Depression and anxiety are two separate disorders. They are related in some ways - there is a high comorbidity between anxiety and depression, indicating that they have something in common - but they're technically different disorders that cause different symptoms and require different treatments.
Antidepressants, however, are commonly prescribed to treat anxiety. That causes many people to wonder whether antidepressants are useful for anxiety, and if they're a good choice given alternative options.
Antidepressants and Anxiety
There is no one-size-fits-all approach to anxiety, because there is more than one anxiety condition, anxiety has different causes and symptoms, and people respond to medications differently.
But doctors do commonly prescribe antidepressants to treat anxiety. They include:
- Selective Serotonin Reuptake Inhibitors (SSRI) Examples include Lexapro, Paxil, Prozac, and Zoloft.
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRI) Examples include Cymbalta and Effexor.
- Tricyclic Antidepressants Examples include Adapin, Anafranil, and Elavil.
- Monoamine Oxidase Inhibitors (MAOI) Examples include Aurorix, and Emsam.
While the drugs themselves are all different, they all affect the serotonin system in the body. Most often, a doctor will choose based on their own personal preference, the history of side effects, the allergies of the person with anxiety, other medications, etc.
It should be noted that antidepressants can also take weeks to work and do not always affect everyone. Doctors may prefer a different course of treatment to provide immediate relief or to benefit those with a different type of anxiety disorder.
Why Are Antidepressants Used Instead of Anxiolytics?
By most accounts, antidepressants became an anxiety drug by accident - something that appears to be true about many of the medications for anxiety. Antidepressants were created to control depression and bipolar disorder, and then studies found that there was a noticeable decrease in anxiety.
This makes sense on a chemical level as well. Serotonin is a key neurotransmitter that has an effect on multiple brain functions, including anxiety. Antidepressants affect serotonin, so those with anxiety should receive similar relief to those that have depression.
Antidepressant Side Effects for Anxiety
Antidepressants do have many side effects, and in many cases these side effects can be severe enough that they cause the person to stop taking the medication. It's better to expect that your first antidepressant will have too powerful side effects, because many of those that use these drugs have to go through a few before they find one they tolerate. Side effects include:
- Sexual dysfunction.
- Increased nervousness/anxiety.
- Weight gain
Remember, antidepressants have a fairly powerful effect on the brain, so some side effects should be expected. Anything that affects your brain has the potential to make you feel differently.
Important Notes About Antidepressants
Antidepressants are not happy pills, though they do release a neurotransmitter that should improve mood. Some antidepressants cause dependency, and you may need to wean off them slowly even if you're suffering from side effects, otherwise you may go through withdrawal.
Antidepressants may also cause what's known as "psychological dependence" - especially if you decide to depend only on an antidepressant and do not partner it with a long term treatment. Psychological dependence is when you start to "need" them to cure anxiety simply because you've essentially forgotten how to try to deal with anxiety yourself. That's why it's important that you never just take an antidepressant, and instead partner it with some type of non-pharmacological treatment.
If possible, you should consider avoiding medications altogether. The psychological dependency alone is actually a very serious problem, and one that can cause long term setbacks in your ability to cure anxiety without medications.