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This question originally appeared on Quora. Answer by Andrew Gumperz, professor emeritus, bio-sophistry.

Other answers have made the medical case for anti-depressants. I will talk about my own experience with them as a supplement to those answers.

I resisted using anti-depressants for years because I feared they would alter my personality and I would no longer be me if I took them. I spent years in talk therapy, but no amount of self-knowledge lifted the depression. Finally, because depression was threatening my employment, I tried anti-depressants. My first prescription was for Prozac, and I still remember when it finally began to work (Prozac has to build up in your system for several weeks before you get the benefits).

I first went through a period of 4-5 days where all I wanted to do was sleep. I probably slept 12+ hours a day, and I could still barely keep my eyes open during the day. I had been told to expect it, but when it happened it was unsettling; it seemed like it would never end.

Then one day, I woke up and I felt wide awake. I was relieved to feel normal again. I went about my day. After a few hours I noticed a strange absence. My internal self-chatter was gone. It was like total radio silence in my head. Things felt clear and I felt completely calm. I didn't feel happy, I didn't feel sad, I didn't feel much of anything. I felt kind of dead inside. All fears and anxieties were erased.

Until then, I had perceived life through a surface layer of anxieties and fear. Any significant event triggered these feelings. A good example was if someone yelled at me. No matter what the content, this triggered guilt and fearfulness. If the person yelling was a stranger, I feared he might hit me. If the person yelling was an authority figure, I immediately reacted as though I had screwed up (before I even asked myself if the anger was justified). And now that surface layer was gone. Without it, I felt empty. This didn't feel troublesome, just new. I could now choose how I wanted to react, but I needed to learn what was worth reacting to.

The absence of fears made learning much easier. If I thought, "I'd like to learn Japanese," I no longer had a knee jerk fear of failure so it was easier to take on new projects. I suddenly felt like any big project was manageable. For the first time, I could see how the other half lived, how some people could complete big tasks without getting overwhelmed.

In addition to learning new skills, I also learned a lot about myself. I could now see more deeply into my own motivations. My fears and anxieties had masked a deeper layer of motivations which were now visible.

And although initially, I felt emotionless, it wasn't true. It just took more stimulation to get me emotionally involved. For example, I no longer felt the anxiety that I had to pay attention to others or I was committing the cardinal sin of rudeness. Sometimes this led to comical situations. I remember being at a party and speaking to a woman I know. She was droning on and I wasn't interested. Previously my social anxieties would have kept me listening, but those anxieties were long gone, so my mind just wandered while she talked. Eventually she asked a question and my answer made it clear I hadn't heard a word she said. "Well," she said, "I can see you are not interested." before walking off huffily.

I was nonplussed but I didn't feel guilty or even embarrassed. I knew I had made a social error, but I also saw no serious harm had been done. After an apology, I would continue my relationship with her as though nothing had happened. I saw the event as a learning experience rather than a faux pas.

It was strange to relearn reactions to ordinary situations as an adult, but it was also fun to reflect on how I would have previously reacted and to coolly assess whether that was best.

Anger on an antidepressant was different. Previously, I had been quick to anger but in my new state small irritants flowed by like water. I was the Buddha... that is until a big irritant occurred. When something did stir me up, my anger reaction was far more intense. I was fearless. Previously when angry, fear of consequences helped me control how strongly I responded. With that fear gone, I could say whatever I wanted and I did. This felt liberating and while I didn't use it to behave abusively (I hope), it did mean I never backed down, I was willing to be brutally honest and I could stay completely focused on my grievance while angry.

I remember arguing with an acquaintance. I complained about some behavior of his, A. His responses was essentially. "Yes but B" some counter-complaint about me. In the past, I would have been sucked into defending myself against B. Now I didn't bother. B was irrelevant to me because I didn't give a damn what he thought about me. I went right back to my grievance. I was immune to his attempt to redirect the conversation.

Sometimes I had to consider whether expressing my anger served my purpose. I was on a freeway and approaching my exit. I checked the lane to my right in my mirror, which was clear, signalled and began to change lanes. A driver who must have been going 30 MPH faster than me (since he had not been in sight when I began my lane change) zoomed past dangerously close. I swerved away to avoid him. I was enraged--this idiot had almost killed us.

He exited and stopped at the red light. I did too, right behind him. At this point I was planning how to intercept his car. I pulled myself back from the brink of driving him off the road. I literally had to think to myself, "He might have a gun" and "Is it worth that risk to tell him what a prick he is?" Without fear, the decision felt like a cool calculation that could go either way, not a self-evident decision.

Since then, I have been using antidepressants off and on, mostly on, for the last 15 years. I have used many different medications, mostly to see what they were like. They are not all the same; each tweaks my feeling state a little differently. Here are some of my conclusions:

  1. Antidepressants do not change your identity. They are not like intoxicants that fundamentally alter your experience of the world.
  2. Antidepressants are not happy pills. They do not make you euphoric like some recreational drugs do. They are lift-the-fear,-anxiety-an d-bleakness pills. After that you are on your own. It is up to you to find happiness but at least now you have the mental fortitude to keep trying things until you find some happiness.
  3. Antidepressants are learning drugs. They lift the barriers that prevent you from learning (both about external topics and your internal motivations). However, you must act on the opportunity they provide to get the benefit. They are a great supplement to talk therapy and you will get more benefit if you do both.
  4. Antidepressants come with minuses. Some make it difficult to orgasm (think of pushing and pushing like trying to give birth to get an idea of what I mean). However, the orgasm when it happens is intense, so there is a silver lining. That side effect diminishes over time and not all anti-depressants have it.

I don't claim any scientific basis for my thoughts--they are simply how anti-depressants affected me. Good luck, and I hope you find a path away from your pain.

This answer is not a substitute for professional advice; it is for general informational purposes only. If you think you may have a medical emergency, call your doctor or 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Quora users who provide responses to health-related questions are intended third party beneficiaries with certain rights under Quora's Terms of Use​.

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