Why Antidepressants Don’t Always Work – And What Can Make a Difference

Why Antidepressants Don't Always Work - And What Can Make a Difference

The presence of hope can be just as powerful as its absence. Just ask anyone with depression. Depression is a devastating illness that thrives on hopelessness. This sense of hopelessness can be worsened when medication, often taken as a last resort, fails to deliver any relief. New research finds clues as to why antidepressants don’t work for everyone.

There are a number of treatments for depression, and amongst the most common are SSRI’s (Selective Serotonin Reuptake Inhibitors). About 50% of people who take SSRI’s find that their depressive symptoms are halved within 8 weeks of taking the medication. Then there are the other 50%. For those people, antidepressants just don’t work. 

Out of the people who do find relief, half of them will see a return of the symptoms, taking the actual recovery rate to 25%.

The way we think about depression is changing. 

Though SSRIs are a lifeline for many people, their sketchy levels of effectiveness have put pressure on the idea that depression is caused by a lack of serotonin. The way we think about depression is changing. More recently, there has been a dramatic shift away from the serotonin theory of depression. There are a number of reasons for this:

  • If depression was caused by low serotonin, it would be expected that medication which increases serotonin would be more effective than the 50% strike rate of SSRIs.
  • A number of studies (including here and here) have found that in some depressed people, serotonin is elevated.
  • There are other treatments for depression, including therapy, a combination of meditation and exercise, and medication that has little effect on levels of SSRI, that can reduce depression as much as SSRI’s do.
  • The key argument in the serotonin theory of depression was the observation that increasing serotonin relieved depression. However, in the same way that a headache is not caused by low levels of paracetamol, the effectiveness of SSRI’s does not necessarily mean that depression is caused by low serotonin.
  • Recent research points to the possible role of oxidative stress in depression. 

SSRI’s seem to have some capacity to heal, but not reliably, and only in around half of the people who take them. Clearly something is missing. New research seems to have found some pieces that can start to fill out the picture.

Why Antidepressants Don’t Always Work – Let’s talk about the research. 

In a study published in the journal, ‘Brain, Behavior and Immunity,’ researchers found important clues about how SSRI’s work, and more importantly, what can be done to increase their effectiveness.

 ‘There is no doubt that antidepressants work for many people, but for between 30 and 50% of depressed people, antidepressants don’t work. No-one knows why. This work may explain part of the reason.’ – Silvia Poggini, researcher, Intituto Superiore di Sanita, Rome.

From the research, it seems that the effectiveness of SSRIs doesn’t happen directly by increasing serotonin. What seems more likely, it that SSRIs facilitate recovery by increasing the plasticity of the brain so it can be changed, healed and strengthened by environmental and lifestyle factors. (Plasticity refers to the brain’s capacity to change.)

‘In a certain way it seems that the SSRIs open the brain to being moved from a fixed state of unhappiness, to a condition where other circumstances can determine whether or not you recover’ – Silvia Poggini. 

The research was conducted in mice. (Mice are often used in research in place of humans because of their biological and genetic similarity to humans.) After the mice had been stressed for two weeks, they were all given SSRIs. They were then split into two groups. Half the mice continued to be exposed to stress while the other half were put in a calmer, less stressful environment.

The mice that were treated with SSRIs and put into the more comfortable environment showed an improvement in their depression symptoms. In contrast, the ones who were treated with the SSRIs and put into the stressful environment showed a distinct worsening of their symptoms.

What makes a difference?

When someone takes SSRIs, the environment and the things that person does, play a critical role in whether he or she will get better, stay the same, or get worse.

The research suggests that the effects of the SSRIs aren’t necessarily on serotonin, but on the brain’s capacity for change. The medication conditions the brain for recovery, and the environment drives the recovery – for better or worse. The environment has a heavy influence on how the person will respond to the antidepressants.  

‘This work indicates that simply taking an SSRI is probably not enough. To use an analogy, the SSRIs put you in the boat, but a rough sea can determine whether you will enjoy the trip. For an SSRI to work well, you may need to be in a favourable environment. This may mean that we have to consider how we can adapt our circumstances, and that antidepressant treatment would only be one tool to use against depression.’ –Silvia Poggini. 

What can help?

Environment seems to be key. Environments that are nurturing and supportive of healing are more likely to change and strengthen the brain in a positive way. This might be enhanced if SSRIs have prepared the brain for this. On the other hand, environments that are stressful and unsupportive, and a lifestyle that doesn’t nurture the body and the brain, will potentially fail to make the most of any benefits of SSRIs.

The research is in its early days, and more will be needed before we have a clearer picture. 

In the meantime, an abundance of research has found strong evidence for the effectiveness of various lifestyle and behavioral factors in easing the symptoms of depression. These include meditation, exercise, reduced stress, diet, sleep, and the company we keep. These have been found to change the structure and function of the brain in ways that promote a healthy brain.

The idea that healing is more likely through a combination of environment and medication is nothing new, but this research gives us evidence of the importance of environment and lifestyle in healing from depression.

