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6 Signs Your Mental Health Medication Isn’t Working For You, According To Doctors

by Kyli Rodriguez-Cayro
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Many people with mental health issues struggle with universal symptoms, including depression, anxiety, and fatigue. But there's unfortunately no one-size-fits-all treatment option or pill that works for everyone. With so many different mental health medications to choose from, it may take some time to find an antidepressant or psychiatric medication that works well for you.

"Depression is a [...] complex issue. Treatment is effective, though no one treatment works for everyone. Many people have to change or adjust their treatment over time," Dr. Scott West, the medical director of ThriveLogic TMS And Neurohealth, and Nashville NeuroCare Therapy, tells Bustle.

According to the National Alliance on Mental Illness (NAMI), one in five adults in the U.S. will experience mental illness in a given year, with around 16 million people impacted by depression alone. As NBC News reported, a 2016 study found one in six people in the U.S. now take a psychiatric drug, with antidepressants being the most widely prescribed. Because there are a number of different kinds of antidepressants, psychiatrists may take certain steps at your first few appointments to try and ensure they prescribe you the best medication possible.

"Make sure that whoever is prescribing [psychiatric medications] takes a thorough history from you," Dr. Mark Goulston, MD, a psychiatrist, author, and co-creator of the suicide prevention documentary, Stay Alive, says. This history may include detailed information about past medications you've tried, your family history of mental illness, and so on. What's more, as TIME reported in 2018, genetic testing is now available that can reveal how you may metabolize and respond to different antidepressants. These insights can help you and your doctor make more informed decisions about your mental health treatment.

Yet, even with these tools, there's no guarantee you'll be prescribed a medication that's effective on your first go-around. Finding the right antidepressant or mental health medication may still require some trial and error. Here are six signs your mental health medication may not be a good fit for you, according to doctors themselves.

1You Mental Health Symptoms Worsen

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Camilla Lyons, MD, MPH, a psychiatrist and member of the Alma mental health co-practice community, says that if you "develop new or worsened mental health symptoms," it's a definitive sign your antidepressant isn't working. This could occur for any number of reasons: For example, as Psychology Today reported, many people who have bipolar disorder are often misdiagnosed with depression, and, while Healthline says mental health professionals may choose to prescribe antidepressants to people with bipolar disorder, they can also have adverse side effects, like potentially triggering a manic episode.

"While some psychiatric medications are associated with rare but serious side effects, you should always consult with a physician before making any changes to your medications," Lyons says, adding that, "When in doubt, you can always visit your nearest emergency room in the event that you cannot reach your doctor."

2You're Experiencing Sleep Issues

From your quality of sleep, to what you dream about, antidepressants can impact many aspects of sleep. Goulston says that "persistent sleepiness or sluggishness that may cause you to drink excess caffeine to stay awake" is one indication your antidepressant isn't a good fit. Oppositely, he says that if your medication is causing "persistent insomnia," it may also be a sign your antidepressant isn't right for you.

3Your Symptoms Simply Haven't Gotten Any Better

It's important to keep in mind that, according to VeryWell, research has shown it can take anywhere from eight to 12 weeks to feel the full benefits of an antidepressant. In more severe cases, it could take up to six months. However, West explains, "Antidepressants may not be working if your mood remains depressed, [or] you find yourself not functioning at your usual level. These are changes you may personally notice yourself, or in some cases, you might not be as aware, but someone close to you who you spend time with might observe."

Antidepressants won't work overnight like magic. Yet, it's a good idea to try to schedule an appointment with your prescriber if you find your symptoms haven't began to improve as you near that eight-week mark.

4The Side Effects Are Unbearable

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When you first begin an antidepressant, the Mayo Clinic reports it's normal to experience side effects from the medication, with nausea, diarrhea, decreased libido, fatigue, dry mouth, weight changes, dizziness, irritability, and insomnia among the most common symptoms. Yet, Lyons says if these side effects become "intolerable," or don't seem to go away once you've been on a steady dosage of the antidepressant, it may be time to consult with your physician if you should make a medication switch. Though many medications have side effects, you may want to consider talking to your doctor if you feel they are interfering daily activities.

5You Feel More Apathetic

Goulston says that you may want to speak to your prescriber about switching your mental health medication if you find you're less depressed, but also less motivated. As Harvard Health reported in 2016, it's not uncommon for folks on psychiatric medications to experience a "blunting" effect that seems to almost dulls their emotions. In fact, a 2018 study found that antidepressants can induce apathy, indifference, and a lack of interest in some people within six weeks of starting a medication.

6Your Mental Health Symptoms Still Interfere With Your Daily Activities

"If you are feeling 'back to yourself,' and those close to you agree, the treatment you are engaged in is likely working," says West. However, if your mental health issues still seem to be interfering in your daily activities, work, or relationships, you still might need to adjust your dosage or switch your psychiatric medication.

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West says that, in some cases, your doctor may make other treatment recommendations if you don't have success with traditional mental health medications. "Research has found 5.5 million depression sufferers do not find relief from antidepressant medications, and that is when a specialist may be needed," he explains.

All-in-all, Goulston says being your own advocate and speaking up if you experience any of these signs is one of the most important things you can do throughout this process. Try not to feel discouraged if an antidepressant doesn't work for you — it's very typical to have to try multiple medications before finding one that's effective for you. With the help of your psychiatrist, you can get to a place where you feel confident about your mental health treatment.

If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.

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