Self-help approaches to treating depression are best thought of as adjuncts or additions to professionally prescribed treatments. Don't delay treating your depression professionally, or attempt to treat your depression solely on your own. Instead, seek a professional diagnosis at the earliest opportunity. Early diagnosis of depression is critical. The sooner your depression has been properly diagnosed and treated, the sooner you will have a good chance of recovering. Many people think that their low mood is temporary and will resolve by itself. While some depressions are temporary and relatively mild conditions, others really aren't. Delaying treatment in such cases allows symptoms to worsen and can cause serious problems to occur such as severely impaired health and occupational functioning, damage to your interpersonal relationships, and suicidal thoughts and behavior. A small but significant minority of people die from depression-caused suicides each year.

Patients with generalized anxiety disorder can’t control their constant worry. They worry about life events that may never even happen. They are “worry warts” who often expect the worst possible outcome of every situation. Physical symptoms such as fatigue, trouble concentrating, and having tense muscles are common in these patients. Phobias are fears of specific objects or places, such as an intense fear of social interactions that causes the patient to avoid most social situations (social phobia). Physicians and mental health professionals assess these symptoms through interviews, surveys, and observing patient behavior.

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular can feel angry and restless. No matter how you experience depression, left untreated it can become a serious health condition. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation. There are plenty of powerful self-help steps you can take to lift your mood, overcome depression, and regain your joy of life.


Bipolar Disorder: Formerly known as Manic Depression or Manic Depressive Disorder. While different from depression, bipolar disorder is often included in discussions around depressive disorders as it involves episodes of extreme lows similar to major depression. Someone with bipolar disorder, however, will swing in the opposite direction towards mania or extreme highs.
Because depression can affect how a person acts, it might be misunderstood as a bad attitude. Other people may think the person isn't trying or not putting in any effort. For example, a negative or irritable mood can cause someone to act more argumentative, disagreeable, or angry. That can make the person seem difficult to get along with or cause others to keep their distance. Low motivation, low energy, difficulty concentrating, and thoughts of "why bother?" can lead someone to skip classes or school.
Monoamine oxidase inhibitors (MAOIs) were among the earliest treatments for depression. The MAOIs block an enzyme, monoamine oxidase, that then causes an increase in brain chemicals related to mood, such as serotonin, norepinephrine and dopamine. Examples are phenelzine (Nardil), tranylcypromine (Parnate) , isocarboxazid (Marplan), and transdermal selegiline (the EMSAM skin patch). Although MAOIs work well, they're not prescribed very often because of the risk of serious interactions with some other medications and certain foods. Foods that can negatively react with the MAOIs include aged cheese and aged meats.
A wide variety of treatments have been proven effective in treating depression. Some involve talking and behavioral change. Others involve taking medications. There are also techniques that focus on neuromodulation, which incorporates electrical, magnetic or other forms of energy to stimulate brain pathways. Examples of neuromodulation include electroconvulsive therapy (ECT), vagus-nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and the experimental deep-brain stimulation (DBS).
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.
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. 

