I commonly see people who found that antidepressants helped for a while, often many months or even years, but then seem to stop working. There may well be a number of explanations, depending on the individual person. People can get tolerant to antidepressants and sometimes the illness just gets worse. The most common reasons, in my opinion, has nothing to do with the medication, but more with how the medication was used. More often than not I think people do not use their antidepressant properly so it was almost certain to stop working.
A scenario I often see is that someone comes to me depressed or anxious. There is usually a cause- maybe their relationship is not working, the drink to much, they are unhappy with their job, the are socially isolate or any number of issues. In such cases depression and anxiety is a signal- a sign that something is wrong and needs to change. Maybe that person needs to leave their job, leave and abusive partner, stop drinking, get out of the house more or make any number of changes in their life
If such a person takes an appropriate antidepressant they will often feel a bit better, be less stress and feel less despondent. Their is a risk however that since they feel better, they no longer have the drive to change so they do not address the issues in their life which are causing the problem. Sometimes these people come back and tell me they feel better, so there is no longer a need to do anything drastic in their life. They go back to their usually routine, and often I don’t see them again for a while.
The good feeling however can’t last. If the person doesn’t make changes in their life, more often than not the depression of anxiety return. Sometimes I see people starting to make changes, but as soon as the antidepressant kick in their motivation wanes, and they go back to their old ways. I see this often in people trying to lose weight, or stop drinking. They feel better at the beginning, so their motivation wains. That is a recipe for future disaster.
Antidepressant can alleviate stress and depression, but in most cases this must also be accompanied by real change, or else the effects simply can’t last.
I you are taking an antidepressant ask yourself-“What changes do I need to make in my life for my anxiety and depression to stay away permanently”. Do you need to stop or reduce alcohol or drug use, work on you relationships, improve work or career, focus on health, get clear goals in life, get out of the house more or spend less time watching TV or playing video games. Odds are the answer to at least one of those questions will be yes.
When people combine medication with genuine change then the effects of an antidepressant will often continue indefinitely. In many cases it is often possible to then reduce or cease psychiatric medications.