Buspirone is marketed as an antianxiety medication; however, it may have antidepressant effects at doses above 45 mg/day. The antidepressant effects may increase when buspirone is used in combination with SSRIs and TCAs in patients with treatment-resistant depression. Buspirone is a partial 5-HT1A agonist with serotonergic and some dopaminergic effects in the CNS. It has anxiolytic effects but may take up to 2-3 weeks for full efficacy.
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.
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.
Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.
Life events and changes that may precipitate depressed mood include (but are not limited to): childbirth, menopause, financial difficulties, unemployment, stress (such as from work, education, family, living conditions etc.), a medical diagnosis (cancer, HIV, etc.), bullying, loss of a loved one, natural disasters, social isolation, rape, relationship troubles, jealousy, separation, and catastrophic injury. Adolescents may be especially prone to experiencing depressed mood following social rejection, peer pressure, or bullying.
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.
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.
For example, abruptly stopping an SSRI such as paroxetine can cause dizziness, nausea, flu-like symptoms, body aches, anxiety, irritability, fatigue, and vivid dreams. These symptoms typically occur within days of abrupt cessation, and can last one to two weeks (up to 21 days). Among the SSRIs, paroxetine and fluvoxamine cause more pronounced discontinuation symptoms than fluoxetine, sertraline, citalopram, escitalopram, vortioxetine, and vilazodone. Some patients experience discontinuation symptoms despite gradual tapering of the SSRI. Abrupt cessation of venlafaxine, duloxetine, desvenlafaxine, or levomilnacipran can cause discontinuation symptoms similar to those of SSRIs.
Krill oil may have benefits, but for now it's best to rely on omega-3 sources that have received greater scientific scrutiny, including fish, fish oil, and plant sources of ALA. The American Heart Association recommends that healthy adults eat at least two servings per week of EPA- and DHA-rich fish, such as salmon, herring, mackerel, sardines, and albacore or bluefin tuna. People with heart disease should consume 1 gram of EPA plus DHA daily from fatty fish or fish oil supplements. Heart experts also recommend getting ALA from food sources such as soy products, flaxseed, walnuts, and oils extracted from flaxseed, canola seed, olives, walnuts, or soybeans.
Behavioral therapies for depression require a commitment to changing behaviors that make depression worse. They often focus on getting involved in enjoyable or rewarding activities, knowing that if you force yourself to do these things your mood will improve over time. Changing thoughts about certain aspects of life can also be useful. Behavioral interventions for anxiety include safe and gradual exposure to the things that the patient fears. It too involves changing how the patient thinks about those things. Behavioral therapies are effective for depression, and tend to be more effective than medication for anxiety disorders, particularly for long-term relief. For many patients, combining medication and behavioral therapy is better than either one alone for depression, anxiety, and headache.
“[If there was] certainty that an acute episode [of depression] will last only a week, a month, even a year, it would change everything. It would still be a ghastly ordeal, but the worst thing about it — the incessant yearning for death, the compulsion toward suicide — would drop away. But no, a limited depression, a depression with hope, is a contradiction. … [T]he conviction that it will never end except in death — that is the definition of a severe depression.”
TCAs have a long record of efficacy in the treatment of depression and have the advantage of lower cost. They are used less commonly because of the need to titrate the dose to a therapeutic level and because of their considerable toxicity in overdose. TCAs are often prescribed for many other psychiatric disorders, such as generalized anxiety disorder and posttraumatic stress disorder. They are also used to treat chronic pain, such as neuropathy, and migraine headaches.
If you tend to worry a lot, even when there’s no reason, you may have anxiety. It may be something you are so used to that you may think it’s just “how you are.” Common worries include health, money, family, or work. While everyone worries about these things once in a while, if you always expect the worst, it can get in the way of living a normal life. Though researchers are still investigating the causes of anxiety, they have identified the areas of the brain responsible for fear and anxiety and are using proven studies to increase knowledge in this field in an effort to create improved treatments for anxiety and related disorders.
Youth—More than a quarter of a million Canadian youth—6.5% of people between 15 and 24—experience major depression each year. Depression can be hard to recognize in youth because parents and caregivers often mistake a teen’s mood swings and irritability for normal adolescence, rather than depression. Studies have shown that gay, lesbian, bisexual or transgendered youth have higher rates of major depression.
Sticking to your treatment plan is one of the most important things you can do. It’s easy to get discouraged in the first few weeks of treatment. You may not want to continue. All types of treatment can take a few months before you notice a difference. It’s also easy to feel like you’re doing much better and stop treatment all together. Never stop treatment without consulting your doctor first.
Medication treatment of anxiety is generally safe and effective and is often used in conjunction with therapy. Medication may be a short-term or long-term treatment option, depending on severity of symptoms, other medical conditions, and other individual circumstances. However, it often takes time and patience to find the drug that works best for you.
Bipolar II disorder is a significant variant of the bipolar disorders. (The usual form of bipolar disorder is referred to as bipolar I disorder.) Bipolar II disorder is a syndrome in which the affected person has repeated depressive episodes punctuated by hypomania (mini-highs). These euphoric states in bipolar II do not completely meet the criteria for the full manic episodes that occur in bipolar I.
Older adults—Around 7% of seniors have some symptoms of depression. This can be brought on by the loss of a spouse, a shrinking circle of friends or the onset of an illness. It’s also much more common among seniors living in care homes or who have dementia. Depression in people 65 and over appears to be less common than in younger groups, but researchers aren’t sure if this is a real difference or an issue with the research questions. It’s likely that depression is at least somewhat under-recognized in seniors. Some symptoms like changes in sleep or activity levels may be mistaken as signs of aging instead of 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.
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.
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.
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.
Not only does it take time to get an accurate depression diagnosis, finding the right medication to treat depression can be a complicated, delicate process. Someone may have a serious medical problem, such as heart disease or liver or kidney disease, that could make some antidepressants unsafe. The antidepressant could be ineffective for you or the dose inadequate; there may not have been enough time to see an effect, or the side effects could be too bothersome -- leading to a failure of treatment.
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.
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.
For mild depression, many people start with self-help strategies and emotional support. There are some common herbal treatments that research has also shown to be effective, including St. John’s wort and kava (Sarris, 2007). The positive effects of exercise and diet should not be under-estimated in helping mild to moderate depression symptoms as well. Increased, regular exercise is recommended as a component of treatment for all severity levels of depression.
A. Krill oil is extracted from the bodies of Antarctic krill — tiny shrimp-like shellfish — and can be taken in capsules. Like fatty fish and fish oil supplements, krill oil capsules contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Consuming these fatty acids (and alpha-linolenic acid, or ALA, which is derived from plants and converted in the body to DHA and EPA) is associated with a reduced risk for cardiovascular disease.
Left untreated, depression can be a debilitating illness for individuals and their families. Often, symptoms are not recognized for their severity and can worsen, and severe depression may lead to suicidal thoughts and actions. Common treatments for depression 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, especially for those who have not found relief in symptoms through other treatment methods.
Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This can be a serious problem as taking antidepressants for bipolar depression can actually make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder.