It’s known by its medical term, tachyphylaxis and it describes what happens when the drugs stop working.
For people who rely on antidepressants, this is otherwise known as the ‘poop out’ and it can be very scary as the once reliable anti anxiety and depression meds don’t work anymore.
As with many areas of depression, the medics can’t give a definitive answer as to why this happens.
However, it has been suggested[i] that tachyphylaxis may result from the way that the body reacts to the drug and/or the drug makes its way through the body or, to put it another way, the progression of pharmacokinetic and/or pharmacodynamics.
It’s complex and no one quite understands it and we simply have to accept that sometimes the meds just stop working.
When you’ve found the right depression treatment for you it can come as a huge disappointment when you sense the drug’s efficacy is waning especially as it can leave you vulnerable to suffering a reoccurrence of the depression.
The rate of antidepressant tachyphylaxis is estimated to be approximately 25% of those people who’ve been treated for depression.
Knowing this, it’s good to be prepared for this possibility by researching your options if antidepressant tachyphylaxis starts to kick in.
How Do I Know If Tachyphylaxis Takes Place?
The way you may know that this is happening if you're feeling worse whilst still taking the same dose of antidepressants that previously worked for you.
What Do I Do When My Depression Medication Stops Working? Follow Through On These Suggestions To Find Other Options That May Work For You.
Go back to your doctor
There are other options to discuss with your doctor if you think your antidepressant is no longer giving you the relief you need.
Occasionally it works better when your doctor prescribes a different dose of the same drug. Often, however, your doctor may increase your dosage and, although it can be effective immediately, for many people it can take up to 12 weeks to see the difference.
If you don’t see ANY difference in the depression after, say, six weeks, it maybe that your doctor will switch your medication for another type of antidepressant.
In this blog post I talk about the different types of antidepressants: Click Here
Failing that, your doctor may advise combining the antidepressant with other types of medication or that you try a completely different type of medication.
Ask To See A Psychiatrist
Generally speaking, a GP in the UK or a primary care doctor in the US prescribes most antidepressants. However, you may want to see a psychiatrist.
A psychiatrist is trained to deal with mental health as opposed to a primary care doctor who is trained to generalise in everything.
Therefore, by speaking to a psychiatrist you can talk specifics and discuss the details which will help the psychiatrist better understand exactly what type of antidepressants will suit you.
Psychiatrists specialise in understanding medication at a granular level as their primary job is to they prescribe them and then monitor the results.
What Makes A Good Psychiatrist? Here’s A List Of Ten Things To Look For:
Spends a good amount of time with you
Asks lots of questions to help them discover as much about you as possible
Is very respectful of how you feel
Really, really listens to your concerns
Has an in depth knowledge of medications
Shows you this by understanding why they haven’t worked for you
Has plenty of options which they run past you and takes into account your wish to lower or increase dosages
Understands limits and safety issues to do with all medication they are prescribing and issues any necessary cautions
Knows when medication should be stopped and is not hesitant to halt them if they haven’t worked
Has a positive outlook and displays confidence in their treatment plans
Have You’ve Tried Different/New Medication And Nothing Works?
You maybe one of those people for whom no amount of antidepressants will make you feel better. Take heart, you're not alone.
Are Antidepressants The Only Solution?
There’s a growing body of doctors who believe that antidepressants just don’t work - period.
Part of this thinking has resulted from some studies, which state how published trials show how antidepressants work but fail to flag up how they don’t work.
For example one study[ii], in the New England Journal of Medicine, found that 40% of people taking a placebo got better. In testing antidepressants, the drug companies have to do their balances and checks alongside people taking a placebo yet they don’t publish how well people actually do on the placebos.
This is perfectly legal yet can give a biased and skewed result on drug trials.
Looking at this study another way, if 40% of people got better on the placebo and only 60% got better on the antidepressants then you could argue that a total of 80% of people got better on a placebo.
Can We Talk Side Effects? They May Affect Our Decision To Stop Taking Meds
The problem is also that you have to take the side effects into consideration e.g. fatigue, nausea, headaches, loss of libido, insomnia, weight gain etc. They can sometimes be severe and therefore a game changer.
The side effects can leave some of us with no choice except to find alternatives.
What Are The Alternatives To Antidepressants? Here’s 5 Steps To Help Beat Depression Without Antidepressants.
If you’re one of those who’s experiencing tachyphylaxis, there are many ways to treat depression without antidepressants. I am living proof you can beat depression with alternatives.
1. Change Your Diet
Good food boosts your mood. That’s a fact and the evidence to support this is overwhelming.
One study[iii] showed the link between diet and depression with a group of people with severe to moderate depressive symptoms. They followed a healthy eating plan for twelve weeks, which included whole foods, fruit and vegetables and discouraged sugar, fried and refined foods.
This group displayed a significant reduction of symptoms when benchmarked against other groups, so much so that it concluded that 32% of participants no longer had any depression.
I’ll just repeat that: 32% No Longer Had Depression. It begs the question, why isn’t our doctor or psychiatrist putting us on a mood boosting diet?
2. Deal With Chronic Stress
Is There A Specific Link Between Depression And Stress?
Not all of us suffer from acute stress when we are depressed but as a rule we all suffer from more stress than is good for us.
We are becoming tolerant of higher stress levels: if someone walked into a doctor’s surgery with modern-day ‘normal’ stress levels, 50 years ago they would have been diagnosed with a major stress disorder!
Even if we’re not a ‘stressy’ type, our higher stress levels could simply be down to modern life. With the pace accelerating all the time, it’s hard not to be affected by our 24/7 lifestyle. By decreasing our stress levels, even if we think we don’t feel stressed, we’re going to beat depression faster.
