Websites run by organizations like the National Institute of Mental Health (NIMH) provide copious background information as well as updates on clinical trials. Grassroots groups like the National Alliance on Mental Illness connect you with support and services, offer education, and let you know that you are not alone. Personal blogs share the struggle and the wisdom of lived experience. And numerous online depression tests can help those who aren’t sure whether or not they need help get started on the pathway to a healthier life.
At first glance the ability to walk may not seem like something to be grateful for. Think about it this way, however: There are people who were born without it. If you have something not everyone in the world has, you can consider that something to be grateful for. This attitude will allow you to transform your perception of belongings and abilities into sources of gratitude.

Concerns about long-term use of the benzodiazepines led many doctors to favor tricyclic antidepressants (amitriptyline, imipramine, and nortriptyline). Although effective in the treatment of some anxiety disorders(but not Social Anxiety Disorder), they can cause significant side effects, including orthostatic hypotension (drop in blood pressure on standing), constipation, urinary retention, dry mouth, and blurry vision.
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.
Premenstrual Dysphoric Disorder; a severe form of Pre-Menstrual Syndrome that is diagnosed when a woman experiences severe symptoms of depression, tension, and irritability in the week prior to menstruation. While it isn’t uncommon for most women to experience emotional and physical changes prior to menstruation, women who meet criteria for PMDD experience changes that impact their lives in more profound ways.[5] 
But there’s more to the story. There are medications that help people feel better a lot faster than today’s antidepressant pills. And feeling better sooner means that people can take helpful actions sooner, developing helpful habits for long-lasting change and lifting themselves out depression. And there are other medications that might not work any faster, but have antidepressant effects without some of the most troubling side effects associated with medications like Zoloft (sertraline) or Paxil (paroxetine).

Monoamine oxidase inhibitors (MAOIs) – MAOIs have more serious side effects, so they are rarely prescribed unless other medications do not work. MAOIs have many interaction effects with foods and other medications, so people who take them may have to change their diet and other medications. SSRIs and many other medications taken for mental illness cannot be taken with MAOIs.
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.

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.
Despite the popularity of social media platforms and the rapidity with which they’ve inserted themselves into nearly all facets of our lives, there’s a remarkable lack of clear data about how they affect us personally: our behaviors, our social relationships, and our mental health. In many cases, the information that’s available isn’t pretty. Studies have linked the use of social media to depression, anxiety, poorer sleep quality, lower self-esteem, inattention, and hyperactivity — often in teens and adolescents.
Express Yourself. Talk about what is bothering you with a therapist or with friends or family members. If you don't feel comfortable talking, then keep a journal and vent through writing. Expressive writing (such as in a journal) for 15 to 20 minutes three or four days in a row helps you get some perspective on what is bothering you. Writing about what you are feeling can also help decrease the pressure you may be feeling in the moment. Talking and journaling about what bothers you are both known to help raise mood.
Tricyclic antidepressants (TCAs) were developed in the 1950s and '60s to treat depression. They are called tricyclic antidepressants because their chemical structures consist of three chemical rings. TCAs work mainly by increasing the level of norepinephrine in the brain synapses, although they also may affect serotonin levels. Doctors often use TCAs to treat moderate to severe depression. Examples of tricyclic antidepressants are amitriptyline (Elavil), protriptyline (Vivactil), desipramine (Norpramin), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), trimipramine (Surmontil), and perphenazine (Triavil).

Regardless of ethnicity, men appear to be particularly sensitive to the depressive effects of unemployment, divorce, low socioeconomic status, and having few good ways to cope with stress. Women who have been the victim of physical, emotional, or sexual abuse, either as a child or perpetrated by a romantic partner are vulnerable to developing a depressive disorder, as well. Men who engage in sex with other men seem to be particularly vulnerable to depression when they have no domestic partner, do not identify themselves as homosexual, or have been the victim of multiple episodes of antigay violence. However, it seems that men and women have similar risk factors for depression for the most part.
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 Apr 2019), Cerner Multum™ (updated 1 Apr 2019), Wolters Kluwer™ (updated 29 Mar 2019) and others.

Vitamin D deficiency has been linked with rickets, cancer, cardiovascular disease, severe asthma in children and cognitive impairment in older adults. Causes include not ingesting enough of the vitamin over time, having limited exposure to sunlight, having dark skin, and obesity. Symptoms include bone pain and muscle weakness. Treatment for vitamin D deficiency involves obtaining more vitamin D through supplements, diet, or exposure to sunlight.


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.


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.
Some people with milder forms of depression get better after treatment with therapy. People with moderate to severe depression might need a type of medicine called an antidepressant in addition to therapy. Antidepressants change the levels of certain chemicals in your brain. It may take a few weeks or months before you begin to feel a change in your mood. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants.
Mirtazapine (Remeron), another antidepressant, is a tetracyclic compound (four-ring chemical structure). It works at somewhat different biochemical sites and in different ways than the other medications. It affects serotonin but at a postsynaptic site (after the connection between nerve cells). It also increases histamine levels, which can cause drowsiness. For this reason, patients take mirtazapine at bedtime; physicians often prescribe mirtazapine for people who have trouble falling asleep. Like the SNRIs, it also works by increasing levels in the norepinephrine system. Other than causing sedation, this medication has side effects that are similar to those of the SSRIs.
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.
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.

