Hi Ness,
First, educate yourself by watching this:
http://m.youtube.com/watch?v=NOAgplgTxfcSecond, as someone who has used antidepressants on and off for generalized anxiety disorder, I think that I can give you some insight into what taking them is like: both the advantages and the disadvantages.
Let me start with what it's like. Whatever SSRI you're put on (Prozac, Zoloft, Lexapro, Viibryd, etc.), you're going to have a headache for the first three days, along with diarrhea. Within a week, this will subside. As you increase the dose, these symptoms could reappear, but to a lesser extent, and they'll subside.
Once you've reached an effective dose, you need to stay on it probably for four weeks--and possibly as long as eight--to realize the benefits. If you get lucky, your depression will left, gradually and imperceptibly, until you find yourself laughing for no particular reason. If the antidepressant works, the depression will simply dissipate, or go completely away.
But there will be problems. For example, you could have an allergic reaction along the way, such as hives, that could require you to switch to another antidepressant. Or one antidepressant might simply not work for you. You might have to cycle through many different ones, at different doses, to try to find one that works for you. And even when you do find one, the probability is pretty high, in my experience, that you'll experience side-effects.
The most commmon one is a reduction in libido and the likely inability to experience an orgasm. Not every antidepressant has this effect. (Viibryd is one example.) But most do. Another really terrible one is massive fat gain. Paxil is notorious in this regard. It doesn't matter how little you eat, and how much you exercise. Generally, with nearly all antidepressants, you're going to gain a LOT of fat, and you're going to hate it. Another nasty possibility is daytime sleepiness. How would you like to feel sleepy during the day much of the time, despite ingesting megadoses of caffeine? It could happen (but it doesn't happen for everyone, and some antidepressants are worse than others in this regard). And then there's the problem that in general, SSRI's alter the architecture of sleep, apparently inhibiting REM sleep.
A strange thing happened to me on Viibryd. Keep in mind that many people take 20 mg/day. I took 10 mg/day for a few months, experience daytime sleepiness, and decided to stop. A few weeks later, I tried again at 5 mg/day. I experienced the same problem with daytime sleepiness. Keep in mind that 5 mg/day is considered far less than an effective clinical dose. It should hardly be noticeable. But, for me, it was quite noticeable in its negative side-effects. I'd go to sleep, and then wake up four or--if I was lucky--five hours later, unable to go back to sleep. This surely isn't a good thing for one's body after months or years. And I awoke in a strange way. I would toss and turn, involuntarily. Read up on restless legs syndrome. That's how it felt.
If you can get through all of that, as long as you keep taking the antidepressant, it'll keep working, quite possibly for years. But at some point, for a not insignificant percentage of people, the antidepressant will stop working. Sometimes an increase in dose will fix the problem. Other times, switching to another antidepressant is needed.
When taking any antidepressant (or other psychotropic drug), it's important to keep in mind that you're dealing with tradeoffs. You want to rid yourself of depression, and an antidepressant might actually do that. But there's a price to be paid with regard to unwanted side-effects. I personally tried Viibryd because I was hoping for the best: no loss of libido (and that worked), no fat gain (and that worked), and no or greatly reduced anxiety (I'm not sure; see below). What I experienced was daytime sleepiness to the point where I wondered if something was seriously wrong with me, and then there was the nasty way of awakening that I just described.
A few weeks ago, I was taking not only 5 mg of Viibryd per day, but 0.5 mg of Klonopin per day to hopefully make it easier to stay asleep at night. That didn't work, but Klonopin definitely does work for alleviating anxiety. Anyway, I went far, far away---competely alone, in a beautiful, secluded area--on vacation.
When I arrived--I spent the entire day traveling--I was very stressed out and highly anxious. So much for Klonopin and Viibryd helping, I told myself. Within a few days, I noticed how stressful sleeping just for a few hours and then awakening uncomfortably really was. One week into my vacation, I decided to stop both Klonopin and Viibryd, to see what would happen.
It turned out that that was the best move that I've made in over a year. (Please keep in mind that this is just a personal anecdote, and not something that I'd necessarily recommend to others.) Within a few days, I had a positively *great* day: much "better than good" (ironically, what people say about antidepressants). I still experienced daytime sleepiness, and wondered how many weeks, or months, I'd have to wait to see if it really was being caused by the Viibryd. (The effects that a psychotropic drug has can last for a very long time after you stop taking the drug.)
