Picture this: For the past two weeks you have felt continuously dejected. You have lost interest in what normally makes you happy. Perhaps you’ve slept poorly or lost your appetite. There is a risk that you have one of the most common maladies in the world: Depression.

You decide to see a doctor. She considers different treatments and finally she gives you a prescription for a small box of antidepressants. Whether they will help you is unclear. Some patients report an effect after two or three weeks, others don’t notice any change at all. Some even get even more depressed.

More depressed? If it is actually a healthy person who doesn't have clinical depression, it's certainly possible. 

What is known is that after a pill has been swallowed, the human body does begin to react - and that may take psychology treatment out of symptom-based diagnosis and trial and error solutions and into the 21st century.

An immediate effect

The use of antidepressants has surged across developed countries over the past decade, according to Organisation for Economic Co-operation and Development figures. Doctors in some countries write prescriptions for more than one in ten adults, with Iceland, Australia, Canada and the European Nordic countries topping the list. There are concerns that pills are being over-prescribed.

A team in the Department of Psychology at University of Oslo wanted to test antidepressants in a new way. Instead of asking patients which effect they experience, which is a common method in studies performed by the industry, they gave a group of healthy, young women a single dose of the antidepressant citalopram. Then they studied how this dose affected the women’s eye movements.  The women were presented photos of neutral human faces on a computer screen. Below the screen an eye tracker registered the reflection of light from the women’s eyes. The eye tracker could measure the exact eye movements of the women.

“Some of those that take the medication seem to look away from other people’s eyes. This effect occurs quite immediately,” says Dr. Rune Jonassen, a postdoctoral fellow at the Department of Psychology.

For healthy women, an antidepressant created symptoms of anxiety

What does it mean when our eyes avoid other peoples’ eyes? Earlier research has pointed to this being a sign of anxiety and unrest. Usually we first look at other people’s eyes, then their nose and mouth, to register moods and feelings. If we are restless or anxious, we might subconsciously avoid eye contact.

“Several women had a reaction that reminded us of such an anxiety effect. We didn’t see the same reaction in the control group. It is well known that antidepressants can give a feeling of unrest in the first period of use. Previously branded a side effect, it now rather looks like a part of the actual effect of the medications,” Jonassen said.

The researchers believe that this subconscious tendency to avoid other people’s eyes remains during the treatment, and that this can get us thinking along different lines. We avoid observing the uncomfortable.

”Many people on antidepressants explain that their emotions become flatter. Our findings support this. Antidepressants don’t seem to change the mood directly, instead they seem to change what we notice in our surroundings.”

For actual depressed people this can be a favorable effect, but if antidepressants are over-prescribed...

“Depression is characterized by getting stuck in negative thinking patterns. Antidepressants may help us to break these patterns. They seem to make us more flexible.”

Even though there was a significant difference between the group of women who received the medications and those that didn’t, there were also large differences inside the groups. Not all that received the medications changed the way they looked at human faces.

“Using one kind of treatment for all patients may be a dead end,” Jonassen said.

The study was conducted at Clinical Neuroscience Research Group, led by professor Nils Inge Landrø and the data was collected by students at the Department of Psychology, University of Oslo. 

Citation: A single dose of antidepressant alters eye-gaze patterns across face stimuli in healthy women. R. Jonassen, O. Chelnokova, C. Harmer, S. Leknes og N. I. Landrø (2014) Psychopharmacology