Depression and anxiety treatment begins first with recognizing if you have symptoms. Both often appear as physical symptoms, some of which are similar to those seen in migraine. For example, problems with sleep and appetite changes, being easily upset, trouble concentrating, and low energy are all symptoms of migraine, depression, and anxiety. As a result, it is better to pay attention to thoughts and feelings. Depression usually involves strong feelings of sadness or hopelessness that last two weeks or more. Some migraine patients who are depressed do not feel sad or down, but are simply not as interested in activities that they normally enjoy. Others include feeling worthless, guilty, or thoughts of suicide.
Self-help—For mild depression, or when moderate or severe depression begins to improve with other treatments, there are some things you can do on your own to help keep you feeling better. Regular exercise, eating well, managing stress, spending time with friends and family, spirituality, and monitoring your use of alcohol and other drugs can help keep depression from getting worse or coming back. Talking to your doctor, asking questions, and feeling in charge of your own health are also very important. Always talk to your doctor about what you’re doing on your own.
"Even more than the depression, it was my anxiety and agitation that became the defining symptoms of my illness. Like epileptic seizures, a series of frenzied anxiety attacks would descend upon me without warning. My body was possessed by a chaotic, demonic force which led to my shaking, pacing and violently hitting myself across the chest or in the head. This self-flagellation seemed to provide a physical outlet for my invisible torment, as if I were letting steam out of a pressure cooker." ~ Douglas Bloch, M.A., author of "Healing From Depression"

355 million people are affected by depression, making it one of the most common disorders in the world. Over 40 million American adults are affected by anxiety, making anxiety disorders the most common mental health conditions in the United States. At McLean Hospital, we are committed to providing support for individuals with depression and anxiety through world-class treatment, innovative research into causes and cures, and robust education for patients and families, clinicians, and the broader community.

The ADAA 2020 40th Annual Conference (March 19-22, San Antonio, Texas) will bring together clinicians and researchers who want to improve treatments and find cures for anxiety, depression and related disorders. Join more than 1,400 peers from across the US and around the world. Connect, share and collaborate. Choose from 160+ sessions, hear engaging keynotes, learn about cutting-edge thinking in research and clinical practice, and earn continuing education credits (CEs and CMEs). Find your professional home and leave more connected to your peers, and better able to integrate research, practice, and community. #ADAA2020
Anxiety disorders involve more than common nervousness and worry. They can cause terrifying fear about things other people wouldn’t think twice about. Many people with anxiety disorders fully comprehend that their thoughts are irrational. But they still can’t stop them. Feelings of losing inner control haunt them. This angst is one of the entry ways for depression.2
Taking the first step is always the hardest. But going for a walk or getting up and dancing to your favorite music, for example, is something you can do right now. And it can substantially boost your mood and energy for several hours—long enough to put a second recovery step into action, such as preparing a mood-boosting meal or arranging to meet an old friend. By taking the following small but positive steps day by day, you’ll soon soon lift the heavy fog of depression and find yourself feeling happier, healthier, and more hopeful again.
Being both anxious and depressed is a tremendous challenge. Clinicians have observed when anxiety occurs comorbidly (together) with depression, the symptoms of both depression and anxiety are more severe compared to when each disorder occursalone. Moreover, the symptoms of depression take longer to resolve, making the illness more chronic and more resistant to treatment (read more about: Depression Treatment).
While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular can feel angry and restless. No matter how you experience depression, left untreated it can become a serious health condition. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation. There are plenty of powerful self-help steps you can take to lift your mood, overcome depression, and regain your joy of life.

Remember, antidepressants aren’t a cure. Medication may treat some symptoms of depression, but can’t change the underlying issues and situations in your life that are making you depressed. That’s where exercise, therapy, mindfulness meditation, social support and other lifestyle changes come in. These non-drug treatments can produce lasting changes and long-term relief.