And finally …

The hopelessness that is so characteristic of depression can be worsened when medication fails to bring any sort of relief. For at least 50% of people, medication makes no dent at all in their symptoms. From the research, it seems that the effect of antidepressants may be more indirect than once thought. More importantly, it seems that they might not be as effective on their own, as they can be when lifestyle and environmental factors are able to support the healing.

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I was diagnosed with major depression in March this year following 3 terrible years in my life having lost my Dad to altzheimers in 2016, my mom 5 months after that I think as a result of loneliness, watching my sister go downhill from bipolar, seeing my dog run over by a car and then loosing my father in law to cancer very recently. I had just started a new job 5 months prior to my father’s passing and this put huge stress on me in that the environment was extremely stressful and unsympathetic to what I was going through. I just had to continue every day without showing anyone how I felt for fear of losing my job. The people I worked with were career driven and not interested in what you were going through. I was driving to work every day with a complete knot in my stomach and so fearful of what I would encounter that day. People are extremely vocal at the office and are very quick to point out the smallest of mistakes which eventually drove me to a complete breakdown and being admitted to a hospital for 3 weeks for severe depression. I attended therapy with a psychiatrist, psychologist and group therapy every day which didn’t help. Was also out on medication which hasnt helped either. I have since resigned from my job as I couldn’t face going back due to the stigma involved with depression and unsympathetic and extremely judgmental people. I need to find new employment as I am not able to stay at home indefinitely for financial reasons. I can truly say that the medication has made me feel very foggy in my head and almost unable to think at times. I have tried different medication but with similar results. I am afraid of just stopping the medication and cannot afford to continue seeking help from all the professionals due to financial constraints. Besides which the first thing that was asked by my professionals was whether I could afford to pay for their consultation fees which isn’t very comforting when you thought that they were there to help but it turns out that it is all about the money in the end for most people. Very sad indeed. I am trying my best to stay positive and focused but depression is as most people who suffer from it extremely debilitating. Never in my life will I ever judge anyone going through this as I never thought that one could feel this low, unworthy, unaccepted and judged by so many people. I have even had my one sister ask whether I feel “normal” yet. It is a daily fight within you to get up and try and cope as best you can without showing people how you really feel. I often wonder whether this is life and whether this is how I am going to feel until I die. I am 51 years old but some days feel 91 years old. Just trying to put one foot in front of the other.


Thanks for sharing your story which is very similar to mine. I hope you are in a better place today. I am 50 and have been trying to survive a major nervous breakdown followed by profound depression for almost 3 years. The cumulative suffering seems of biblical proportions. Of course, tried all the meds, ECT, etc. I too know nothing else to do but take one step and one breath at a time. My family of 5 depends on my income and health insurance so the feeling of being trapped in an untenable situation has been tremendous. I have a perfect life on paper- great family, job, no real problems outside of my head. Guess I’m telling myself that things could always be worse.


I can’t read all the comments but this article is the best ever.

My question however is how does one who is hopeless, frustrated and rather angry at the years of torture change? When there is hardcoded pain and agony – thinking positive is almost a poison now. When I do push a bit it backfires and then that pain grows.

Seems when bitterness set in, I’m beyond movement. I try still and nothing ever gets sustainable traction.


Totally agree with you Rob! Fact of the matter is I have NEVER liked what has been set out for us in life, nor did I ask to be any part of it.

School for 20 years, then 25 years of working 40 – 50 hours a week (most likely at a job you dispise while dealing with shitheaded co-workers you would otherwise be exposed to) THEN as your big rewards you retire at 65 (if you’re lucky) and watch your health deteriorate.

I want no part in any of this and I envy anyone who can fool themselves into somehow being happy with this reality.


I have had a traumatic life. Was on meds for 30 years. I had to get off one for heart reasons and went downhill. 65 and all have bad side effects. Have had enough. Didn’t think I’d be her now. Things have gotten worse since pandemic. What to look forward to after a horrible life. Deteriorated health.


Find a quiet place to be on your own because people don’t usually understand . Take rest in quiet . The things don’t go away , but you can face them with more energy.


I found my twin brother of 32 years dead of an accidental fentanyl overdose and that was the day my life changed forever. My heart physically broke, as did my mind. My wife was 8 months pregnant and we had to drive home to Northeast Alabama from Port Angeles, Washington to lay him to rest because my wife couldn’t fly. Since then I’ve been prescribed xanax and a laundry list of antidepressants which all seem to cause serotonin syndrome. I’m dependent on the xanax now and am taking 8-16 mg of xanax a day just to function and be a father to my 5 yr old and my 6 month old daughter. The first doctor was absolutely terrible telling ne there were no real risks with taking xanax yet I was dependent on them in less than a month. Now they just seem to keep me from experiencing withdrawal. I was an opiate user for many years and I can tell you without a doubt that xanax us much more addictive than oxycontin. That took years to become physically dependent on, and only weeks with benzos. I’m still working as much as possible but I’ve turned to bying my medication from a friend who somehow acquires thousands of 2mg generic alprazolam that he tests religiously for fentanyl and sells them for 1/3rd the price of the pharmacy. My doctor became so expensive without insurance that I had to stop seeing him, he never was much help anyway. I’m at a loss, I miss my brother so much, wish that I could go back and be there for him before he put that needle in his arm. Before this I honestly never experienced anxiety but now it’s all I know when I’m not medicated and my family judges me but they didn’t have the bond he and I had. They think its all a ploy to get high. They look down their noses at me. I’m stuck in this hole and can’t seem to find a way out. If they had been the ones to see his face and tried to resuscitate him unsuccessfully for 20 minutes waiting on an ambulance I’m sure they would see it differently. Not sure where to go from here. I’m stuck in Alabama so not able to self medicate with a safer substance like cannabis which I was free to do back home in Port Angeles. It feels like constant pressure in my chest that never goes away until that xanax dissolves and I feel slight relief. Needless to say I thought 33 would be different. One positive is that I’m not bound to a job I hate, I’m self employed so I do something I enjoy but its hard to see a light st the end of this. I’m losing hope.


