Uncontrollable Sadness May Require Medication

By Tenille L. Lawson PharmD BCPS

Olivia* has slept less than six hours in the past week. It has been two weeks since she remembers feeling “normal.” Miserable thoughts keep her up at night, and she dreads feeling drained and worthless every morning. She finds herself staying home crying instead of going out with friends. She is starting to forget things like where she left her toothbrush. She has lost weight because she has no appetite. She is too tired to care about the changes in her life, but her family is concerned. At Olivia’s next primary care doctor visit, she is given a mental health survey. She has trouble answering some of the questions because she is uncomfortable admitting to herself that she is not able to control her feelings. She begins to cry, as completing the survey is taking more motivation than she can muster. After consulting with her doctor, she decides to take an antidepressant medication.

Antidepressants balance chemicals in the brain that are responsible for controlling feelings of sorrow, sadness and guilt. Although studies show up to 60% of patients respond to these medications, the National Institute of Mental Health advises that most antidepressants can take up to four weeks to see effects. Common side effects of antidepressants such as fluoxetine, paroxetine, and sertraline may include diarrhea, nausea, dizziness, or sexual dysfunction. Understanding how your medications work can help reduce feelings of depression and empower you to take control of your mental health.

Research shows alternatives such as cognitive behavioral therapy (CBT) may benefit you if your medications do not work. It may help to use the problem-solving strategies of CBT on days you feel down. The American Heart Association suggests walking, making healthy food choices or even taking a bath to help improve your mood, even if you are taking medication.

For Olivia, writing in a journal each day helps her keep track of her goals such as addressing unhealthy thoughts and celebrating milestones when positive changes occur. She also stays in communication with her healthcare team, which includes her primary care physician, yoga instructor, and behavioral therapist. She is finding ways to laugh, relax, and take deep breaths regularly as she focuses on feeling happier. Although she is still taking her medication, she feels more confident and in control of her health.

If you experience symptoms similar to those described above visit your doctor more frequently to discuss what you should expect from the medication.