I was physically abused for 40 yrs. ... 2 marriages.... and my head generally took the brunt of the abuse. I was also in 2 car accidents. Again head injury. At this point someone special- a friend- spoke to another friend knowledgeable about TBI and told me he did. I began to realize after feeling hurt and betrayed that something was wrong. I go from happy to sad to panic like flipping a light switch. I get emotional and emotionally hurt over nothing. I don't want to go on this way I need some coping skills and ways to stop what's happening before I get worse.....
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including depression. During clinical trials, some participants receive treatments under study that might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. Other participants (in the “control group”) receive a standard treatment, such as a medication already on the market, an inactive placebo medication, or no treatment. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Interpersonal and cognitive/behavioral therapies are two of the short-term psychotherapies that research has shown to be helpful for some forms of depression. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving that are often associated with depression. A form of cognitive behavioral therapy, dialectical behavior therapy (DBT) tends to focus on intensive, simultaneous acceptance of the depression sufferer's abilities, while motivating emotionally healthy changes using a highly structured approach. This form of therapy treats severely or chronically depressed people. Psychodynamic therapies sometimes treat depression. They focus on resolving the patient's internal psychological conflicts rooted in childhood. Long-term psychodynamic therapies are particularly important if there seems to be a lifelong history and pattern of inadequate ways of coping (maladaptive coping mechanisms) by using negative or self-injurious behavior.
Compared to women, men with depression are more likely to experience low energy, irritability, and anger, sometimes to the point of inflicting pain on others. Men with depression are also more likely to exhibit sleep problems, a loss of interest in work or hobbies, and substance abuse. They may work excessively and engage in more risky behaviors when struggling with depression, committing suicide four times as often as women with this condition. Despite these difficulties, men tend to be much less likely to receive treatment for any condition, particularly depression.
The SSRIs work by keeping serotonin present in high concentrations in the synapses. These drugs do this by preventing the reuptake of serotonin back into the sending nerve cell. The reuptake of serotonin is responsible for turning off the production of new serotonin. Therefore, the serotonin message keeps on coming through. This, in turn, helps arouse (activate) cells that have been deactivated by depression, thereby relieving the depressed person's symptoms. SSRIs have fewer side effects than the tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). SSRIs do not interact with the chemical tyramine in foods, as do the MAOIs, and therefore do not require the dietary restrictions of the MAOIs. Also, SSRIs do not cause orthostatic hypotension (sudden drop in blood pressure when sitting up or standing) and are less likely to predispose to heart-rhythm disturbances like the TCAs do. Therefore, SSRIs are often the first-line treatment for depression. Examples of SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), fluvoxamine (Luvox), escitalopram (Lexapro), vortioxetine (Trintellix), and vilazodone (Viibryd).
However, some depressive mood disorders might have an adverse effect for creativity. Upon identifying several studies and analyzing data involving individuals with high levels of creativity, Christa Taylor was able to conclude that there is a clear positive relationship between creativity and depressive mood. A possible reason is that having a low mood could lead to new ways of perceiving and learning from the world, but it is unable to account for certain depressive disorders. The direct relationship between creativity and depression remains unclear, but the research conducted on this correlation has shed light that individuals who are struggling with a depressive disorder may be having even higher levels of creativity than normal people, and would be a close topic to monitor depending on the future trends of how creativity will be perceived and demanded.[34]
While you can’t force yourself to have fun or experience pleasure, you can push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.
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.
Anxiety and depression are the most common mental health disorders. In the U.S., approximately 19 million people suffer from anxiety and 18 million from depression. Additionally, it is estimated that about 85 percent of Americans with depression also suffer from an anxiety disorder, and almost 54 percent of people with an anxiety disorder also have major depression.
Perimenopause, which is the time of life immediately before and after menopause, can last as long as 10 years. While perimenopause and menopause are normal stages of life, perimenopause increases the risk of depression during that time. Also, women who have had depression in the past are five times more likely to develop major depression during perimenopause.
Depression drains your energy, hope, and drive, making it difficult to take the steps that will help you to feel better. But while overcoming depression isn’t quick or easy, it’s far from impossible. You can’t just will yourself to “snap out of it,” but you do have more control than you realize—even if your depression is severe and stubbornly persistent. The key is to start small and build from there. Feeling better takes time, but you can get there by making positive choices for yourself each day.
Websites run by organizations like the National Institute of Mental Health (NIMH) provide copious background information as well as updates on clinical trials. Grassroots groups like the National Alliance on Mental Illness connect you with support and services, offer education, and let you know that you are not alone. Personal blogs share the struggle and the wisdom of lived experience. And numerous online depression tests can help those who aren’t sure whether or not they need help get started on the pathway to a healthier life.
Some symptoms of depression as described above are normal after any kind of loss including the onset of a disability or severe illness. If you have had these symptoms for a long time it may be helpful to talk with a mental health professional. It is also helpful to talk to someone if you have other symptoms such as feeling guilty or worthless, or if sadness interferes with the ability to do important life tasks (take medication; go to therapies, work or school).

