A friend is writing a column on the long-term effects of antidepressants,and about cases where people start taking them to help get past a specific trauma,but never go off. She wondered who needs them long term and who is just hurting themselves? 

She wonders about antidepressants causing withdrawal, dependence? She wonders about Dr.’s leaving people on them for life even after depression is resolved.  

The problem is in the marketing. People have no idea what antidepressants do or how they really work. There really is no such thing as an antidepressant that’s marketing bullshit.  No legal medication can make you happy. Happiness is a transient state, the result of some behavior – or should be. Ecstasy and such bypasses this but the happiness or oblivion they cause can’t last. You can say antidepressants secondarily help with depression.  

Medications can’t reformat your brain, when you stop them the brain goes back to the way it was before you took medication. 

Serotonin antidepressants can best be describes as turning the brains gain down decreasing sensitivity and distortions. This is primarily right brain activity.      

Norepinephrine antidepressants can best be described as turning up specificity or attention. This is Left brain activity. They give energy, alertness, sharpness or more accuracy.  

Thus, after people feel better and decide they don’t need medications anymore and go off, most people relapse into symptoms again after a time as they are who they are. 

Even on antidepressants people still need skills and counseling. In fact, antidepressants alone with no skill acquisition, in studies after 10 years of use, people are worse off than when they started the medications. Medications don’t make good life decisions for you and feeling better is not related to being better.  It takes skills to make good life decisions in alignment with one’s intent. 

Now feeling and empathy, the right brain, is 12x faster than left brain data and common sense. Thus, even with 40-year worth of skill building (as i have known people to have had) without medication the brain works so instantaneously they have reacted and behaved before they ever realized to use a skill.  So, without medications people don’t and can’t use the wonderful skills they have acquired.  Medications give that 3 second pause when you can choose. They allow left brain common sense based on data to catch up with the right brain emotional impulse.  This is why medications are often necessary for a lot of people their whole life.   

Humans are emotional based critters and that is for survival. You don’t need to be accurate to survive you just need a gist then react. Over kill is ok. Paranoia is a survival thing. Kill them before they kill you such and such… Survival is why we are built this way but it doesn’t work as well in a crowded 9-5 culture. You can’t just kill the person at the next desk.   Although these days that’s getting way more popular. 

An interesting story regarding all this:  A person I know was on Zoloft for 20 years   but had to be changed due to developing a side effect, muscle movements.  Some interesting occurrences happened with different medications.  

On Wellbutrin they felt better, more alert, more energy, more sexual, but changed their religion to a more conservative one as they got really into ritual and detail and the brevity of depth to their previous religion had started pissing them off. Only their obsessiveness and perseveration of thoughts (why they were on Zoloft) over time returned.  

Next was Cymbalta (adding serotonin back) and the obsessiveness went away. They changed back from the new conservative religion to the previous more liberal religion. The details of conservative ritual which makes up much of their old religion became cumbersome and bored them.  Who they were as a person, their needs and desires, changed with medication. 

It is fascinating that personality can be changed and adjusted.  This of course is freaky but good as off medication they get bogged down with obsessive thinking and can’t function well despite having had many years of skill building. It just doesn’t matter off medication as they can’t use the skills. With medications you feel how you feel until you don’t feel that way.   

My friend next asked about artists. Do you think effectiveness of medication is vocationally affected?

Meaning on medications will artists who often use angst as a muse cease to be productive? And what about artists who drink? Is it safe with medications?  

Mixing alcohol and antidepressants is always a bad idea. People want to numb out with alcohol so you don’t then want to numb out with medication. What drugs people take should always inform what medications are chosen as medications often target the same chemicals and receptors people fall into via self-medicating but with treatment you want to always target an overall balance. Self-treatment street drugs or marijuana often is like a torpedo for one side of the brain vs a pebble to push the balance to open up the other side to make better decisions.  

Other doctors often do not think or practice this way. They do not consider left right balance, they won’t mention things like the brains gain. That’s all me for now but newer info coming out does look at this. The current paradigm is wrong, the DSM one.  A lot of Dr’s know this but we are forced to talk in the old system due to insurance and politics. 

As far as effectiveness of medication vs. vocationally affected?  –  This has been disproved scientifically. Angst isn’t needed to create but a paradigm shift has to occur and the type of art a person might make would definitely change.    Artistic ability doesn’t go away without pain but one might not write dark pain driven shit. They might instead make the new marry Poppins?    

The have to channel one’s pain shit is a myth. If one is on the right medications they should still be able to feel joy and create from that joy.  Medications shouldn’t numb one, only help in creating balance. Many doctors enable people to feel numb, fire that doctor. They are not helping you toward the bigger picture or you’re potential.  

The need for dis-inhibition and dis-control is also a myth. Creativity doesn’t come from dis-control. It can be volitional.    

Again if you have been numbed out your treatment provider didn’t know what they were doing or communication was poor.  This is an important point.  

A friend asks what’s better in the long run, self-control, or medication? 

Dr. Brilliant Cliché replies:

“One might need the other to exist.  At the level of master yogi maybe not but in the real world; medications, exercise, nutrition, healthy positive friends, and good books, are all one together.    Taking medication regularly can be a form of self-control.  Shot gun self-treatments like marijuana (yes I went there) isn’t.    I admit there might be medial use for CBD but THC, nope, not. It’s a torpedo.  Never a good idea.  “

The Granny Dr. makes a Cameo appearance with this comment:

All life demands struggle. Those who have everything given to them become lazy, selfish, and insensitive to the real values of life. The very striving and hard work that we so constantly try to avoid is the major building block in the person we are today.”― Pope Paul VI 

This quote from Pope Paul turned on a lightbulb in regards to why many artists eschew antidepressants, even if life is easier with them.

It’s not because of the myth of the “suffering artist” and that misery is necessary for creation.

It is because the struggle with the bipolar nature we are born with is as much a part of artistic development

as the struggle of developing a master’s thesis out of a swirling mass of ideas is to someone attaining a doctorate.

If you pay someone to do it for you, you ain’t learned nothing. And when it’s done, and you’ve learned, it’s over.

Otherwise, it’s never really over, is it?”


Dr. Brilliant Cliché replies:

Within boundaries this is true but can fail as did Rothko and many others in suicide. “Too much of a bad thing is a bad thing.” – Dr. B.C. 2018


About Dr. Brilliant Cliché

Dr. Brilliant Cliché and the Granny Dr. are a fictional web presence and advice blog. Together we offer a joint perspective that is deep but not academic, entertaining but not fluff, and educated yet street smart. By joining the internet community we hope to share thoughts and stimulate insightful conversation around pressing issues that affect us all. Looking forward to hearing your thoughts. (This is not a site for therapy nor does it intend to replace medical or other professional care. ) You can leave comments here or email The Dr. at and don’t forget to like us on facebook. Our facebook page is Dr. Brilliant Cliche
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