, but often the drugs don’t work, and other effective treatments are dismissed

Photo: Julia Zolotova/Unsplash

This is the third in a four-part series on preventing depression, a serious and growing mental disorder that can strike at any age and, if untreated, persist and worsen.

Antidepressant drugs can be an effective treatment for many people diagnosed with depression, particularly in the most severe cases. But these medications, which can have troubling side effects, are far from the only option, and for many people they simply don’t work. New research illustrates what experts have long known: though antidepressants are often a go-to prescription, the causes of depression are highly individualized, and treatments need to be tailored much more thoughtfully.

The finding comes amid skyrocketing rates of depression. The disorder has been rising for well more than a decade in teens and hiked further during the pandemic. And after a pandemic-induced spike, depression symptoms now plague more than a quarter of U.S. adults. More than 13% of Americans were taking antidepressants before Covid hit and during the pandemic, prescriptions shot up 6%.

In the new study, published online June 9 by the journal Nature Translational Psychiatry, researchers combined brain scans with other health markers collected by smartwatches, as well as self-reported information on mood and lifestyle factors. While depression is known to be rooted roughly 40% to 50% in genetics, predictors of depression in three of the 14 participants, as an example, were wildly different:

• Sleep and stress were chief factors for one person.
• Exercise and caffeine intake were the main issues for another.
• Brain function and cognition had the most impact in a third person.

The takeaway: Before you turn to medications, make sure you and your doctor or therapist fully understand your specific needs. As I wrote recently, there are two significant non-pharmaceutical approaches to preventing depression or treating mild to moderate cases:

• Lifestyle changes, including improvements in diet, physical activity, sleep or simply spending more time outdoors.