Therapists and physicians generally attempt to treat antenatal depression with non-medication methods first, as there is evidence that antidepressants may pose a risk to fetuses. For women with severe antenatal depression, however, antidepressants may be essential. Women need to educate themselves and work with their physicians to balance the risks and the benefits to both themselves and their infants.
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.
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.
Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.
Strengthen your social support. Although you cannot control your depression diagnosis, there are some things you can control. You can seek or create a positive support system for yourself. Whether your social network stems from your spouse, family members, close friends, co-workers, religious organizations, or community groups, support is available.
Believed to be caused in part by a malfunction of brain chemistry, generalized anxiety is not the normal apprehension one feels before taking a test or awaiting the outcome of a biopsy. A person with an anxiety disorder suffers from what President Franklin Roosevelt called "fear itself." For a reason that is only partially known, the brain's fight-or-flight mechanism becomes activated, even when no real threat exists. Being chronically anxious is like being stalked by an imaginary tiger. The feeling of being in danger never goes away.
Major depression is characterized by at least five of the diagnostic symptoms of which at least one of the symptoms is either an overwhelming feeling of sadness or a loss of interest and pleasure in most usual activities. The other symptoms that are associated with major depression include decrease or increase in appetite, insomnia or hypersomnia, psycho motor agitation or retardation, constant fatigue, feelings of worthlessness or excessive and inappropriate guilt, recurrent thoughts of death and suicidal ideation with or without specific plans for committing suicide, and cognitive difficulties, such as, diminished ability to think, concentrate and take decisions. The symptoms persist for two weeks or longer and represent a significant change from previous functioning. Social, occupational, educational, or other important functioning is also impacted. For instance, the person may start missing work or school, or stop going to classes or their usual social activities.
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.
Try to notice good things. Depression affects a person's thoughts, making everything seem dismal, negative, and hopeless. If depression has you noticing only the negative, make an effort to notice the good things in life. Try to notice one thing, then try to think of one more. Consider your strengths, gifts, or blessings. Most of all, don't forget to be patient with yourself. Depression takes time to heal.
With the ECT procedure, a brain stimulation therapy, a physician passes an electric current through the brain to produce controlled convulsions (seizures). ECT is useful for certain patients, particularly for those who cannot take or have not responded to a number of antidepressants, have severe depression, and/or are at a high risk for suicide. ECT often is effective in cases where trials of a number of antidepressant medications do not provide sufficient relief of symptoms. This procedure probably works, as previously mentioned, by a massive neurochemical release in the brain due to the controlled seizure. Often highly effective, ECT relieves depression within one to two weeks after beginning treatments in many people. After ECT, some patients will continue to have maintenance ECT, while others will return to antidepressant medications or have a combination of both treatments.
Increasingly, doctors may use a combination of antidepressants from different classes or add a medication from a completely different chemical class, such as Abilify or Seroquel, that are thought to enhance the effectiveness of antidepressant medication more rapidly than adding or switching to a second antidepressant. Also, new types of antidepressants are constantly being developed, and one of these may be the best for a particular patient.
Occasional anxiety is a normal part of life. It’s common for people to feel anxious if there’s conflict in a relationship, a problem at work, a big test looming or a major decision dead ahead. But anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away. It often gets worse over time to the point where feelings interfere with their daily functions.3
Depressive disorders are mood disorders that come in different forms, just as do other illnesses, such as heart disease and diabetes. However, remember that within each of these types, there are variations in the number, timing, severity, and persistence of symptoms. There are sometimes also differences in how individuals express and/or experience depression based on age, gender, and culture.
Daniela McVicker is an editor for Top Writers Review. She is also an experienced writer with a degree in social psychology from Durham University. Daniela is primarily focused on writing about self-improvement. She has authored a number of insightful and motivating articles like “Making The Right Choices Every Day” and “7 Steps To Open Yourself To New Opportunities & Possibilities.”
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.
National Institute of Mental Health: "Mental Health Medications," "Antidepressants.", Mayo Clinic: "Antidepressants: Selecting one that's right for you.", The New York Times: "Meditation Plus Running as a Treatment for Depression," "To Treat Depression, Drugs or Therapy?"; Pond5; Guido Vrola; Rocketclips, Inc.; pertusinas; Andrey Popov; Thinkstock; EpicStockMedia; AudioJungle.
Postpartum depression, in which mothers experience symptoms of major depression after giving birth. Mood impairment is much stronger, and lasts longer, than the “baby blues” — the relatively mild symptoms of depression and anxiety that many new mothers experience. Feelings of extreme sadness, anxiety, or exhaustion can make it difficult for the mother to bond with or care for her baby.
