8 Common Misconceptions About Antidepressants

iStock
iStock

Think you have depression, but feeling uncomfortable about the idea of treating it with medication? Each person’s treatment plan is unique, but if you feel like your life could be improved by antidepressants, you shouldn’t let the many common myths and misconceptions surrounding their use keep you from seeking the help you need.

Mental Floss spoke with Dr. David Mischoulon, director of research at Massachusetts General Hospital's Depression Clinical and Research Program, who set the record straight on some common misconceptions about antidepressants.

1. THE MYTH: ANTIDEPRESSANTS DON'T ADDRESS THE ROOT CAUSE OF DEPRESSION.

There are multiple factors that can contribute to depression, ranging from environmental or situational components to brain biochemistry. Medication can help when the underlying cause is partly biological in nature.

“For example, there are some people who may develop depression for no apparent reason,” Dr. Mischoulon says. “There is absolutely no particular stress in their lives. There hasn’t been any misfortune of any sort. In fact, they’ll often say, ‘I’ve got a life that most of the world would envy,’ and yet they’re depressed ... Those people often respond very well to antidepressants, and in that sense, [the medicine] is getting at the root cause [of the depression], which is a biochemical imbalance in the brain.”

At the other end of the spectrum, some people “may become depressed primarily because of situational problems,” Mischoulon adds. "They may be experiencing problems in the workplace, family problems, or a divorce, things like that. Those factors can certainly contribute to depression—perhaps in combination with a proclivity to becoming depressed, or because … the stress is just so, so tremendous that the person becomes depressed as a result.”

Sometimes these individuals may not respond to antidepressants because the root cause is situational. If their situations were to improve—say, they got a better job—they might start feeling better. Therapy might also help them develop better coping skills.

“There are certain kinds of therapies that have been carefully studied in clinical trials, and for many [depression] cases, they can work very well,” Mischoulon says. “For example, cognitive behavioral therapy is one of the better studied forms; it’s been shown in some studies to be as effective as antidepressants.”

That said, research also suggests that for many people, treating depression with a combination of therapy and medication can be the best course of treatment. “The two will work synergistically," Mischoulon explains. "By combining the two you can get a better result.” (If you're thinking about beginning therapy, here's a guide to figuring out which type is best for you.)

Mental health researchers are trying to pinpoint ways to differentiate between a biochemical depression and situational depression. But as of right now, "we’re not at a point where we can use what we've learned in a clinical setting," Mischoulon says.

2. THE MYTH: ANTIDEPRESSANTS ARE "HAPPY PILLS."

“If I give an antidepressant to a healthy individual—someone who’s not depressed—they’re not going to be happier, or more cheerful” as a result of taking it, Mischoulon says. “It only works to return the mood to the patient’s normal baseline. So if you’re depressed, the antidepressant can help you get back to where you were.”

3. THE MYTH: ANTIDEPRESSANTS ARE ADDICTIVE.

Antidepressants “aren’t drugs of abuse,” Mischoulon says. They may improve your depression symptoms, which can lead to increased energy levels and an improved mood, but they won’t get you high or make you crave additional or stronger doses—all hallmarks of addiction.

However, since your body grows accustomed to the drug, you may experience withdrawal syndromes—including headaches, dizziness, nausea, and irritability—if you stop taking it abruptly, “similarly to what you might have with a recreational drug,” Mischoulon explains. If you’re thinking about discontinuing an antidepressant, check with your doctor first. He or she will likely recommend that you taper your dosage over a period of days or weeks, depending on the medication.

4. THE MYTH: ANTIDEPRESSANTS WILL PERMANENTLY ALTER YOUR PERSONALITY.

Taking the right antidepressant can slowly help a depressed person return to his or her baseline mood, making them feel and act more like “themselves." That said, Mischoulon does say that some patients on antidepressants “report being emotionally numbed, like they can’t experience normal emotions.” There aren’t many prospective or systematic studies that examine this phenomenon, but Mischoulon estimates that maybe 10 percent of the patients in his practice have reported it. It's "a relatively small minority," he adds. 

If this happens to you, don’t worry: It’s usually "not a known cause for concern,” Mischoulon says. This won’t “cause permanent damage to someone’s personality, or their capacity to feel emotions … It’s simply a matter of discontinuing the antidepressant and trying another one.”

5. THE MYTH: ANTIDEPRESSANTS ARE A SHORT-TERM FIX.

If you were successfully treated with antidepressants, you may want to speak with your doctor about continuing to take them as a preventative measure, even if you now feel fine. Research shows that experiencing just one episode of depression puts a person at a 50 percent risk for experiencing another episode, and increases their chances for future relapse.

Some doctors suggest treating conditions like major depression in the same way that you would a chronic illness—with lifelong management. “The good thing is that most antidepressants are very safe to take over the long term, so if a person had to take one indefinitely, it’s not the worst thing in the world,” Mischoulon says.

