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. 
Antidepressants. A variety of antidepressants are prescribed for both anxiety and depression. Some of these also help alleviate nerve pain. The research most strongly supports the use of serotonin and norepinephrine reuptake inhibitors (SNRIs) or tricyclic antidepressants (TCAs) as double-duty drugs that can treat both psychiatric disorders and pain. The findings are more mixed about the ability of selective serotonin reuptake inhibitors (SSRIs) to alleviate pain.
Other alternatives include drinking special teas or taking supplements. The properties of green tea and chamomile tea give them a calming effect, and some have found success drinking St. John’s Wort tea to treat depression. It can also be taken as a supplement. While there is no proof that St. John’s Wort improves depression symptoms, fish oil and SAM-e are supplements with a proven impact.

Antidepressants can have central and peripheral anticholinergic effects, as well as sedative effects, and can block the active reuptake of norepinephrine (NE), serotonin (5-HT), and dopamine. SSRIs are metabolized via the cytochrome P-450 system and may have drug interactions on that basis. The degree of enzyme inhibition varies among SSRIs. Effects on blood levels and bioavailability of coadministered drugs, as well as pharmacodynamic interactions, account for most clinically significant SSRI-drug interactions.
Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead-end job, the best treatment might be finding a more satisfying career rather than simply taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.
Track your thoughts. Writing down your thoughts is a good way to identify those that are contributing to making you feel down and depressed; these might include thoughts like ‘I’m useless’ or ‘no one cares about me’. Just because we think something, it doesn’t mean it’s true, so learn how to challenge negative thinking. If your mood is really low and you have difficulty challenging your thoughts, avoid writing them down on your own and instead seek help from a mental health professional.
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.
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.
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.

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.
Patience is required because the treatment of depression takes time. Sometimes, the doctor will need to try a variety of antidepressants before finding the medication or combination of medications that is most effective for the patient. Sometimes, it's necessary to increase the dosage to be effective or decrease the dosage to alleviate medication side effects.
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.
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]
^ Schuch FB, Vancampfort D, Firth J, Rosenbaum S, Ward PB, Silva ES, Hallgren M, Ponce De Leon A, Dunn AL, Deslandes AC, Fleck MP, Carvalho AF, Stubbs B (July 2018). "Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies". The American Journal of Psychiatry. 175 (7): 631–648. doi:10.1176/appi.ajp.2018.17111194. PMID 29690792.

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.
Depression can increase the risks for developing coronary artery disease and asthma, contracting the human immunodeficiency virus (HIV) and many other medical illnesses. Other complications of depression include its tendency to increase the morbidity (illness/negative health effects) and mortality (death) from these and many other medical conditions.
The new world of pharmacogenetics holds the promise of actually keeping the genes responsible for depression turned off so as to avoid the illnesses completely. Also, by studying genes, we are learning more about the matching of patients with treatment. This kind of information can tell us which patients do well on which types of drugs and psychotherapy regimens.
Several specific antipsychotic medications have been shown to enhance the effects of an antidepressant when an initial response is poor. These include aripiprazole (Abilify), brexpiprazole (Rexulti), and quetiapine (Seroquel). Symbyax, a combination of the antipsychotic drug olanzapine (Zyprexa) and an SSRI (Prozac, or fluoxetine), is approved for treatment-resistant depression or depression in people with bipolar disorder.

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.
However, researchers have also been looking into ketamine for treating depression. And results have been encouraging. Ketamine may have a “rapid onset” of antidepressant effect, meaning that it can help people feel better quickly. That boost may be temporary, lasting just a few days. And unlike antidepressants you can take once a day at home, ketamine must be injected or given by IV. Repeated treatments at a clinic might be necessary to help produce a long-lasting antidepressant effect, and psychiatrists and family doctors might not feel comfortable doing that. But here’s the promise: Quicker relief that helps people start living their lives again — getting out of that depressive funk sooner.
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.
Hypnosis. During this therapy, a clinician helps a patient achieve a trance-like state and then provides positive suggestions — for instance, that pain will improve. Some patients can also learn self-hypnosis. One study showed that hypnosis training reduced both gastrointestinal distress and levels of depression and anxiety in 71% of those studied.
TCAs are associated with a number of cardiovascular (heart and blood vessels) effects such as orthostatic hypotension and abnormal heart rates and rhythms. Orthostatic hypotension may lead to dizziness, falls, and fractures. Orthostatic hypotension may be managed by reducing or discontinuing the TCA dose, increasing salt intake, or treatment with steroids.
Reminiscence of old and fond memories is another alternative form of treatment, especially for the elderly who have lived longer and have more experiences in life. It is a method that causes a person to recollect memories of their own life, leading to a process of self-recognition and identifying familiar stimuli. By maintaining one’s personal past and identity, it is a technique that stimulates people to view their lives in a more objective and balanced way, causing them to pay attention to positive information in their life stories, which would successfully reduce depressive mood levels.[38]

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.


