This story was originally published June 23, 2020, and updated August 7, 2026.
Taking an antidepressant is incredibly common—about 1 in 6 people in the United States do. But despite their prevalence, these drugs are often misunderstood, in part because of stereotypes and stigma around mental health.
“Conditions like hypertension and diabetes are treated with medications, and a mental health condition can be viewed similarly,” says UNC Health psychiatrist Nick DeVito, MD. “We don’t chide someone for taking their medication for those other diseases, and we shouldn’t for people using medications for mental health disorders either.”
Dr. DeVito unpacks some of the misconceptions around antidepressants and explains what you can expect from these medications.
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Antidepressants are not just for depression.
There are several types of antidepressants, and they can be used for conditions beyond depression.
“The term ‘antidepressant’ is a bit of misnomer, because these medications can be used for anxiety disorders, obsessive-compulsive disorder, panic disorders and post-traumatic stress disorder,” Dr. DeVito says. “They may even be used for nonpsychiatric disorders like migraine, chronic pain and irritable bowel syndrome.”
The most common types of antidepressants used are selective serotonin reuptake inhibitors (SSRIs), which include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac) and sertraline (Zoloft), and serotonin and norepinephrine reuptake inhibitors, which include duloxetine (Cymbalta) and venlafaxine (Effexor).
These medications work to ease the symptoms of depression by increasing the amount of serotonin and/or norepinephrine in the brain. With more of these neurotransmitters available, the parts of the brain that regulate mood can work better.
You may also hear about atypical antidepressants, which include bupropion (Wellbutrin) and older classes of antidepressants called tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs), which may be considered if the other types don’t work for you.
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Antidepressants take time to be fully effective.
Unlike a medication you take for a headache, antidepressants need time to work to ease symptoms; it’s not as simple as taking one ‘happy pill.’
“It takes four to six weeks to see the effects,” Dr. DeVito says. “You might start to see a positive effect in symptoms before that, but for those first few weeks, we’re really just looking to see how you tolerate the medication and possible side effects rather than looking to see a huge difference in mood.”
You might start at a low dose of the medication to see how you’ll tolerate it, so it may also take time to reach the dose that will be effective.
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You might have to try more than one medication.
Everyone has different genetics and brain chemistry, so antidepressants are not one-size-fits-all. Because there are several types of antidepressant, and multiple medicines within each type, it may take some time to find the medication that will work best to relieve your specific symptoms.
“It’s common for there to be a little trial and error,” Dr. DeVito says. “If we’re able to tease out certain aspects of your depression or anxiety, we might be able to figure out the best choice from the beginning. If you had a parent or sibling who had a good response to a certain medication, that can also give us a good indication.”
It can be frustrating to try a medication that doesn’t work, but try to have patience.
“We hope for more precision in the future, so that these medications work for everyone from the beginning,” Dr. DeVito says. “But if you come back and follow up, we can collaborate on finding the best choice.”
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Your doctor can help with antidepressant side effects.
As with all medications, there is a risk of side effects. While the specific side effects will vary slightly depending on which antidepressant is used, common side effects include nausea, constipation, changes to sleep or alertness, headache, dizziness, weight changes and sexual dysfunction (reduced libido, erectile issues and difficulty with orgasm).
“The side effect profile can help guide the choices we make about which medication to start,” Dr. DeVito says. “If you tell us what you most want to avoid, we can try to steer clear.”
Some side effects, particularly gastrointestinal symptoms, headache and sleep changes, tend to go away as your body adjusts to the medication. Tell your doctor which symptoms continue and how they impact your quality of life.
“One option is to reduce the dose to see if it’s still effective for depressive symptoms while alleviating side effects,” Dr. DeVito says. “We can also consider an entirely different medication or see if there’s something else that manages the side effects.”
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Antidepressants don’t change your personality.
You may be concerned that antidepressants will change your personality or make you artificially happy.
“The vast majority of people don’t have that experience,” Dr. DeVito says. “They see gradual improvements in their symptoms rather than a wholesale personality change.”
It is possible at a high dose to feel numb to any emotion, good or bad, which is something to tell your doctor.
“Pay attention to how you’re reacting emotionally once you’re on a medication for a few weeks,” Dr. DeVito says. “It can help ease excessive worrying or tearfulness, but we’re sensitive to when you feel like you’re going too far in the other direction—not sad as much, but not feeling anything.”
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Antidepressants are one part of treatment.
An antidepressant on its own may be enough to relieve symptoms of depression or anxiety, but it’s usually not the only thing your healthcare provider will recommend.
“Medications are one tool, but they’re not the be-all, end-all,” Dr. DeVito says. “For most people, a holistic plan that includes lifestyle changes, psychotherapy and medication will be most effective.”
An antidepressant might be the first step that makes other steps possible.
“Antidepressants can help people feel better enough to engage in therapy or to make lifestyle changes, like avoiding substances or exercising more,” Dr. DeVito says.
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You may be able to continue taking your antidepressant through pregnancy and breastfeeding.
If you’re planning on carrying a child, talk to your doctor about the use of antidepressants during pregnancy and breastfeeding. Some options are considered safer than others.
“It’s an area of research that’s historically been understudied, but with more data, we’re becoming more reassured about the safety of antidepressants in pregnancy and breastfeeding,” Dr. DeVito says.
Your doctor can help you understand specific risks of specific medications, and the risk of not taking an antidepressant when you have depression or anxiety.
“We want to weigh the risk of the antidepressant while pregnant against the risk of mental health conditions in pregnancy,” Dr. DeVito says. “We do know that untreated maternal depression can affect children’s long-term outcomes, so there’s a lot of nuance in the discussion.”
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You may take an antidepressant for a short period or indefinitely.
An antidepressant may be needed only for a short period of time.
“If it’s your first episode of depression, you might get treatment, feel better and be able to taper off and be totally fine,” Dr. DeVito says. “It helps if you’re doing therapy alongside the medication and working on other things that build resilience, which helps to lower the risk of recurrence of depression.”
For some people, antidepressants might be a lifetime treatment, particularly if you’ve had severe or multiple episodes of depression. These medications are safe to take for the long-term, but you need to stay in touch with your doctor.
“We want to evaluate over time how well your medication is working to treat and prevent your symptoms, as well as your side effects and any changes to your health,” Dr. DeVito says.
If you’re experiencing symptoms of depression or anxiety, talk to your doctor. If you need a doctor, find one near you.