That said, if you’ve responded well to treatment and don’t have a prior history of depressive episodes, there’s a chance that you’ll be OK if you come off them under a doctor’s supervision.

6. THE MYTH: IF YOU TRY ONE ANTIDEPRESSANT AND IT DOESN'T WORK, MEDICATION ISN'T FOR YOU.

Once you begin taking an antidepressant, it can take weeks, if not months, to feel the full effects. And since there’s currently no good way to predict which antidepressant will work for any one individual, there’s always the chance that the one you’re trying may end up not being the right one for you. If this ends up being the case, you’ll have to begin the cycle anew—this time, with a different pill.

This trial-and-error process can be discouraging for some patients. Keep in mind, however, that there are more than two dozen antidepressants on the market—meaning there’s a good chance you’ll find something that alleviates your symptoms.

“There are antidepressants from different families that differ biochemically,” Mischoulon explains. “What we find is that a lot of people will take a particular type of antidepressant and it may not work, and then they’ll try an antidepressant from another family, and that one will work better for them.”

7. THE MYTH: ALL ANTIDEPRESSANTS HAVE AWFUL, LONG-LASTING SIDE EFFECTS.

From insomnia to blurred vision to fatigue, the long checklist of potential side effects included in your medicine packet can be intimidating, if not downright frightening. Don’t worry: The likelihood that you’ll experience every single one of them is slim, Mischoulon says. Most people only encounter one or two; common side effects include upset stomach, headaches, weight gain, and sedation, but side effects vary from one medication to the next. (For example, on average, Mischoulon estimates that about 15 percent of his patients report weight gain.)

These side effects are sometimes short-term, popping up during the initial stages of treatment and tapering off as the patient’s body gets used to the medication. Still, in other cases, they persist. In the latter instance, you may want to talk with your doctor about switching to another medication or the best way to treat your side effects.

8. THE MYTH: DOCTORS OVERTREAT AMERICANS FOR DEPRESSION.

According to the National Center for Health Statistics, antidepressants were the third most commonly prescribed drug taken by Americans of all ages between 2005 and 2008. (Though not all patients take antidepressants for depression and anxiety; they can also be used to treat other issues, including insomnia and chronic pain.) Are these medications overprescribed to patients?

“I think in certain circles they may be overprescribed, and in others they may be underprescribed,” Mischoulon says. “What we do know is that there are a lot of people with depression out there who are not being adequately treated … This could apply to antidepressants, as well as psychotherapy. A lot of people are not getting treatment at all who should be getting some treatment.”

People with depression don’t receive care for a variety of reasons, Mischoulon points out: Stigma, a lack of education, limited economic resources, or not living near a health care professional for treatment are just a few examples. That said, there can be dire repercussions for those who don't seek treatment, including suicide and worsened outcomes for concurrent medical conditions, like cardiovascular disease.

If you think you have depression and have the means to see a doctor, "get a professional evaluation," Mischoulon advises. "Don’t try to self-diagnose. Don’t try to treat it yourself with over-the-counter supplements. Speak to your primary care doctor, and maybe speak to a psychiatrist ... If not treated properly, depression can have devastating consequences."

The Horrors of Anglerfish Mating

Masaki Miya et al. "Evolutionary history of anglerfishes (Teleostei: Lophiiformes): a mitogenomic perspective," BMC Evolutionary Biology 10, article number: 58 (2010), Wikimedia Commons // CC BY 2.0
Masaki Miya et al. "Evolutionary history of anglerfishes (Teleostei: Lophiiformes): a mitogenomic perspective," BMC Evolutionary Biology 10, article number: 58 (2010), Wikimedia Commons // CC BY 2.0

When you think of an anglerfish, you probably think of something like the creature above: Big mouth. Gnarly teeth. Lure bobbing from its head. Endless nightmares. 

During the 19th century, when scientists began to discover, describe, and classify anglerfish from a particular branch of the anglerfish family tree—the suborder Ceratioidei—that’s what they thought of, too. The problem was that they were only seeing half the picture. The specimens that they were working with were all female, and they had no idea where the males were or what they looked like. Researchers sometimes found some other fish that seemed to be related based on their body structure, but they lacked the fearsome maw and lure typical of ceratioids and were much smaller—sometimes only as long as 6 or 7 millimeters—and got placed into separate taxonomic groups.

It wasn’t until the 1920s—almost a full century after the first ceratioid was entered into the scientific record—that things started to become a little clearer. In 1922, Icelandic biologist Bjarni Saemundsson discovered a female ceratioid with two of these smaller fish attached to her belly by their snouts. He assumed it was a mother and her babies, but was puzzled by the arrangement.

