Sticking to your treatment plan is one of the most important things you can do. It’s easy to get discouraged in the first few weeks of treatment. You may not want to continue. All types of treatment can take a few months before you notice a difference. It’s also easy to feel like you’re doing much better and stop treatment all together. Never stop treatment without consulting your doctor first.

Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.


There are two circumstances under which an anxiety patient may need specific help for depression. One is if he or she has become so depressed in response to anxiety that they no longer have the energy and motivation to overcome the anxiety disorder. In this case, either medication or cognitive behavioral methods can be used to help overcome the depression. The second is the case of a person who experienced a severe depression before the anxiety disorder appeared, a depression which was not just a reaction to the troubles imposed by the anxiety disorder. This depression, called a primary depression, is likely to require medication treatment.
People who wonder if they should talk to their health professional about whether or not they have depression might consider taking a depression quiz or self-test, which asks questions about depressive symptoms that are included in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), the accepted diagnostic reference for mental illnesses. In thinking about when to seek medical advice about depression, the sufferer can benefit from considering if the sadness lasts more than two weeks or so or if the way they are feeling significantly interferes with their ability to function at home, school, work, or in their relationships with others. The first step to getting appropriate treatment is accurate diagnosis, which requires a complete physical and psychological evaluation to determine whether the person may have a depressive illness, and if so, what type. As previously mentioned, the side effects of certain medications, as well as some medical conditions and exposure to certain drugs of abuse, can include symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through a clinical interview, physical examination, and laboratory tests. Many primary care doctors use screening tools, which are symptom tests, for depression. Such tests are usually questionnaires that help identify people who have symptoms of depression and may need to receive a full mental health evaluation.
Suicidal behavior is defined as a preoccupation or act that is focused on causing one’s own death voluntarily. Suicidal ideation refers to thoughts of suicide or wanting to take one’s own life. Suicidal behavior refers to actions taken by one who is considering or preparing to cause his or her own death. Suicide attempt usually refers to an act focused on causing one’s own death that is unsuccessful in causing death. Suicide refers to having intentionally caused one’s own death. Talking about suicide is the best way to prevent it. Although it is not possible to predict suicide with any certainty, our best tool is recognition of the signs that many people exhibit when contemplating suicide. These three behaviors should prompt you to seek immediate help for you or a loved one: talking about wanting to die or to kill oneself; looking for a way to kill oneself, such as searching online or obtaining a gun; talking about feeling hopeless or having no reason to live. See the Resources section below for actions to take if you or someone you know needs help.
Towards the end of the treatment, the dose is gradually reduced over the course of several weeks. You may experience temporary sleep problems, nausea or restlessness while coming off the medication. These problems are especially common if you stop taking antidepressants suddenly. Sometimes people stop taking their medication as soon as they start feeling better. But doing so increases the likelihood of the depression returning. Unlike many sleeping pills and sedatives, though, antidepressants do not cause physical dependence.
Regular appointments with the doctor are important during treatment. There you can talk about whether the symptoms have improved and whether there are any side effects. The dose will be adjusted if necessary. By no means should you increase or reduce the dose on your own. If you do, the tablets might not work properly or they may cause more side effects.
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.
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.
Many migraine patients suffer from symptoms of depression and anxiety. Migraine patients are between two to five times more likely to have these symptoms than patients without migraine. About 25% of patients with migraine have depression, and about 50% have anxiety. Some patients have symptoms of these disorders after living with migraine for years. Others develop them before migraine. At this time, scientists don’t know the exact answer why all are so common. One of the brain chemicals involved in all these conditions is called serotonin. Hormone changes in women can also trigger both conditions.
Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness, or a rapid heartbeat.

Focus on behaviors. If the person is reluctant to seek help, then don’t try to convince the person that a mood disorder is causing the problems. Instead, talk about their behaviors and the ways in which treatment can help. For example, after you have listened and sympathized with the person’s feelings, try to agree on wellness goals (e.g., consistent sleep and feeling less irritable). Then, try to assign some action steps that you can agree on to reach these goals (e.g., after two weeks, if the person does not improve, you will set up a medical evaluation).


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.

