‘Vanderpump Rules’ Star Scheana Shay’s Antidepressant Experience Is Super Relatable for This 1 Reason

Reality TV star Scheana Shay is no stranger to getting candid about her life on a public platform. The Vanderpump Rules alum has talked about relationships, career shifts, and more on the hit show, but now, she's turning toward her mental health. In the latest episode of her podcast, Scheananigans, Shay reveals that she’s been living with depression for the past six months. 

“It was something that I kept trying to just mask and say, 'No, I’m fine. It’ll go away,'” Shay said on the episode. She went on to say that her depressive symptoms began while on the competition show The Masked Singer, which she was hesitant to join to begin with. Being sent home from the competition right away also took an emotional toll.

At first, Shay suspected her antidepressant medication was the reason behind her mood. Because of this, she started adjusting the dose that she was taking. "I was just like, 'Maybe I up my meds a little bit,'" she said. "But then I started grinding my teeth a lot at night. So I'm like 'No, I'll just go back to, like, 25 milligrams.' As if that's enough Zoloft for anyone: It's not," she added.

Thankfully, during these fluctuations, Shay was able to talk to her psychiatrist and therapist to help navigate through it. She learned that a lower dose of her antidepressant—a selective serotonin reuptake inhibitor (SSRI) called Zoloft or Sertaline generically—wasn't right for her, noting that she's now taking a 75-milligram dose and is "considering 100 milligrams," she said. (For context, the maximum recommended dosage of Zoloft for major depressive disorder is 150-200 milligrams.¹)

And while Shay stressed that her life is currently “great,” she added that it hasn't necessarily been so mentally. “I just wanted to open up about that because I feel like you could have everything in the world and still not always feel completely happy,” she said. “I just wanted to normalize it.”

Questioning your antidepressant dosage is not rare. "This is something a lot of people on antidepressants wonder about,” says Thea Gallagher, PsyD, a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast. But it's important to remember that finding the right dose for you can take some time.

Want to know whether you need a med adjustment? Here are some signs to help you figure it out, plus when to know it's time to talk with your healthcare provider about making the switch (because it's not recommended to do it on your own).

Why does your antidepressant dose need to be adjusted sometimes?

There are a few reasons for this. For one, most people begin taking antidepressants on what's called a “starter dose” to get their body used to it, Dr. Gallagher says. “You see how you tolerate the medication,” she adds. “But it’s very normal for people to need to go up on their medication once they get used to it,” she says.

Some people might also have reservations about taking antidepressants at first due to societal stigma, which can cause them to start on a lower-than-needed dose, Dr. Gallagher says. “People may get nervous and decide to use a low dose. That’s why it’s really important to work with someone who specializes in these medications and prescribing them," she adds. Not only can they prescribe the proper dosage for you, but they can also help weigh out the pros and cons of certain types of medication, and calm and fears or concerns you may have.

Lastly, Dr. Gallagher adds that it's fairly common to need to tweak your dosage or even the type of medication you take over time, especially if you find one is no longer working for you.² While the medical research is mixed, anecdotal evidence has pointed to some antidepressant medications losing their efficacy over time.³

3 signs you may need to adjust your antidepressant dose

It can be surprisingly tricky to figure out of if you need a dosage adjustment on your own. “Depression is really good at convincing us that it’s coming back and that you don’t have the ability to handle it,” says Aaron Brinen, PsyD, an assistant professor of psychiatry and behavioral sciences at Vanderbilt University Medical Center. That’s why conversations with your healthcare providers—whether a primary-care physician, psychiatrist (who prescribes the medications), or psychologist (who typically leads therapy sessions), are crucial. “It’s a team effort,” he adds.

If you already take an antidepressant for mental health conditions such as depression or anxiety, here are some signs that you might need to check in with your providers about adjusting your dose.

1. The strategies you learned in therapy aren’t helping.

Most providers usually recommend that people on antidepressants also go through regular therapy, Dr. Brinen points out. “The medication serves a role in creating a space for a person to get back to the life that they want, but it’s what the individual then does with using a set of skills they learn in therapy that helps,” he says. 

Dr. Gallagher agrees: “Some people may see an increase in their symptoms, but they don’t have any skills or tools to manage them,” she says. “It’s important to make sure you’re getting some kind of therapy, too.” If you’re noticing unwanted symptoms and your therapy skills aren’t helping, Dr. Gallagher says you may need a higher dose of your medication.

2. Your symptoms have gotten worse—and they’re sticking around.

It’s possible that your antidepressant worked for a little while at a lower dose, but that you still haven’t hit your "sweet spot," Dr. Gallagher says. “Some people may experience a significant benefit at first, and then the symptoms creep in. That doesn’t mean it’s not working anymore; You just may need to be on a more therapeutic dose," she adds.

These worsening symptoms (like low energy, low mood or motivation, changes in appetite, anxiety symptoms, etc.) can come on gradually or they can be dramatic, Dr. Gallagher says. So, “it’s important to monitor your symptoms and how you’re feeling in your life,” she says. 

3. You’re having a difficult time completing daily tasks.

“The question of adjusting the medications comes in when a person can’t rally and the depression is impairing their quality of life,” Dr. Brinen says. This may include things like feeling unable to get out of bed in the morning or having trouble sticking to your normal daily routines, he adds. “In that situation, there’s no way to apply skills learned in therapy because the depression is impairing their life,” he points out, which may be an indication that you need a medication adjustment. 

How to tell these apart from ‘regular’ emotions

Dr. Brinen stresses that just because you're taking antidepressants, doesn’t mean you won’t feel down at times or have hard days. “We don’t want to mistake 'normal' human feelings for symptoms of depression,” he adds. “People can get really scared that the symptoms are coming back, but you might feel sad because something sad is happening [in life], or anxious because something stressful is happening.” Though, again, this can be difficult to differentiate without a trusted support system of loved ones or mental health experts.

Ultimately, if you notice a change in your mental health status and you’re not sure what’s behind it, it’s important to flag it to your healthcare team. “Work closely with your doctor,” Dr. Gallagher says. “You may need to adjust your dosage or you may not, but it’s important to speak up.” This is how Shay found what works best for her mental health.

Additionally, it's important to recognize that antidepressant medication may not be right for everyone and their body. An adverse reaction (like worsening mood) could be a sign that you need to try a completely different medication or an alternate treatment approach. If you think this is your situation, don't stop taking your medication until you get the "okay" from your healthcare provider. They can help you slowly and properly come off the medication to avoid side effects like headaches, nausea, or discontinuation syndrome (i.e., withdrawals from antidepressant medications).⁴

If you or someone you know is dealing with a mental health condition, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or go to FindTreatment.gov for resources and treatment options. If you’re having thoughts of harming yourself or others, call or text 988 for the Suicide & Crisis Lifeline.