Panic Disorder is when a person has panic attacks. These are intense feelings of anxiety along with the kind of physical symptoms and overwhelming sensations you would have if you were in great danger, like a pounding heart, feeling faint, sweating, shaky limbs, nausea, chest pains, breathing discomfort and feelings of losing control. The symptoms rise and peak rapidly. The effects can be so severe that people experiencing panic attacks can believe they are dying. Despite being frightening and very uncomfortable they are not life threatening. 
All antidepressants on the market are potentially effective. [120] Usually, 2–6 weeks at a therapeutic-dose level are needed to observe a clinical response. The choice of medication should be guided by anticipated safety and tolerability, which aid in compliance; physician familiarity, which aids in patient education and anticipation of adverse effects; and history of previous treatments. Often, treatment failures are caused not by clinical resistance but by medication noncompliance, inadequate duration of therapy, or inadequate dosing.
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.
Symptoms of both conditions usually improve with psychological counseling (psychotherapy), medications, such as antidepressants, or both. Lifestyle changes, such as improving sleep habits, increasing social support, using stress-reduction techniques or getting regular exercise, also may help. If you have either condition, avoid alcohol, smoking and recreational drugs. They can make both conditions worse and interfere with treatment.

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.


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.
Fluvoxamine enhances serotonin activity due to selective reuptake inhibition at the neuronal membrane. It does not significantly bind to alpha-adrenergic, histamine, or cholinergic receptors and thus has fewer side effects than tricyclic antidepressants. Fluvoxamine is a strong inhibitor of cytochrome P-450. Although fluvoxamine is FDA approved only for obsessive-compulsive disorder, it is commonly prescribed for other psychiatric disorders, including social anxiety disorder, posttraumatic stress disorder, pain disorder, and major depression.
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.
Depression occurs more often in women than men. Some differences in the manner in which the depressed mood manifests has been found based on sex and age. In men it manifests often as tiredness, irritability and anger. They may show more reckless behavior and abuse drugs and alcohol. They also tend to not recognize that they are depressed and fail to seek help. In women depression tends to manifest as sadness, worthlessness, and guilt. In younger children depression is more likely to manifest as school refusal, anxiety when separated from parents, and worry about parents dying. Depressed teenagers tend to be irritable, sulky, and get into trouble in school. They also frequently have co-morbid anxiety, eating disorders, or substance abuse. In older adults depression may manifest more subtly as they tend to be less likely to admit to feelings of sadness or grief and medical illnesses which are more common in this population also contributes or causes the depression.  

Depression, also known as clinical or major depression, is a mood disorder that will affect one in eight Canadians at some point in their lives. It changes the way people feel, leaving them with mental and physical symptoms for long periods of time. It can look quite different from person to person. Depression can be triggered by a life event such as the loss of a job, the end of a relationship or the loss of a loved one, or other life stresses like a major deadline, moving to a new city or having a baby. Sometimes it seems not to be triggered by anything at all. One of the most important things to remember about depression is that people who have it can’t just “snap out of it” or make it go away. It’s a real illness, and the leading cause of suicide.
Some medical conditions can trigger depressive symptoms in individuals. This is called depressive disorder due to another medical condition. Endocrine and reproductive system disorders are commonly associated with depressive symptoms. For example, people with low levels of the thyroid hormone (hypothyroidism) often experience fatigue, weight gain, irritability, memory loss, and low mood. When the hypothyroidism is treated it usually reduces the depression. Cushing's syndrome is another hormonal disorder caused by high levels of the hormone cortisol which can also cause depressive symptoms. Other conditions that have been found to cause depression include conditions such as HIV/AIDS, diabetes, strokes, Parkinson’s disease etc.
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.
Thus far in this document, we've described therapies that are generally best prescribed and monitored by clinical professionals. However, it is also possible to take a self-help approach to the treatment of depression under certain circumstances. Self-help approaches emphasize what people can do for themselves rather than what professionals can offer.
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
Tricyclic antidepressants (TCAs) were some of the first medications used to treat depression. Examples are amitriptyline (Elavil), desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Side effects include stomach upset, dizziness, dry mouth, changes in blood pressure, changes in blood sugar levels, and nausea.
Dr. John Grohol is the founder, Editor-in-Chief & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member and treasurer of the Society for Participatory Medicine. He writes regularly and extensively on mental health concerns, the intersection of technology and psychology, and advocating for greater acceptance of the importance and value of mental health in today's society. You can learn more about Dr. John Grohol here.
The future is very bright for the treatment of depression. In response to the customs and practices of their patients from a variety of cultures, physicians are becoming more sensitized to and knowledgeable about natural remedies. Vitamins and other nutritional supplements like vitamin D, folate, and vitamin B12 may be useful in alleviating mild depression when used alone or more severe degrees of depression when used in combination with an antidepressant medication. Another intervention from alternative medicine is St. John's wort (Hypericum perforatum). This herbal remedy is helpful for some individuals who suffer from mild depression. However, St. John's wort being an herbal remedy is no guarantee against developing complications. For example, its chemical similarity to many antidepressants disqualifies it from being given to people who are taking those medications.
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 and anxiety treatment begins first with recognizing if you have symptoms. Both often appear as physical symptoms, some of which are similar to those seen in migraine. For example, problems with sleep and appetite changes, being easily upset, trouble concentrating, and low energy are all symptoms of migraine, depression, and anxiety. As a result, it is better to pay attention to thoughts and feelings. Depression usually involves strong feelings of sadness or hopelessness that last two weeks or more. Some migraine patients who are depressed do not feel sad or down, but are simply not as interested in activities that they normally enjoy. Others include feeling worthless, guilty, or thoughts of suicide.


Scientists have some evidence that depression susceptibility is also related to diet, both directly—through inadequate consumption of nutrients such as omega-3 fats—and indirectly, through the variety of bacteria that populate the gut. Of course, depression involves mood and thoughts as well as the body, and it causes pain for both those with the disorder and those who care about them. Depression is increasingly common in children.
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.
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