“I can form no idea of how, or when, the larvae, or young, become attached to the mother. I cannot believe that the male fastens the egg to the female,” he wrote. “This remains a puzzle for some future researchers to solve.”

When Saemundsson kicked the problem down the road, it was Charles Tate Regan, working at the British Museum of Natural History in 1924, who picked it up. Regan also found a smaller fish attached to a female ceratioid. When he dissected it, he realized it wasn’t a different species or the female angler’s child. It was her mate.

The “missing” males had been there all along, just unrecognized and misclassified, and Regan and other scientists, like Norwegian zoologist Albert Eide Parr, soon figured out why the male ceratioids looked so different. They don’t need lures or big mouths and teeth because they don’t hunt, and they don’t hunt because they have the females. The ceratioid male, Regan wrote, is “merely an appendage of the female, and entirely dependent on her for nutrition.” In other words, a parasite.

When ceratioid males go looking for love, they follow a species-specific pheromone to a female, who will often aid their search further by flashing her bioluminescent lure. Once the male finds a suitable mate, he bites into her belly and latches on until his body fuses with hers. Their skin joins together, and so do their blood vessels, which allows the male to take all the nutrients he needs from his host/mate’s blood. The two fish essentially become one.

With his body attached to hers like this, the male doesn't have to trouble himself with things like seeing or swimming or eating like a normal fish. The body parts he doesn’t need anymore—eyes, fins, and some internal organs—atrophy, degenerate, and wither away, until he’s little more than a lump of flesh hanging from the female, taking food from her and providing sperm whenever she’s ready to spawn.

Extreme size differences between the sexes and parasitic mating aren’t found in all anglerfish. Throughout the other suborders, there are males that are free-swimming their whole lives, that can hunt on their own and that only attach to the females temporarily to reproduce before moving along. For deep-sea ceratioids that might only rarely bump into each other in the abyss, though, the weird mating ritual is a necessary adaptation to keep mates close at hand and ensure that there will always be more little anglerfish. And for us, it’s something to both marvel and cringe at, a reminder that the natural world is often as strange as any fiction we can imagine.

Naturalist William Beebe put it nicely in 1938, writing, “But to be driven by impelling odor headlong upon a mate so gigantic, in such immense and forbidding darkness, and willfully eat a hole in her soft side, to feel the gradually increasing transfusion of her blood through one’s veins, to lose everything that marked one as other than a worm, to become a brainless, senseless thing that was a fish—this is sheer fiction, beyond all belief unless we have seen the proof of it.”

10 Facts About the Winter Solstice, the Shortest Day of the Year

Matt Cardy/Getty Images
Matt Cardy/Getty Images

Amid the whirl of the holiday season, many are vaguely aware of the approach of the winter solstice, but how much do you really know about it? Whether you're a fan of winter or just wish it would go away, here are 10 things to note—or even celebrate—about the shortest day of the year.

1. The winter solstice HAPPENS ON DECEMBER 21/22 in 2019.

Sun setting behind a tree in the winter
buxtree/iStock via Getty Images

The date of the winter solstice varies from year to year, and can fall anywhere between December 20 and December 23, with the 21st or 22nd being the most common dates. The reason for this is because the tropical year—the time it takes for the sun to return to the same spot relative to Earth—is different from the calendar year. The next solstice occurring on December 20 will not happen until 2080, and the next December 23 solstice will not occur until 2303.

2. The winter solstice hAPPENS AT A SPECIFIC, BRIEF MOMENT.

sun setting through the trees
yanikap/iStock via Getty Images

Not only does the solstice occur on a specific day, but it also occurs at a specific time of day, corresponding to the instant the North Pole is aimed furthest away from the sun on the 23.5 degree tilt of the Earth's axis. This is also the time when the sun shines directly over the Tropic of Capricorn. In 2019, this moment occurs at 4:19 a.m. UTC (Coordinated Universal Time) on December 22. For those on Eastern Standard Time, the solstice will occur at 11:19 p.m. on December 21. And regardless of where you live, the solstice happens at the same moment for everyone on the planet.

3. The winter solstice mARKS THE LONGEST NIGHT AND SHORTEST DAY OF THE YEAR FOR THE NORTHERN HEMISPHERE.

sun setting over Central Park
rmbarricarte/iStock via Getty Images

As most are keenly aware, daylight hours grow shorter and shorter as the winter solstice approaches, and begin to slowly lengthen afterward. It's no wonder that the day of the solstice is referred to in some cultures as the "shortest day of the year" or "extreme of winter." New York City will experience 9 hours and 15 minutes of sunlight, compared to 15 hours and 5 minutes on the summer solstice. Helsinki, Finland, will get 5 hours and 49 minutes of light. Barrow, Alaska, will not have a sunrise at all (and hasn't since mid-November; its next sunrise will be on January 22), while the North Pole has had no sunrise since October. The South Pole, though, will be basking in the glow of the midnight sun, which won't set until March.