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.
There are various methods you could use to sooth the symptoms of depression. All of us could stand to exercise more often, but exercise is especially helpful for the depressed mind. It enables you to better handle stress, and the endorphins released during exercise give you a mental boost. Aside from the mental health benefits, the Centers for Disease Control and Prevention (CDC) report that physical activity helps you sleep better at night.
Negative thinking. People with depression get stuck in negative thinking. This can make people focus on problems and faults. It can make things seem bleaker than they really are. Negative thinking can make a person believe things will never get better, that problems are too big to solve, that nothing can fix the situation, or that nothing matters. 
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).
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are highly effective and generally cause fewer side effects than the other antidepressants. SSRIs help to alleviate symptoms of depression by blocking the reabsorption or reuptake of serotonin in the brain. Serotonin is a naturally occurring neurotransmitter (chemical) that is used by brain cells to communicate. As SSRIs mainly affect the levels of serotonin and not levels of other neurotransmitters, they are referred to as “selective.”
Thyroid disease and disorder symptoms and signs depend on the type of the thyroid problem. Examples include heat or cold intolerance, sweating, weight loss or gain, palpitations, fatigue, dry skin, constipation, brittle hair, joint aches and pains, heart palpitations, edema, feeling bloated, puffiness in the face, reduced menstrual flow, changes in the frequency of bowel movements and habits, high cholesterol, hoarseness, brittle hair, difficulty swallowing, shortness of breath, a visible lump or swelling in the neck, tremors, memory problems, depression, nervousness, agitation, irritability, or poor concentration.
Bear in mind that while effective treatment for anxiety or depression need not be a long-term commitment, it is likely to require regular, ongoing appointments at least in the short-term (e.g., 6-12 months). Therefore, it is critical to find a professional you trust and with whom you feel comfortable speaking about your symptoms. It is equally important to make sure that you find a clinician that you can afford. Before making the commitment for ongoing care, you may want to meet with a couple of providers to get a feel for therapeutic styles/approaches and their treatment recommendations; you can then use this information to determine which path forward feels best to you.
A number of psychiatric syndromes feature depressed mood as a main symptom. The mood disorders are a group of disorders considered to be primary disturbances of mood. These include major depressive disorder (MDD; commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia, a state of chronic depressed mood, the symptoms of which do not meet the severity of a major depressive episode. Another mood disorder, bipolar disorder, features one or more episodes of abnormally elevated mood, cognition and energy levels, but may also involve one or more episodes of depression.[22] When the course of depressive episodes follows a seasonal pattern, the disorder (major depressive disorder, bipolar disorder, etc.) may be described as a seasonal affective disorder. Outside the mood disorders: borderline personality disorder often features an extremely intense depressive mood; adjustment disorder with depressed mood is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode;[23]:355 and posttraumatic stress disorder, a mental disorder that sometimes follows trauma, is commonly accompanied by depressed mood.[24]
Different neuropsychiatric illnesses seem to be associated with an overabundance or a lack of some of these neurochemicals in certain parts of the brain. For example, a lack of dopamine at the base of the brain causes Parkinson's disease. There appears to be a relation between Alzheimer's dementia and lower acetylcholine levels in the brain. The addictive disorders are under the influence of the neurochemical dopamine. That is to say, drugs of abuse and alcohol work by releasing dopamine in the brain. The dopamine causes euphoria, which is a pleasant sensation. Repeated use of drugs or alcohol, however, desensitizes the dopamine system, which means that the system gets used to the effects of drugs and alcohol. Therefore, a person needs more drugs or alcohol to achieve the same high feeling (builds up tolerance to the substance). Thus, the addicted person takes more substance but feels less and less high and increasingly depressed. There are also some drugs whose effects can include depression (these include alcohol, narcotics, and marijuana) and those for whom depression can be a symptom of withdrawal from the substance (including caffeine, cocaine, or amphetamines).
Monoamine oxidase also breaks down tyramine, a chemical present in aged cheese, wines, and other aged foods. Since MAOIs inhibit monoamine oxidase, they decrease the breakdown of tyramine from ingested food, increasing the level of tyramine in the body. Excessive tyramine can elevate blood pressure and cause a hypertensive crisis. Patients treated with MAOIs should adhere to recommended dietary modifications that reduce the intake of tyramine. Interestingly, the 6 mg/24 hour dose of selegiline transdermal system (EMSAM, and MAO inhibitor) does not require dietary restrictions because at this dose EMSAM does not substantially inhibit tyramine. Higher selegiline transdermal system (EMSAM) doses require dietary restrictions.
TCAs are safe and generally well tolerated when properly prescribed and administered. However, if taken in overdose, TCAs can cause life-threatening heart-rhythm disturbances. Some TCAs can also have anticholinergic side effects, which are due to the blocking of the activity of the nerves that are responsible for control of the heart rate, gut motion, visual focus, and saliva production. Thus, some TCAs can produce dry mouth, blurred vision, constipation, and dizziness upon standing. The dizziness results from low blood pressure that occurs upon standing (orthostatic hypotension). Anticholinergic side effects can also aggravate narrow-angle glaucoma, urinary obstruction due to benign prostate enlargement (hypertrophy), and cause delirium in the elderly. Patients with seizure disorders or a history of strokes should avoid TCAs.
Lithium (Eskalith, Lithobid), valproate (Depakene, Depakote), carbamazepine (Epitol, Tegretol), and lamotrigine (Lamictal) are mood stabilizers and, except for lithium, are used to treat seizures (anticonvulsants). They treat bipolar depression. Certain antipsychotic medications, such as ziprasidone (Geodon), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), asenapine (Saphris), paliperidone (Invega), iloperidone (Fanapt), lurasidone (Latuda), and brexpiprazole (Rexulti), may treat psychotic depression. They have also been found to be effective mood stabilizers and are therefore sometimes been used to treat bipolar depression, usually in combination with other antidepressants.

