What to expect when you use SSRIs to treat depression—including why it sometimes gets worse before it gets better
Margaret, thank you so much for your time. I think your expertise can help inform psychologists, like me, and the patients we treat about how SSRIs actually work; why they usually take so long to start working; and why people sometimes feel worse before they feel better when they start taking them.It is my pleasure to answer any questions you have about SSRIs. Before I get into the nitty-gritty, I wanted to mention something that I feel is important.
All things considered, that's a bad answer for me to hear because some people expect these medications to trigger an exaggerated euphoric response, but that's simply not the case. We need to train ourselves to understand that these medications, at best, are going to make people feel well enough to begin implementing the structural life changes recommended by their therapists.
In our brains, there are sending cells and receiving cells, and the space between them is called a synapse. In depression, there is a deficiency of serotonin being sent to the receiving cell. Sometimes, the sending cell reabsorbs the serotonin before it even makes it to the receiving cell: it's as if the sending cell had a change of heart.
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