On March 5, 2019 the FDA approved a new nasal spray medication- Spravato (esketamine) for treatment-resistant depression, available only at a certified doctor’s office or clinic. Ketamine represents a major step forward in the treatment of depression and suicide prevention. ADAA recognizes that clinicians want to offer their patients evidence-based options which have passed through the numerous stages of FDA testing, and this marks the first FDA approval of a ketamine product for a psychiatric indication. This is also the first antidepressant with a novel mechanism of action that we have had in decades.     
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.

By working with a therapist or thinking strategically about the tactics you want to try, you can integrate them and execute several at once. For example, therapist Asta Klimaite often asks her clients to incrementally increase their exercise by using different methods and routes to reach her office. Her tactic also helps them develop a sense of accomplishing simple goals. They start by taking a different route to her office and using whatever mode of transportation they like. She then challenges them to ride a bike or walk to her office. Before they even start therapy, they are already working on their mental health.
Another possible cause of depression that should not be overlooked is physical illness or medications. Glandular fever, influenza, hepatitis, thyroid hormones, anaemia, diabetes, birth control pills, alcohol and other substances of abuse, or other medications such as those for heart or blood pressure conditions, may all cause symptoms of depression.
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.
SNRIs can be used as first-line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. The SNRIs also have an important role as second-line agents in patients who have not responded to SSRIs. Safety, tolerability, and side-effect profiles are similar to those of the SSRIs, with the exception that venlafaxine and desvenlafaxine have been associated (rarely) with a sustained rise in blood pressure. Venlafaxine has been particularly associated with hyponatremia.
Mental health researchers agree that the causes of depression are much more complex than the chemical imbalance theory suggests. A growing body of research points to other physiological factors, including inflammation, elevated stress hormones, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. And these are just the biological causes of depression. Social and psychological factors—such as loneliness, lack of exercise, poor diet, and low self-esteem—also play an enormous role.
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.
We know it can be tough take on any of these depression self help tips when you’re feeling really bad. Also, when it comes to self-help, strategies for feeling better are very individualistic. That is, different things work for different people. Not everyone will want to start doing yoga, for example, so keep trying different ideas even if the first thing you try doesn’t help.
Some types of depression run in families, indicating an inheritable biological vulnerability to depression. This seems to be the case, especially with bipolar disorder. Researchers have studied families in which members of each generation develop bipolar disorder. The investigators found that those with the illness have a somewhat different genetic makeup than those who do not become ill. However, the reverse is not true. That is, not everybody with the genetic makeup that causes vulnerability to bipolar disorder will develop the illness. Apparently, additional factors, like a stressful environment, are involved in its onset and protective factors, like good support from family and friends, are involved in its prevention.
Being both anxious and depressed is a tremendous challenge. Clinicians have observed when anxiety occurs comorbidly (together) with depression, the symptoms of both depression and anxiety are more severe compared to when each disorder occursalone. Moreover, the symptoms of depression take longer to resolve, making the illness more chronic and more resistant to treatment (read more about: Depression Treatment).
The side effects of tricyclic antidepressants are often worse than the side effects of SSRIs and SNRIs. As a result, more people tend to stop taking tricyclic antidepressants: Studies found that about 15 out of 100 people did so, compared with around 10 out of 100 people who were taking SSRIs. Taking an overdose of tricyclic antidepressants is also more likely to lead to severe side effects than taking an overdose of the other antidepressants.
Antidepressants, sometimes in combination with psychotherapy, are often the first treatment people get for depression. If one antidepressant doesn't work well, you might try another drug of the same class or a different class of depression medicines altogether. Your doctor might also try changing the dose. In some cases, your doctor might recommend taking more than one medication for your depression.
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.
Some of the classic "adult" symptoms of depression may also be more or less obvious during childhood compared to the actual emotions of sadness, such as a change in eating or sleeping patterns. (Has the child or teen lost or gained weight or failed to gain appropriate weight for their age in recent weeks or months? Does he or she seem more tired than usual? Does the minor have a sense of low self-worth?)

Several supplements are promoted for improving depression. Examples include St. John's wort, 5-hydroxytryptophan (5-HTP), SAMe, fish oil, and L-theanine. Although these supplements may have mild antidepressant properties, it is important to remember that depression is a serious condition that needs proper evaluation and treatment under the care of a physician. It is also important to note that these supplements are not regulated by the FDA; their safety and efficacy have not been proven in large clinical studies, and they may interact with other drugs.

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).


Your GP will have suggestions for alternative things you can try to help manage your depression from day to day, and will be able to assess if you need medication or further help. Treatments such as cognitive behavioural therapy and medication, and having a good relationship with a GP, psychologist and/or psychiatrist, can be effective in treating depression and improving mood.
Certain brain chemicals called neurotransmitters are associated with depression — particularly serotonin (ser-o-TOE-nin), norepinephrine (nor-ep-ih-NEF-rin) and dopamine (DOE-puh-meen). Most antidepressants relieve depression by affecting these neurotransmitters. Each type (class) of antidepressant affects these neurotransmitters in slightly different ways.
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.
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