I was diagnosed with BPD 18 years ago as a teenage. Spent my whole life fighting BPD. I suffered severe depression and mental disorder. Not until my mom recommended me to psilocybin mushrooms treatment. Psilocybin treatment saved my life honestly. 8 years totally clean. Never thought I would be saying this about mushrooms.

I have never watched anyone who can explain things as well as you do, Dr. Marks. You are so thorough and go into such depth and yet you can still make all the complicated, scientific information easy for us to understand. Thank you.

There is no hell like the human mind. Is an understatement. If you get help from a doctor you're one in a million or you just thought you had a problem.

Wellbutrin was the one that made a difference for me. I can actually wake up in the morning, ready to start my day and actually enjoy my day without brain fog, constant tiredness, and I'm not cynical and depressed anymore. Finally. It's a shame that it took me until almost age 30 to feel normal. I still have my not-so-great days, but at least I can feel just okay again, content. That's all I need.

My sertraline dose for anxiety was recently doubled from 50 to 100mg. What a difference! After only four weeks I actually noticed I was at peace and happy for a change. The side effects are a little severe, but it's worth it for me to finally feel this way after a couple of decades of living in constant fear, worry, overthinking and perfectionism. Don't be afraid to let your doctor determine what's best. Sometimes it really works.

Right on the money! My dose of Wellbutrin was increased this week, and already I feel less foggy, less numb. I actually can say that this morning I felt joy. Yes, there is a lot of snow outside, but the sun is out. Yes, it is bitter cold, but the sun feels nice coming through the window. I am on so many medications that I ask my doctor each time to review them, this time I don't care so much for these pills whereas before I would not want anyone to know. She also prescribed me Rexulti and that made another positive change. I really feel better than two months ago, for instance. So slowly but surely the ship is coming around.

I have struggled with mental illness and my mental health since I was a kid. Before I even knew what those terms were. After years of depression, anxiety, and even an attempt to take my life, I never thought I would be able to live without psych medications. I clung to them because it was the only thing that made my mind quiet, but it also made me a zombie. Microdosing has given me control of my mental health for the first time, and they essentially gave me my life back.

It puts you into a state where nothing matters in a good way. You truly don't give a shit about anything and you're just happy as fuck as a result, because nothing matters. Nothing matters, nothing means anything, there's nothing to do, there's no point, there's no goal but there's also no boredom, there's no negative meanings attached to the meaninglessness, it's just perfectly meaningless and it's awesome. You're basically just like sitting like a cat on a windowsill enjoying whatever experience is before it, just being and it feels amazing. 🦄

Thanks, doctor. I don't remember anyone ever discussing how you're supposed to feel on antidepressants. I think a lot of patients have unrealistic expectations and therefor, stop taking their meds.

The story of my life. After the military I lost all motivation and happiness. I'm fighting to get it back but it's a very slow process and an up and down process with the utilization of medication.

God bless you guys😁 We will all get through this anxiety/depression ❤️

The numbness was too much for me. It does a number on relationships. You become indifferent to anyone and everything. What really did it for me was being in dangerous situations and feeling zero fear. It made me understand how people can do messed up things while taking theses medications.

The way i interpret is that depression is having needs and desires that you believe or feel you can't meet, and feel unsupported to get those needs and desires met. (desires such as wanting to feel loved or valued, or have friends, or just not be ignored and neglected) The harder the pull of "wanting" to meet those needs, the worse the depression feels. Basically, the belief that you can't meet those needs is like a chasm in between you and the thing you desire. The meds decrease the pull of the desires. It makes you not care or want the desires anymore, or think that it's that important. That's the "Numb/Zombie" feeling. Blunting desires. But then... you can tell it's blunted, and also doesn't feel good or normal. The meds can also make it easier to distract yourself from what your true wants are. I know my depression comes from mere neglect. I used to think my depression was so random, and until I understood that my "Depression only goes away sometimes" because I find ways to distract myself, until that distraction is used up, and I have to find another one, and finding another distraction isn't always practical. I have to sit around, feel depressed, and wait for one to become available. Hence, the random.

