I don't like to talk about depression too much via typing because it is sooooo individualized and is one of those things where there are both a million ways to see relief and a million ways to self destruct. Before I say anything else, if you are considering any medication for depression, it can be a very, very good thing. With that said, I STRONGLY advise you get all mental health prescriptions from the people who deal with mental health medication only; psychiatrists. I also recommend talking with a psychologist and having a team between you and both of them. Many PCPs will give patients depression/ADHD/anxiety meds, but if you want the best positive outcome with the least probability of harm, you need to do this with mental health professionals. Like almost any medication, correct diagnosis and use can change your life and make it better than you think possible; incorrect diagnosis and use can do the exact opposite.
The scariest thing I am often told about depression and antidepressants is that how they actually work is not well understood. Most of those fancy online demonstrations showing neurotransmitter changes and fancy Flash animations are all 'theorized'...look for small print and you will see a disclaimer. Exact function is poorly understood and most explanations say "___ is THOUGHT to...". How they work is not something worth trying to get a complete understanding of as people dedicate their entire lives to understanding brain function and as a patient, you do not need a 3,000 page manual of how neurotransmitters interact with the body. Luckily, these people who spend their whole lives studying the brain are in the practice of helping people and you are paying them to understand the brain for you. Depression is a highly individualized medical condition and it requires a team to tackle it; this team also includes the patient themselves and of course a real mental health pro and not a PCP or walk in clinic.
There are substances you can put into the body which can make a person want to die, but I understand what you are saying as we don't intentionally use these chemicals outside of torture. Most of the shrinks I work with have explained it to me that most antidepressants restore energy before mood and so then someone who is badly depressed is now badly depressed and energetic, which can allow them to commit and succeed with suicide. It is seen more in younger persons because you have energy + depression + compulsiveness.
I agree to a part, but some of the antidepressants tear the body apart for the first few weeks, and certain side effects can cause depression and anxiety on its own. Even the newer SSRIs can be very unpleasant; even with a gradual increase of dose. With that said, a LOT of people are on antidepressants and not a lot kill themselves. SSRIs like Paxil have very bad sexual side effects and one's sexuality is directly linked with mood. The problem I have is that the degree of side effects I have seen some people have would make me want to kill myself. That isn't common in relation to how many people use them, but at a certain point, a medicine makes life worse than better. Some people have found help with the even newer SNRIs, but debate on how much more effective they are, if at all, is varied. All of this is even more reason to use this medication under the guidance and close monitoring of a psychiatrist as they are the people who specialize in making these medications help you and also making sure they do not harm you.
Also, there are antibiotics and medications unrelated to traditional ADs that have been reported to cause suicide...I am not saying if this is true, but some medications have seen substantial reports of changes in mood that are not designed to impact mood.
Ultimately, ANY chemical that goes into the body will have some type of reaction within your body, and each person's reaction will vary. As scary as that sounds, almost nothing is 'completely safe' but at the same time, many things are safer than others.
Doctors often vary on their drugs of choice based on their school of thought and their training. Some will go old school, some will go new school, some will go neither school. Buproprion is liked around here and I have to agree that overall, it seems to have a great gain in depression relative to the risks; of course Wellbutrin does almost nothing for anxiety however. Also, it is not good for people with a decreased seizure threshold and severe insomnia, both which as considerations in any community, but especially the aging community. For people with depression and anxiety and/or people with depression that has not responded to 'first line' treatments, Buproprion and a smaller dose of a SSRI (such as Prozac) has been reported to have very favorable outcomes. In some areas, I have been told that MAOIs are still popular and personally, I would be a little taken back to hear that they are used as a first line treatment given the side effects and interactions, but perhaps they achieve better outcomes with them. Once again, depression is individualized and what may sound crazy may be what it takes to work. Some shrinks, usually older ones, like the TCAs...with that said, younger doctors should more often consider the TCAs in the elderly community especially because of their ability to have positive outcomes in regards to chronic pain and chronic gastrointestinal conditions and so you may help a few issues, with one med.
Above all, you can't take a medication and feel better, usually. Medical conditions and life events can cause/fuel depression that have no effect on the brain in a traditional medical sense. An example would be losing a limb. Due to this, you need to take a holistic approach and a good mental health professional will help, and a good PCP (primary care physician) can be the central coordinator. Exercise, sex, sleep, diet, toxins, and about 1,001 other things relate to depression as well...it's complicated, but it isn't impossible to treat.
Finally, I will note explicitly on the link between a lack of Omega 3 and depression/anxiety. Recently, Omega 3 Fish Oil has come into the spotlight for having positive effects on at least 50-100 individual issues relating from weight to cardiovascular health to cognitive ability to sexual ability to anti-cancer to immune function and more. Studies on both human beings and animals have found depression rates sky-rocket in people who are Omega 3 deficient. When I say 'rocket', studies have seen certain types of depression from 30-300 times higher in people who are Omega 3 deficient versus people getting sufficient Omega 3 intake. It has also been linked in blinded studies to remission of depression and remission of bipolar disorder. It is being studied in regards to numerous learning disabilities, short and long term memory, schizophrenia, and a few other psychological conditions...all which so far have yielded results that are more than just statistically significant. Some studies have been canceled half way (+/-) through because the effectiveness was evident and at a certain point, if your patients getting the experimental treatment are doing so much better than those getting the placebo/standard, you, on ethical grounds, sometimes have to stop (this is what I have read; I did not have anything to do with the study but I agree that experiments need to be changed due to excessive benefit potential for the control or excessive harm risk for the experimental group). It may be an option worth looking into and discussing with your health care provider. Like anything you put into your body, there is always some (no matter how small of) a risk for unexpected outcomes and even supplementation and diet change may be worth discussing with a doctor and/or a nutritionist.