I am taking a poll here…. Does anyone believe there will
ever be a cure for depression?
Thank you for your responses.

Karen Young

Let me be the first to respond. Yes. Absolutely there will one day be a cure for depression. The research is expanding by the day – the work is being done. We are discovering more and more about the brain and the body and what doesn’t work, and what does. We are getting closer and closer to finding the causes, or the things that contribute, which means we are getting closer to a cure. I have absolutely no doubt there will be one. In the meantime, we know there are things that can help – exercise, meditation, therapy, sleep, gut health. These aren’t necessarily cures, but they can help when they are done consistently.


I have terrible anxiety and sickness from Klonopin. Anti-depressants don’t seem to work. The doctor tried one ant pshchotic WOW one was enough to stop the other make so sick sometimes nauseous or won’t let me sleep. I am no young and I need my sleep beside with depression it’s more needed until you can get one to work..I am sooo soo very frustrated.


Don’t give up still fight This U will eventually see light To all these post Life is precious


Is anyone still on this thread? I have suffered from depression since i was a kid. I grew up in a scary neighborhood, felt fear a lot, and my parents (bless their hearts) were hardly ever home because they were working their butts off. Complete latch key kid. It was at 16, when my brother was murdered, that it got much worse. I have always tried to be strong, push through the depression, make my life better… but having suffered from this illness for nearly a lifetime, I’m at my wits end. I have tried everything they tell you to (check blood work to rule out physical issues, so many meds, psychotherapy, exercise, aromatherapy, moving, diet, intensive outpatient, I worked hard and put myself through school, got a degree, etc), but it has gotten progressively worse. I’ve had numerous tragedies to deal with (more untimely deaths, a perpetually mourning family due to these deaths, drug addicted family members, friends committing suicide) but I just don’t feel I can bounce back this time. I feel like I’m only bouncing back to suffer more because by now, at 33, I see that life is hell. I’ve had a series of bad boyfriends who were narcissistic or abusive in some way, and that has really messed up my head. I finally thought I found a good guy and we were together for 3 years but then we had to do long distance temporarily and I found out that while he was telling me he loved me everyday and that he’d be home soon, he was leading a double life with another girlfriend and coming home to me periodically. I understand that millions of people go through this. I’m not trying to make it bigger than it is, but for me, it was just the straw that broke the camel’s back. It was then that I felt my last bit of hope die. And when you truly have no hope, life is truly painful. There are so many horrifying things going on. I’m empathetic so when I see or hear about tragedies or see a homeless person, my heart sinks. I can give them money, buy them food and blankets… but I don’t feel any better because I know there are millions of others out there exactly like the one I just helped (and that it’s not even very much help, really). Everyday and every hour I wish for death. The agony of living in this body just hurts too much. Most people do not understand. I broke both arms on a dirt bike, trying to run from my pain, last Summer and that pain was nothing next to the emotional pain I feel persistently. I try to give people that comparison to help them understand (like my family), but they don’t. All I hear is “get over it,” “just stop looking at the bad,” etc. Other people tell me I need to turn to faith and I have tried, but I feel nothing. No relief. I have a scientific mind and work in a scientific field and I just can’t truly jump onboard with there being a god out there watching over me. I try to, but one cannot make a belief set in. If there is a god, then he is cruel. I don’t know why I’m even writing this except that I’m sitting alone in the dark again, desperately wishing for my heart to stop feeling crushed. Life has broken my heart… I don’t feel I can trust anyone or believe in anything, and I really wish I could just go but I don’t want my family to suffer more. I feel terrified and alone in the universe. Is anyone out there? 🙁

Scared mom

My heart breaks reading this. I have a 22 yr old son who goes through feelings of Suicidal thoughts. It terrifies me. He has seen a psychiatrist but he feels they don’t care just push meds. its crazy though because he can one day literally be wanting nothing more then to die and he said the most painful part of it is that he won’t do it because he knows what it would do to me and the rest of the family. He is beyond loved and has complete family support. He says he feels the meds have made him feel worse but has already tried different meds nothing has worked. Depression has become an epidemic and it breaks my heart. I’m a believer and I feel people are lonely we all need someone in this life and nowadays that’s the biggest issue people communicate through technology instead of face to face. it hurts sooo bad to have your healthy, handsome, intelligent son wishing to no longer want to live because of the pain they feel and that nothing will ever make it better. My heart and prayers go out to every last one of you on this thread.