MAOIs also impair the ability to break down tyramine, a substance found in aged cheese, wines, most nuts, chocolate, certain processed meats, and some other foods. Tyramine, like norepinephrine, can elevate blood pressure. Therefore, the consumption of tyramine-containing foods by a patient taking an MAOI drug can cause elevated blood levels of tyramine and dangerously high blood pressure. In addition, MAOIs can interact with over-the-counter cold and cough medications to cause dangerously high blood pressure. The reason for this is that these cold and cough medications often contain drugs that likewise can increase blood pressure. Because of these potentially serious drug and food interactions, MAOIs are usually only prescribed for people who are thought to be willing and able to manage the many dietary restrictions required by these medications and after other treatment options have failed.
McLean Hospital offers comprehensive mental health services to help children and adults living with mood disorders such as depression and anxiety. We utilize evidence-based treatment and therapy models informed by cutting-edge research conducted at McLean and around the world. By incorporating various approaches, treatment can be customized for each individual to help ensure recovery.
While the majority of individuals with depression have a full remission of the disorder with effective treatment,only about a third (35.3%) of those suffering from severe depression seek treatment from a mental health professional. Too many people resist treatment because they believe depression isn't serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.
Depression can have a significant impact on the structure and function of many parts of the brain. This can result in many negative consequences. For example, people with severe depression are at higher risk of suffering from anxiety, chronic depression, other emotional issues, or having more medical problems or chronic pain. The trouble thinking (cognitive problems) that depression sufferers may experience can persist even after the illness resolves. People with a chronic illness, such as diabetes and heart disease, who also have depression tend to have worse outcome of their medical illness.
Kessler RC, Birnbaum HG, Shahly V, Bromet E, Hwang I, McLaughlin KA, Sampson N, Andrade LH, de Girolamo G, Demyttenaere K, Haro JM, Karam AN, Kostyuchenko S, Kovess V, Lara C, Levinson D, Matschinger H, Nakane Y, Browne MO, Ormel J, Posada-Villa J, Sagar R, Stein DJ. Age Differences in the Prevalence and Co-Morbidity of DSM-IV Major Depressive Episodes: Results From the WHO World Mental Health Survey InitiativeExternal. Depression and Anxiety 2010;27(4):351–64 [accessed 2018 Mar 22].
When these types of thoughts overwhelm you, it’s important to remember that this is a symptom of your depression and these irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic. When you really examine them they don’t hold up. But even so, they can be tough to give up. You can’t break out of this pessimistic mind frame by telling yourself to “just think positive.” Often, it’s part of a lifelong pattern of thinking that’s become so automatic you’re not even completely aware of it. Rather, the trick is to identify the type of negative thoughts that are fueling your depression, and replace them with a more balanced way of thinking.
Connect with others. It’s common to withdraw when you’re feeling depressed, but this can make you feel worse. Try to reconnect with friends. Again, make your goal realistic: if you’ve been avoiding your friends altogether, a starting point might be to send a text or (finally) to reply to one. If you don’t feel like leaving the house, you could ask them to come and hang out with you at home.
Monoamine oxidase inhibitors (MAOIs) block the activity of monoamine oxidase, an enzyme that breaks down norepinephrine, serotonin, and dopamine in the brain and other parts of the body. MAOIs have many drug and food interactions and cause significant side effects in comparison to the new antidepressants. As such, MAOIs have been replaced by newer antidepressants that are safer and cause fewer side effects.
Play is natural and fun for children and an important part of learning and development. Play therapy is a therapy used by licensed mental health professionals to help children to better express their thoughts and emotions and to address a variety of problems. When children are unable to put into words their feelings or concerns, play can help them express themselves and learn ways to cope.
There are a number of potential reasons for this. Women may be reluctant to reveal negative feelings at a time in their lives when society, family, and friends all expect them to be joyful. Women who are poor or who became pregnant unintentionally may regard symptoms of depression as a realistic response to their situation. Plus, some of the signs of depression — fatigue, changes in eating habits, sleep disturbances —are similar to the changes that many women experience as a typical part of pregnancy, making it harder to spot depression.
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
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Light therapy—This treatment has been proven effective for people with seasonal affective disorder. It involves sitting near a special kind of light for about half an hour a day. Light therapy should not be done without first consulting your doctor because there are side effects to this treatment. It is being researched for use in other kinds of depression as well.
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.
Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. You can learn more about these therapies on the NIMH Brain Stimulation Therapies webpage.