Why I gave taking antidepressants a second chance with NMOSD

Note: This column describes the author’s own experiences with antidepressants. Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

After realizing recently that I should have been more upset about various life situations, I had to reconsider the benefits and drawbacks of continuing the antidepressant I was on. It had dulled my emotions so much that my reactions to events felt unrecognizable. This wasn’t my first attempt at taking this medication, and the reasons I returned to it — and ultimately discontinued it again — are worth reflection.

The first time I tried the antidepressant was years ago, after an honest conversation with my primary care doctor about how I was coping with neuromyelitis optica spectrum disorder (NMOSD). Even though I didn’t feel depressed, he thought the medication might help. I gave it a fair try, but after a couple of months, I felt flat, like my emotions were stuck in neutral — a permanent “meh” mode — so I stopped.

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Over the years, I’ve learned that bodies change, and so does NMOSD. It only makes sense, then, that how we respond to treatments also evolves. When I started prednisone during my first year managing NMOSD, the side effects were brutal: weight gain, mood swings, and temper tantrums. But with time, my body has adjusted.

Now, when I’m required to take prednisone, I still experience some side effects, but they’re easier to manage. That experience showed me that just because a treatment doesn’t work at one point doesn’t mean it won’t help later.

Trying a treatment again

That’s why, during this past year filled with NMOSD relapses, I was more open when my specialist suggested trying an antidepressant again. This time, the reasoning was different: not just for mood, but because certain antidepressants can also help with pain management, something I was desperate to find support for. Between the stress of ongoing relapses and the return of more chronic pain, I decided it was worth another try.

This wasn’t just about adding another medication to my regimen. It was about recognizing that treatment decisions aren’t fixed. They shift as our conditions, bodies, and needs change. Sometimes, revisiting a therapy can make all the difference, even when it didn’t seem like the right fit before.

Unfortunately, my body had the same reaction, or lack thereof, on the antidepressant. Moreover, I didn’t see an improvement in my pain levels, so I opted out of yet another handful of pills every day. But I don’t regret trying the treatment again. If it had worked for pain management, the relief couldn’t have come soon enough.

Like many people with chronic illnesses, I live with a growing list of prescriptions and supplements. Taking medication becomes part of the daily rhythm of life, but it can also be overwhelming. Each new pill comes with the weight of responsibility: remembering the timing, tracking the side effects, hoping it delivers the promised relief. Over time, this can add up to what’s often called “pill fatigue” — the mental and emotional exhaustion of constantly managing medication. For me, saying no to one more treatment felt like reclaiming a small piece of control.

Another challenge with treatments like antidepressants is that it can be hard to tell what’s really happening inside. Am I genuinely feeling better, or am I simply feeling less? Am I calmer because the medication is working or because it’s numbing me? Self-monitoring becomes essential.

I’ve found journaling to be a surprisingly effective tool; it was how I recognized that the antidepressant wasn’t effective in my pain management. By writing down not only what I’m taking, but also how I’m feeling day to day, I can see patterns more clearly. It helps me separate the temporary side effects from the long-term impact and gives me something concrete to share with my doctors. Most importantly, it helps me stay in tune with myself amid all the noise of a rare disease.

Living with NMOSD has taught me that treatment is rarely a straight path; rather, it’s a journey of trial, error, learning, and adjustment. I can’t stress enough that these decisions should never be made in isolation. Always consult with your doctors, share what you’re noticing, and lean on their expertise to guide the way forward.

While self-awareness is powerful, partnership with your care team is what truly turns reflection into progress. What didn’t serve me years ago sometimes deserves a second look, and what doesn’t fit now might make sense in the future. The key is to stay curious, reflective, and open to change.

Note: Neuromyelitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Neuromyelitis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to neuromyelitis optica spectrum disorder.