I have had Suicidal thoughts since I was 12 years old,I will be 55 Friday the 23rd,I feel the same way about psychiatrist.I here (try this),Me.that made me sick,psyc,try this,me,cant sleep.psyc,try this,me,I sleep all the time,or the one time I could not think clear enough to wright a check. I dont have an answer but I have made it this far.my mind still tells me I am no good and no one likes or wants me. I really dont care if I wake up tomorrow ,But I will not give up and kill my self. Tell your son He is not alone.


My younger brother was handsome smart and popular. We both had suicidal tendencies. He acted on his and I have almost done it many times. I was the one with all the problems. Am 65 now and been on meds for years. Had heart issues had to stop meds been depressed for a year no meds I can tolerate. Miserable.


So sorry to hear all of you. My daughter has been in the same situation and is not getting better with meds or therapy or TMS. I can only pray for her

John ( LivingDeadguy)

Yes others are here,and you are not alone. and I am sitting alone in the dark to


You are not alone even when you can’t feel the connection. Your pain is big and real and wanting to escape that makes all the sense in the world. And you have the capacity for vulnerability and strength to connect even after so much- I can see it in your words.


What date was this published in? I need it to use this as a credible source for my research paper. It will be very helpful if you helped me out! Thank you. uwu


I’m sure no one is going to love my comment. I’m a realist , and just tell it like it is……. I’ve tried 7 antidepressants, none of them worked on me at all. I did them all the proper length of time. No results. I was no happier, and Everyone I know noticed no change whatsoever, if anything worse.
This whole idea of serotonin and depression being caused by a ” chemical imbalance ” is absurd and totally wrong..
I’ve never been an up person ” high on life” looking back now at 46 , I loved my old life and would give anything to have it back….. but that is impossible for me and thousands of others. I’ve always been a medium or low person. The reason for that is life itself. We were not meant to be happy all of the time. Some of us get slapped really hard in the face very early in life , others late and they are lucky for getting it later in life. It’s inevitable that we will all get it though.
I talked with a psychiatrist several times. He put me in my first antidepressant. His exact words were ” we know very little about the brain or how it works. We just know that increasing serotonin causes these tiny hairlike particles in your brain to move more and that is common in happier people. Now , first and foremost, would any of you let someone work on your car that admitted they had no idea how it worked??
Again , its no chemical imbalance. Take my life for example. I met a woman I truly loved . We had a great life together, 3 children along the way….. and no , it was not always perfect. But, we both loved each other and our children . We made it well through everything. Good times , bad …. you name it. In 2008 the economy got bad and my business went down with it , we lost our home , had to move into a smaller rental home. Through all of our financial problems, we actually got closer. We both have great faith in God and finances are something that can be recovered. At the time we thought it was horrible. That was only because we didn’t truly know horrible…. yet.
We moved into a second rental home and a month later she was diagnosed with the worst of the worst type of breast cancer there is at 37 years old, at 39 me and our 3 children had to watch her suffer and die in our den.
How is it possible for any of us to be “happy” anymore? Our children have coped a little better than me. But still nothing like they were. I will never be the same person again and I knew it the day it happened. I would never do anything stupid, I wNt to be here for our children as long as possible. But as far as myself, I went from being afraid of death to actually looking forward to it one day. I can’t stand this world and there are so many that go through the same and worse. There is no amount of therapy or pill I can take that will make me feel one bit better about my life now. It has NOTHING to do with a chemical imbalance.
I’m 46 with 3 children ( 9, 15 and 18) It happened 4 years ago and time makes nothing better.
And there are those that tell me , find someone else and make the best of it. There’s not too much to choose from at this age and I don’t want a woman with 2 or 3 children pulling me away from ours. I also really don’t care to be going on first dates at 46 years old. I was ready for us to raise our children and grow old together. But we didn’t have that luxury. That is why myself and millions of others are depressed. Life throws you things you don’t want and can’t cope with. I tried dating in spite of not wanting too, she was actually good with the kids, had nine if her own and was the first girlfriend I ever had, in the 5th grade. Most people thought it was perfect…… but I wanted nothing to do with her, ended it in 2 months. I just have no interest there anymore. Just want to raise our children and go , because I hope to see my wife again.
Aside from my “terrific life? ” Let’s just take someone with an average good life. I don’t understand how ANYONE can wake up….. do the same things over, and over, and over for 75-80 years without being bored and depressed. There’s just nothing here that can keep you happy. People let you down even when they don’t want to , they have no choice. I look forward to the next world and God . I’m sure some will laugh at this , with all the atheists out there now…… but I really never cared what anyone thought of me, and really don’t now. God is our only hope, and better than any medication for depression.
On another note , I was also told that doctors were making tremendous strides with breast cancer. After, watching everything they did, and seeing what it did to her. I really believe they just killed her faster. She would have had a longer, better quality life had she never set foot in a hospital.

