Doctors often use one of the SSRIs initially because of their lower severity of side effects compared to the other classes of antidepressants. It's possible to further minimize side effects of SSRI medications by starting them at low doses and gradually increasing the doses to achieve full therapeutic effects. For those patients who do not respond after taking a SSRI at full doses for six to eight weeks, doctors often switch to a different SSRI or another class of antidepressants. For patients whose depression failed to respond to full doses of one or two SSRIs or whom could not tolerate those medications, doctors will usually then try medications from another class of antidepressants. Some doctors believe that antidepressants with dual action (action on both serotonin and norepinephrine), such as duloxetine (Cymbalta), (Cymbalta), mirtazapine (Remeron), venlafaxine (Effexor), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima), may be effective in treating patients with severe depression that is treatment resistant. Other options include bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban), which has action on dopamine (another neurotransmitter).
Do your best to not be this way. Instead, choose to accept your diagnosis and to take the medications and other therapies that have been prescribed for you regularly. Make it a point to talk with your doctor when you are not getting relief as expected or new symptoms develop so that your doctor has a chance to address these concerns. Tell the people that you are close to that you are clinically depressed and ask for their help in overcoming the problem. For instance, your friends can help you resist the urge to withdraw and isolate, and give you feedback as to how you appear to be doing both physically and emotionally. Allow the time necessary for medication therapies to pass before you decide that they aren't working. In general, accept your diagnosis and cooperate as best you can with the people who are trying to help you recover.

Another type of depression is bipolar disorder, which encompasses a group of mood disorders formerly called manic-depressive illness or manic depression. These conditions often show a particular pattern of inheritance. Not nearly as common as the other types of depressive illnesses, bipolar disorders involve cycles of mood that include at least one episode of mania or hypomania and may include episodes of depression, as well. Bipolar disorders are often chronic and recurring. Sometimes, the mood switches are dramatic and rapid, but most often they are gradual, in that they usually take place over several days, weeks, or longer.

The serotonin-norepinephrine reuptake inhibitor, or SNRI, class (venlafaxine and duloxetine) is notable for a dual mechanism of action: increasing the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. As with other medications, side effects may occur, including stomach upset, insomnia, headache, sexual dysfunction, weight gain and minor increase in blood pressure. These medications are considered as effective as SSRIs, so they are also considered a first-line treatment for the treatment of anxiety disorders, but not for obsessive compulsive disorder ,where SSRI’s are the preferred first line treatment.
Depression is a common and debilitating mood disorder. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. The feelings of helplessness, hopelessness, and worthlessness can be intense and unrelenting, with little, if any, relief.
For many people with SAD, simply waiting for spring to arrive is not an option. Light therapy, which generally involves sitting in front of a light box first thing in the morning, can help; so can cognitive behavior therapy, a type of psychotherapy. Physicians also prescribe antidepressants, usually an SSRI (selective serotonin reuptake inhibitor), a category of drug that includes Prozac and Zoloft, or Wellbutrin (bupropion). Combining a number of different approaches under the oversight of a physician may be your smartest move.
One reason is that while the medication may ultimately help you, your depression might also naturally lift over the course of a few weeks or months. That doesn’t happen for everyone, but it is surprisingly common. Another is that it can take awhile for “antidepressant effects” to kick in — but more on that below. Finally, these medications often treat symptoms of depression — like trouble sleeping, or not eating enough. When those symptoms improve a bit, you can take more positive actions — like exercising, getting back to your hobbies, working, and being social. And a rise in your mood often follows from those actions. Talk therapy often works in the same way: helping you take action first, leading to you feeling better later.
Esketamine (Spravato) is a unique medicine originally developed as an anesthetic and thought to treat depression though its effects on a brain chemical called glutamate. It is administered as a nasal spray and is for use in those who have not responded to treatment by other antidepressants. Its most common side effects include sedation, dissociation (having strange perceptions about time and space, or feeling as if things around you are not real), problems with thinking, and high blood pressure. If any of these side effects occur they are usually mild and temporary.
People who are depressed may reject your help because they feel they should be able to help themselves, and feel worthless when they can’t. Instead, they may withdraw or start an argument in an effort to resolve their difficulties. In addition, people with depression may have negative thoughts and feel so hopeless that they do not see recovery as a reality.
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.
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.

