Mental Health: Concerns About SSRIs and Stress Management

Many worries?

Doctor: I'm not sure if this is an illness or just a poor mindset; it might be due to high stress, which makes me feel anxious.
I'm uncertain if the level of anxiety is within a normal range, but I feel completely fine during holidays.
1.
If it were an illness, shouldn't I feel abnormal every day? 2.
I would like to ask if taking SSRIs long-term in this situation could lead to the emergence of abnormal conditions when the original state was normal.
3.
I also came across an article (https://goodmood.com.tw/what-antidepressant-do-people/) mentioning that monkeys without depression showed a reduction in the volume of the anterior cingulate cortex and hippocampus after receiving a daily dose of the SSRI antidepressant Lexapro (equivalent to humans taking the medication continuously for five years).
Will taking this medication cause my hippocampus to shrink? 4.
Should I take the medication? I apologize for asking so many questions, but I'm really troubled and would appreciate your opinion.
Thank you very much.

Qq, 10~19 year old female. Ask Date: 2022/12/28

Dr. Qiu Junda reply Psychiatry

Hello.
I'm not sure if you have ever been treated with SSRIs (selective serotonin reuptake inhibitors) for depression.
If you have used them, these medications can actually help prevent the shrinkage of the hippocampus, so there’s no need to worry.
As for whether you should take medication (seek medical attention), it needs to be evaluated whether it's a disease or what you refer to as a mindset.
Personally, I initially believe it hasn't reached the level of a disorder.
Of course, you can also take the time to consult with a psychiatrist (consider it as seeking treatment) to clarify your doubts.

Reply Date: 2022/12/28

More Info

It's completely understandable to have concerns about mental health, especially when it comes to the use of medications like SSRIs (Selective Serotonin Reuptake Inhibitors) and how they interact with stress management. Let's break down your questions and concerns one by one.

1. Understanding Mental Health and Normalcy: It's important to recognize that mental health is not a binary state of being either "well" or "ill." Many people experience fluctuations in their mental health based on stress, life events, and other factors. Feeling anxious or stressed, particularly in response to work or personal pressures, is a common experience. It’s also normal to feel more relaxed during breaks or vacations, as these times allow for recovery from stressors.

2. Long-term Use of SSRIs: Your concern about whether long-term use of SSRIs could lead to the development of abnormal conditions is valid. SSRIs are designed to help manage symptoms of depression and anxiety by increasing serotonin levels in the brain. While they can be effective for many individuals, there is ongoing research about their long-term effects. Most studies suggest that SSRIs are safe for long-term use, but they should be monitored by a healthcare provider. It's crucial to have regular check-ins with your doctor to assess the effectiveness of the medication and any potential side effects.

3. Impact on Brain Structure: The article you referenced raises an interesting point about brain structure changes in response to long-term SSRI use. While some studies in animals have shown changes in brain regions like the hippocampus and cingulate cortex, it's essential to approach these findings with caution. Human brains are complex, and the effects of SSRIs can vary widely among individuals. The benefits of SSRIs in alleviating symptoms of depression and anxiety often outweigh the potential risks. However, if you have concerns about brain health, discussing them with your healthcare provider can help you make informed decisions.

4. Should You Take Medication?: Deciding whether to take medication is a personal choice that should be made in consultation with a healthcare professional. If your symptoms are significantly affecting your daily life, work, or relationships, medication might be a beneficial option. SSRIs can be particularly effective for anxiety and depression, but they are most effective when combined with therapy and lifestyle changes, such as stress management techniques, exercise, and healthy eating.

In addition to medication, consider incorporating stress management strategies into your routine. Techniques such as mindfulness, meditation, yoga, and regular physical activity can help reduce stress and improve overall mental health. Cognitive-behavioral therapy (CBT) is also an effective treatment for anxiety and can provide you with tools to manage stress more effectively.

Lastly, it's important to remember that seeking help is a sign of strength, not weakness. If you're feeling overwhelmed, reaching out to a mental health professional can provide you with the support and guidance you need. They can help you navigate your feelings, assess your mental health, and determine the best course of action for your situation.

In summary, while SSRIs can be an effective treatment for anxiety and depression, it's essential to have open discussions with your healthcare provider about your concerns and experiences. Mental health is a journey, and finding the right balance of medication, therapy, and self-care is key to managing stress and improving your overall well-being.

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