听好几个抑郁症学生说过，看病吃药对他们的症状没有多少改善，那些处方药似乎只是把症状临时压制下去，一旦停药就又回到原来的状况，于是都对这些抗抑郁药没什么信心。我于是特意去查了一下相关资料，看看外国心理医生怎么说。
现在疫情快结束了，山水学堂打算带一些学生去美国基地游学，其中可能会有一些少年是抑郁症患者，有可能需要和美国心理医生打交道，才能买到抗抑郁症处方药，大家需要对这些术语有一些了解。
Many antidepressants cause side effects that improve with time. 许多抗抑郁药会导致副作用，但它会慢慢改善。 For example例如， initial side effects when starting an SSRI can include SSRI 疗程开始时的初始副作用可能包括：dry mouth口干, nausea恶心, loose bowel movements腹泻 , headache 头痛and insomnia失眠, but these symptoms usually go away 但这些症状通常会消失 as your body adjusts to the antidepressant 随着你的身体逐渐适应抗抑郁药物.
When to Stop 何时停止用药
Under American Psychiatric Association guidelines根据美国精神病协会的指导方针, if you are taking an antidepressant for your first depressive episode如果你在第一次抑郁症发作时开始服用抗抑郁药， you should stay on it for at least 4 or 5 months after your symptoms of depression stop 那么即使在抑郁症状停止后，你也应该坚持至少4到5个月. Keep in mind 请记住，that you may need to try several different antidepressants to find the right option for you你可能需要尝试几种不同的抗抑郁药来找到适合你的选择, and even then, it can take 2 or 3 weeks to see an initial improvement即便如此，也可能需要2到3周的时间才能看到初步的改善. After that, it can take 3 to 6 months for symptoms to improve to the point that you are no longer depressed之后，症状可能需要3到6个月才能改善到不再抑郁的程度. Altogether, this could mean taking a prescription for about a year to get the full benefits总的来说，这可能意味着需要服用一年左右的处方药，才能获得全部药效.
If you have ongoing major depressive disorder 如果你患有持续性重度抑郁症, or you have had three or more depressive episodes 或者你有过三次或三次以上的抑郁发作, the APA recommends treatment for at least a few years APA建议至少治疗几年. Doctors may also recommend longer treatment when the risk of relapse is high当复发的风险很高时，医生也可能建议延长治疗时间。.
This can depend on a few factors including your: 这取决于几个因素，包括：
- Family history of mental illness精神疾病家族史
- Other long-term medical or mental health problems 其他长期医疗或心理健康问题
- Ongoing symptoms while you’re on medication 服药期间持续出现的症状
- Ongoing stressors, such as trouble sleeping or work or relationship problems 持续的压力源，如睡眠问题、工作或关系问题
“Decide with your doctor what you expect to gain and improve from taking medication 和你的医生一起决定你希望从服用药物中获得和改善什么,” Baron says巴荣医生说. “Poor sleep睡眠不佳、low energy精神不振 and low self-esteem symptoms 和情绪低落灯症状 might respond to medication 可能会对药物产生反应，but antidepressants don’t take care of relationship problems.但抗抑郁药不能解决人际关系问题。”
Antidepressants and risk of suicide 抗抑郁药与自杀风险
Most antidepressants are generally safe大多数抗抑郁药通常是安全的, but the Food and Drug Administration (FDA) requires that all antidepressants carry black box warnings但美国食品和药物管理局（FDA）要求，所有抗抑郁药都用黑盒包装，以示警告, the strictest warnings for prescriptions 这是最严格的处方药警告. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants在某些情况下，儿童、青少年和25岁以下的年轻人在服用抗抑郁药物时可能会有更多的自杀想法或行为, especially in the first few weeks after starting or when the dose is changed 尤其是在开始服药后的前几周，或在剂量改变时.
Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior任何服用抗抑郁药的人都应该密切关注抑郁症恶化或异常行为. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help 如果你或你认识的人在服用抗抑郁药时有自杀念头，请立即联系你的医生，或寻求紧急帮助.
Keep in mind 不过请记住，that antidepressants are more likely to reduce suicide risk抗抑郁药更有可能降低自杀风险 in the long run 从长远来看，by improving mood通过改善情绪。