4. ANCIENT CULTURES VIEWED THE WINTER SOLSTICE AS A TIME OF DEATH AND REBIRTH.

snow on tree branches
Eerik/iStock via Getty Images

The seeming death of the light and very real threat of starvation over the winter months would have weighed heavily on early societies, who held varied solstice celebrations and rites meant to herald the return of the sun and hope for new life. Scandinavian and Germanic pagans lit fires and may have burned Yule logs as a symbolic means of welcoming back the light. Cattle and other animals were slaughtered around midwinter, followed by feasting on what was the last fresh meat for several months. The modern Druidic celebration Alban Arthan reveres the death of the Old Sun and birth of the New Sun.

5. THE  shortest DAY of the year MARKS THE DISCOVERY OF NEW AND STRANGE WORLDS.

Pilgrims landing at Plymouth Rock
Hulton Archive/Getty Images

The Pilgrims arrived at Plymouth on December 21, 1620, to found a society that would allow them to worship freely. On the same day in 1898, Pierre and Marie Curie discovered radium, ushering in an atomic age. And on December 21, 1968, the Apollo 8 spacecraft launched, becoming the first manned moon mission.

6. THE WORD SOLSTICE TRANSLATES ROUGHLY TO "SUN STANDS STILL."

colorful sunset
a_Taiga/iStock via Getty Images

Solstice derives from the Latin scientific term solstitium, containing sol, which means "sun," and the past participle stem of sistere, meaning "to make stand." This comes from the fact that the sun’s position in the sky relative to the horizon at noon, which increases and decreases throughout the year, appears to pause in the days surrounding the solstice. In modern times, we view the phenomenon of the solstice from the position of space, and of the Earth relative to the sun. Earlier people, however, were thinking about the sun's trajectory, how long it stayed in the sky and what sort of light it cast.

7. STONEHENGE IS ALIGNED TO THE SUNSET ON the WINTER SOLSTICE.

Stonehenge sunset
jessicaphoto/iStock via Getty Images

The primary axis of the megalithic monument is oriented to the setting sun, while Newgrange, another structure built around the same time as Stonehenge, lines up with the winter solstice sunrise. Some have theorized that the position of the sun was of religious significance to the people who built Stonehenge, while other theories hold that the monument is constructed along natural features that happen to align with it. The purpose of Stonehenge is still subject to debate, but its importance on the winter solstice continues into the modern era, as thousands of hippies, pagans, and other types of enthusiasts gather there every year to celebrate the occasion.

8. ANCIENT ROMANS CELEBRATED REVERSALS AT THE MIDWINTER FESTIVAL OF SATURNALIA.

Saturnalia parade
A Saturnalia celebration in England in 2012.
Christopher Furlong/Getty Images

The holiday, which began as a festival to honor the agricultural god Saturn, was held to commemorate the dedication of his temple in 497 BCE. It quickly became a time of widespread revelry and debauchery in which societal roles were overturned, with masters serving their slaves and servants being allowed to insult their masters. Mask-wearing and play-acting were also part of Saturnalia's reversals, with each household electing a King of Misrule. Saturnalia was gradually replaced by Christmas throughout the Roman Empire, but many of its customs survive as Christmas traditions.

9. SOME TRADITIONS HOLD THAT DARK SPIRITS WALK THE EARTH ON THE WINTER SOLSTICE.

Snowy woods
Serjio74/iStock via Getty Images

The Iranian festival of Yalda is celebrated on the longest night of the year. In pre-Islamic times, it heralded the birth of Mithra, the ancient sun god, and his triumph over darkness. Zoroastrian lore holds that evil spirits wander the Earth and the forces of the destructive spirit Ahriman are strongest on this long night. People are encouraged to stay up most of the night in the company of one another, eating, talking, and sharing poetry and stories, in order to avoid any brushes with dark entities. Beliefs about the presence of evil on the longest night are also echoed in Celtic and Germanic folklore.

10. SOME THOUGHT THE WORLD WOULD END ON THE 2012 WINTER SOLSTICE.

snowy woods with sun through the trees
Delpixart/iStock via Getty Images

December 21, 2012 corresponds to the date 13.0.0.0.0 in the Mesoamerican Long Count calendar used by the ancient Maya, marking the end of a 5126-year cycle. Some people feared this juncture would bring about the end of the world or some other cataclysmic event. Others took a more New Age-y view (literally) and believed it heralded the birth of a new era of deep transformation for Earth and its inhabitants. In the end, neither of these things appeared to occur, leaving the world to turn through winter solstices indefinitely, or at least as long as the sun lasts.

A version of this story originally ran in 2015.

SECTIONS

arrow
LIVE SMARTER