Almost every week in clinic, I see someone who has been struggling with depression or anxiety for quite some time before finally coming around to the idea of medication. Often, the hesitation isn’t really about taking treatment. It’s about what they believe the treatment might do to them.
“Will I become addicted?”
“Will I become a different person?”
“Does needing medication mean I can’t cope on my own?”
These are questions I hear regularly, and I don’t think they should ever be dismissed. If you’ve heard a worrying story from a friend or family member, or read something online, it’s perfectly reasonable to have concerns about taking medication.
Let’s address some of the common misconceptions about antidepressants that I come across in my practice.
Myth 1: Antidepressants are addictive
This is probably the most common concern. The confusion is understandable because some people do feel unwell if they suddenly stop taking an antidepressant. But that doesn’t mean they are addicted to it.
Addiction involves things such as craving, loss of control over use, and continuing to take a substance because of its rewarding effects despite harm. Antidepressants don’t generally produce a “high” or the kind of compulsive use we associate with addictive substances.
What can happen is something called antidepressant discontinuation symptoms, sometimes referred to as withdrawal symptoms. If certain antidepressants are stopped suddenly, a person may experience dizziness, nausea, irritability, anxiety, sleep problems or unusual sensations in the body. This is the body’s adjustment to a change in medication. It is different from addiction.
For this reason, I usually advise patients not to stop their antidepressant abruptly, even if they’re feeling better. If the time comes to stop, we can work out a gradual reduction together.
Myth 2: Antidepressants will change my personality
Some patients tell me, “I don’t want to become numb,” or “I don’t want the medication to change who I am.” I understand that concern. Nobody wants to feel that they’re no longer themselves. However, that’s not what we’re trying to achieve with an antidepressant.
When someone is depressed, their usual personality can already become obscured. Someone who is normally sociable may withdraw from friends. Someone who enjoys spending time with their family may stop wanting to be around people. Things that used to bring pleasure no longer do. Concentration and motivation can also suffer.
When treatment works, the aim is to reduce these symptoms and help the person get back to their usual self. Some people describe it quite simply: “I feel like myself again.”
That said, antidepressants aren’t free of side effects. Some people may experience emotional blunting, sexual side effects, sleepiness, nausea or other problems. If that happens, it’s important to tell your doctor. Sometimes a change in dose or medication can make a big difference.
The goal isn’t to take away your emotions, but to help you experience them more normally.
Myth 3: If I need medication, I've failed to cope
Depression isn’t a sign that someone is weak, lazy or not trying hard enough. People often tell me, “I’ve tried to be strong,” or “Other people have it worse than me.” But mental health problems aren’t a competition, and suffering isn’t something you need to justify.
There are many different factors involved in depression, including our biology, genetics, psychological make-up, relationships, life circumstances, sleep and physical health. Often, there isn’t one single reason why someone becomes depressed.
Needing treatment doesn’t mean you’ve failed. We don’t tell someone with asthma to try harder to breathe, or someone with high blood pressure that they should be able to control it through willpower alone.
Similarly, there is no prize for suffering in silence. Sometimes the strongest thing a person can do is acknowledge that they’re struggling and accept help, rather than waiting until things become unbearable.
Myth 4: My depression isn't serious enough for medication
I often hear patients say, “I don’t think my condition is serious enough to require medication,” or “Other people have it much worse than me.” But there is no single severity threshold that determines whether medication should be considered.
Waiting until things become unbearable before seeking help can mean a longer and harder road to recovery. Mild to moderate depression can still significantly affect someone’s work, relationships and quality of life, even if it doesn’t look dramatic from the outside. Seeking treatment earlier may help prevent symptoms from becoming more persistent or difficult to manage.
This doesn’t mean medication is necessary for everyone with low mood. For milder presentations, other treatments such as psychotherapy or lifestyle changes may be tried first. The decision to consider medication should be based on how much someone is struggling, their individual circumstances and what would genuinely help them, rather than comparing their suffering to someone else’s.
Myth 5: All antidepressants are basically the same
There are several different types of antidepressants, and even medications within the same broad group can have quite different effects and side-effect profiles.
When I’m choosing an antidepressant with a patient, I’m not simply thinking, “Which antidepressant should I give?” I’m also thinking about which symptoms are most troublesome, what the person has taken before, whether they have responded to medication in the past, what other medications they are taking, their physical health and, most importantly, what matters to them.
For one person, avoiding daytime sedation might be particularly important. For another, sexual side effects may be a major concern. Someone else may be particularly worried about weight gain or insomnia.
There isn’t a single medication that is best for everyone. Sometimes we get the choice right the first time. Sometimes we need to make adjustments along the way. That doesn’t mean the treatment has failed. It means we’re finding the treatment that works best for that particular person.
