When my doctor told me that the antidepressant she had just described would take up to six weeks to take maximum effect, I didn’t know what to say. It had taken all the energy I had just to make that appointment and show up to it. I had no idea how to think about, let alone make it through, six more weeks of anxiety and exhaustion....CONTINUE READING
More than a decade later, those six weeks now appear as just a blip on the arc of a lifetime. But in the throes of depression, the prescription to wait weeks for relief is hard to hear.
Why do the most commonly prescribed antidepressants — selective serotonin reuptake inhibitors, or SSRIs — take so long to work? And how do they work? Answers to these questions have proven surprisingly elusive, but new research has brought us closer to a full understanding and also pave the way for insights into what causes depression to begin with
Can you hear me now?
Nerves communicate to each other by releasing chemical signals — including serotonin — at small connections called “synapses” between the nerves. While the brain sends some signals to the body by way of the bloodstream with hormones that hang around for minutes to days, signals sent through nerves (whether to other parts of the brain or other parts of the body, like muscles) need to be brief.
Imagine a symphony where every note played by every instrument lasted for 5 minutes. The result would be a cacophony — not music. In the same way, nerve signals need to be snappy if you are going to, say, run down the street or process a constant stream of visual data from your eyes.
Nerves accomplish this instantaneous signaling by slurping their chemical signals back up right after they release them — a process called “reuptake”. SSRIs slow down this reuptake process to make the signals sent by some nerves a little longer and a little louder.
Simple enough, right? Not exactly. Although SSRIs alleviate depression for many people, it has proved difficult to determine how nerve signaling with serotonin is involved in depression in the first place. And as a result, we…