The edits on your videos have some details that crack me up. Like the b&w image of you in your residency, 24 years ago.

I so wish that this was common knowledge among prescribers. The more I more I complained about the not feeling good the more the SSRI’s were increased. And was added max Wellbrutrin. Was never asked if I was numb. Patient reported outcomes needs to be a standard tool. The regular questionaries do not bring this up.

I have been taking a SSRI since I had my residency training. I love this short video. Thank you.

thank you so much for using generic names alongside brand names for medication. as a european viewer, this makes it much easier to follow along and understand what we're talking about. in general, thank you so much for all the work you do on education and raising awareness around mental health conditions and treatments!

Numbness/anhedonia/apathy are both effects of my depression and side effects I experience on certain antidepressants. I’m using Wellbutrin now, and I definitely feel less “grey” than I used to

I require my clients to watch your videos prior to their appointment because I want them to be educated about their illness. Thank you for these videos!💕💚💕

I prefer numbness over struggling. However, the numbness is not so severe after a few weeks, you just feel a little less than the normal, so that you can cope with everyday stress.

I've been on Wellbutrin for quite some time and I recently stopped taking it and my anti-anxiety med and I can say for a fact that Wellbutrin ABSOLUTELY still makes you feel unmotivated, at least for me. After being off it, I may have feelings of laziness but I can much more easily push myself into a momentum of getting started and continuing getting things done on most days as opposed to feeling like I need a crane to get going and then it's like pushing a boulder up a hill all day. The important thing to remember with meds is that they have a generalized INTENDED affect, but that affect may be different in different people; all people's reactions to meds may vary slightly.

Thank you for sharing this. Hopefully it will help many people develop more realistic expectations about antidepressants. There's still so much stigma and misunderstanding.

Thank you Dr. Marks. Your explanations are so clear and extremely helpful. I sincerely appreciate your videos ❤

I've tried SOOO many anti-depressants. I'm on Viibryd now and it is the first one that has made a difference. I had a genetic test done and it says I will only partially respond to SSRI's and I need to be on a low dose. This is also true for my ADHD med. It still shocks my Psych dr that I can't be on a dose higher than 10mg.

I chuckled at the use of black and white footage at "residency training 24 years ago." It's amazing how much has changed AND not changed in the field of psychiatry in those 24 years.

Wellbuterin definitely made me feel better already on day 3. Actually better, not placebo

Dr. Marks, Thank you so much for this video! I just realized that my experience with SSRIs is related largely to apathy rather than a lack of depression or increase in happiness. I’ve tried very many meds (at least 4 or 5) and the one I stuck with is Lexapro. It is the only one that does anything at all, but what it does is make me numb. In bouts of depression, I don’t go as low, but I also just don’t experience the joys of life anymore. 😢 I might as my psychiatrist about what he thinks about possibly reducing my dose of SSRI and adding in Wellbutrin again so I have kind of a joint effect. We’ll see! Wish me luck!

I'm a new psychiatrist. And I'll say this video was more helpful than anything I ever learned in school or in medical conferences.

This video was exceptionally informative for me.. now I am able to understand my doctor's treatment plan better and I am more confident that he is treating me correctly.. 😅

This was the best explanation of how antidepressants work and how we may feel when starting that I have ever seen. Thanks Dr Marks!❤

I wouldn't say I feel numb. I'd definitely say that my emotions feel quieter, but that's exactly what I wanted. I mostly started them for anxiety with depression, and it feels like it turned down the volume of those thoughts to a more normal level. The only point at which I felt "numb" was shortly after beginning them, I think because I was so used to feeling intense negative feelings that having those gone did feel "numb" in comparison. I don't think my ability to feel joy has been affected, I feel excited to see people I love and for making delicious meals and feeding the birds, though one thing I would say I don't do as much is laughing. I feel a lot more chill and peaceful. I realised last month when I had a progress meeting that in the past I might've got a lot more anxious about that meeting. It was really nice to be able to get on with preparing for it and not being distracted by the horrible physical side effects.