Myth 6: If antidepressants didn't work for me before, they never will
Some patients come to me having tried an antidepressant in the past without success, understandably concluding that medication simply isn’t for them. But a single unsuccessful trial doesn’t mean all antidepressants will fail.
There are several reasons an earlier attempt might not have worked: the dose may have been too low, the trial period too short, the medication may not have been suitable for that person’s particular symptoms, or side effects may have led to stopping before the medication had a chance to take effect. Sometimes, what looks like “antidepressants don’t work for me” is really “that particular antidepressant, at that particular dose, wasn’t right for me.”
In my practice, I’ve seen patients who had given up on medication after one or two disappointing trials go on to respond well to a different option. Sometimes it’s because we chose a medication that better matched their specific symptoms. Other times, it’s because we gave it a longer trial at an appropriate dose.
None of this happens overnight, though. Finding the right medication and understanding how your body responds to it can take time and patience.
Myth 7: Antidepressants should work straight away
Antidepressants are not a magic elixir that takes effect the moment you swallow a tablet. You don’t usually take one today and expect your depression to disappear tomorrow.
Some people begin to notice changes within the first couple of weeks, while for others it takes longer to see a meaningful improvement. Different symptoms can also improve at different speeds.
One frustrating part of starting an antidepressant is that side effects can sometimes appear before the benefits do. This can understandably lead someone to think, “I’m feeling worse and I’m not even feeling better yet. Why am I taking this?”
That’s why it’s important to talk about expectations before starting treatment. If you’re having problems with a medication, let your doctor know rather than simply stopping it yourself. We can then decide whether to continue, adjust the dose, manage the side effects or consider another option.
Myth 8: You can just take antidepressants when you're feeling low, like a painkiller
It’s a very reasonable assumption, since that’s how many other medications work. You take a painkiller when you have a headache and stop once it’s gone. However, antidepressants generally don’t work this way.
Most antidepressants are taken daily, regardless of how someone feels on a particular day. Their therapeutic effects typically develop over time, and regular dosing helps maintain consistent medication levels in the body. Taking them only on “bad days” doesn’t provide the consistent treatment needed for a meaningful effect and, with some medications, can increase the risk of discontinuation symptoms when doses are missed.
This is one of the reasons consistency matters so much in the early weeks of treatment, even before the benefits become obvious. It’s also why decisions about starting, adjusting or stopping medication are best made together with your doctor, rather than based on how you happen to be feeling on any given day.
Myth 9: Once I start antidepressants, I'll have to take them for the rest of my life
For many people, antidepressants are used for a particular period of their lives — for example, to treat a depressive episode and reduce the likelihood of depression returning.
Once someone has recovered, we don’t simply assume they have to remain on medication forever. We look at their history and consider things such as how severe the episode was, whether they’ve had previous episodes, how many times the depression has returned and how they’ve responded to treatment.
Some people can eventually come off medication. Others may benefit from staying on it for longer, particularly if they have had recurrent or severe depression. There isn’t a fixed answer that applies to everyone.
If the decision is made to stop medication, it should generally be reduced gradually and with medical guidance rather than stopped suddenly.
So, do antidepressants work?
Yes, antidepressants can be effective treatments for depression and some anxiety disorders. But they aren’t magic pills, and they’re not the answer to every problem.
In my practice, I often see good results when medication is considered as one part of a wider treatment plan. For some people, that might include psychotherapy. For others, improving sleep, getting back into a routine, addressing relationship or work difficulties, or rebuilding social connections may be equally important.
Sometimes medication is the main intervention needed. Sometimes it is only one piece of the puzzle. And sometimes, after discussing the options, we decide that medication isn’t appropriate at all.
That’s why I don’t think the important question is simply, “Should I take antidepressants?” A better question is: “Given my situation, what treatment is most likely to help me, and what are the benefits and risks?”
If you’ve been avoiding antidepressants because of something you’ve heard from a friend, family member or online, it’s worth having a proper conversation with your doctor before making a decision. You don’t have to commit to taking medication simply because you’ve asked about it. You can ask questions. You can discuss your concerns. You can consider the alternatives.
Ultimately, the decision should be made together. Mental health treatment shouldn’t be about forcing someone to take a particular medication. It should be about understanding the problem, discussing the available options and finding an approach that makes sense for that individual.
If you're unsure whether antidepressants are right for you, our experienced psychiatrists and psychologists at Private Space Medical can help you better understand your symptoms, explore your treatment options and make an informed decision about your mental health care. Contact us to arrange a consultation.
Dr Tan Ho Teck
Senior Consultant Psychiatrist
Senior Consultant Psychiatrist