Millions of Americans take an anti-inflammatory medication like Advil (ibuprofen) or Aleve (naproxen) for occasional aches and pains. Many take one daily for arthritis. And one common prescription medicine — Celebrex (celecoxib) — may not be helpful just for joint pain, it may also be a decent treatment for depression. Many researchers believe that there’s a link between depression and systemic inflammation — at least for some people. So, can an anti-inflammatory medicine — especially COX-2 inhibitors like Celebrex — help with symptoms of depression?
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.
Some of these side effects are believed to be a direct consequence of the medication's effect on the brain and are relatively similar among various drugs of the same group. Patients who are taking antidepressants sometimes have a dry mouth, headaches, feel faint, anxious, and have a decreased sex drive. These kinds of symptoms are often perceived to be a side effect of the medications. But some of them may be caused by the depression itself.
Express yourself. With depression, a person's creativity and sense of fun may seem blocked. Exercise your imagination (painting, drawing, doodling, sewing, writing, dancing, composing music, etc.) and you not only get those creative juices flowing, you also loosen up some positive emotions. Take time to play with a friend or a pet, or do something fun for yourself. Find something to laugh about — a funny movie, perhaps. Laughter helps lighten your mood.
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.
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.
Anxiety disorders are the most common type of mental disorder. 50-60% of migraine patients will suffer from an anxiety disorder. Most anxiety disorders involve chronic worry or fear and avoiding things that trigger these feelings. In panic disorder, the patient has recurrent, unexpected feelings of intense fear or terror that seem to come from out of the blue. The heart starts beating rapidly and breathing becomes strained. Other symptoms may involve sweating, fear of dying, or losing control. Although attacks don’t last very long and are not dangerous, many people develop significant anxiety between attacks and come to fear normal body sensations.
Major Depressive Disorder (Clinical Depression); a mental health condition characterized by an inescapable and ongoing low mood often accompanied by low self-esteem and loss of interest or pleasure in activities that a person used to find enjoyable.  To meet the criteria for Major Depressive Disorder (MDD), symptoms must be present nearly every day for at least 2 weeks. MDD is also often referred to as Major Depression.
Depression symptoms take many forms, and no two people’s experiences are exactly alike. A person who’s suffering from this disorder may not seem sad to others. They may instead complain about how they just “can’t get moving,” or are feeling completely unmotivated to do just about anything. Even simple things — like getting dressed in the morning or eating at mealtime — become large obstacles in daily life. People around them, such as their friends and family, notice the change too. Often they want to help, but just don’t know how.
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.

I have also suffered a recent brain injury (concussion). Medication is not an option for my panic and anxiety symptoms. I am now taking cranio- sacral therapy providing significant relief. How I recovered from my horrific addiction to phsyco meds 10 years ago is still a very painful memory not to be easily forgotten. I am convinced & am choosing a holistic safer route instead of the dead end road of pharmaceutical therapy. God Bless. Julie


Phobias are extreme and irrational fears about a particular thing. The can be so great that the person goes to great lengths to avoid it, even if it’s harmless. For example social phobia is fear of being judged or embarrassed in public, even in everyday situations like when eating, speaking at work or making small talk.  Another type is agoraphobia, often thought to be a fear of open spaces. It is also a fear of being closed in, or away from a safe place or person who makes you feel safe. It can be extremely disabling and frightening, and can leave people unable to leave their home.