Thus far, nearly four weeks have gone by since I stopped taking meds, and for the past few days, I've felt well: no real anxiety (actually, I feel sort of blissed out and positively happy :) ), optimistic, and focused. I feel like myself for the first time in a very long time. This wasn't the case last week, though.
When you stop taking an SSRI, bad things generally tend to happen to your mood, and you might even experience physiological effects such as dizziness that could last for weeks (close to two months!), and what people call "brain zaps." Because I'd been taking such a low dose of Viibryd, I didn't really experience dizziness or brain zaps, but I continued to experience daytime sleepiness and a severe crash in my mood. That's unusual, because generally, I don't experience depression. My problem is anxiety. However, I found myself not only depressed for a few days, but highly irritable and gloomy. Emotionally, I felt quite awful. I told myself that it was "only" the SSRI withdrawal--and it was. But for about three days, 2.5 weeks after I discontinued the Viibryd, I felt quite awful. It could take two months for all of these withdrawal effects to stop.
Here's the problem, though. If you have depression, take an antidepressant, and it alleviates the depression, if you stop taking the antidepressant--with all else equal--the depression will come back. And on top of that, you'll have put your body and emotions through lots of stress associated with the startup and discontinuation of the SSRI, which will make you wonder: "Was any of this even worth it?"
This is why it's so hard to make a decision about taking an antidepresasnt. Yes, there's a decent chance that it'll help with depression. For most people, though, it helps imperfectly, and involves tradeoffs.
It's true that depression is a neurochemical and metabolic (and possibibly even circuit-related) problem in the brain, but that does NOT mean that you have a faulty brain. What it does probably mean is far more complicated. You were born with a certain genome, and that gave you both advantages and vulnerabilities. During childhood, developmental events can set you on the wrong trajectory, causing depression (or other symptoms associated with genetic vulnerabilities) to appear. The longer that this goes on, the more difficult it is to change in later life. Also, external events and ongoing toxic situations can keep you in the depressive loop. So, it's possible that if you got out of a toxic situation, you might not need an antidepressant, and your depressioon would eventually go away. You'd always be vulnerable to experiencing depresssion again, but if the environment cooperated, and you weren't totally unlucky in your "genetic loading," you might be able to live a depression-free life.
However, most of us aren't that lucky. We can't easily get away from abusive people and stressful situations in our environment. And so, we compromise, and take an antidepressant, which is usually an imperfect solution.
Think of depression as a condition that's chronic for many people. Like diabetes, you can't (currently) cure it. You have to manage it, and an antidepressant is one tool for managing it. It's not a cure. It's not perfect. But it is one weapon in your armory, and it's better for us to have that weapon than no weapon at all. In other words, "better something than nothing."
Cognitive-behavioral therapy might help, but personally, I'm skeptical. I've tried it, without any positive results. Many people say the same thing. The underlying problem, in my opinion, isn't with negative thoughts, but negative emotions that cause negative thoughts. Forcing oneself to identify distorted thoughts and trying to consciously change them seems to be ineffective in changing the underlying negative emotions. Definitely try it, but don't feel discouraged if it doesn't work for you. People say that the combination of cognitive-behavioral therapy (or other psychotherapy) and an antidepressant has the best outcome.
You mentioned breastfeeding a baby. If you take an antidepressant, you'll definitely have to stop breastfeeding. The last thing that you would want to put into the body of a rapidly developing infant is an exogenous drug, especially a psychotropic. There's no telling what effect it might have, and there's simply no reason or excuse for exposing a child to an unnecessary drug. Because there are good alternatives to breastfeeding, though, this shouldn't be a show stopper in considering taking a drug.
I hope that some of what I've said in this message will help you. An antidepressant is just a tool. It's neither good nor bad. Depressioon is a terrible condition with complicated causes. It's no reflection on you as a person. Plenty of famous people have suffered terribly from depression: both saints and sinners. Some people have diabetes. You have depression. That's your own, unique, burden to bear, and hopefully one that you'll be able to recover from.
I believe that hormones can affect depression, so post-partum depression might possibly be at play. I recommend seeing a psychiatrist, explaining your concerns, mentioning whatever I've said in this message that concerns you, and then making an informed decision. Find a psychiatrist who will truly support you (i.e. listen to you and truthfully explain the benefits and risks of any psychotropic drug), and don't be afraid to see a bunch before you settle on one.
And remember: it's not your fault. Life has its ups and downs, and sometimes, we get incredibly unlucky for years at a time. Don't be afraid to try an SSRI. It could really help. Just educate yourself first, and get the support that you need.
Best Wishes,
Steve