Generally, people who have anxiety or depression disorders display significant disruptions in their ability to work, go to school, or participate in social functions. But with high-functioning anxiety and depression, although those disruptions are not as apparent, they still can occur. The signs and symptoms are often overlooked, because sufferers are able to manage daily activities, but they are suffering in silence. To the outside world, people living with high-functioning anxiety and depression seem fine and often excel at accomplishing tasks and goals.
Selegiline inhibits MAOb at lower doses and both forms at higher doses. Because it does not inhibit MAOa, it does not require dietary restrictions at lower doses. Lower doses of oral selegiline (Eldepryl) appear to lack antidepressant properties and are usually prescribed to treat Parkinson disease. Higher doses are used to treat major depressive disorder, and the selegiline transdermal patch is FDA approved for this indication. Selegiline is sometimes used off-label to treat attention-deficit/hyperactivity disorder.
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).
Atypical antidepressants are considered “atypical” because these agents do not fit into any of the other classes of antidepressants. Each medicine in this category has a unique mechanism of action in the body. However, like other antidepressants, atypical antidepressants affect the levels of dopamine, serotonin, and norepinephrine in the brain. Brintellix and Viibryd inhibit reuptakeof serotonin but also act on serotonin receptors.
If you have such thoughts, and find them disturbing, it's a good idea to discuss them with a qualified therapist. People often want to keep these thoughts to themselves, because they feel ashamed of them, and worry that a therapist will over-react and want to hospitalize them. However, these thoughts are a common part of anxiety disorders, and a therapist who is well versed in the treatment of anxiety disorders will probably be able to evaluate these thoughts and come to a realistic understanding of what they mean and don't mean. So review these with a therapist, in the same way you would review all the other symptoms you experience.
Appropriate treatment for depression starts with a physical examination by a physician. Certain medications, as well as some medical conditions such as viral infections or a thyroid disorder, can cause the same symptoms as depression and should be ruled out. The doctor should ask about alcohol and drug use, and whether the patient has thoughts about death or suicide.
After years of working hard at your job each day, you’ve just been laid off. You feel sad, tired and emotionally drained. The last thing you feel like doing is getting out of bed in the morning. This sadness is a natural part of being human and feeling this way for a few days is normal. In fact, many people hear people say “I’m depressed” in their day-to-day life when they are talking about that low feeling that we can all have from time to time. But if these sad feelings last for more than a couple of weeks and you start noticing that it’s affecting your life in a big way, you may be suffering from an illness called depression.
Clinical depression is different from normal sadness — like when you lose a loved one, experience a relationship breakup, or get laid off from work — as it usually consumes a person in their day-to-day living. It doesn’t stop after just a day or two — it will continue for weeks on end, interfering with the person’s work or school, their relationships with others, and their ability to just enjoy life and have fun. Some people feel as if a huge hole of emptiness has opened inside when experiencing the hopelessness associated with this condition. In any given year, 7 percent of Americans will be diagnosed with this condition; women are 2 to 3 times more likely to be diagnosed than men (American Psychiatric Association).
Recovery from a depressive episode takes time as well as a desire and willingness for change. You can start by talking to someone — anyone — about your feelings, and finding some immediate emotional support through the sharing. Many people start their journey of recovery off by going to see their family physician for an initial diagnosis. Such a professional can also help connect you with referrals or encouragement to continue your treatment with a mental health specialist.

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.
All antidepressants can have side effects, but some may be more problematic than others. Guided by your doctor, you may need to try several different drugs before you find the one that’s best for you. Keep in mind that they do not work immediately and usually take at least several weeks for maximal benefit. Combining the right medication with psychotherapy or another intervention, like a support group, might be what you need to feel better.
The following information is not intended to provide a medical diagnosis of major depression and cannot take the place of seeing a mental health professional. If you think you are depressed‚ talk with your doctor or a mental health professional immediately. This is especially important if your symptoms are getting worse or affecting your daily activities.
suggests exercise can be an effective treatment for depression because it’s a natural mood booster and releases feel-good hormones. However, for some people, exercise or a gym can trigger anxiety and fear. If that’s the case for you, look for more natural ways to move, such as walking around your neighborhood or looking for an online exercise video you can do at home.
Antidepressant medication side effects and drug interactions are barriers to successful treatment for depression. Some side effects of antidepressants resolve with continued use while other side effects can be managed by dose reduction or adding other therapies. Appropriate management of side effects and avoiding drugs and alcohol that may interact with antidepressants may improve the success of depression therapy.
Lithium (Eskalith, Lithobid), valproate (Depakene, Depakote), carbamazepine (Epitol, Tegretol), and lamotrigine (Lamictal) are mood stabilizers and, except for lithium, are used to treat seizures (anticonvulsants). They treat bipolar depression. Certain antipsychotic medications, such as ziprasidone (Geodon), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), asenapine (Saphris), paliperidone (Invega), iloperidone (Fanapt), lurasidone (Latuda), and brexpiprazole (Rexulti), may treat psychotic depression. They have also been found to be effective mood stabilizers and are therefore sometimes been used to treat bipolar depression, usually in combination with other antidepressants.

Nortriptyline blocks the reuptake of serotonin and, more potently, norepinephrine at the presynaptic neuronal membrane. It has less affinity for H1 and M1 receptors and, thus, is better tolerated than other TCAs. Although nortriptyline is FDA approved only for depression, it has also been prescribed for chronic pain, myofascial pain, anxiety disorders, and attention-deficit/hyperactivity disorder. As with desipramine, there is a therapeutic window for nortriptyline
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Clomipramine potently inhibits the reuptake of serotonin at the presynaptic neuronal membrane. It has strong affinities to both H1 and M1 receptors, which results in sedation, weight gain, and anticholinergic side effects. Although clomipramine is FDA approved only for obsessive-compulsive disorder, it has also been prescribed for depression, panic attacks, and chronic pain.

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

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