Sometimes I feel like I need medication, when things get really, really dark. But then I fight through those feelings, and when it passes, I feel like I don’t need medication. How do you know if/when it is the right time to start taking medication for depression?

When deciding about taking medication for depression, you’ll want to consider the general evidence, your individual experience, and your personal preferences.

About the general evidence: Research tells us about averages. On average, taking an antidepressant medication is more effective than taking a placebo for people with more severe and more long-term depression. On average, people with milder or shorter-term depression do just as well taking a placebo as taking an antidepressant medication. When we say that placebo “works”, we really mean that support, encouragement, and the passage of time seem to be effective “treatments” for milder or shorter-term depression. On average, antidepressant medications and specific kinds of psychotherapy are about equally effective. For people experiencing moderate depression, either treatment is reasonable. For more severe or long-term depression, combining medication and psychotherapy is—on average—more effective than either treatment alone.

Regarding your individual experience: If you have taken antidepressant medication before, then you have a different kind of evidence. If a specific medication has been helpful for you in the past (or caused you side effects in the past), it would likely have a similar effect. But your past experience with one medication doesn’t necessarily predict how you would react (positively or negatively) to a different medication.

Regarding your personal preferences: Some people have a strong preference to avoid taking medication. Some people prefer psychotherapy over medication, and some prefer the other way. Your preferences do count in this decision. Doctors and therapists may have useful information for you about averages. Families and friends can sometimes offer a useful outside perspective about how you are doing now and about your past experiences with treatments.  Taking medication for depression can be a complicated decision, so you’ll want to use the best information you can get. Decisions involve both information and preferences, and your preferences are the ones that matter.

DBSA’s Treatment Choices webinar includes more information about understanding the range of depression treatments and wellness strategies.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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