Patients often are tempted to stop their medication too soon, especially when they begin feeling better. It is important to keep taking medication therapy until the doctor says to stop, even if the patient feels better beforehand. Doctors often will continue the antidepressant medications for at least six to 12 months after symptoms are alleviated because the risk of depression quickly returning when treatment is stopped decreases after that period of time in those people experiencing their first depressive episode. Patients must stop some medications gradually to give the body time to adjust (see discontinuation of antidepressants below). For individuals with bipolar disorder, recurrent or chronic major depression, medication may have to become a part of everyday life for an extended period of years in order to avoid disabling symptoms.
Monoamine oxidase inhibitors or MAOIs were the first class of antidepressants to be developed. They fell out of favor because of concerns about interactions with certain foods and numerous drug interactions. MAOIs elevate the levels of norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monoamine oxidase. Monoamine oxidase breaks down norepinephrine, serotonin, and dopamine. When monoamine oxidase is inhibited, norepinephrine, serotonin, and dopamine are not broken down, increasing the concentration of all three neurotransmitters in the brain.
You may know Botox (botulinum toxin) for its wrinkle-reduction prowess. But a bit of research is being conducted into using it to treat depression. Doctors observed that people who had Botox injections into their forehead seemed to have a better mood after the injection — and not just because they felt more attractive. So, researchers in the U.S. and Germany pooled the results of three clinical trials with a total of 134 people who were treated in that way — with Botox — for depression. More than 80 of them got Botox shots in addition to their usual antidepressant medication. People with depression tended to see substantially greater improvement in their depression symptoms 6 weeks after treatment than people who got a fake (placebo) injection.
Trazodone is effective in the treatment of major depression. It inhibits reuptake of serotonin and modulates serotonergic neurotransmission. It also significantly blocks histamine (H1) receptors. Its most common side effect is sedation, and thus, it has an off-label indication as a hypnotic. It can be very rarely associated with priapism, a medical emergency and a dangerous side effect of this drug in men. It is often used at a low dosage (25 to 50 mg) as an adjunct to SSRIs to treat insomnia.
It is normal to experience feelings of sadness and despair in response to adverse life events. Such events could include loss, major life changes, stress, or disappointment. In most cases, the sad feelings resolve as you come to terms with the changes in your life. In situations such as bereavement, these feelings may persist for months and return at significant times, such as birthdays and anniversaries related to the lost loved one. Provided you have times when you can enjoy things, however, this sadness is not a sign of depression.
Just as there are many different experiences of anxiety and depression, there are a variety of options for treatments and coping techniques to help manage symptoms. The recommendations in this section take an integrative mental health approach, which incorporates health-promoting lifestyle changes; evidence-based holistic therapies and healing practices; and mainstream interventions, including psychosocial therapies and the judicious use of prescription medication. We cover each of these areas in detail--click the links or see the menu on the left for more information.
Over the years, the technique of ECT has improved from the procedure that still invokes stigma in the minds of many. Physicians administer the treatment in the hospital under anesthesia so that people receiving ECT do not hurt themselves or feel emotional or physical pain during the induced seizures or at any other time. Most patients undergo six to 10 treatments. A health care professional passes an electrical current through the brain to cause a controlled seizure, which typically lasts for 20-90 seconds. The patient is awake in five to 10 minutes. The most common side effect is short-term memory loss, which usually resolves quickly. Doctors safely perform ECT as an outpatient procedure.
Even in the most severe cases, depression is highly treatable. The condition is often cyclical, and early treatment may prevent or forestall recurrent episodes. Many studies show that the most effective treatment is cognitive behavioral therapy, which addresses problematic thought patterns, with or without the use of antidepressant drugs. In addition, evidence is quickly accumulating that regular mindfulness meditation, on its own or combined with cognitive therapy, can stop depression before it starts by effectively disengaging attention from the repetitive negative thoughts that often set in motion the downward spiral of mood.
Occasional feelings of sadness or depression are experienced by most people at some point in life. Feeling sad is a normal human response to difficult situations such as loss of a loved one, financial troubles, or problems at home. These feeling usually last for a few days. However, when these feelings turn into intense sadness, or a person feels helpless, worthless, and hopeless, and last for weeks or longer, it could be due to clinical depression. Depression is a common but serious mental illness that affects millions of Americans. The symptoms of depression interfere with daily life and cause significant pain to the patient and their loved ones. Although with proper treatment even severe symptoms of depression can get better, many people never seek treatment due to the societal stigma associated with mental illnesses.
Imipramine is one of the oldest agents available for the treatment of depression. It is demethylated in the liver to desipramine. Imipramine inhibits the reuptake of norepinephrine and, more potently, serotonin at the presynaptic neuronal membrane. It has a strong affinity for alpha-adrenergic, H1, and M1 receptors. Common side effects include orthostasis, sedation, weight gain, and anticholinergic effects. It is also used off-label in the treatment of panic disorder, posttraumatic stress disorder, and attention deficit/hyperactivity disorder.
As the name implies, antidepressants are used for the treatment of depression. It is now clear that in addition to improving one’s mood, antidepressants also have an anti-anxiety effect. Antidepressants are believed to affect certain (chemical messengers) in the brain, resulting in a better mood and less anxiety. Today, antidepressants are the usual choice of medication intervention for major depressive disorders and anxiety disorders.
Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that in 2014, an estimated 15.7 million adults in the United States reported having at least one major depressive episode in the previous 12 months. That is 6.7% of all U.S. adults ages 18 and older. SAMHSA records from 2014 also note that an estimated 2.8 million adolescents reported having at least one major depressive episode in the previous 12 months. That number is 11.4% of all U.S. adolescents ages 12 to 17.
