I recently heard from a reader who’s lived with depression for most of his life. After hearing much about how treatment works, he sought medical advice; and his doctor did, in fact, diagnose clinical depression and wrote a prescription for an antidepressant.
Unfortunately, the doctor did not satisfy the patient’s need to understand the science behind the prescription. Feeling ill-informed and uneasy about filling and taking the scrip, he asked me to explain how antidepressants literally worked.
Here’s a brief run-down of what I told him:
To understand how antidepressants work, you must first know how the brain works. The brain is made up of millions of cells, some of which are called neurons.
Messages pass from neuron to neuron using chemical messengers called neurotransmitters. The messages include information about emotions, behavior, body temperature, appetite… essentially all body functions. Different neurons are responsible for different functions.
When a message passes from a sending neuron to a receiving neuron, the neurotransmitters leave the sending neuron and enter the space between the sending and receiving neurons. This space is called the synapse. The neurotransmitters then connect to a receptor on the receiving neuron to deliver the message.
Once neurotransmitters have sent their message, they return to be reabsorbed by the sending neuron in a process called reuptake. Reuptake allows the messengers to be reused. Two of these neurotransmitters are serotonin and norepinephrine. Low levels of serotonin and norepinephrine in the synapse are associated with depression and sadness. Some medications used to treat depression work by increasing the amount of certain neurotransmitters that are available to carry messages.
Each type of antidepressant works on brain chemistry a little differently. All antidepressant medications influence how certain neurotransmitters, especially serotonin and norepinephrine, work in the brain.
Antidepressants, such as selective serotonin reuptake inhibitors, or SSRIs, and tricyclic antidepressants, work by slowing or blocking the sending neuron from taking back the released serotonin. In that way, more of this chemical is available in the synapse. With more of this neurotransmitter available, depression is reduced.
The antidepressants known as MAO inhibitors, or MAOIs, affect neurotransmitters differently. Monoamine oxidase (MAO) is a natural enzyme that breaks down neurotransmitters. The MAOI disrupts the action of the enzyme MAO. In that way, there is an increase in the amount of neurotransmitters in the synapse, making more messengers available to the receiving neuron, thus reducing depression.
Because he needed to understand the science of depression and its treatment, my reader now feels comfortable filling and taking the prescription. He will soon feel better.
If ever you have questions about your health or its treatment, seek information.