Karen Young

I wish I could take your pain away. It sounds as though you shared the deepest, purest, most beautiful love for each other and I’m so sorry she’s gone. I can hear how the absence of her has left such a deep and profound pain in you and I’m not surprised that medication isn’t taking away the pain you’re feeling. The vastness of the pain that comes with losing the people we love could swallow us up if we let it, and I know it can be a constant, daily fight to stop that from happening. I wish you much love and strength.


Grief is the name of your pain. I have found it to be the hardest emotion to have. The loss you are experiencing is profound.

My boyfriend of 17 years, lost his daughter to a mistake at a hospital. She was supposed to be monitored by a nurse in the room at all times due to seizures. The nurse stepped out, she had anot her seizure and aspirated. She never recovered. This grief was overwhelming, his whole world felt like it had ended. And it took him a very long time before his anger and his outlook on life was able to disipate even a litttle. Now, after 15 years, he is finally able to feel and accept a bit of love and find life again.
My hope for you is to be open to any joys your kids can accept into their life. Help them understand how much you miss her, but that you want to be happy with them. You want your kids, who are resilient, to be able to recover from this lOSS and find happiness. And for them to know that you will be ok. It does take a long time. There is hope, it’s hidden right now, but it will come.


Hello Stephen, I read your post here. I totally agree with much of what you are saying. First I’m so sorry for your lost. Been down that road a few times. I have anxiety since I was 11 years old and through the years I developed depression and a mood disorder. No medications work for me and I was on xanax for 8 years and it does not work. I’m tapering off but since my doctor is an adiot I spoke with another doctor and they both aren’t tapering me off properly. So I still have and go through paralyzing thoughts & feelings. It’s very hard to live. I was getting through life somewhat but still not at all good. Now for 4 years everything is worse than it could get. I’m sure there’s more but I wouldn’t know because I’m at my last. I couldn’t handle anything else. I can’t now. I’m a frequent in the emergency room. I have so much going on inside me but nothing going in outside of me. Very hard to live. Although I’m not living. It’s like my heart is beating but like a zombie I live. It’s horrifying. There is no help. Not for me anyway.


For 20 years I have been taking 75mg of Effexor XR, which is an SNRI – raising both serotonin and norepenephrines. I tried 2 SSRI before that – both made me feel worse. But the Effexor was the ticket. My boyfriend is in a deep depression with a lot of anxiety – the SSRIs didn’t help and neither did the SNRI. Now they are trying Wellbutrin and he’s off the wall with the anxiety. I keep telling him he has to see a psychiatrist for a true diagnosis and blood work to determine what neutransmittor isn’t too low. Hopefully he’s not one of the people that is medicine resistant. He does exercise every day. But he was fine for years before this bout of depression and exercises more now than he did when he was happy. And he is seeing a psychologist to talk. Thanks for an interesting article.


why aren’t companies forced by government to reveal true results of drug tests ? this is such a major issue , peoples well being and even lives may be at stake , depression is not a game , our damaged minds are not footballs to be kicked around , were being treated appallingly when companies are allowed to manipulate results and keep results secret then put ineffective drugs on the market .I gave up so called ‘ therapy, ‘ talking was such a humiliation but I did it but simply repeating myself week after week was humiliating and a complete waste of time , anti depressants also . one type of tablet after the other , and when you ask why none of them work its always the same reply , ‘ not everyone responds . ‘ but reading articles like this and others such as in new scientist etc it seems a lot more people are aware that these so called anti depressants are a con and a waste of money as they are actually ineffective , and as the government will not force companies to reveal honestly the real test results , it appears as though depression is being treated as just game by a lot of people in the know , and those that have the illness are being treated as mugs as were the ones who have to go through this charade and pay for these drugs which actually are simply a waste of money as they are not going to help at all , but no one will admit it

Karen Young

Antidepressants can be useful and they can provide relief, but not for everyone. Whether medication is used or not, for anyone struggling with depression it is important to also put other strategies in place to strengthen and protect the brain against depression. This includes meditation, exercise etc. There are still a lot of unanswered questions about depression, but the research is happening and hopefully there will be more answers soon.


” anti depressants don’t work for everyone ” seems to be drug companies stock answer whenever the question is asked as to why I’m not getting any benefit from taking them. I have tried so many types of so called anti depressant over more than 30 years and have not had any benefit what so ever .talking ” therapy ” is humiliating and a complete waste of time , all the depressive is doing week after week after week is repeating themselves .we keep getting these new fads from America as if we must follow because its from America and we are constantly told of the benefits and the difference these new fads from America will have on our mental state , until the next fad .whether its positive thinking , well being meditation , exercise ” therapy ” , music ” therapy, ” cbt , etc , etc , I have even known someone whos parents wasted their money and paid for him to attend the priory clinic to try to cure his depression, and when I asked him what he got for his parents money , ” I repeated myself week after week ” was his reply . theres been a lot in the media lately about mental health care , I just wish someone in government would just take a look at the so called therapies and treatments and ask whether drug companies are delivering drugs that actually work by fully analizing the true data from tests and make sure that money is spent where real and positive results are independently verified .


