Psychiatrist Questions Antipsychotic Medications

Will I have to be on anti-depressants throughout my life once I start them?

I have some psychiatric issues but I am scared to start any treatment as I may have to be on medicines for the rest of my life. Are my fears justified?

7 Answers

The most important thing is to help you get well. The decision about the length of treatment will be made by you and your psychiatrist.
The question is how long have you suffered from depression? If one suffers from depression as a child or adolescent they will probably have bouts of depression throughout their lives. If your depression is not long term than anti-depressant medication is helpful. Important to note that these type of medications are not addictive. My recommendation is to continue taking them until you have about 6-12 without symptoms.
Your fears are certainly understandable, but may not be justified.

It's unclear if you fear (A) starting an antidepressant because your body will become dependent on the medication, thus making it difficult for you to stop the antidepressant, or (B) if you fear seeking evaluation because you may be advised that you're a good candidate for long-term treatment with antidepressant therapy.

If you fear (A), fear not! Although antidepressants can cause discomfort if improperly discontinued, a skilled clinician can discontinue any antidepressant with minimal or no discomfort to the patient.

If you fear (B) above: whether or not you remain on medications long-term is--firstly--your choice. A psychiatrist's job is to educate you about your illness, as well as the potential risks and benefits of various treatment options (including no treatment), then to help you decide upon a course of treatment. No one should pressure you to decide either way.

The likelihood that a given patient will need antidepressant therapy long-term depends upon several factors. One factor predictive of a need for long-term (sometimes lifetime) treatment with antidepressants, for example, is the number and severity of mood episodes that have occurred in the past.

A very general rule of thumb for depressed patients, for example, is: if a person has had three or more major depressive episodes, they are likely to do best on long-term medication maintenance treatment. The data is very clear regarding these patients: those who do not remain on maintenance antidepressant medication have a high likelihood of having additional--and often increasingly disabling--major depressive episodes in the future, with each major depressive episode predisposing that patient to additional future episodes, sometimes worsening in severity.

Not every patient diagnosed with depression is an appropriate candidate for antidepressants, as many patients are more suitable for counseling or therapy.

I hope that helps, and I wish you luck!

Again, that is a very general rule of thumb. Only after a thorough evaluation and discussion with your provider can a reasonable outlook be formed and appropriate treatment recommendations made.

A single bout of depression is 6-9 months of treatment. CBT psychotherapy can help prevent relapse. If you have recurrent depression that responds to medication, you can usually cut the dose in half after several months.
The short answer is no. The medication will help you get to a point where you can begin to learn CBT tactics and techniques that you then can rely upon. Once your more confident using CBT than using medicine you can begin with the advice of your doctor to slowly move off the meds. Take a a look at Dr. Amen's approach to healthy brain capability through using natural supplements. Take his Brain Type Test.
Not really. If you have a diagnosis of anxiety, etc., you're good, but if you have depression, it gets a little tougher and bipolar a bit more, but schizophrenia you might be on for good. Medical doctors tend to keep one on the meds, but you can tell your doctor that you want to slowly stop or less and less. There are even herbs that can help once you’re off.
Not everyone that is put on anti-depressants do so for life. Much depends on duration, severity, and history with depression. Psychiatrists are careful to find the right medicine so help reduce your symptoms. I believe, therapy is advised to help cope with the behavior and emotional issues that go along with depression. Your psychiatrist can reassure or guide you on the likely duration of the use of anti-depressants.