Depression (also known as "depressive disorder") is one of the fastest-growing mental disorders in the United States. According to a CBS survey, almost 18.8 million Americans suffer from major depression (this does not include those who suffer from minor or occasional depression, so the numbers are even higher!). There are 190 million prescriptions given out each year for the treatment of this mental disorder. And while the causes of depression are still not known, the staggering numbers alone attest that for millions of Americans, having a partner on antidepressants is a fact of life.
First, depression is a mental disorder. It can be hereditary, due to past abuse, caused by a severe event, or a mixture of all three. Also, people diagnosed with one mental disorder are more likely to suffer from others (multiple diagnoses). Other mental and psychiological disorders that often accompany depression are panic disorder, anxiety disorders, manic-depression, and PTSD. For these people's partners, lots of patience and a vigilant, watchful eye for additional symptoms are necessary.
On the other hand, depression can not be self-diagnosed. I've heard of many people who have self-diagnosed (or been diagnosed by family or friends) and "decided" they are depressed. The truth is, no one but a medical doctor can tell you that. Many of the symptoms of depression are exactly the same as the symptoms of thyroid trouble, low blood sugar, severe mental disorders, past sexual, physical, or emotional abuse, or drug and alcohol abuse. In addition, many people use it as an excuse for their behavior ("I'm too depressed to go to work") or as a way to get attention. If your spouse won't go get checked by a doctor, there is no reason to think he is actually depressed. A doctor or phychiatrist is needed to determine the causes of all symptoms.
In fact, I'll go so far as to add that all the people I've know who are clinically, medically-verifiably depressed, did not realize they were depressed until a doctor examined them. A truly depressed person has no concept of "normal" and thus does not realize she is "depressed." And in all the cases I've seen where people without a medical diagnosis were touting depression as the source of all their troubles, they were generally seeking attention or making excuses for their own terrible behaviors.
But if your spouse is one of the 18.8 million Americans suffering from real depressive disorder, antidepressants are going to have an effect on your relationship. What can you expect from a partner on antidepressants?
First, antidepressants chemically alter the brain to rectify an imbalance of chemicals. Often they keep healthy chemicals that cause happiness from being sucked back up by the brain too soon. But any medication that chemically alters the brain can be dangerous, and you need to watch for side effects.
One common side effect, especially in children and young adults up to 25, is an increase of suicidal thoughts. Young people on medication need to check in with a doctor regularly, and you need to watch your child or spouse carefully to monitor for suicidal thoughts. You also need to be prepared and know how you will react if they should actually attempt suicide.
Of course, side effects depend upon the particular medicine given. But many antidepressants have some things in common.
Many cannot be mixed with other medicines, even over-the-counter herbs and pills. Be very careful with tylenol and ibuprophen, and read the back of the box. Cold, allergy, and sinus pills are often very dangerous when mixed with these pills; I once nearly passed out from inadvertently mixing these two. I would never recommend this! Alcohol, sleeping pills, and other sedatives are also very dangerous for people already on antidepressants, as the chemicals in the pills will change the body's natural reaction and will often compound the effect of the sleeping pills or alcohol.
Another quite terrible effect of some antidepressants is a blurring between reality and dreams. These pills can actually cause people to have nightmares, and more terrible and vivid nightmares than ever before. Others will just increase the vividity of all dreams. For nightmares, this is often terrifying, but even for normal dreams it can be confusing. The dreamer may wake up confused, thinking she was already awake, or she may have a hard time remembering which conversations she had in a dream and which she actually had. She may have to ask you, "Did we talk about this...No?...I must have had another dream..."
This may also take extra patience on your part, as often the vividity of the dreams can cause very real emotions that stay with the dreamer all day. And so, day after day, you may wake up, through no fault of your own, to find your spouse mad at you for something you did in a dream. Just be patience and understanding; no matter how hard your spouse tries to convince herself that it was just a dream, the accompanying emotins are completely out of her control. I know I once spent months angry at a boyfriend, no matter how hard I tried to surpress the feeling, because I had such terrible dreams about him nightly. When he got frustrated or angry at me for this, it just made things worse.
If your partner is suffering from vivid dreams or nightmares, be patient! Remember that he cannot remember if you said something for real or in his sleep. Be aware that he may still feel genuinely hurt and angry at you, even after you've calmly explained something was only a dream. And I know when I have those terrible nightmares, the awful feeling of dread does not go away when I wake up. I will sometimes wake up my partner, needing to be comforted and held, but if he just rolls over and goes back to sleep, it just makes me feel more hurt and abandoned than before. Try to remember that this isn't any more fun for your partner, either, and it is neither of your faults, but just something you have to work through together.