Yes, i am one of the 50% who has battled for four years to find an anti depressant. Each one has been a failure and the side effects horrendous. I now find myself trying to quit the last one and having withdrawals, just as debilitating. There must be something out there that will work, i was living a happy normal life till this hit after a major surgery, which resolved quickly, but im left with what theynsay is anxiety which will not go away. And i am now fearful of everyday events and socialising so it has morphed into depression. Where does one go from here, looks like psych will try another a/d and ill be the guinea pig again.


I have tried various antidepressants and while I can function I still feel depressed most days. It’s situational. I am stuck in a marriage that I want to leave after 28 years. However I will have no means of support I have two. I have 2 daughters in college. One has some learning issues. I have tried therapy. Etc. I exercise daily etc


you could have not said this better! been through it all and I am still depressed. waste of time and money and it seems nobody really cares!



That’s because the reason for depression isn’t due to Serotonin.

Mine was a lack of Dopamine. They offered me wellbutrin (it’s like an SSRI but works on another pathway and doesn’t make you gain weight).

I decided to use a natural adaptogenic from iherb (or any vitamin shop) and it fixed it. I no longer have depression. I dont even have PMS anymore. It’s called Vitex and it stops prolactin, increases dopamine and progesterone.

Who would have thought my depression was caused by my female hormones? It was by fluke I stumbled upon an article on the internet that saved me. I still love this website even though I’ve fully recovered (in just 3 months!)

NB if you’re male then this is not an option for you, it will dampen your testosterone making your situation worse. It’s also not recommended for women who are menopausal.

I truly hope you stumble upon your answer. I know where you are. It’s painful, scary and dark! If you are reading this then you are still better off than many and you still have hope of finding the light. It’s there waiting for you. You may have forgotten what happiness feels like just ask for help. Whatever is out there is watching over you. It’s a kind beautiful spirit.

It’s real, joy after depression.

Riza Sukman

I think the importance of increasing the range of someones ability to handle and be present with over-whelming “bad” emotions needs to be mentioned as relevant for curing depression. As is mentioned in Theodore I. Rubin’s book “The Angry Book” unacknowledged and unfelt anger is often a big player in the cause of depression and symptoms. Often times avoiding the “bad” emotions in order to feel better can prolong and worsen the condition. I think that medication can help us get out of the depth of depression but then we need to do work to get in touch with all of the suppressed emotional pain that we really don’t want to feel which will help to release stuck energies that create depressive symptoms.


What if taking an SSRI makes you feel worse? That happened to me 8 years ago, then as a result I was diagnosed with Bipolar 2 and set off on a road that ultimately led to taking a LOT of strong medications. Finally in the last year I have been able to take a wean off most of them and at last discovered how to be more mindful and grateful. I still don’t know how to make sense of that initial event where the SSRI made me feel worse and what else could have been done or how else it could have been interpreted.

Karen - Hey Sigmund

A worsening of symptoms is definitely a potential side effect of SSRI’s, which is why finding the right medication can sometimes take a bit of experimenting. It’s not clear why this is, but one explanation according to this new research, is because SSRI’s work by making the brain more plastic, which means more open to change. The problem is that sometimes the conditions or the environment you are in might not necessarily support the change happening in a positive direction. In this study, the mice that were used showed a worsening of symptoms when they were put in the stressful environment. This is just one theory as to why SSRI’s lead to a worsening of symptoms. There are no definitive answers for this, just that it’s clear that it happens. It’s difficult to say what else could have been done because we don’t know exactly why it happens. It might just be something to do with the way the medication interacted with your particular chemistry. It’s like any side-effect – we don’t always know someone is going to have a reaction until they’re actually having the reaction.

It sounds like you’ve worked hard to get to where you are now. That can’t have been easy but you’re doing it. All the best to you.


I don’t know why they jumped to the conclusion that it was bipolar with not a lot of other evidence. 8 years of serious meds and still weaning. Yes I was in therapy before the SSRI and 7 years after but somehow never got the message that moods are normal and not to panic and keep asking for more meds. Oh well, like you said I am on a really good path now and need to be grateful!!


Thanks for sharing your story. I was also given the diagnosis of “soft bipolar” after 8 years on Cipralex (medication made me a bit hypomanic until I reduced my dose). Now the psychiatrist wants to start me on another round of stronger medications to stabilize my mood. Like you I am using visualization, yoga, meditation and social support to stay on track.


I sometimes say that I was born depressed. Actually, it kicked in big time as I entered my teens and have been wrestling with it since. My opinion is that mine is half genetic, half situational.

That said, anti-depressants can lift my mood. My experience showed St. John’s Wort to have the exact same effect as the pharmaceuticals, though now I can’t take it due to a medication interaction. So they do work, but not all that much. Hardly worth the effort of taking them.

Because the situational part is so stressful and shows little hope of being resolved, I’ve found that my “escape” is medication and visualization. My mind can be taken to a much nicer place. Also, writing my feelings down helps quite a bit.

