Areas › Low mood and hard feelings › When everything feels flat
Before deciding a medicine did not work, check that it was taken at a dose and for a length of time that could have worked.
Venlafaxine is the standard example. At low doses it behaves much like a plain SSRI, and the second mechanism people choose it for only comes in higher up. So someone who stopped at a low dose after three weeks has not really had a trial of it. The same goes for anything taken erratically, or stopped as soon as the first fortnight felt rough. Rebuilding that history is worth more than adding another name to the list of things that failed.
Qur’an and Sunnah
Go and seek news of Joseph and his brother and do not despair of God's mercy (Quran 12:87). It is said about a search that had already run for years without result.
يَٰبَنِيَّ ٱذۡهَبُواْ فَتَحَسَّسُواْ مِن يُوسُفَ وَأَخِيهِ وَلَا تَاْيۡـَٔسُواْ مِن رَّوۡحِ ٱللَّهِۖ إِنَّهُۥ لَا يَاْيۡـَٔسُ مِن رَّوۡحِ ٱللَّهِ إِلَّا ٱلۡقَوۡمُ ٱلۡكَٰفِرُونَ
My sons, go and seek news of Joseph and his brother and do not despair of God’s mercy- only disbelievers despair of God’s mercy.’
Qur’an 12:87read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
The evidence that a treatment works comes from trials where it was delivered properly and for long enough. Pooling 115 studies, cognitive behavioural therapy clearly outperformed control conditions for adult depression, though its advantage over other established therapies was small. Those numbers describe the treatment as it was actually given, not a shortened version of it.
Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A, Dobson KS. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments.. Canadian journal of psychiatry. Revue canadienne de psychiatrie doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A treatment that was never given a real chance tells you nothing about whether it works for you.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Never come off an antidepressant on your own. The taper belongs to the prescriber, and for some drugs it needs to be slower and longer than people expect.
Coming off an antidepressant is a piece of work in itself. Plan it slowly with the prescriber rather than stopping on the day you feel well.
If the usual antidepressants have not reached you, there are treatments that work on an entirely different system in the brain. They are worth asking about.