I never experienced the numbness and lack of motivation or emotional problems. Ssris have always been a silver bullet for me. There is a dampner on tears but feeling joy and motivation is no issue.

When your dose is just right you won't notice anything at all. You'll notice a gradual improvement after two months. It's not magic, and unrealistic expectations are why people stop taking their meds. The only exception that comes to mind is Wellbutrin. I took it for depression, and stopped smoking without even trying.

Thank you for explaining this in a way that no one else has! This makes a lot more sense now

Antidepressants and counseling make life bearable most of the time for me. I still have periods of crippling depression. It's an endless cycle. I'm 55 and I'm fucking tired of it.

I appreciate your knowledge and great presentation. Thankyou!

I know it probably sounds redundant to you, but you're an absolute Godsend! ❤ Your videos are very informative, and help many through their most difficult times! Thank you❤

My depression is the numbness without medication

Thank you, doc. We love, appreciate, and need you in this space!

Another incredibly helpful video Dr. Marks! Anything that helps me to evaluate my emotions and feelings critically is amazing! Thank you again!

Thank you for this great video. I am struggling with the numb feeling. The first few months of meds was great but now I feel numbness and wanting to cry but not tears or energy to cry..

Thank you for this video! It was very helpful. I feel like this explanation should be mandatory when prescribing.

In the early part of the video, it's mentioned that the suppression of dopamine can lead to apathy and reduced emotional reactivity. I experienced something like this multiple times when I was prescribed ADHD medications. It would start out fine at first, even great, but then about 2 weeks into treatment, I would become apathetic and lose empathy for my child and anyone else. Also having short-fused angry outbursts when things didn't go as quickly as I felt they should. The first time I took Vyvanse, I actually had to have a mental conversation with myself to smile back at people. Every time I discussed my responses to medications, therapists always seemed perplexed, like they had never heard of anyone responding like that. If someone with ADHD has low dopamine reserves, making it difficult to push through low-dopamine producing tasks, and then takes a medication that makes them use up all of the dopamine reserves, it makes sense that they would have a response like I did. I'm not sure why the therapists understand the symptoms from taking antidepressants, but not ADHD medications. Realizing that the trade offs weren't worth it for me, I stopped taking ADHD medications over 11 years ago.

Celexa made me feel apathy for a few weeks and then I felt better. We added Wellbutrin to the mix and I feel great.

Thank you so much for these educational videos Dr. Marks. You are a rare gem to us out here in KZfaqland.

I have had INCREDIBLE results from a combination of Nortriptyline 75 mg and Adderall XR 25 mg for the treatment of severe treatment resistant depression! Tricyclics can be very beneficial for this form of depression!

This is how I feel on a normal basis. Wellbutrin really helps with that. This video was well explained.

I like to say that taking Prozac means that I start everyday on a 5 out of 10 mood, compared to a 3 out of 10 mood without it, giving me a better starting point for doing things throughout the day to let myself get to at least a 7 out of ten and feel vaguely content.

Dr. Marks what causes the night terrors associated with these medications? I felt like my dreams were screaming at me when I took AD’s for a time. Thank you for all the information and support 💜

2:50 you’re wrong, there is a med that makes you “zone out and check back in when ready to” I know this because I take it. It got me through my husband leaving me after 20 years together. If it weren’t for this med then I would not probably be alive right now

It's such an empowering feeling to know that I'm NOT supposed to feel numb. Feelings like this is what's kept me from adhering to medication or trying new ones. Thank you for this video. Quick question. I was recommended a very small dose of an antipsychotic called Quetiapine to help manage my overall depression and severe anxiety. (The doctor I consulted with was resistant to giving me conventional benzodiazepines). If I chose to follow this treatment I understand numbness and apathy could be a potential side effect even at a low dose. Is this still considered a side effect and NOT a therapeutic effect with antipsychotics as opposed to antidepressants?