Where Do Depression And Stress Overlap? It’s All About Sleep.
The exact point where stress tips into depression is when you’re so stressed you can’t sleep and the lack of sleep causes your mood to plummet.
This explains why it’s important to stay ahead on the stress levels to minimize their effect on depression levels.
3. Take Vitamin D & Omega-3
Vitamin D is called the sunlight vitamin because the body produces it when the sun’s ultraviolet B (UVB) rays strike the skin. It is the only vitamin the body manufactures naturally and is technically considered a hormone.
Vitamin D has been a key nutrient to help Seasonal Affective Disorder (SAD) sufferers and studies have found that people with SAD who received increased amounts of Vitamin D achieved a significant improvement in depression symptoms – albeit after one month.
Foods high in Vitamin D are: Prawns, Milk, Cod, Eggs
Omega-3 fatty acids are another type of compound which has been proven to lift depression.
This important nutrient is critical for good health. Omega-3 compounds are a form of polyunsaturated fats, one of four basic types of fat that the body derives from food. All polyunsaturated fats, including the omega-3s, are increasingly recognized as important to human health but they cannot be produced by the body, which means they need to be provided by our diet.
A lack of Omega-3 mood- boosting nutrients may lead to depression and other mental health problems.
Here is a list of the gorgeous Omega-3 fat sources: Fish, Canola oil, Olive oil, Flaxseed oil, Walnuts
Taking supplements for both these nutrients is a great substitute.
4. Exercise for 30 minutes, 5 times per week.
Modern day medicine says depression is partly a result of ‘the sitting disease’ and that physical inactivity is responsible for one in six deaths in the UK.
This would make inactivity one of the top 10 causes of illness in the UK - which is the same as smoking!
One organization in Australia[iv] has proven studies indicating that even just 1-2 hours per week make a powerful impact on mood.
The UK Government advice is: 150 minutes of physical activity a week, or half an hour, 5 days a week.
That can be anything that raises your heart rate, makes you breathe faster and feel warmer. You should be still able to talk but only just.
5. Get Some Therapy
All of us need help. No one can recover from depression alone. You may well have a strong circle of friends or a partner who can help by listening and being supportive.
However, you may also need to speak to someone outside of your circle.
Where Can I Find A Therapist?
Therapists range in different types of practices, all of which have demonstrated effectiveness in treating depression.
Group therapy: Group therapy takes place with a group of people together rather than with an individual during a one to one session.
Cognitive behavioral therapy: helps you to manage problems by changing the way you think and behave.
Mindfulness therapy: helps by tackling negative thinking – something that is rampant in depression.
Psychodynamic therapy: helps people understand and resolve their problems by becoming aware of their subconscious world and its influence over relationships.
Counselling: involves a trained counsellor listening to you and helping you find ways to deal with emotional issues.
There are other therapies but these are the main ones which work for depression.
Which Therapy Is The Most Effective For Depression? Here’s My Personal Preference.
Group therapy has been my favorite and has proven to be extremely effective for depression.
The support and camaraderie of a peer-to-peer group helps bring people out of isolation and alleviates symptoms quicker, in my opinion, than any other type of therapy.
How Much Does Therapy Cost?
The problem often isn’t so much which help to get it’s more a matter of cost.
With counseling/therapy treatments being cut back from health services and long waits for free services, the onus is often on the individual to seek the help they need.
Private treatment can be costly. I’ve known people charge $20-$200 per hour.
However, if you haven't got the funds, it’s worth knowing that many counselors/therapists have a certain number of ‘slots’ each week to assist those on a low income.
Also, there are charitable organizations that employ highly trained staff but charge low prices. Since it’s important to get the support, asking around and researching local practitioners might bring you great success.
Group therapy has traditionally been lower to fund simply because the cost of the therapists time is divided into more people. If you find a good therapist then it’s worth its weight in gold.
How Do We Know Which Therapy Is Right For Us? In My Case I Just Showed Up
When I was so depressed that I could hardly function I simply rang someone, showed up and collapsed. Sometimes it’s like that.
The first person I saw wasn’t the right one. She would make a pot of tea, pour it out and smoke – I’m not joking – seven or eight cigarettes in the hour. I actually took up smoking to keep up with her. I stank when I left!
She said nothing, gave me no feedback, just smiled or glanced down. Or nodded. Still, at least I’d made a start on getting help.
The people I saw after her gradually became a better match for me until I found someone who really understood the nature of my depression. Once I found her, the change in me was dramatic and swift.
You won’t know who’s right for you until you try them out. It’s a personal thing, which comes down to getting along with someone. There’s no shame in abandoning a therapist if it doesn’t feel right.
Building a trusting relationship is the key to making it work. If you don’t feel safe, it won’t work. Check out their credentials and make sure they have appropriate training.
My advice is to trust your own instincts. I believe that we find the right person for us at the right time.
Even though I had a poor experience to start with, I was pretty ‘off the wall’ myself and might have found a highly trained therapist a ‘bit of a bore’ or going too slowly for me. I may not have been able to handle their gentleness or willingness never to judge me and to be there always. Who knows?
It’s a journey with no end and we meet extraordinary people along the way.
There are lists of accredited organizations on the web and, although finding someone registered with a professional body is a safeguard, it doesn’t mean you will automatically have someone really, really good.
A therapist or counselor is only as good as their own journey, but having someone recognized by a professional body at least gives you recourse if it goes wrong. It’s not likely that you will ever need it but having this recourse available is a step towards looking after yourself.
[ii] (1) Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine. 358: 252-260.
***I am not a doctor and my opinions are only my own. Please see your doctor for any medical help***