Premenstrual Dysphoric Disorder; a severe form of Pre-Menstrual Syndrome that is diagnosed when a woman experiences severe symptoms of depression, tension, and irritability in the week prior to menstruation. While it isn’t uncommon for most women to experience emotional and physical changes prior to menstruation, women who meet criteria for PMDD experience changes that impact their lives in more profound ways.[5] 
Your GP will have suggestions for alternative things you can try to help manage your depression from day to day, and will be able to assess if you need medication or further help. Treatments such as cognitive behavioural therapy and medication, and having a good relationship with a GP, psychologist and/or psychiatrist, can be effective in treating depression and improving mood.
People with substance use problems—There is a direct link between depression and problem substance use. Many people who are experiencing depression turn to drugs or alcohol for comfort. Overuse of substances can actually add to depression in some people. This is because some substances like alcohol, heroin and prescription sleeping pills lower brain activity, making you feel more depressed. Even drugs that stimulate your brain like cocaine and speed can make you more depressed after other effects wear off. Other factors, like family history, trauma or other life circumstances may make a person vulnerable to both alcohol/drug problems and depression.

Educate Yourself. Depression is a type of illness, and illnesses tend to make people feel out of control. One way to regain a sense of control is to educate yourself about your illness. You can do this by talking with your doctors and therapists, by listening to what other people who have had depression have to say about it, and by reading as much as you can. The more you know about what depression is and how it may be treated, the better chance you have of figuring out the combination of treatments and techniques that will help you feel better. There are literally thousands of self-help books out there for depression. Some of them are even worth reading. We provide a list of such books we consider worthwhile at the end of this document.
When you’re suffering from deep, disabling depression, the idea that a pill can give you back your life—and sense of hope—is incredibly appealing. But are antidepressants always the best treatment option? What are the potential side effects and safety concerns? And are there any truly effective non-drug alternatives? These are some of the important questions to think about when considering antidepressant treatment. Learning about what antidepressants can (and can’t) do will enable you to weigh the benefits against the risks, make a more informed decision, and find the depression treatment that’s right for you.
Depression and Anxiety, the official journal of the Anxiety and Depression Association of America (ADAA), welcomes original research and synthetic review articles covering neurobiology (genetics and neuroimaging), epidemiology, experimental psychopathology, and treatment (psychotherapeutic and pharmacologic) aspects of mood and anxiety disorders and related phenomena in humans.
For mild depression, many people start with self-help strategies and emotional support. There are some common herbal treatments that research has also shown to be effective, including St. John’s wort and kava (Sarris, 2007). The positive effects of exercise and diet should not be under-estimated in helping mild to moderate depression symptoms as well. Increased, regular exercise is recommended as a component of treatment for all severity levels of depression.
Tricyclic antidepressants (TCAs) were some of the first medications used to treat depression. Examples are amitriptyline (Elavil), desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Side effects include stomach upset, dizziness, dry mouth, changes in blood pressure, changes in blood sugar levels, and nausea.
Sometimes it is best to both take medication and see a therapist. Medications can be helpful in many cases. Sometimes people are afraid of acting and thinking strangely, or becoming dependent on drugs used to treat anxiety and depression. When these medications are taken as prescribed by a doctor, bad side effects can be reduced or eliminated and there is little risk of becoming addicted to them. Remember that these medications are not the same as street drugs used to get high.
The definition of a genetic disease is a disorder or condition caused by abnormalities in a person's genome. Some types of genetic inheritance include single inheritance, including cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis. Other types of genetic diseases include multifactorial inheritance. Still other types of genetic diseases include chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Understanding the main pharmaceutical options requires becoming familiar with a number of acronyms: SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), NDRIs (norepinephrine–dopamine reuptake inhibitors), TCAs (tricyclic antidepressants), and MAOIs (monoamine oxidase inhibitors). These represent categories of drugs, grouped together because of their effect on various neurotransmitters (chemical messengers) in the brain.

Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first three months after childbirth. Women can experience psychotic depression, in that the depression causes them to lose touch with reality, have auditory hallucinations (hearing things that aren't actually happening, like a person talking when there is no one there), and delusions (interpreting things completely differently from what they are in reality). Visual hallucinations (seeing things that aren't there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, strange feelings and behaviors, as well as less commonly having suicidal or homicidal thoughts. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes doctors hospitalize women because they are at risk for hurting themselves or someone else, including their baby.

Self-help—For mild depression, or when moderate or severe depression begins to improve with other treatments, there are some things you can do on your own to help keep you feeling better. Regular exercise, eating well, managing stress, spending time with friends and family, spirituality, and monitoring your use of alcohol and other drugs can help keep depression from getting worse or coming back. Talking to your doctor, asking questions, and feeling in charge of your own health are also very important. Always talk to your doctor about what you’re doing on your own.