Symptoms of depression and anxiety often co-occur in certain disorders. In fact, according to the National Institute of Mental Health, major depression often accompanies panic disorder and other anxiety disorders. While depression and anxiety have distinct clinical features, there is some overlap of symptoms. For example, in both depression and anxiety, irritability, decreased concentration and impaired sleep are common.
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.
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.
In a structured psychotherapy, like cognitive behavioral therapy (CBT), the treatment approach for anxiety and depression can vary slightly. Naturally, CBT for these issues will teach you how to work with unhelpful thought traps. And, for either problem, CBT is likely to ask that you do more behaviorally. For anxiety, however, this is to minimize avoidant behavior and to help you disconfirm a feared consequence. For depression, this is to help you experience positive emotion, a surge in energy (even if briefly), or another type of pleasant interaction with the world (the theory being that activating behavior, even when, or especially when your energy or mood is low can result in some type of positive reward).
Post-traumatic Stress Disorder (PTSD) is a reaction to a highly stressful event outside the range of everyday experience when a person feels very unsafe or threatened. These are unsual experiences such as war, violent attack (verbal, physical or sexual) or a natural disaster. The symptoms usually include irritability, anxiety, flashbacks, repeated nightmares, and avoiding situations that might bring back memories of the event. 
Persistent depressive disorder, formerly referred to as dysthymia, is a less severe but usually more long-lasting type of depression (dysphoric) compared to major depression. It involves long-term (chronic) symptoms that do not disable but prevent the affected person from functioning at "full steam" or from feeling good. Sometimes, people with persistent depressive disorder also experience episodes of major depression. Double-depression is the name for this combination of the two types of depression.
What we do know is certain medications that alter the levels of norepinephrine or serotonin can alleviate the symptoms of depression. Some medicines that affect both of these neurochemical systems appear to perform even better or faster. Other medications that treat depression primarily affect the other neurochemical systems. One of the most powerful treatments for depression, electroconvulsive therapy (ECT), is certainly not specific to any particular neurotransmitter system. Rather, ECT, by causing a seizure, produces a generalized brain activity that probably releases massive amounts of all of the neurochemicals.

Prioritize. Depression is frequently an overwhelming situation. At the same time that you are depressed and suffering, life demands do not stop. One way to reduce the amount of stress you experience is to prioritize the demands you are facing and then to attend to only the most pressing tasks. Enlist the help of other family members or friends to get the rest of your responsibilities done, or simply let them ride for a while. For instance, if you normally cook the evening meal for your family after returning home from a full day's work, perhaps you can figure out an easier way to get dinner on the table for a while (working to support the family is a higher priority than making sure that every meal the family eats is nicely balanced and well-presented).
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.

Anxiety disorders are the most common type of mental disorder. 50-60% of migraine patients will suffer from an anxiety disorder. Most anxiety disorders involve chronic worry or fear and avoiding things that trigger these feelings. In panic disorder, the patient has recurrent, unexpected feelings of intense fear or terror that seem to come from out of the blue. The heart starts beating rapidly and breathing becomes strained. Other symptoms may involve sweating, fear of dying, or losing control. Although attacks don’t last very long and are not dangerous, many people develop significant anxiety between attacks and come to fear normal body sensations.


The most commonly diagnosed form of depression is Major Depressive Disorder. In 2015, around 16.1 million adults aged 18 years or older in the U.S. had experienced at least one major depressive episode in the last year, which represented 6.7 percent of all American adults. Depression is the leading cause of disability in the United States among people ages 15-44.  View the NIMH website for statistics from the 2016 National Survey on Drug Use and Health

