Selective serotonin reuptake inhibitors or SSRIs are the most widely used class of antidepressants. They work by increasing the level of serotonin in the brain. Unlike MAOIs and TCAs, SSRIs do not significantly affect norepinephrine levels in the brain. SSRIs also have fewer and milder side effects, fewer drug interactions, and are much less likely to be associated with suicide than TCAs.
Stay active. Exercise can make a difference to your energy levels and help stimulate hormones (such as endorphins) that help you feel better about yourself. Make a realistic goal to increase your level of activity. For example, if you’ve found it difficult even to get out of bed for the last few days, an achievable goal might be just to go for a walk outside in the fresh air for five minutes.
Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
It is not uncommon to experience occasional and brief periods of feeling down and anxious. These episodes are not usually a cause for concern, and once passed, you are able to resume life as usual. But, if you suffer from depression and anxiety and your symptoms are present for more than two weeks, frequently recur, or are interfering with how you live your life, it’s time to get help.
Other health conditions. Some antidepressants may cause problems if you have certain mental or physical health conditions. On the other hand, certain antidepressants may help treat other physical or mental health conditions along with depression. For example, bupropion (Wellbutrin, Aplenzin, Forfivo XL) may help relieve symptoms of both attention-deficit/hyperactivity disorder (ADHD) and depression. Other examples include using duloxetine (Cymbalta) to help with pain symptoms or fibromyalgia, or using amitriptyline to prevent migraines.
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.
Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”