Neuroscience And Mental Health: Do Antidepressants Make You Happy?

Note: Some medications may not work for everyone and can have side effects or interact with other treatments. For this reason, consult a medical doctor like a psychiatrist or primary care physician before starting, changing, or stopping your medication. This article is not a replacement for medical advice. 

Antidepressants are a type of medication often prescribed to treat mental health conditions that impair functioning. They can treat symptoms associated with depression, anxiety, and other psychological conditions that do not improve with talk therapy. In addition, lifestyle changes or a combination of medication with therapy can be beneficial.

Antidepressants and neurotransmitters

Antidepressants are medications specifically designed to target the levels of certain chemicals and neurotransmitters within the brain to restore balance. These primarily include serotonin, norepinephrine, and dopamine. The type of antidepressant used determines the exact chemicals and neurotransmitters the medication affects.

Selective serotonin reuptake inhibitors (SSRIs) 

Selective serotonin reuptake inhibitors (SSRIs) are the most common class of antidepressants. SSRIs function by increasing serotonin levels in the brain, inhibiting the reuptake of said chemical, and allowing more of it to be available for use. 

This type of antidepressant is often considered effective in treating moderate to severe depression, especially when a chemical imbalance contributes to an individual's symptoms. Serotonin is thought to be responsible for a significant portion of mood control and affects a person's sleep habits, memory, digestion, and appetite. 

Low serotonin levels may be detected in those experiencing a depressive disorder. Balancing serotonin in the brain has been shown to improve depressive symptoms. However, it is also possible to overmedicate with serotonin if someone does not require the chemical, such as someone with bipolar disorder. 

When taking prescription medications that affect serotonin levels, ensure you work with a licensed psychiatrist or medical doctor. Let your provider know if you are taking dietary supplements or illicit substances. The brain can be overloaded with serotonin and develop serotonin syndrome, which can be life-threatening.

Those with too much serotonin in the body may experience the following symptoms:

• Sweating
• Confusion
• Increased blood pressure
• Increased heart rate
• Restlessness
• Headaches
• Loss of muscle control

Extremely high serotonin levels can lead to seizures, unconsciousness, heart palpitations, and a high fever.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) 

Serotonin and norepinephrine reuptake inhibitors (SNRIs) inhibit serotonin and norepinephrine reuptake. SNRIs may relieve depression symptoms, such as irritability and sadness, but can also be used for nerve pain and anxiety disorders.

Norepinephrine, sometimes called "noradrenaline," is a neurotransmitter and a hormone responsible for inciting a person's "fight or flight" response. SNRIs can cause increased blood pressure and heart rate, blood glucose levels, and panic attacks during quick and intense norepinephrine spikes, so speak to a doctor about the potential for these side effects. 

Those with low levels of norepinephrine may experience the following symptoms:

• Depression
• Anxiety
• Migraines
• Brain fog
• Difficulty with memory 
• Low blood sugar 
• Lack of arousal or interest
• Restless leg syndrome
• Fibromyalgia

Dopamine

Dopamine is a neurotransmitter often called the "feel-good" chemical. It affects mood, memory, movement, and well-being. A deficiency of dopamine can be caused by multiple factors, including certain pre-existing health conditions, an unhealthy diet, substance use, and obesity. 

Though it may not cause certain illnesses on its own, a dopamine deficiency is often associated with depression, Alzheimer's, Parkinson's disease, schizophrenia, substance use disorders, attention deficit hyperactivity disorder (ADHD), and psychosis. 

The symptoms of high levels of dopamine may include:

• Increased pleasure
• Increased cognitive speed and performance
• Anxiety
• Agitation and restlessness
• Increased libido
• Insomnia
• Social-and reward-seeking behaviors and impulses

Norepinephrine-dopamine reuptake inhibitor (NDRI)

Bupropion is an antidepressant that functions as a norepinephrine-dopamine reuptake inhibitor (NDRI). It only affects the levels of dopamine and norepinephrine available for use and does not affect serotonin levels within the body. It is prescribed both for treating depression and aiding in smoking cessation due to its effects on blocking nicotinic receptors.

Tricyclic antidepressants 

Tricyclic antidepressants are another class of antidepressants that function similarly to SNRIs, blocking serotonin and norepinephrine reuptake. However, they differ in that they also block acetylcholine, a neurotransmitter affecting pain responses in the body, muscle contractions, and the control of certain sleep functions. 

