Medically reviewed by Susan Vachon, PA-C on February 4, 2022
After you finally find the right combination of lifestyle changes, therapy, and medication to treat your depression, you’ll likely be overjoyed. You can start feeling like yourself again. But what happens when, one day for seemingly no reason, your sadness starts to seep back into your daily life?
Unfortunately, it is possible for depression treatments to become less effective over time. This doesn’t mean you’re out of options! It just means you may need to switch things up a bit. Let’s talk a bit more about why certain depression treatments stop working and what you can do about it.
It Could All Be Because of Tachyphylaxis
Tachyphylaxis is the medical term for when your body stops responding to repeated doses of medication. It’s a fast process, so in the case of antidepressants, you might go to sleep feeling fine and wake up wondering what the point of life is. When this happens, people also colloquially call it feeling “pooped-out.”
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Tachyphylaxis may affect up to 33% of clinically depressed patients at some point during their lives, so it’s not exactly rare. Knowing it’s a possibility can help you stay prepared.
What Causes Tachyphylaxis?
Generally, tachyphylaxis happens after your body has had continual doses of a medication for a long period of time. However, scientists don’t know exactly what causes it.
One theory is that the brain’s neurotransmitter receptors — parts of the brain that receive messages from neurotransmitters — can become desensitized. In particular, this can be a problem for serotonin receptors. Serotonin is a neurotransmitter responsible for your mood and feelings of pleasure, so if your receptors aren’t properly absorbing it, this may contribute to depression.
Finally, in some cases, doctors think that an initial response to an antidepressant may just be a bit of a placebo effect. In other words, because you think the medication is working, it does — for a while, anyway.
Other Reasons Your Antidepressants Might Not Be Working Anymore
Tachyphylaxis isn’t the only reason for an antidepressant to stop working. There are plenty of other things that might be factors in the return of your symptoms. One of the most common issues is non-adherence to your medication regimen.
Unfortunately, a lot of people may stop taking their pills as soon as they start feeling better. Or, they may forget to take them regularly every day. These types of noncompliance problems can have huge repercussions.
Antidepressants work by altering your brain chemistry. This isn’t a process that happens overnight — it takes several months for the medications to truly kick in. Stopping your meds when they’re just starting to work can cause your brain to go back to the way it was before. And not taking your meds consistently means your brain may never become fully regulated like it should be.
Substance abuse and alcohol misuse can be another reason your depression treatment is no longer working. These substances can interfere with the way your body processes antidepressants, making them less effective.
Having another medical condition can also make it harder for your body to respond to depression treatment. In particular, thyroid disorders, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and pancreatic cancer can all make it harder to treat depression. So can having bipolar disorder. Because bipolar disorder mimics some depressive symptoms, doctors often mistakenly prescribe antidepressants, which can actually make symptoms worse.
Age is another factor when it comes to depression treatments. As you get older, your metabolism slows, meaning you probably won’t absorb drugs as quickly or as effectively as when you were younger. If your brain is used to getting a dose of antidepressants delivered in a precise amount at a precise time, changing this up could make the drug less effective.
Being older also means you have an increased risk of taking other medications. There are certain medications that can interfere with the absorption of antidepressants, like stomach-acid reduction pills, antibiotics, and steroids.
How You Can Find a New Treatment
Once you realize your symptoms have started returning, your first step should be to speak to a medical professional. They will be able to ask you questions about your lifestyle, medication adherence, and other medical conditions to see if there is a fixable issue. If it looks like your tachyphylaxis is caused by something out of your hands, you and a professional can work together to find a viable alternative treatment.
First, they may try increasing your dose. If you’ve developed a tolerance to antidepressants, increasing the dose may cause your body to respond to the medication again. If that doesn’t work after four to six weeks, the next step is switching to a different class of antidepressants.
There are several classes of antidepressants, all of which target slightly different neurotransmitters in the brain. One of the most common classes is selective serotonin reuptake inhibitors (SSRIs), which target serotonin. Other types include selective serotonin noradrenaline reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).
In addition to a new medication, your doctor may also recommend additional alternative treatments. For example, light therapy can help to reset your body’s internal clock if you experience seasonal depression. And if you don’t already follow an exercise routine, working out regularly has many benefits for those suffering from depression.
Keep in Mind, Depression Is a Chronic Disease
The thing to remember about depression is that it’s chronic, meaning it doesn’t just go away after a quick dose of antibiotics or a couple of weeks of rest. You’ll likely deal with it in some form or another for your entire life, so switching treatments is just a natural course of the journey.
Luckily, with the support of a medical professional, these depression treatment changes shouldn’t be too arduous or scary. If you feel that your treatment isn’t as effective anymore, speak to a professional to see if changes to your treatment regimen can help before your depression gets too overpowering.
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