Medication. Many people with depression find that taking prescribed medications called antidepressants can help improve their mood and coping skills. Talk to your doctor about whether they are right for you. If your doctor writes you a prescription for an antidepressant‚ ask exactly how you should take the medication. If you are already using nicotine replacement therapy or another medication to help you quit smoking, be sure to let your doctor know. Several antidepressant medications are available‚ so you and your doctor have options to choose from. Sometimes it takes several tries to find the best medication and the right dose for you, so be patient. Also be aware of the following important information:
See a depression expert. It's important to talk with a trained professional during your treatment. Although psychologists cannot prescribe medication, they are well-trained in psychiatric assessment and psychotherapy. You can work with a psychologist while taking antidepressants prescribed by your regular doctor, or you can see a psychiatrist for both your depression medication and talk therapy. Try to find someone who has a lot of experience helping people with treatment-resistant depression. Mood disorder experts can often be found through university-based hospitals or organizations such as the American Society of Clinical Psychopharmacology, the American Psychiatric Association, or the Depression and Bipolar Support Alliance (DBSA) "Find a Pro" online search engine.
8. Check with your doctor before using supplements. "There's promising evidence for certain supplements for depression," Cook says. Those include fish oil, folic acid, and SAMe. But more research needs to be done before we'll know for sure. Always check with your doctor before starting any supplement, especially if you’re already taking medications.
Researchers once thought the relationship between pain, anxiety, and depression resulted mainly from psychological rather than biological factors. Chronic pain is depressing, and likewise major depression may feel physically painful. But as researchers have learned more about how the brain works, and how the nervous system interacts with other parts of the body, they have discovered that pain shares some biological mechanisms with anxiety and depression.
Medical problems. Dealing with a serious health problem, such as stroke, heart attack, or cancer, can lead to depression. Research shows that people who have a serious illness and depression are more likely to have more serious types of both conditions.4 Some medical illnesses, like Parkinson’s disease, hypothyroidism, and stroke, can cause changes in the brain that can trigger depression.
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.
Depression can lead to isolation. Loneliness is a common experience with 80% of the population under 18 years of age. A lack of interaction and connection can worsen depression symptoms. Obviously, you can’t make your child have friends or force them to socialize. Some children find it hard to socially interact and make the first move with new friends. That’s why this subject matter is delicate and takes time. You can:
A type of mild to severe depression that typically sets in as the hours of daylight wane in the fall, seasonal affective disorder (SAD) afflicts as many as 6 percent of Americans. Women are particularly at risk, experiencing SAD four times more often than men, as are people who have a relative with depression. People who live far from the equator tend to experience SAD in greater numbers — 9 percent of Alaskans versus 1 percent of Floridians, according to the National Institute of Mental Health (NIMH).
The study has also gone beyond to compare the level of depressive mood between the victims and non-victims of the daily bullying. Although victims were predicted to have a higher level of depressive mood, the results have shown otherwise that exposure to negative acts has led to similar levels of depressive mood, regardless of the victim status. The results therefore have concluded that bystanders and non-victims feel as equally depressed as the victim when being exposed to acts such as social abuse.
A person with anxiety disorder, however, experiences fear, panic or anxiety in situations where most people would not feel anxious or threatened. The sufferer may experience sudden panic or anxiety attacks without any recognized trigger, and often lives with a constant nagging worry or anxiousness. Without treatment, anxiety and depression disorders can restrict a person's ability to work, maintain relationships, or even leave the house.
The presence of maternal-fetal stress is another risk factor for depression. It seems that maternal stress during pregnancy can increase the chance that the child will be prone to depression as an adult, particularly if there is a genetic vulnerability. Researchers believe that the mother's circulating stress hormones can influence the development of the fetus' brain during pregnancy. This altered fetal brain development occurs in ways that predispose the child to the risk of depression as an adult. Further research is still necessary to clarify how this happens. Again, this situation shows the complex interaction between genetic vulnerability and environmental stress, in this case, the stress of the mother on the fetus.
We know it can be tough take on any of these depression self help tips when you’re feeling really bad. Also, when it comes to self-help, strategies for feeling better are very individualistic. That is, different things work for different people. Not everyone will want to start doing yoga, for example, so keep trying different ideas even if the first thing you try doesn’t help.
Beware of drug interactions. You should avoid drinking alcohol when taking SSRIs since it can lessen the effects of the medication. Dangerous drug interactions can occur when SSRIs are taken with antihistamines, found in many over-the-counter cold and allergy medicines and sleep aids, or with prescription painkillers. Always talk to your doctor or pharmacist before combining medications.
When your doctor recommends an antidepressant to fight depression—such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs)—it's about more than just boosting your mood. Depression has many potential physical effects. "Most people aren't aware that depression can lead to other health problems," says Dr. Amanda Hernandez, a geriatrician at Harvard-affiliated Massachusetts General Hospital.
Buspirone is marketed as an antianxiety medication; however, it may have antidepressant effects at doses above 45 mg/day. The antidepressant effects may increase when buspirone is used in combination with SSRIs and TCAs in patients with treatment-resistant depression. Buspirone is a partial 5-HT1A agonist with serotonergic and some dopaminergic effects in the CNS. It has anxiolytic effects but may take up to 2-3 weeks for full efficacy.
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.
Reminiscence of old and fond memories is another alternative form of treatment, especially for the elderly who have lived longer and have more experiences in life. It is a method that causes a person to recollect memories of their own life, leading to a process of self-recognition and identifying familiar stimuli. By maintaining one’s personal past and identity, it is a technique that stimulates people to view their lives in a more objective and balanced way, causing them to pay attention to positive information in their life stories, which would successfully reduce depressive mood levels.
Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This can be a serious problem as taking antidepressants for bipolar depression can actually make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder.