When I was on antidepressants, I wished I knew why they took so long. Now we might.

James Gaines
08.03.16

For me, the scariest part of taking antidepressants was the purgatory of waiting to see if they worked.

In 2012, I started taking a medicine called bupropion. For about a month, I watched every single thought that came into my head. And it was, if I may be blunt, pretty damn weird.

Am I having a good day because it's one of Seattle's rare sunny winter days? Or is it the drug? If I have a rough day, is it because I've hit a natural, temporary low? Or does this mean I'll have to switch to another medicine (and have to play this game even longer)?

Depression affects about 1 in 5 Americans at some point in their lives, so I know I wasn't alone. But trying to live outside of your own mind — well, it made me feel kind of messed up and very lonely. I felt like I was a stranger, even in my own head.

It was about a month before I could say for sure that the antidepressants were working.

Antidepressants can take a while to work for lots of people, and we're still not entirely sure why.

There are many different types of antidepressants, but the most commonly prescribed kinds, known as SSRIs or SNRIs, can take six to eight weeks to reach their full effect. (Frustratingly, the bad side effects can often happen before the beneficial ones.)

Unfortunately, we don't yet have a complete picture of why that long wait occurs. While we know that antidepressants can work, we're still learning how depression affects the brain and how different antidepressants can change that.

We know, for instance, that some kinds of antidepressants can help boost mood-altering chemicals known as neurotransmitters, but scientists will admit that's not the whole picture.

But new research is helping us find and study new pieces of the puzzle.

Take, for instance, the humble G-protein. It turns out that in depressed people, certain proteins called G-proteins get clumped up in our brain cells. G-proteins are part of big signal-transmitting machines in our cells, and if they clump up, the other parts of the machine can't really get to them. So the signal falters.

A new study suggests that part of what certain antidepressants do is go into the cell and break up these clumps, helping to repair the machinery. It can take a while for the antidepressants to do their job, though, if the G-proteins are really clumped up. This might explain why that purgatory period exists.

The study notes that different antidepressants may have different or even multiple modes of action, so this "anti-clumping" probably isn't the only explanation. But this study does help us learn more about how depression works and might even lead to better therapies or medications one day.

If you're stuck in antidepressant purgatory, there's science behind it, and it's OK to feel frustrated.

It might take a while to find out the best course of treatment for you — maybe antidepressants are the answer, but maybe not. There are other courses of action, such as cognitive behavioral therapy, that work well too. The important thing is to find what works for you.

But if you are trying antidepressants and are stuck in that weird, alienating state, know that it's natural and there's a reason why — and you're not alone.

mental health depression antidepressants g-proteins snris ssris neurotransmitters
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The moving reason this teen's modeling wish was fulfilled

Courtesy of Macy's

In many ways, 18-year-old Idaho native, Hank Cazier, is like any other teenager you've met. He loves chocolate, pop music, and playing games with his family. He has lofty dreams of modeling for a major clothing company one day. But one thing that sets him apart may also jeopardize his future is his recent battle against a brain tumor.

Cazier was diagnosed in 2015. When he had surgery to remove the tumor, he received trauma to his brain and lost some of his motor functionality. He's been in physical, occupational, and speech therapy ever since. The experience impacted Cazier's confidence and self-esteem, so he's been looking for a way to build himself back up again.

"I wanted to do something that helped me look forward to the future," he says.

Enter Make-A-Wish, a nonprofit organization that grants wishes for children battling critical illnesses, providing them a chance to make the impossible possible. The organization partnered with Macy's to raise awareness and help make those wishes a reality. The hope is that the "wish effect" will improve their quality of life and empower them with the strength they need to overcome these illnesses and look towards the future. That was a particularly big deal for Cazier, who had been feeling like so many of his wishes weren't going to be possible because of his critical illness.

"In the beginning, it was hard to accept that it would be improbable for me to accomplish my previous goals because my illness took away so many of my physical abilities," says Cazier. His wish of becoming a model also seemed out of reach.

But Macy's and Make-A-Wish didn't see it like that. Once they learned about Cazier's wish, they knew he had to make it come true by inviting him to be part of the magical Macy's holiday shoot in New York.

Courtesy of Macy's

Make-A-Wish can't fulfill children's wishes without the generosity of donors and partners like Macy's. In fact, since 2003, Macy's has given more than $122 million to Make-A-Wish and impacted the lives of more than 2.9 million people.

Cazier's wish experience was beyond what he could've imagined, and it filled him with so much joy and confidence. "It is like waking up and discovering that you have super powers. It feels amazing!" he exclaims.

One of the best parts about the day for him was the kindness everyone who helped make it happen showed him.

"The employees of Macy's and Make-A-Wish made me feel welcome, warm, and cared for," he says. "I am truly grateful that even though they were busy doing their jobs, they were able to show kindness and compassion towards me in all of the little details."

He also got to spend part of the shoot outdoors, which, as someone who loves climbing, hiking, and scuba-diving but has trouble doing those activities now, was very welcome.

Courtesy of Macy's

Overall, Cazier feels he grew a lot during his modeling wish and is now emboldened to work towards a better quality of life. "I want to acquire skills that help me continue to improve in these circumstances," he says.

You can change the lives of more kids like Cazier just by writing a letter to Santa and dropping it in the big red letterbox at Macy's (you can also write and submit one online). For every letter received before Dec. 24, 2019, Macy's will donate $1 to Make-A-Wish, up to $1 million. By writing a letter to Santa, you can help a child replace fear with confidence, sadness with joy, and anxiety with hope.

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