It is important to remember that many of these symptoms can occur with illnesses such as brain injury or stroke or even less serious problems like a cold or flu, but may not indicate depression. Even if you have trouble sleeping, lack of appetite and problems concentrating, there is no reason to be concerned about a separate mental health condition unless you also feel sad most of the time or rarely find enjoyment in life.


Many forms of psychotherapy are effective at helping depressed individuals, including some short-term (10-20 weeks) therapies. Talking therapies (psychotherapies) help patients gain insight into their problems and resolve them through verbal give-and-take with the therapist. Behavioral therapists help patients learn how to obtain more satisfaction and rewards through their own actions. These therapists conduct behavior therapy to help patients to unlearn the behavioral patterns that may contribute to their depression.
Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

When psychotherapy and antidepressants don’t work, clinicians may turn to other treatment options. Usually the first is to try and adjunct medication to the existing antidepressant medication. In more serious or treatment-resistant cases, additional treatment options may be tried (like ECT or rTMS). Ketamine infusion treatments also appear to be effective, but are generally not covered by insurance and the long-term risks are unknown.

A person’s personality characteristics are an important factor. When people are depressed, they usually have a very negative view of themselves and the world. They do not appreciate good things, and bad things seem overwhelming. Some people have a tendency to view things this way even when they are not depressed. In other words, they may have a depressive personality style.

As a matter of fact, many researchers think that antidepressant medications should work more quickly — that people shouldn’t have to take a medication for weeks before they see some improvement. Especially because the most common antidepressants cause short- and long-term side effects — all antidepressants can produce psychological side effects, tricyclic antidepressants (TCAs) can cause heart problems, and SSRI and SNRI medications cause issues ranging from nausea to weight gain and low sex drive, among others. Alternatives and better options are a good thing.
Selective serotonin reuptake inhibitors (SSRIs) are medications that increase the amount of the neurochemical serotonin in the brain. (Remember that brain serotonin levels often are low in depression.) As their name implies, the SSRIs work by selectively inhibiting (blocking) serotonin reuptake in the brain. This block occurs at the synapse, the place where brain cells (neurons) connect to each other. Serotonin is one of the chemicals in the brain that carries messages across these connections (synapses) from one neuron to another.
It helps to try to think about the last two weeks, rather than just when you felt very anxious or stressed. Also remember that this test is just one part of an assessment of whether anxiety might be a problem for you. There’s more to it, like getting feedback from people who know you well, and looking at how long anxiety’s been a problem for you and how it impacts on your life.

By working with a therapist or thinking strategically about the tactics you want to try, you can integrate them and execute several at once. For example, therapist Asta Klimaite often asks her clients to incrementally increase their exercise by using different methods and routes to reach her office. Her tactic also helps them develop a sense of accomplishing simple goals. They start by taking a different route to her office and using whatever mode of transportation they like. She then challenges them to ride a bike or walk to her office. Before they even start therapy, they are already working on their mental health.

It helps to try to think about the last two weeks, rather than just when you felt very anxious or stressed. Also remember that this test is just one part of an assessment of whether anxiety might be a problem for you. There’s more to it, like getting feedback from people who know you well, and looking at how long anxiety’s been a problem for you and how it impacts on your life.
A complete physical and psychological diagnostic evaluation by professionals will help the depressed person decide the type of treatment that might be best for him or her, including if they are in need of treatment for a physical condition that is causing or contributing to their depressed mood. However, if the situation is urgent because a suicide seems possible, having loved ones take the person to the emergency room for evaluation by an emergency-room doctor is essential. If the patient makes a suicide gesture or attempt, call 911. The patient might not realize how much help he or she needs. In fact, he or she might feel undeserving of help because of the negativity and helplessness that is a part of depressive illness.
Tricyclic antidepressants (TCAs) were one of the first approved antidepressants. Although they are effective, they have been replaced by newer antidepressants that generally cause fewer side effects. Like SNRIs, TCAs work by blocking the reabsorption of the neurotransmitters serotonin and norepinephrine in the brain. Additionally, they block muscarinic M1, histamine H1, and alpha-adrenergic receptors.
SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
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