As someone who has struggled with depression and suicidal thoughts and has been on antidepressants, this is a topic I feel inclined to talk about. First and foremost, if you are currently experiencing suicidal thoughts or mental health-related distress, please seek professional help or text/call the Suicide and Crisis Lifeline at 988.
If this is not an emergency but something you struggle with, understand you are not alone. Approximately 280 million people worldwide have depression (1), 970 million worldwide struggle with mental illness or drug abuse, and 14.3% of deaths worldwide, or approximately 8 million deaths annually, are attributable to mental disorders. Additionally, 1 in 4 people will be affected by a mental illness at some point (2). Again, you are not alone.
With depression at an all-time high, it’s no wonder over the past six years, antidepressant prescriptions have increased by 34.8%, from 61.9 million in 2015/2016 to 83.4 million in 2021/2022 (3).
What Are Antidepressants
Antidepressants are prescription medications used to treat depression. Of course, a healthcare provider may prescribe antidepressants for anxiety, chronic pain, insomnia, or other health conditions. If you’re looking into antidepressants, you’re likely already familiar with what depression is, but just to recap:
Depression is more than feeling a little sad or experiencing grief. Depression is a common and serious mental health disorder/illness that negatively impacts how you feel, think, and act. Depression provokes intense, long-term sadness and/or a loss of interest in once-enjoyed activities. Depression can lead to various emotional and physical problems and decrease your ability to function at work and home, leading to a poorer quality of life (4).
Like most pharmaceuticals, there are different classes of antidepressants, so let’s discuss them.
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- Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressants. They’re usually preferred over other antidepressants as they cause fewer side effects and are less likely to have a serious outcome in the event of an overdose (5).
- Serotonin-noradrenaline reuptake inhibitors (SNRIs) are similar to SSRIs but were designed to be more effective than SSRIs. Although the evidence that SNRIs are more effective in treating depression is uncertain, some people respond better to SSRIs, while others respond better to SNRIs (5).
- Noradrenaline and specific serotonergic antidepressants (NASSAs) may be effective for people who cannot take SSRIs. The side effects of NASSAs are similar to those of SSRIs. Although NASSAs are thought to cause fewer sexual problems, they may also cause more drowsiness at first (5).
- Serotonin antagonists and reuptake inhibitors (SARIs) are usually not the first choice but may be prescribed if other antidepressants have not worked or have caused side effects (5).
- Tricyclic antidepressants (TCAs) are usually not recommended as the first treatment for depression because they can be more dangerous in the event of an overdose. Additionally, TCAs cause more unpleasant side effects than SSRIs and SNRIs (5).
- Monoamine oxidase inhibitors (MAOIs) are rarely used today as they can cause potentially serious side effects and should only be prescribed by a specialist doctor (5).
Every class of antidepressants has a risk of side effects, so let’s discuss the overall risks associated with antidepressants.
Risks of Antidepressants
The risks of antidepressants are often worse than the symptoms of depression. Have you ever heard the commercials for antidepressants?
“This medication is not for everyone. Call your doctor about unusual changes in behavior, worsening depression, or thoughts of suicide. Antidepressants can increase these in those 24 and younger. Elderly dementia patients taking this medication have an increased risk of death or stroke. Call your doctor if you have high fever, stiff muscles, and confusion to address a possible life-threatening condition or if you have uncontrollable muscle movements, as these may be permanent. High blood sugar was reported with this medication and, in extreme cases, can lead to coma or death. Other risks are increased cholesterol, weight gain, decreased white blood cells, which can be serious, dizziness on standing, seizures, trouble swallowing, and impaired judgment or motor skills.”
Risks associated with antidepressant usage include (6,7):
- Insomnia
- Skin rashes
- Headaches
- Joint and muscle pain
- Stomach upset
- Nausea
- Diarrhea
- Dizziness
- Loss of coordination
- Fatigue
- Tingling
- Burning
- Blurred vision
- Vivid dreams
- Flu-like symptoms
- Irritability
- Anxiety
- Crying spells
- Decreased concentration of the neurotransmitter serotonin in platelets
- Decreased libido
- Problems with sexual performance
- Delay or inhibit ejaculation (in men)
- Delay or prevent orgasm (in women)
- Insomnia
- Blood clots
- Increased risk of internal bleeding
- Weight gain
- Suicidal thoughts or behavior
- Addiction
- Inability to feel emotions
- High blood sugar levels
- Tachyphylaxis (sudden decrease in response to a drug)
Aside from the long list in their commercials, there is mixed data regarding an association between antidepressants and breast and ovarian cancer in both pre-clinical and clinical data (8). The possibility that ADs may exhibit a bi-phasic effect, whereby short-term use and even low-dose antidepressants may increase the risk of breast and ovarian cancer, warrants further investigation.
This is quite the list of potential side effects and, honestly, quite overwhelming. For some, antidepressants may be the only choice, and that’s okay. Looking for support? Check out our blog, When Mama Needs Support (and How to Find it), which is great for anyone, not just mamas.
Herbs With Antidepressant Properties
It still blows my mind that we prescribe potentially harmful antidepressants as a first line of defense against depression instead of considering other factors. For instance, doctors rarely consider the gut-brain connection, foods for mental health, adaptogens, and herbs to help manage symptoms.
Basil
Basil is said to reduce depression related to chronic stress. One study found Ocimum basilicum relieves chronic unpredictable mild stress-induced depression in mice (9). In another study, they found Ocimum basilicum to have an antidepressant-like effect in animal models of depression (10).
CBD
Cannabinoids (cannabis and CBD) have shown benefits for anxiety, cognitive impairment, and discomfort before public speaking while having an antidepressant effect. It’s said that cannabis can positively affect the serotonin receptors in the brain, and low serotonin levels (the happy hormone) are likely connected with depression (11).
Holy Basil
Holy basil has pharmacological properties that can help the mind cope with many types of stress. In animal studies, holy basil leaf extract enhanced metabolism, improved swimming time, less tissue damage, and lower stress levels in environment-induced stress/loud environments (12). Additionally, studies have found holy basil has anti-anxiety and depression properties comparable to pharmaceuticals like Diazepam (13).
Reishi Mushrooms
Reishi mushrooms may help improve overall mental health. One study found four weeks of a reishi powder supplement reduced fatigue, anxiety, and depression and improved quality of life in breast cancer patients (14). Another study found after eight weeks, reishi mushroom supplementation, reduced fatigue and improved overall well-being in people with neurasthenia (15).
Schisandra
Schisandra may help improve symptoms of depression (16). Animal studies have found that Schisandra extract had an antidepressant effect on mice (17,18). Although there have been successful outcomes in animal studies, Schisandra’s antidepressant effects haven’t been studied much in humans.
