I have discussed this subject often in articles and on forums but I want to say, as I always do, that antidepressants are greatly helpful to many people and in fact have probably been lifesavers for many as well.

One disease that commonly causes anxiety and depression as part of the symptoms, is thyroid disease that results in hyperthyroidism (over-active) or hypothyroidism (under-active) plus there are other diseases that cause emotional symptoms as well.

I believe if a thyroid patient is on adequate treatment/hormone therapy but still needs the added help of antidepressant, there is nothing at all wrong with this! Having said this, let me now point out problems I see with Doctors who do not first give thyroid hormone replacement time to work, before adding an antidepressant to a patient's treatment. Certainly Thyroid HRT (thyroid hormone therapy) has the potential to relieve symptoms greatly. I'll say in my case, the emotional symptoms of anxiety and depression, were the ones helped the most, when I was treated for thyroid and this alone was a great accomplishment for me.

What was not good in my case and that of many others, is that I was originally "diagnosed" with emotional-only problems and the thyroid disease was not blood-tested for. Because of this, my fatigue, joint pain, dry skin, etc...., did not improve on the antidepressant alone but actually worsened. This combined with the side effects, caused me to get off the SSRI antidepressant and in the mean time, blood tests I demanded and had blood drawn for, just prior to starting the mood drug, revealed thyroid disease, including hypothyroidism and highly elevated thyroid antibody levels.

The problem I saw in my GP pushing constantly for me to resume the antidepressant, along with my thyroid med, was that there was the potential for me to confuse the SSRI side-effects, with unrelieved thyroid symptoms. The side-effects after all, include those identical to hypothyroidism/thyroid disease; "fatigue, tremor, nervousness, lightheadedness etc...".

In my opinion, thyroid disease symptoms, including depression/anxiety, should be monitored with hormone treatment, to see how much they improve and if they do not begin improving after a few weeks, an SSRI and other medications, such as those for muscle/joint aches etc..., can be added. I believe if anxiety and/or depression is thyroid disease related, obviously hormone replacement has even more potential to improve it, than an antidepressant does.

Another problem, is "withdrawal". Patients who have been on an antidepressant, will experience a worsening of the emotional symptoms, plus other withdrawal symptoms, when coming off an antidepressant and they will mistakenly believe this means the emotional symptoms are severe without the SSRI, when in reality, this is a common reaction (worsening emotions) when tapering off one.

If a patient, with Dr. supervision, decides to taper off an antidepressant, it must be done very slowly, with withdrawal symptoms monitored closely because some patients actually have become suicidal from withdrawal. while others don't have as difficult a time.

If a patient does not have a problem with the possibility of needing antidepressants as lifelong treatment and they do indeed need the drug (and many do), then they should make the decision to remain on them as long as is necessary but if at some point they want to wean off, it should be done slowly and very cautiously and never without the supervision a Doctor.

While antidepressant medications are very helpful and necessary under the right conditions, consideration should also be given to the possibility of underlying medical causes of emotional symptoms that must also be diagnosed and treated, with adequate time for disease-treatment to resolve symptoms.