This medication may be used to treat depression but may also be prescribed for obsessive-compulsive disorder (OCD). Some off-label uses include reducing chronic pain symptoms, insomnia, irritable bowel syndrome, bulimia, anorexia nervosa, bipolar disorder, anxiety, and panic disorder. 

Though less commonly prescribed than SSRIs and SNRIs, tricyclic antidepressants might be used when other medications do not relieve symptoms.

Monoamine oxidase inhibitors (MAOIs) 

Monoamine oxidase inhibitors (MAOIs) are the first type of antidepressant ever created and have since been replaced with much safer options (such as those mentioned above) with fewer side effects. Monoamine oxidase is an enzyme that assists in removing serotonin, norepinephrine, and dopamine from the brain. 

MAOIs function by preventing the action of the monoamine oxidase and allowing more of the chemicals to be available for use within the body. Due to MAOIs also affecting other factors within the brain and the digestive tract, these antidepressants are prone to causing numerous side effects compared to the other classes. They may require dietary restrictions to take safely. They also have a high risk of dangerous side effects when mixed with other medications.

Serotonin antagonist reuptake inhibitors (SARIs) 

Serotonin antagonist reuptake inhibitors (SARIs) are technically antidepressant medications but are often prescribed for other conditions, such as insomnia and anxiety. These medications resemble SSRIs. SARIs prevent serotonin reuptake in the brain by targeting the 5HT2a receptor responsible for serotonin reuptake and blocking the transporter protein that allows this process to occur. 

The most common SARI medication is trazodone. Though it may not always be prescribed for depression, it is commonly used for those experiencing sleep difficulties in conjunction with other antidepressant medications.

Common mental health conditions treated with antidepressants

There is no one "happy pill" that can change the mood of those struggling with mental health concerns. However, some clients take medications to manage the symptoms. Antidepressants are often prescribed to treat the symptoms of depression, anxiety, and major depressive disorder. However, due to the chemical makeup of the brain and how these affect various factors in a person's psychological and mental health experiences, antidepressants may also be prescribed to treat the following conditions:

• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Anxiety
• Severe phobias
• Insomnia
• Eating disorders
• Post-traumatic stress disorder (PTSD)
• Non-neuropathic chronic pain conditions
• Bedwetting (in children)

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Consult your doctor before starting medication. When trying a new medication, they can check in with you regularly regarding your symptoms and side effects to adjust the dosage if needed.

Antidepressants in combination with therapy 

For successful treatment and recovery from mental health conditions, antidepressants are often used alongside therapy and counseling. Medications may reduce symptoms and allow a person to function in their daily lives short term, but they aren't necessarily a long-term cure. The underlying causes of mental health conditions may be addressed in therapy to help individuals feel happier and healthier. 

Non-medicinal methods of improving mood

There are methods for improving mood without prescribed medications. For some, these options are more effective for symptom relief. 

Diet and exercise

To feel healthier mentally, it can be helpful to get healthier physically. Once physical health conditions have been ruled out, your mood and overall well-being may significantly improve through a balanced diet and regular physical exercise. Regular, low-intensity exercise, like walking outside, may reduce symptoms of mild to moderate depression. Exercise can increase endorphins in the brain, providing a mood boost. 

A positive attitude

Research suggests that smiling can cause a release of serotonin and dopamine. Positive activity interventions are a less formal idea of treatment for depression that focuses on making intentional thoughts and behaviors a regular occurrence in your daily life. Gratitude, optimism, and participation in acts of kindness may alleviate symptoms. Increased positivity has been linked to building healthy relationships, careers, and community connections.  

Though optimism can work for some, people with severe symptoms and overwhelming anxiety may feel further harmed by trying to force positive emotions instead of acknowledging their emotions. Forced positivity is considered a form of "self-deception" in these cases. 

Professional therapeutic guidance 

Prescription medications may not be appropriate for every person struggling with sadness, hopelessness, loneliness, or anxiety. If you are curious to learn more about a mental health condition or receive guidance in effective coping strategies, consider contacting a therapist. 

If you face barriers to treatment, such as financial insecurity or difficulty finding a provider, you can also connect with a therapist through an online platform like BetterHelp. Online therapy allows you to attend therapy from a personal smart device at home. In addition, you can choose between phone, video, or chat sessions with your therapist. 

A literature review regarding online counseling established that it has a similar impact as traditional, face-to-face counseling. A 2007 study revealed no differences in effectiveness between the two methods. A recent study found that 71% of participants found online therapy more effective than in-person options. 

Counselor reviews

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