Can antidepressants make a healthy person happier?
Although I am fortunate to not suffer from depression, I do sometimes wish I could boost my mood a little and be a bit happier. I’m not the only one - the internet is filled with articles declaring the ‘top secrets to happiness’ and adverts selling products that claim to improve your mood. The country of Bhutan actually uses a ‘gross national happiness’ index to guide its government!
If an antidepressant pill can help someone with depression, does that mean it can also make a non-depressed person happier? We asked 5 experts in neuroscience, psychiatry and pharmacology ‘Can antidepressants make a healthy person happier?’, here is what they said…
Can antidepressants make a healthy person happier?
4 out of 5 experts say ‘no’
What are antidepressants and what are they for?
Depression is a psychiatric condition associated with a range of symptoms. Dr Ivor Ebenezer, a neuroscientist from Portsmouth University in the UK, says “depression is usually associated with low mood, loss of interest in most activities, inability to feel pleasure, reduced energy, pessimistic thoughts, suicidal ideas, changes in sleep patterns, loss of appetite, and cognitive symptoms, such as difficulty in focusing attention or deficits in memory recall”
Antidepressants, as the name suggests, are used to relieve symptoms in those suffering from this condition. Dr Jeffrey Witkin, a pharmacology expert from Indiana University Medical Centre in the USA, says “Antidepressant drugs are approved by the U.S. Food and Drug Administration for relieving symptoms of depression… For many people these drugs can also help reduce stress-related behaviours and reduce anxiety.” Although antidepressants are most typically associated with treating depression, they are also used to treat a range of other conditions including obsessive-compulsive disorder (OCD), anxiety, phobias, post-traumatic stress disorder (PTSD) and chronic pain.
There are many different types of antidepressants that work in different ways. The most commonly used are ‘selective serotonin reuptake inhibitors (SSRIs). This group includes the most highly prescribed antidepressant in the UK, sertraline (also called Zoloft), as well as fluoxetine (Prozac) and citalopram (Celexa).
Antidepressants are very widely used – in the UK 20 million antidepressants were prescribed in just the last 3 months of 2020. In the USA, a study carried out between 2015 and 2018 found that over 13% of adults that participated in the survey had used antidepressant medications in the past 30 days.
Can antidepressants make non-depressed people happier?
In order to identify whether antidepressants can make non-depressed people happier, we would need quantify an individual person’s happiness. Dr Ebenezer points out that “Happiness is not a psychiatric term like depression and is therefore difficult to define in scientific terms." Dr Christopher Lowry, a neuroscientist from Colorado Bolder University in the USA, agrees, saying “the science of measuring ‘happiness’ is in its infancy, and few if any controlled studies have been done to test if antidepressants can make a healthy person happier.”
Professor Michael Thase, an expert in psychiatry from Perelman School of Medicine in the USA, says “The short answer is no – an antidepressant won’t enhance a healthy and reasonably happy person (i.e., someone who is not suffering from a problem that the antidepressant might treat).” However, he highlights the interesting complication of potential undiagnosed problems. He says “lots of people who consider themselves to be ‘normal’ do have sufficient signs and symptoms of common problems with mood or anxiety or related disorders and might actually gain benefit from taking an antidepressant. This includes milder conditions in the psychiatric realm, such as persistent minor depression, cylcothymia (a condition related to bipolar affective disorder, but with milder mood swings), attention deficit disorder, binge eating disorder and certain kinds of insomnia”
Taking antidepressants when you don’t have one of these conditions is probably a bad idea. Dr Ebenezer says “There is no evidence in the medical literature that people who do not have depression will benefit from taking antidepressants and feel 'happier' by doing so. In fact, they may feel worse as they may display some of the side effects that are associated with these drugs.”
What are the potential side-effects of antidepressants?
Professor Thase says that antidepressants “can have side effects – including rare ones that can be severe – and should not be taken unless there is good reason to believe that the chance of benefit outweighs the likely risks. This is why a prescription is still required – they are not available over the counter – and follow-up with a healthcare provider is a standard of practice.”
Dr Ebenezer adds that “all the antidepressants that are used clinically have side effects that range from mild to life threatening and include sedation, anticholinergic effects, sexual dysfunction, gastrointestinal dysfunction, sleep disturbances, suicidal thoughts, serotonin syndrome, postural hypotension, and cardiovascular problems.”
How do antidepressants work?
Another reason to steer clear of antidepressants unless you need them is that they have to be taken for long periods of time to be effective. Professor Thase says that “importantly, the beneficial effects of antidepressants generally take several weeks or even a month or two to be evident and they generally don’t work on the spot or when taken ‘as needed’”
It is not known exactly how antidepressants work. Some antidepressants change the levels of certain chemicals in the brain. Dr Ebenezer says “Antidepressant drugs act to reduce the symptoms of depression by increasing central neurotransmitters, such as noradrenaline (norepinephrine) and 5-hydroxytryptamine (serotonin).” There are still many unanswered questions, however. For example, we know that antidepressants can change neurotransmitter levels within hours, but patients do not feel the beneficial effects of these medications until they have been taking them for days or weeks.
If you don’t suffer from a condition that could benefit from antidepressants, taking these medicines will probably not make you any happier, and you might experience side-effects.
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