I love your videos and the information you include in them. Been very helpful for me going through my own challenges

I started taking paxil at 15 years old for social anxiety disorder at 20 mg . I didn't understand why I was getting prescribed an anti depressant when I was really not depressed, I was living in fear everyday, not depressed. I thought that might cause problems and later in life it really did. I went from 20 mg to the maximum dose, 60 mg, later in my life. I am 37 now and In the last year, i very slowly, which is really important if withrawing, went down from 60 mg to 20 mg and I will eventually stop it for good, which I thought I would never be able to do because everytime I tried to quit, it was just getting worse. I tried quitting for years but trying to quit cold turkey or too fast is 1 of the worst nightmares I went through. I also learned that eating and digesting food creates serotonin and a problem that I had for years was eating before I was going to bed, also with only having moved around very little all day, which logicaly made me understand that I wouldn't digest a lot at night, then I wouldn't be hungry during the day so I wouldn't eat during the day, so I wouldn't secrete serotonin during the day, so I would have no energy, I didn't even have the energy to take my shower. Not spending energy during the day made me sleepless at night and eating before going to bed made the cycle keep going. Leave yourself 3 to 4 hours to digest before going to bed is best and whether it's best for you to take your meds earlier or later during the day, the most important is to take them at the same time everyday to avoid an imbalance which is 1 if not the main reason to take ssri's. Taking paxil really helped me, even saved my life. It blocked a lot of my fears but also took away a lot of my emotions which I figured out, had everything to do with my motivation. To me, taking paxil was lifes way of helping me confront my fears and stop me from ruining my life and others with my irresponsible behaviors. I hope with all my heart that my experiences will help you and others. Thank you so much for taking the time to have read my book of a comment lol

Excellent to see you back Doctor.... 😊😊😊😊😊😊

I didn’t ask for a coast but a help through and my doctor did just that. The people I know on antidepressants no longer care about things they used to. It’s sad to watch. Even worse after dose increases.

I’d love to learn about what the signs are when the medication should have the dosage reduced.

Thank you very much for this valueable information Dr.❤❤

Thank you Dr. Marks. Please continue to make more content like this on how meds work, also cannabis and how cbd might work.

Thank you so much for your explanations. I learn something helpful every time you post. It’s especially reassuring to learn about current and ongoing clinical research into treatments for depression/anxiety and is most helpful when monitoring one’s own treatment responses and expectations.

Incredibly helpful. I love learning about the brain chemistry behind these meds. Thank you!

Happy New Year Dr. Marks- thanks so very much for all you do- you help people and have helped me so very much- take care and God bless!😀

I took escitalophram for almost 2 years. i felt weak, tired, no libido at all, and yes sometimes i feel numb.😢😢😢

Thank you kindly Dr. Marks, this video has been helpful beyond words. In the grand scheme of things it might not change the price of eggs, but knowing your landscape can go a very long way.

Once I was depressed and my psychiatrist gave me Seroxat, I believe another name of that medicine is Sertraline, 50 mg, which is a selective serotonin reuptake inhibitor and she said that it will take a few weeks until I start feeling something. I was taking that medication for one year and I felt nothing. Maybe that is the idea, I am not sure, but because my depression was caused by something real, some bad thing happening in my life which solved itself after one year, after that I stopped taking that medication because I saw no reason to take something that probably was not working... In any case, I was not in such a stressful situation and my doctor agreed that I should stop taking Seroxat.

Im treatment resistant, so ive tried over 20 medications and other fun treatments like Ketamine and ECT. Still i struggle everyday. Id rather be numb than suicidal. By the way, I like your hair.

I don’t feel happier that’s for sure

Thank you, Tracy! This was a very enlightening presentation and very useful indeed!

Thank you for your work, Doctor. Greetings from Rome, Italy. ❤

Brava Dr. Marks! Great explanation of a difficult subject.

This video was EVERYTHING! thank you so much for creating this. Super helpful

She pronounces it as BupropRion. There's no second R in the name but for some reason i've pronounced it that way too.

Good Evening, yup it's nice information and learning about positive psychology. Very give me new knowledge. Thanks You very much.

I learned the hardway recently. I wasnt sure if my antidepressants were really working after about a year of being on them. I went off of them (after talking with my PCP and therapist) and it was fine for about 4-5 weeks but then I couldnt get out of bed, my hygiene wasnt really existent and it led me to stop taking my adhd meds. I ended up failing a lot of my classes and as soon as I started taking my meds again I felt an immediate difference. I appreciate you and your vids, Dr. Tracy!

