Encourage the person to get a clinical evaluation. You can start by helping them to fill out our Depression and Bipolar Test. When finished, you can print the results so that the person can bring them to a clinician for further evaluation. Mention that depression and bipolar disorder are both treatable medical conditions. Often, people feel relieved to learn that they are suffering from a medical condition. Ask the person to see a medical professional, offer to make an appointment, and go with the person or call the doctor in advance to state the person’s symptoms.

People should try to avoid mixing medications of any kind (prescribed, over the counter, or borrowed) without consulting their doctor. Patients should inform their dentist or any other medical specialist who prescribes a drug that he or she is taking antidepressants. Some medications that are harmless when taken alone can cause severe and dangerous side effects when taken with other medications. This may also be the case for individuals taking supplements or herbal remedies. Some addictive substances, like alcohol (including wine, beer, and liquor), tranquilizers, narcotics or marijuana, reduce the effectiveness of antidepressants and can cause mental health and/or physical symptoms. Patients should avoid these. These and other drugs can be dangerous when the person's body is either intoxicated with or withdrawing from their effects due to increasing the risk of seizure or heart problems in combination with antidepressants medications.
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.

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.
8. Check with your doctor before using supplements. "There's promising evidence for certain supplements for depression," Cook says. Those include fish oil, folic acid, and SAMe. But more research needs to be done before we'll know for sure. Always check with your doctor before starting any supplement, especially if you’re already taking medications.
When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.
One reason depression is difficult to identify is that its symptoms can vary depending on age and sex. Adults with depression generally feel overwhelmed by sadness, while depression in adolescents tends to express itself mainly as irritability. Women with depression are more likely to note symptoms like anxiety and indecisiveness, while men are more likely to report anger and aggression.

People living with high-functioning anxiety and depression may appear fine, but they are far from being as emotionally and mentally healthy as they could be. Seeking treatment is an important step to improving overall emotional and mental health to its potential level. High-functioning anxiety and depression is very treatable, but often the difficulty is in identifying the signs and symptoms and realizing there is a problem.

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.
Women—Depression is diagnosed twice as much in women as it is in men. Some reasons for this difference include life-cycle changes, hormonal changes, higher rates of childhood abuse or relationship violence, and social pressures. Women are usually more comfortable seeking help for their problems than men which likely means that depression in men may be highly under-reported. Men generally feel emotionally numb or angry when they are depressed whereas women usually feel more emotional.

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.
Mental health concerns among college students have increased in recent years—rates of depression, anxiety, substance use and suicidal behaviors have all increased. One in four college students had a psychiatric diagnosis in the past year, and racial-ethnic minority students maybe at high risk of undetected mental illnesses, according to new research published in Psychiatric Services.
Despite major advances in drugs and medical treatments, maintaining a healthy diet, being physically active, and not smoking are still the best approaches to preventing heart disease. In this Special Health Report, Healthy Eating for a Healthy Heart, find out how improving your diet lowers your risk for heart disease in many ways, including helping to lower high cholesterol, blood pressure, and blood sugar and insulin levels, as well as preventing obesity and improving the function of your heart and blood vessels. Fortunately, a heart-healthy diet is relatively easy to define, and you don’t have to give up great-tasting food.
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).
Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings Cdc-pdf[PDF – 2.37MB]External. Rockville, MD: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, 2014 [accessed 2018 Mar 22].
Americans are obsessed with happiness, yet we are increasingly depressed: Some 15 million Americans battle the disorder, and increasing numbers of them are young people. Mental anguish is hard on your health. People suffering from depression have three times the risk of experiencing a cardiac event. In fact, depression affects the entire body. It weakens the immune system, increasing susceptibility to viral infections and, over time, possibly even some kinds of cancer—a strong argument for early treatment of depression. It interferes with sleep, adding to feelings of lethargy, compounding problems of focus and concentration, and generally undermining health. Those suffering from depression also experience higher rates of diabetes and osteoporosis. Sometimes depression manifests as a persistent low mood, a condition known as dysthymia. It is usually marked by years-long periods of low energy, low self-esteem, and little ability to experience pleasure.
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
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.
Antidepressants are usually taken daily. The goal in the first few weeks and months is to relieve the symptoms and, if possible, make the depression go away. Once that has been achieved, the treatment is continued for at least four to nine months. This continuation therapy is necessary to stop the symptoms from coming back. The medication is sometimes taken for longer to prevent relapses. The duration of treatment also depends on how the symptoms develop over time and whether there is an increased risk of relapse. Some people take antidepressants for several years.
Imipramine is one of the oldest agents available for the treatment of depression. It is demethylated in the liver to desipramine. Imipramine inhibits the reuptake of norepinephrine and, more potently, serotonin at the presynaptic neuronal membrane. It has a strong affinity for alpha-adrenergic, H1, and M1 receptors. Common side effects include orthostasis, sedation, weight gain, and anticholinergic effects. It is also used off-label in the treatment of panic disorder, posttraumatic stress disorder, and attention deficit/hyperactivity disorder.
Doctors at NIMH are dedicated to mental health research, including clinical trials of possible new treatments as well as studies to understand the causes and effects of depression. The studies take place at the NIH Clinical Center in Bethesda, Maryland and require regular visits. After the initial phone interview, you will come to an appointment at the clinic and meet with one of our clinicians. Find NIMH studies currently recruiting participants with depression by visiting Join a Research Study: Depression.
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