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Sleep, Sex and Sadness

The Extended Impact of Antidepressants

The decision to take antidepressants is a personal choice and one that you will ultimately need to discuss with your physician or psychiatrist. In addition to triggering chemical reactions that can hopefully improve your mood or treat depression and anxiety, antidepressants can also have unintended impacts on other aspects of your life. It’s important to note that lifestyle side effects – such as those that affect sleep, sex drive and appetite – are considered minor in the grand scheme of mental health treatment. For many people, antidepressant medication offers life-changing treatment and the decision not to treat mental illness with medication should not be taken lightly.

Antidepressants interact with neurotransmitters (serotonin, dopamine, norepinephrine) that help control mood. However, because neurotransmitters also play a role in other functions, antidepressants are also prescribed for “off-label” uses such as treating insomnia, migraines, nerve pain and eating disorders. And if antidepressants are effective enough to treat other conditions, it holds that they can seriously influence those areas of your life as side effects, too.

If you are in position to consider antidepressants optional, here are three areas of your life they may impact.


Depression and sleep habits are linked even before you add antidepressants to the mix. Many people who suffer from depression also suffer from insomnia (and consequently fatigue) while a smaller population experiences the inability to get out of bed or stop sleeping. Antidepressants can affect sleep in different ways - some types of antidepressant are considered activating and others are considered sedating – so it’s important to talk to your physician about your sleep habits. Lifestyle choices – afternoon coffee and napping, for example – are also a consideration when determining what kind of antidepressant is right for you.


Low libido can be a symptom of depression and on top of that, as many as 70 percent of people on antidepressants say they have experienced changes in their sex lives after starting medication. Changes include reduced desire – which may or may not be separate from the depression itself – as well as reduced sensitivity and delayed or absent orgasm, which typically are not side effects of depression alone.

While scientists have not pinpointed why these side effects occur – it’s most likely related to interference with nitric oxide, which plays a leading role in arousal. General suggestions to mitigate side effects include increased communication with your partner, and exercise or longer foreplay to improve your experience.


Serotonin, one of the neurotransmitters that regulates mood, also regulates appetite and while most antidepressants are meant to target only the mood function, they can interfere with the neurotransmitter’s ability to indicate fullness as well. As a result, many people on antidepressants experience an increased appetite and consequently, experience weight gain.

Healthy ways to address antidepressant-related weight gain are aimed at producing serotonin in other ways – such as eating carbohydrates on an empty stomach and increasing your physical activity. Furthermore, weight gain on antidepressants can also be a result of social eating, which is to say, when people feel better and are in a better mood, they’re more likely to eat more and eat socially.

However, some antidepressants like bupropion that interact with norepinephrine – a neurotransmitter more closely tied to stress reactions – can actually suppress appetite to the extent that they are sometimes prescribed for severe obesity. Additionally, because one of the general, if temporary, side effects of antidepressants is nausea, some people may experience reduced appetite and weight loss immediately after starting medication.

Antidepressants in Your Life

Not all depression requires treatment with antidepressants. Many people find relief from therapy or a combination of antidepressants and behavioral therapy. It’s important to speak to a professional about what you’re experiencing, your lifestyle and your goals for treatment. Together, you can determine a plan that addresses your emotional health concerns and manage the side effects. However, it’s also essential to understand that antidepressants can and do offer vital care for people struggling with mental illness. For many people, lifestyle side effects are minor considerations compared to the improvements they experience with medication.

If antidepressants are right for you, remember that they take time to work. Benefits should be noticeable, and initial side effects minimized, after four to eight weeks of use. Again, a strong relationship with your physician or psychiatrist can help you decide if antidepressants are the right choice for you and, when the time comes, help you stop taking them as well.

Many of the conditions that antidepressants are also prescribed for, such as insomnia and eating disorders, may also be related to your emotional health and can benefit from a holistic approach. There are a number of different types of antidepressants and your physician and psychiatrist can help you plan a healthy treatment with all your motivations, needs and concerns in mind.