Are Antidepressants Addictive? By Dr. Tracey Marks

  

 Hi, I'm Dr. Tracey Marks a psychiatrist and I make mental health education articles.  Today I'm answering the question, are antidepressants addictive? That answer is no. Thanks for watching, just kidding. Antidepressants are not addictive in the way that we think of or define addiction. Some people feel like if you take a medication and it helps with something, then when you try and stop it, and the problem comes back, it came back because you're now addicted to the medication. But that's just not really addiction and how it works. 

Addiction is when you develop a physiological tolerance to the medication and apsychological dependence. So let me break this down. Physiological tolerance is when you take a medication and it works for a while, but then over time, you need to get more of it for the same effect. There are certain medications in psychiatry that have this tolerance effect. The main ones are the benzodiazepines, like Klonopin and Xanaxand stimulant medications like Adderall or Ritalin.

 Tolerance develops to these medications because of the way that they work in your brain. It has to do with there ceptors that are affected and the behavior of those receptors. So you can start out takinga small dose of Xanax to treat your anxiety. And that works for a while until eventually you notice that dose doesn't seem to work as well.

 So you need to go back to your doctor to increase the dose so that your anxiety goes away like it did before. And this is a normal reaction that happens to most people. If it happens to you, it doesn't mean that you have an addiction. This is a natural process that occurs with some of these medications. Tolerance only happens to a minor degree with antidepressants, and I talk about that in this article. But even if it does happen, it doesn't mean you have an addiction.

 The second part of addiction is the psychological dependence.  This occurs when there'sa psychological reward that you experience from taking the medication, and you start to crave that reward. So let's go back to the Xanax example. You can take Xanax for panic attacks that you start to experience every time you watch the news, or go to the grocery store. So before you make your trip to the store, you take a Xanax to calm down so that you can shop without having a panic attack.

 You start out only using it for this purpose. But then when you start having fights with your spouse, you start using the Xanax to help you settle down from the argument. Before you know it, anytime you experience a negative situation, it feels too overwhelming to handle so you take a Xanax to get through it. That's an example of developinga psychological dependence. When you're at this point, you lose your ability to tolerate the distressing situations and feel you need a medication to take away those unpleasant emotions. 

Now, you may say, isn't that what happens with antidepressants? You take the pill to make depression go away? Well, yes, you do. But the difference is that you're treating a medical condition and not a temporary emotion. Depression is more than negative emotions. It's a daily experience that affects your mood, your sleep, your appetite,your outlook on life. And it can even affect your thinking abilities, making it hard for you to concentrate or problem solve or even get out of bed. So that's why you take antidepressants daily, and not only on an as needed basis to make yourself feel happy for the day. 

Addiction is more reactiveto transient situations. One time I had someone with whom I was only doing therapy and they weren't taking medication, and I got a request from the person saying, Dr. Marks, I'm getting ready to break up with my partner so I need you to prescribe me something so that I can get through it. That's an example of apsychological dependence on something like a pill or a drug to escape experiencing negative emotions. People don't develop that kind of craving or dependence on antidepressant. The antidepressants don't give you instant results, like you see.