Perhaps the SSRI I’m taking does help my brain do these things better. Showing this article to my husband as he decided to stop his anti-depressant due to making him feel like a zombie.

Another very pertinent and informative article. Much appreciated.


Your husband side effect is called La Belle effect of SSRI , SNRI does not have that much of that effect or Dopamine enhancer does not have any side effect if that kind . Talk to your Doctor
Also try Meditation, Exersise,CBT therapy.

Carole Lyden

Hey Karan, I just love this site, when I have time to sit down to read. Always such sensible information. Depression is so unique and complex to each sufferer. It’s great to read a balanced article for a change.


This is so true. I have been taking antidepressants before, with no effect, apart from feeling an un-emotional shell of a person.
It appears I lived with a person who triggers my depression, and the first time I was truly happy and ALL signs of depression have lifted, was when I was so far away from her that there was no way she could follow me.
Now planning for a new life away, feeling more hopeful than ever before. All my other relationships improved nearly instantly. I’m still undergoing psychotherapy, but of course it will take time to be fully recovered.
Thank you for such a timely article – it strengthens my resolve not to take antidepressants.


Great article! This is timely as my son *who has anxiety has asked me a lot of questions about medication. I take an SSRI as does my daughter and we find that it is not a cure for depression, but prevents us from slipping into the depths. Medication is just one tool in our toolbox that also includes a walking, running, gym classes (good for social support), healthy diet, sleep, gratitude, and prayer.


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The temptation to fix their big feelings can be seismic. Often this is connected to needing to ease our own discomfort at their discomfort, which is so very normal.

Big feelings in them are meant to raise (sometimes big) feelings in us. This is all a healthy part of the attachment system. It happens to mobilise us to respond to their distress, or to protect them if their distress is in response to danger.

Emotion is energy in motion. We don’t want to bury it, stop it, smother it, and we don’t need to fix it. What we need to do is make a safe passage for it to move through them. 

Think of emotion like a river. Our job is to hold the ground strong and steady at the banks so the river can move safely, without bursting the banks.

However hard that river is racing, they need to know we can be with the river (the emotion), be with them, and handle it. This might feel or look like you aren’t doing anything, but actually it’s everything.

The safety that comes from you being the strong, steady presence that can lovingly contain their big feelings will let the emotional energy move through them and bring the brain back to calm.

Eventually, when they have lots of experience of us doing this with them, they will learn to do it for themselves, but that will take time and experience. The experience happens every time you hold them steady through their feelings. 

This doesn’t mean ignoring big behaviour. For them, this can feel too much like bursting through the banks, which won’t feel safe. Sometimes you might need to recall the boundary and let them know where the edges are, while at the same time letting them see that you can handle the big of the feeling. Its about loving and leading all at once. ‘It’s okay to be angry. It’s not okay to use those words at me.’

Ultimately, big feelings are a call for support. Sometimes support looks like breathing and being with. Sometimes it looks like showing them you can hold the boundary, even when they feel like they’re about to burst through it. And if they’re using spicy words to get us to back off, it might look like respecting their need for space but staying in reaching distance, ‘Ok, I’m right here whenever you need.’♥️
We all need certain things to feel safe enough to put ourselves into the world. Kids with anxiety have magic in them, every one of them, but until they have a felt sense of safety, it will often stay hidden.

‘Safety’ isn’t about what is actually safe or not, but about what they feel. At school, they might have the safest, most loving teacher in the safest, most loving school. This doesn’t mean they will feel enough relational safety straight away that will make it easier for them to do hard things. They can still do those hard things, but those things are going to feel bigger for a while. This is where they’ll need us and their other anchor adult to be patient, gentle, and persistent.

Children aren’t meant to feel safe with and take the lead from every adult. It’s not the adult’s role that makes the difference, but their relationship with the child.

Children are no different to us. Just because an adult tells them they’ll be okay, it doesn’t mean they’ll feel it or believe it. What they need is to be given time to actually experience the person as being safe, supportive and ready to catch them.

Relationship is key. The need for safety through relationship isn’t an ‘anxiety thing’. It’s a ‘human thing’. When we feel closer to the people around us, we can rise above the mountains in our way. When we feel someone really caring about us, we’re more likely to open up to their influence
and learn from them.

But we have to be patient. Even for teachers with big hearts and who undertand the importance of attachment relationships, it can take time.

Any adult at school can play an important part in helping a child feel safe – as long as that adult is loving, warm, and willing to do the work to connect with that child. It might be the librarian, the counsellor, the office person, a teacher aide. It doesn’t matter who, as long as it is someone who can be available for that child at dropoff or when feelings get big during the day and do little check-ins along the way.

A teacher, or any important adult can make a lasting difference by asking, ‘How do I build my relationship with this child so s/he trusts me when I say, ‘I’ve got you, and I know you can do this.’♥️
There is a beautiful ‘everythingness’ in all of us. The key to living well is being able to live flexibly and more deliberately between our edges.