We are close to having genetic markers for bipolar disorder. Soon after, we hope to have them for major depression. That way, we can know of a child's vulnerability to depression from birth and try to create preventive strategies. For example, we can teach parents the added importance of providing a supportive and otherwise healthy environment given their child's vulnerability. Parents can also be taught the early warning signs of depression so that they can get treatment for their children, if necessary, to ward off future problems.
Nurture yourself with good nutrition. Depression can affect appetite. One person may not feel like eating at all, but another might overeat. If depression has affected your eating, you'll need to be extra mindful of getting the right nourishment. Proper nutrition can influence a person's mood and energy. So eat plenty of fruits and vegetables and get regular meals (even if you don't feel hungry, try to eat something light, like a piece of fruit, to keep you going).
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.  
Whether or not someone has side effects, which side effects they have, and how frequent they are will depend on the drug and on the dose used. And everyone reacts slightly differently to drugs as well. The risk of side effects increases if other medication is also being taken. One of the drugs may make the side effects of the other worse. These kinds of drug interactions are common in older people and people with chronic illnesses who are taking several different kinds of medication.
People living with high-functioning anxiety and depression usually do not fit the stereotype of either disorder. In fact, many appear to be overachievers. The anxiety can serve as an energizer, driving the person towards achieving his or her goals. It’s later, when in private, that the symptoms of depression tend to emerge. Feelings of self-doubt and self-criticism, fatigue, helplessness or guilt, moodiness, and a desire to avoid interaction with others become intensified. Because the stereotypical image of depression or anxiety doesn’t match up with what people living with high-functioning anxiety and depression “look like,” it is hard to spot, even for sufferers to recognize in themselves. However, the symptoms of high-functioning anxiety and depression are the same as for non-high functioning anxiety and depression. The main difference is the ability to suppress or diminish the appearance of disruptions in life activities.
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.     
Explore options if it doesn't work well. If you have bothersome side effects or no significant improvement in your symptoms after four weeks, talk to your doctor about changing the dose, trying a different antidepressant (switching), or adding a second antidepressant or another medication (augmentation). A medication combination may work better for you than a single antidepressant.

If your symptoms are mild, tending to ebb and flow between present and absent, or if you have had formal treatment previously and are concerned about relapse, self-help interventions can be a reasonable place to start. These approaches typically involve little to no guidance by a professional. They can include the use of self-help books, electronic applications that adapt evidence-based psychotherapies, or Smartphone programs that offer an easy way to practice skills that target a highly relevant symptom (such as mindfulness meditation for anger or anxiety).​
Can depression actually be successfully treated? The short answer is yes. According to the National Institute of Mental Health and countless research studies over the past six decades, clinical depression is readily treated with short-term, goal-oriented psychotherapy and modern antidepressant medications. For most people, a combination of the two works best and is usually what is recommended. Psychotherapy approaches scientifically proven to work with depression include cognitive-behavioral therapy (CBT), interpersonal therapy, and psychodynamic therapy (Gelenberg et al., 2010). Psychotherapy is one of the most effective treatments for all types of depression and has very few side effects (and is a covered treatment by all insurers).
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.
Common treatments for anxiety disorders include individual and group therapy, and medications as appropriate. Other treatments may include TMS (transcranial magnetic stimulation) and ECT (electroconvulsive therapy), both of which have been found to have profound effects on individuals with depression or anxiety, especially for those who have not found relief in symptoms through other treatment methods.
Bupropion inhibits neuronal dopamine reuptake and decreases the rate of norepinephrine activity. In addition to major depressive disorder, the indications for bupropion include smoking cessation. Off-label indications include attention-deficit/hyperactivity disorder and depression associated with bipolar disorder. Common side effects include headache and mild weight loss. Unlike other antidepressants, bupropion does not cause sexual dysfunction.
During the holidays, our thoughts may gravitate to memories of our youth, growing up and time spent with family and friends. But as often happens when we age, family members and friends pass away. Loved ones move far away because of family and job obligations. Feelings of isolation and loneliness can take hold, especially during the holidays, a time that in the past was filled with activities and traditions with family and friends.
Additional medication can also be taken. That might help to relieve the symptoms, but no antidepressant can guarantee that. It can take a long time for a medication to start helping some people. Other people still have symptoms even after trying several different medications. They can then discuss the alternative treatment options with their doctor.
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.
Researchers are studying natural and complementary treatments (add-on treatments to medicine or therapy) for depression. Currently, none of the natural or complementary treatments are proven to work as well as medicine and therapy for depression. However, natural or complementary treatments that have little or no risk, like exercise, meditation, or relaxation training, may help improve your depression symptoms and usually will not make them worse.
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