7 Signs Your Mental Health Medication Isn’t Working The Way It Should
Finding the right antidepressant or anti-anxiety medication (or combination of medications) takes sustained effort – but that persistence quickly fades once side effects begin to appear.
Everyone’s brain and body react and process medications differently, so finding the right medication regimen can be a frustrating process for some people.The most frustrating thing is that we don’t always know why.
There are clues that doctors can use to predict someone’s personal response to a prescription drug – the symptoms they experience, their response to other medications, and sometimes certain types of genetic testing – but even with these clues, for many people, it’s still aproblem of repeated testing.
Trying to predict the effect of a drug on a specific individual is nearly impossible, so we must make decisions based on what we know about the patient and the drug in order to try to get the best chance of successful treatment.
Experiencing side effects doesn’t necessarily mean you have to stop or change your medication.But if you feel something is wrong, these common side effect scenarios can help you figure out what to do next.
You feel better right away (but it doesn’t last)
Most current medications work by indirectly increasing the levels of neurotransmitters thought to play a role in mood disorders and anxiety, such as serotonin, norepinephrine, or dopamine – but mood disorders and anxiety are more than just the ebb and flow of these neurotransmitters.
Sometimes changes that occur immediately after starting a medication (or changes in the dose of the medication) can have a transient effect on mood or anxiety.We still don’t know why this happens to some people, but there are several theories.
Depression and anxiety have different patterns, and sometimes a pattern initially responds well to something but then gets worse.
For example, someone with bipolar disorder may experience some initial improvement with medication, but that improvement won’t last long and they may need some mood stabilizers instead of antidepressants.
Similarly, concomitant use of substances (such as alcohol) or suffering from a depression-like illness (hypothyroidism) can sometimes explain why transient reactions lessen over time.
For many people, medication alone is often not enough for optimal recovery.Maintaining physical health (sleep, exercise, nutrition, other conditions) and avoiding substance use are all part of maintaining mental health.
Then there is the placebo effect, the belief that the medication will work because all medications make sense to the person taking them.
The placebo effect is not bad in itself, but many people participating in clinical trials of new drugs respond to placebos, in part because being hopeful about something is inherently good for mental health.
Your side effects won’t go away
Some people are naturally more sensitive to drug side effects than others.There are usually unknown factors at play, but for some people it may be because they metabolize drugs more slowly, so they tend to build up in the body.
If you have this problem repeatedly, there are certain forms of genetic testing that can be done to check how your liver handles these medications to detect opportunities to try or avoid medications due to different metabolic rates.
As your body adjusts to the medication (it may take up to 12 weeks to see the full effects), side effects such as mild nausea, fatigue, or headache may occur and will go away within a few days.However, if you experience persistent side effects (such as diarrhea), these side effects may counteract the benefits of the medication and your doctor may need to consider a different medication.
For best results, see your doctor in a few weeks or a month and be informed of all side effects you are experiencing.This is key not only to finding the right medication for your condition, but also to finding the right dosage and complementary lifestyle changes.
Your symptoms reappeared
Depression and anxiety can be tricky – some people relapse even when they stick to their medication.As it turns out, this is not uncommon.
Think of it like asthma: an inhaler may do a good job of controlling your asthma, but sometimes when seasonal allergies are in the air or you spend a night in a smoky bar, your asthma can come on suddenly.
Similarly, if your stress levels are increasing – you’ve been fired, you’ve had a flare-up of a chronic illness, you’re ending an unstable relationship – you may find that your symptoms come back or get worse, even if you’re still taking medications that once worked.
This is most often the case.It’s not that the antidepressants have suddenly worn off, it’s that circumstances have changed, causing your depressive symptoms to worsen.
If it is true that there have been no significant changes in your environment that would affect the efficacy of your medication, then this may indicate that the effect of your medication is decreasing.
Drugs act on receptors in our cells.Our neurons (brain cells) can modulate the level of response to a drug by adding or removing a number of receptors that can alter the effectiveness of the drug.
This doesn’t happen to everyone who takes a particular drug, and our individual biology does vary, but it’s one of the reasons why drugs that were once effective no longer work.
Your depression or anxiety worsens
Your doctor will usually start you on the mildest medication with good efficacy and side effects, then add adjunctive medications and change the dosage or medication based on the patient’s response.
While it’s true that these medications can take a while for patients to feel the effects, you shouldn’t feel like your condition worsens after you start taking them.This indicates that your medication may not be right for you and you should consult your doctor to try another medication.
You barely feel the difference in how you feel
Many people have only a partial response to medication – for example, they may no longer experience panic attacks, but still experience high levels of anxiety that interfere with daily life.
In fact, it is rare that the first medication, the first dose, provides complete relief of symptoms.For many people, several dose adjustments are not uncommon.
Another possibility is that the medication simply isn’t working, despite being taken for the recommended amount of time as prescribed.If there is no change after a month, follow up with your doctor to discuss other treatment options.These may include trying different classes of medications, using combinations of medications, and consulting a psychiatrist for further evaluation.
Your emotions become tense and unpredictable
Mood swings may be another indicator that the medication you’re taking doesn’t match your particular pattern of depression.
Distinguishing clinical differences between depression in bipolar disorder (characterized by depressive and manic episodes) and unipolar disorder (persistent depressive mood without a history of mania) may be difficult.Depressed people with bipolar disorder sometimes feel a sudden change in their mood or energy after they start taking antidepressants instead of mood stabilizers.
New mood-centered symptoms, such as dramatic mood adjustments after treatment with antidepressant medications, mixed mood states, and hypomania or mania, may signal a different underlying pattern of mood disorders that is masked by the severity of the depression.
Your quality of sleep has plummeted
Side effects of the medication include drowsiness during the day and trouble sleeping at night.It is also common to start having strange dreams.
This can sometimes be a side effect of the medication, a precursor to a different pattern of depression, or a natural worsening of mood symptoms after taking the medication.
Usually, these initial side effects go away within a week or two as your body adjusts to the medication.You can try changing the time you take your medication so that you have more time to relax before bed, or take an over-the-counter medication (such as melatonin) to get through the adjustment period.
Drastic changes and side effects that are overwhelming or lead to crises or safety issues should be dealt with more quickly by doctors.They can use their knowledge and experience to help you find effective treatment options faster and more efficiently.
How to simplify the process of finding the right medication for you
Because the disease states of depression and anxiety are subjective, the best way to streamline the process of establishing an effective medication regimen is to communicate with your doctor as much as possible.
Your doctor will then consider patient-specific factors to narrow down your medication choices, for example:
- Your complete medical history (other illnesses you may have and potential drug-to-drug interactions)
- Family medical history (including if certain antidepressants or anti-anxiety meds have worked well for any of your relatives)
- Current and past substance use (including OTC meds and substances, like NSAIDs, vitamins, marijuana and alcohol)
- Past medication use (and why they were discontinued)
- Cost
Patient preference also plays a crucial role.Rau suggests keeping in mind your highest-priority symptoms: write down what you want the medication to do for you, and know which of those effects you want to target first.
Is grief your biggest concern?Not having motivation?Feeling anxious?Unable to concentrate?If your clinicians know what your priorities are, it will help them work with you to find the best entry points.
It is also important to resist the hesitation to admit that you use substances such as marijuana, as the use of marijuana or nicotine can hinder the healing process by affecting the way the medication works.
The same applies to not informing your doctor about the effects of a medication after taking it.The dosage of these medications (increasing or decreasing, starting or stopping) depends a lot on what the patient says – how they respond to the medication.So make sure you not only follow the treatment program, but also keep track of how you feel.
Medication trackers such as MyTherapy make this process very convenient.Track your dosage, mood, and symptoms, then print out the data for your next appointment.Real and specific so you can restore yourself.