So often though, the ‘shoulds’ and ‘should nots’ we inhale in childhood and as we grow, lead us to abandon some of those precious, needed parts of us. ‘Don’t be angry/ selfish/ shy/ rude. She’s not a maths person.’ ‘Don’t argue.’ Ugh.

Let’s make sure our children don’t cancel parts of themselves. They are everything, but not always all at once. They can be anxious and brave. Strong and soft. Angry and calm. Big and small. Generous and self-ish. Some things they will find hard, and they can do hard things. None of these are wrong ways to be. What trips us up is rigidity, and only ever responding from one side of who we can be.

We all have extremes or parts we favour. This is what makes up the beautiful, complex, individuality of us. We don’t need to change this, but the more we can open our children to the possibility in them, the more options they will have in responding to challenges, the everyday, people, and the world. 

We can do this by validating their ‘is’ without needing them to be different for a while in the moment, and also speaking to the other parts of them when we can. 

‘Yes maths is hard, and I know you can do hard things. How can I help?’

‘I can see how anxious you feel. That’s so okay. I also know you have brave in you.’

‘I love your ‘big’ and the way you make us laugh. You light up the room.’ And then at other times: ‘It can be hard being in a room with new people can’t it. It’s okay to be quiet. I could see you taking it all in.’

‘It’s okay to want space from people. Sometimes you just want your things and yourself for yourself, hey. I feel like that sometimes too. I love the way you know when you need this.’ And then at other times, ‘You looked like you loved being with your friends today. I loved watching you share.’

The are everything, but not all at once. Our job is to help them live flexibly and more deliberately between the full range of who they are and who they can be: anxious/brave; kind/self-ish; focussed inward/outward; angry/calm. This will take time, and there is no hurry.♥️
For our kids and teens, the new year will bring new adults into their orbit. With this, comes new opportunities to be brave and grow their courage - but it will also bring anxiety. For some kiddos, this anxiety will feel so big, but we can help them feel bigger.

The antidote to a felt sense of threat is a felt sense of safety. As long as they are actually safe, we can facilitate this by nurturing their relationship with the important adults who will be caring for them, whether that’s a co-parent, a stepparent, a teacher, a coach. 

There are a number of ways we can facilitate this:

- Use the name of their other adult (such as a teacher) regularly, and let it sound loving and playful on your voice.
- Let them see that you have an open, willing heart in relation to the other adult.
- Show them you trust the other adult to care for them (‘I know Mrs Smith is going to take such good care of you.’)
- Facilitate familiarity. As much as you can, hand your child to the same person when you drop them off.

It’s about helping expand their village of loving adults. The wider this village, the bigger their world in which they can feel brave enough. 

For centuries before us, it was the village that raised children. Parenting was never meant to be done by one or two adults on their own, yet our modern world means that this is how it is for so many of us. 

We can bring the village back though - and we must - by helping our kiddos feel safe, known, and held by the adults around them. We need this for each other too.

The need for safety through relationship isn’t an ‘anxiety thing’. It’s a ‘human thing’. When we feel closer to the people around us, we can rise above the mountains that block our way.♥️

That power of felt safety matters for all relationships - parent and child; other adult and child; parent and other adult. It all matters. 

A teacher, or any important adult in the life of a child, can make a lasting difference by asking, ‘How do I build my relationship with this child (and their parent) so s/he trusts me when I say, ‘I’ve got you, I care about you, and I know you can do this.’♥️
Approval, independence, autonomy, are valid needs for all of us. When a need is hungry enough we will be driven to meet it however we can. For our children, this might look like turning away from us and towards others who might be more ready to meet the need, or just taking.

If they don’t feel they can rest in our love, leadership, approval, they will seek this more from peers. There is no problem with this, but we don’t want them solely reliant on peers for these. It can make them vulnerable to making bad decisions, so as not to lose the approval or ‘everythingness’ of those peers.

If we don’t give enough freedom, they might take that freedom through defiance, secrecy, the forbidden. If we control them, they might seek more to control others, or to let others make the decisions that should be theirs.

All kids will mess up, take risks, keep secrets, and do things that baffle us sometimes. What’s important is, ‘Do they turn to us when they need to, enough?’ The ‘turning to’ starts with trusting that we are interested in supporting all their needs, not just the ones that suit us. Of course this doesn’t mean we will meet every need. It means we’ve shown them that their needs are important to us too, even though sometimes ours will be bigger (such as our need to keep them safe).

They will learn safe and healthy ways to meet their needs, by first having them met by us. This doesn’t mean granting full independence, full freedom, and full approval. What it means is holding them safely while also letting them feel enough of our approval, our willingness to support their independence, freedom, autonomy, and be heard on things that matter to them.

There’s no clear line with this. Some days they’ll want independence. Some days they won’t. Some days they’ll seek our approval. Some days they won’t care for it at all, especially if it means compromising the approval of peers. The challenge for us is knowing when to hold them closer and when to give space, when to hold the boundary and when to release it a little, when to collide and when to step out of the way. If we watch and listen, they will show us. And just like them, we won’t need to get it right all the time.♥️

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