Clinical depression goes by many names, such as “the blues,” biological or clinical depression, and a major depressive episode. But all of these names refer to the same thing: feeling sad and depressed for weeks or months on end — not just a passing blue mood of a day or two. This feeling is most often accompanied by a sense of hopelessness, a lack of energy (or feeling “weighed down”), and taking little or no pleasure in things that once gave a person joy in the past.
For many people with SAD, simply waiting for spring to arrive is not an option. Light therapy, which generally involves sitting in front of a light box first thing in the morning, can help; so can cognitive behavior therapy, a type of psychotherapy. Physicians also prescribe antidepressants, usually an SSRI (selective serotonin reuptake inhibitor), a category of drug that includes Prozac and Zoloft, or Wellbutrin (bupropion). Combining a number of different approaches under the oversight of a physician may be your smartest move.
Depression, a state of low mood and aversion to activity, can affect a person's thoughts, behavior, tendencies, feelings, and sense of well-being. Symptoms of the mood disorder is marked by sadness, inactivity, difficulty in thinking and concentration and a significant increase/decrease in appetite and time spent sleeping. A great deal of people also have feelings of dejection, hopelessness, and sometimes suicidal tendencies. It can either be short term or long term depending on the severity of the person's condition.[1] A depressed mood is a normal temporary reaction to life events, such as the loss of a loved one. It is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. Depressed mood may also be a symptom of some mood disorders such as major depressive disorder or dysthymia.[2]
We are learning more about the interactions of the neurochemicals, the chemical messengers in the brain, and their influence on depression. Moreover, researchers now study new categories of neurochemicals, such as neuropeptides and substance P. As a result, we will soon be able to develop new drugs that should be more effective with fewer side effects. We are also learning startling things about how maternal stress early in pregnancy can profoundly affect the developing fetus. For example, we now know that maternal stress can greatly increase the risk for the fetus to develop depression as an adult.
Do not despair if you think you suffer from separate, co-occurring anxiety and mood symptoms. As described above, there is an overlap in effective psychotherapies for these problems; similarly, a group of medications known as selective serotonin reuptake inhibitors (SSRIs) are among those that have been shown to be helpful with both anxiety and depression.
On March 5, 2019 the FDA approved a new nasal spray medication- Spravato (esketamine) for treatment-resistant depression, available only at a certified doctor’s office or clinic. Ketamine represents a major step forward in the treatment of depression and suicide prevention. ADAA recognizes that clinicians want to offer their patients evidence-based options which have passed through the numerous stages of FDA testing, and this marks the first FDA approval of a ketamine product for a psychiatric indication. This is also the first antidepressant with a novel mechanism of action that we have had in decades.     
Depression generally takes one of two major forms. Unipolar depression is what most people mean when they talk about depression: an unremitting state of sadness, apathy, or hopelessness, and loss of energy. It is sometimes called major depression. Bipolar depression, or bipolar disorder, is a condition marked by periods of depression and periods of high-energy mania; people swing between the two poles of mood states, sometimes over the course of days, sometimes over years, often with stable periods in between. 

There are a range of ways to deal with depression, and often they are best used in conjunction with each other. The primary medical options are Cognitive Behavioural Therapy (CBT), antidepressant medication, and in some severe cases, Electroconvulsive Therapy (ECT). Education and coping strategies are also important when learning to manage your depression.
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.
Teenagers go through various phases. There’s often a lot of mood swings and emotional episodes that comes with adolescence, and it can be hard to know when their behavior is a part of growing up and when it’s more serious. The first step towards helping your child battle depression is to learn how to spot it. Become familiar with the warning signs. 
Some people with milder forms of depression get better after treatment with therapy. People with moderate to severe depression might need a type of medicine called an antidepressant in addition to therapy. Antidepressants change the levels of certain chemicals in your brain. It may take a few weeks or months before you begin to feel a change in your mood. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants.
Teenagers go through various phases. There’s often a lot of mood swings and emotional episodes that comes with adolescence, and it can be hard to know when their behavior is a part of growing up and when it’s more serious. The first step towards helping your child battle depression is to learn how to spot it. Become familiar with the warning signs. 
Stewart, D., & Vigod, S. (2017, August 11). Antenatal use of antidepressants and risk of teratogenicity and adverse pregnancy outcomes: Selective serotonin reuptake inhibitors (SSRIs). Up-To-Date. Retrieved from https://www.uptodate.com/contents/antenatal-use-of-antidepressants-and-risk-of-teratogenicity-and-adverse-pregnancy-outcomes-selective-serotonin-reuptake-inhibitors-ssris
Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.
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