The main aim of treatment with antidepressants is to relieve the symptoms of depression, such as feeling very sad and exhausted, and prevent them from coming back. The medications are designed to restore emotional balance and help people to get on with everyday life. They are also taken to relieve symptoms such as restlessness, anxiety, sleep problems and suicidal thoughts.
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.
A very small number of people have had heart problems, epileptic fits or liver damage while taking antidepressants. It is believed that these were rare side effects of antidepressants. Various studies suggest that teenagers consider suicide more often when taking SSRIs or SSNRIs and also actually attempt to take their own lives more often. Teenagers should see their doctor or therapist more regularly at the beginning of treatment so that any risk of suicide can be identified early on.

Exercise and pleasurable activities are natural ways to improve mood. Exercise increases the levels of endorphins which can elevate mood. Foods high in omega-3-fatty acids may increase serotonin levels in the brain and contribute to relieving depression. During winter months some people may suffer from seasonal depression. Increasing exposure to light alleviates seasonal depression.
More than 1in 6 Americans take a psychiatric drug (such as an antidepressant or a sedative). according to a 2013 Medical Expenditure Panel Survey (MEPS), which gathered information on the cost and use of health care in the United States. Antidepressants were the most common type of psychiatric drug in the survey, with 12 percent of adults reporting that they filled prescriptions for these drugs, the study said.
Cognitive-behavioral therapy (CBT) is one form of psychotherapy that has been shown to be successful in treating depression and anxiety disorders. CBT combines the fundamental concepts of behavioral therapy and cognitive therapy. The term “cognitive” refers to our thought process and reflects what we think, believe and perceive. Put together, CBT focuses on our behaviors and thoughts and how they are contributing to our current symptoms and difficulties.
An external event often seems to initiate an episode of depression. Thus, a serious loss, chronic illness, difficult relationship, exposure to abuse, neglect or community violence, financial problem, or any negative life events or unwelcome changes in life patterns can trigger a depressive episode and chronic exposure to such negative factors can result in persistent depression. People exposed to numerous and/or severe stressors as young children may develop changes in their brain structure that may make them prone to developing depression during adulthood.
Accept Your Diagnosis. Many people (particularly men) have difficulty accepting that they are depressed. They may feel ashamed or weak, or otherwise believe that if they just "push through" they can handle it themselves. This is not a terribly useful or productive approach for people to take as it tends to set them up to sabotage their therapies. Such patients may "forget" to take medications on schedule, or decline to tell anyone who cares for them what they are dealing with.

Major depression, also often referred to as unipolar depression, is characterized by a combination of symptoms that lasts for at least two weeks in a row, including depressed and/or irritable mood (see symptom list), that interferes with the ability to work, sleep, eat, and enjoy once-pleasurable activities. Difficulties in sleeping or eating can take the form of excessive or insufficient of either behavior. Disabling episodes of depression can occur once, twice, or several times in a lifetime.
Suicidal behavior is defined as a preoccupation or act that is focused on causing one’s own death voluntarily. Suicidal ideation refers to thoughts of suicide or wanting to take one’s own life. Suicidal behavior refers to actions taken by one who is considering or preparing to cause his or her own death. Suicide attempt usually refers to an act focused on causing one’s own death that is unsuccessful in causing death. Suicide refers to having intentionally caused one’s own death. Talking about suicide is the best way to prevent it. Although it is not possible to predict suicide with any certainty, our best tool is recognition of the signs that many people exhibit when contemplating suicide. These three behaviors should prompt you to seek immediate help for you or a loved one: talking about wanting to die or to kill oneself; looking for a way to kill oneself, such as searching online or obtaining a gun; talking about feeling hopeless or having no reason to live. See the Resources section below for actions to take if you or someone you know needs help.
Depression and anxiety care incorporates individual, group, and family therapy, behavioral therapies, diagnostic assessment, consultation services, tailored treatment plans, and medication evaluation and management. McLean is committed to providing robust patient and family education and support including informational materials, support groups, and assistance with community resources.
Patients with anxiety or depression sometimes find that combining psychotherapy with medication offers the most complete relief. A randomized controlled trial, the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study, suggests that a combination approach might also work for people suffering pain in addition to a psychiatric disorder.
The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This help may involve encouraging the individual to stay with treatment until symptoms begin to go away (usually several weeks) or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication for several months after symptoms have improved. Always report a worsening depression to the patient's physician or therapist.
This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions. Vertical Health & PsyCom do not provide medical advice, diagnosis or treatment. Use of this website is conditional upon your acceptance of our User Agreement.
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