Many antidepressants cause weight gain. This, of course, affects self esteem, self image, and sex life (for both partners). Others can cause weight loss.
Antidepressants are sedatives, and can dramatically increase the effect of feeling sleepy. This is why sedatives and alcohol should never be mixed with the pills. Also, especially at the very beginning, expect your partner to feel tired and drowsy waaaay beyond the normal proportions! She may drift to sleep during work or while driving a car, so be very careful until you know how it affects her. Or he may fall dead asleep in the middle of the afternoon, right in the middle of your sentence! I once struggled through 8 hours of work, drowsy and almost incoherent, and then fell promptly asleep on my boyfriend's bed as he was talking to me, lights fully on and in the middle of the evening!
Antidepressants are intended to change the chemistry of the brain (for the better!), but sometimes this can have unintended affects. You may notice slight personality changes; these are annoying but normal. But if you notice a big change, your loved one needs to see a doctor. Small changes that are to be expected when taking a new medication are changes in mood, moodiness, irritability, or sudden mood fluctuations. Sometimes appetite changes will occur. Other times, they will become more emotional (sudden flares of temper, crying more often, more likely to scream or yell). Sometimes pills cause them to be less emotional all around, so while they are indeed less anxious and depressed, they are also less happy and excited. This is normal at the beginning and will usually go away as their body adjusts.
Antidepressants also change libido. They can decrease libido and sexual desire in both men and women. In men, it can cause erectile dysfunction. Or, sometimes, the pills will not affect the desire, but will affect the ability to orgasm. On the other hand, if your partner was truly depressed, there probably wasn't much interest in sex anyway, so the pills may not change anything or may actually increase their interest in sex as they slowly get happier!
There can also be physical side effects as your lover's body adjusts to a new drug. They may get sick to their stomach (having them eat the pills with a meal will help). Any new medicine can cause digestive troubles, such as constipation or diahrrea, until their body adjusts.
Generally, all side effects are mild and decrease as you get used to the pill. So just be patient and wait, and they will probably go away! Of course, if the effects are too intense or get worse, you should see a doctor! It takes the average person 3 different types of antidepressants before they can find the right one for their body. I know I went through 5 different medicines and about 8 different possible medicine changes, and am still not on a medicine my doctor is entirely happy with.
Also, it takes antidepressants about 4-6 weeks to really start working. This can be really difficult for someone who is sad and depressed, maybe even not wanting to be alive, and be told you have to wait 4 whole weeks to start feeling better. And since most of us have to be put on several different pills, and at several different dosages, to find the right brand and amount, it often takes months or years to find the correct balance. It took about 7 months for my doctor to finally put me on the correct pill and dosage, and even now he wants to change it again because it doesn't seem to working 100%.
Finally, we need to discuss getting off antidepressants. Because your body is relying on these pills to help it maintain a healthy chemical balance, you should never take yourself off the pills suddenly. Even missing a dosage can affect me and make me an emotional wreck. I took myself off pills once, and survived, but I wouldn't recommend it. You can send yourself into a terrible withdrawl, or often send your body spiraling back down into an even deeper depression than before. If you need to get off a medication, let your doctor know so he can give you the correct dosage and monitor you for problems as you taper off. And if your partner is stopping medication, you should be very vigilant to watch for mood changes, problems, or signs of returning depression/suicidal tendencies.
Most antidepressants have also not been studied as to their effects on pregnant women and fetuses. Therefore, you are usually never advised to take them when pregnant. For those of you at wanting to start a family, talk to you doctor. He can help you find the right pills for you during pregnancy, or help you get off them before you conceive. And if your partner is childbearing age and sexually active, you should be very, very careful about antidepressants. Even if you are using birth control, pregnancy is a possibility. Should you accidentally get pregnant, you run the risk of doing damage to the baby before you realize you're pregnant, or worse, forcing your wife to quit cold turkey for the sake of the baby. Needless to say, this is highly dangerous for your wife, and could send her into withdrawl and a more acute depression than before. This is not what you want for a pregnant mother or baby!
So what should you do if you are in a relationship with one of the millions of people suffering from depression? First, be patient and understanding. Second, arm yourself with information. Research it. The more you know about the disease, the medicine, and the side effects, the more help you will be and the more prepared you will be for problems. And last, watch, watch, watch! Mental illness is such a debilitating disease because it has the unique effect of blinding the victim from seeing that something has gone wrong. You can help your loved one by staying up-to-date on current research, knowing what to look for, and watching her carefully. Good luck!
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