Interesting video. I have mostly taken antidepressants for their side effect, sleeplessness, as I struggle with insomnia and doctors usually consider these drugs safe/none addictive. That they are considered safe has always made me wonder, as they are the medication that seems to alter the way I feel the most. The side effect of sleeplessness and huge appetite seems to affect me after the first days. I have probably only seen the "worst" side of antidepressants but it is a bit concerning that we do not know exactly how the medicine works or how it affects us.

Wow, very informative Thank you Dr Marks

Love how your detailed analysis.

I’m afraid I will never be the same person again! I just had a baby 7 months ago every day I’m feeling severely depressed I’m on abilify but not sure if it’s working. I’m giving up on life. I’ve been feeling so dissociated disconnected from myself, and life.. feels like I’m living in a bubble and I can’t feel anything.. I can’t even enjoy my baby. I’m not here at all!

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Amazing video doctor. Thanks so much. We love you.

Always appreciate your content.

I'm not making a suggestion. I'm not a doctor. My experience taking an antidepressant after going through different ones till we found one that worked for me, was that it "took the fire away" from my anger, and I felt like the weight of stress had lifted. I was able to acknowledge things would anger me or would have bothered me, but they seemed to not bother me. I was still capable of feeling emotion, but it reduced highs and lows. My mother stated she didn't like when I was on them because she described me as seeming more zombie like, but I didn't feel that way. I was happy and after coming off I still feel it was a better time for me. My only issue was sleep issues and I had to come off because I slept walked regularly on sleep medicines and it scared me (my sleep walk self was like a five year old... Not me. That scared me because I couldn't control what the "other person" was doing). When I was a kid I took Imipramine for ADD. I was highly functional. I don't know what my side effects were though because I was too young to pay attention to them and understand what was out of norm. I believe a doctor should try different things. If they only start one need then just up dosage and don't try different things, for me, that's a red flag... But I'm no doctor. I just know what my experiences are.

I felt a decrease in anxiety (together with some degree of sedation as a side effect) immediately after starting sertraline and subsequently after each dose increase but it weaned after a few days. I felt it was way too strong to be considered a placebo effect.

I wish you were my therapist!

When I tried taking Lexapro, the first day was always me being slightly hyper and then the next few times I took it I was numb (which will forever be an issue for me) I stopped taking it when I was trying to get rid of the numbness by self harm. I was already taking a bunch of meds because of epilepsy, I didn’t want a med that’ll hurt me more Nice to know why, thanks Doctor Tracey

Makes sense as to why I got better when starting Bupropion! I got diagnosed with ADHD this year, which means my levels of dopamine were probably low to begin with, so taking all those SSRIs on their own was likely not going to help me get better. Is that something that you see in your practice? SSRIs not working as well for patients with both depression and ADHD?

Taking mine at night before bed was a game changer for me

Well thank you for the informative my beautiful Doctor.

Can you please do a similar video on antipsychotic medication to treat bipolar disorder ?

I need a new psychiatrist. She said oh that's good when I said I felt numb or emotional less on lithium. This video confirms its a side effect and not therapeutic

All right, I got a notice on this one.

We love you doc❤

Seroquel makes you zone out

Can you talk about limerance and how to heal or treat it ?

I get severe akathisia, psychotic symptoms and false memories each time I try to take any AD.

Im on Celexa. Have been for awhile. Bfore I was on it, I cried Constantly. Now I cant cry. Im not numb. It just helps me not cry.

Thanks for letting me know I’ll never get fully better

They gave me an antidepressant for my insomnia and felt like a robot and it was amazing i must admitt

Wellbutrin was the first one I was put on. I completely lost my appetite while I was on it. I lost 12 pounds in about a month because I couldn't force myself to eat because of the Wellbutrin. Luckily it didn't give me night terrors, but it did for every one of my friends that have tried it.

I felt amazing, on top of the worldm the best ever

Thank you. You've answered many questions.