Increasingly, doctors may use a combination of antidepressants from different classes or add a medication from a completely different chemical class, such as Abilify or Seroquel, that are thought to enhance the effectiveness of antidepressant medication more rapidly than adding or switching to a second antidepressant. Also, new types of antidepressants are constantly being developed, and one of these may be the best for a particular patient.
Millions of Americans take an anti-inflammatory medication like Advil (ibuprofen) or Aleve (naproxen) for occasional aches and pains. Many take one daily for arthritis. And one common prescription medicine — Celebrex (celecoxib) — may not be helpful just for joint pain, it may also be a decent treatment for depression. Many researchers believe that there’s a link between depression and systemic inflammation — at least for some people. So, can an anti-inflammatory medicine — especially COX-2 inhibitors like Celebrex — help with symptoms of depression?

Following a major life-changing event like a disabling illness, it is normal to feel a great deal of stress. Stress can build up over time and can lead to anxiety. Anxiety can be a response to a specific situation such as learning to walk all over again; it can also be more generalized such as not wanting to leave the house after being discharged from the hospital.

If the depressed person is taking more than one medication for depression or medications for any other medical problem, each of the patient's doctors should be aware of the other prescriptions. Many of these medications clear from the body (metabolized) in the liver. This means that the multiple treatments can interact competitively with the liver's biochemical clearing systems. Therefore, the actual blood levels of the medications may be higher or lower than would be expected from the dosage. This information is especially important if the patient is taking anticoagulants (blood thinners), anticonvulsants (seizure medications), or heart medications, such as digitalis (Crystodigin). Although multiple medications do not necessarily pose a problem, all of the patient's doctors may need to be in close contact to adjust dosages accordingly.


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.

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.


MAOIs also impair the ability to break down tyramine, a substance found in aged cheese, wines, most nuts, chocolate, certain processed meats, and some other foods. Tyramine, like norepinephrine, can elevate blood pressure. Therefore, the consumption of tyramine-containing foods by a patient taking an MAOI drug can cause elevated blood levels of tyramine and dangerously high blood pressure. In addition, MAOIs can interact with over-the-counter cold and cough medications to cause dangerously high blood pressure. The reason for this is that these cold and cough medications often contain drugs that likewise can increase blood pressure. Because of these potentially serious drug and food interactions, MAOIs are usually only prescribed for people who are thought to be willing and able to manage the many dietary restrictions required by these medications and after other treatment options have failed.
High scores on the personality domain neuroticism make the development of depressive symptoms as well as all kinds of depression diagnoses more likely,[10] and depression is associated with low extraversion.[11] Other personality indicators could be: temporary but rapid mood changes, short term hopelessness, loss of interest in activities that used to be of a part of one's life, sleep disruption, withdrawal from previous social life, appetite changes, and difficulty concentrating.[12]

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.

Even though clinical depression tends to occur in episodes, most people who experience one such episode will eventually have another one. Also, it seems that any subsequent episodes of depression are more easily triggered than the first one. However, most depression sufferers recover from the episode. In fact, individuals who have mild depression and receive treatment with medication tend to respond equally as well to sugar pill (placebo). Those with more severe depression seem to be less likely to get better when taking placebo versus taking antidepressant medication. Other encouraging information is that research shows that even people from teenage through adulthood who do not improve when treated with a first medication trial can improve when switched to another medication or given another medication in addition to psychotherapy. For individuals who experience thoughts of suicide, preventing access to firearms and other highly lethal means of committing suicide are important ways to improve their safety and that of those around them.


All patients are unique biochemically. Therefore, the occurrence of side effects or the lack of a satisfactory result with one SSRI does not mean that another medication in this group will not be beneficial. However, if someone in the patient's family has had a positive response to a particular drug, that drug may be the preferable one to try first.
Treatment for anxiety disorders and depression needs to be administered and managed by a psychiatrist, Connolly says. "It's really crucial for people with both [anxiety and depression] to have a good assessment to rule out bipolar disorder," she says. Bipolar disorder, a condition in which emotions can swing from very low to very high levels of mania and depression, is treated much differently than anxiety disorder with depression.

Bipolar Disorder: Formerly known as Manic Depression or Manic Depressive Disorder. While different from depression, bipolar disorder is often included in discussions around depressive disorders as it involves episodes of extreme lows similar to major depression. Someone with bipolar disorder, however, will swing in the opposite direction towards mania or extreme highs.
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.
These negative thoughts and feelings tend to focus your attention on things you do not like about yourself or your life situation. These thoughts also tend to make your problems seem worse than they really are. As well as concentrating on your negative features and experiences, when you are depressed, you tend to underestimate your positive characteristics and your ability to solve problems. A number of strategies may help you achieve a more balanced view of things:
Just as there are many different experiences of anxiety and depression, there are a variety of options for treatments and coping techniques to help manage symptoms.  The recommendations in this section take an integrative mental health approach, which incorporates health-promoting lifestyle changes; evidence-based holistic therapies and healing practices; and mainstream interventions, including psychosocial therapies and the judicious use of prescription medication. We cover each of these areas in detail--click the links or see the menu on the left for more information. 
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.
Major depression, also often referred to as unipolar depression, is characterized by a combination of symptoms that lasts for at least two weeks in a row, including depressed and/or irritable mood (see symptom list), that interferes with the ability to work, sleep, eat, and enjoy once-pleasurable activities. Difficulties in sleeping or eating can take the form of excessive or insufficient of either behavior. Disabling episodes of depression can occur once, twice, or several times in a lifetime.
Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.
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.
Another type of depression is related to changes in the length of days or seasonality. This type of depression is called Seasonal affective disorder (SAD). People with SAD suffer the symptoms of a Major Depressive Disorder only during a specific time of year, usually winter. This appears to be related to the shorter days of winter, and the lack of sunlight in many parts of the country.
Different neuropsychiatric illnesses seem to be associated with an overabundance or a lack of some of these neurochemicals in certain parts of the brain. For example, a lack of dopamine at the base of the brain causes Parkinson's disease. There appears to be a relation between Alzheimer's dementia and lower acetylcholine levels in the brain. The addictive disorders are under the influence of the neurochemical dopamine. That is to say, drugs of abuse and alcohol work by releasing dopamine in the brain. The dopamine causes euphoria, which is a pleasant sensation. Repeated use of drugs or alcohol, however, desensitizes the dopamine system, which means that the system gets used to the effects of drugs and alcohol. Therefore, a person needs more drugs or alcohol to achieve the same high feeling (builds up tolerance to the substance). Thus, the addicted person takes more substance but feels less and less high and increasingly depressed. There are also some drugs whose effects can include depression (these include alcohol, narcotics, and marijuana) and those for whom depression can be a symptom of withdrawal from the substance (including caffeine, cocaine, or amphetamines).
Depressed mood may not require professional treatment, and may be a normal temporary reaction to life events, a symptom of some medical condition, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition which may benefit from treatment. The UK National Institute for Health and Care Excellence (NICE) 2009 guidelines indicate that antidepressants should not be routinely used for the initial treatment of mild depression, because the risk-benefit ratio is poor.[36] Physical activity can have a protective effect against the emergence of depression.[37]
I was physically abused for 40 yrs. ... 2 marriages.... and my head generally took the brunt of the abuse. I was also in 2 car accidents. Again head injury. At this point someone special- a friend- spoke to another friend knowledgeable about TBI and told me he did. I began to realize after feeling hurt and betrayed that something was wrong. I go from happy to sad to panic like flipping a light switch. I get emotional and emotionally hurt over nothing. I don't want to go on this way I need some coping skills and ways to stop what's happening before I get worse.....
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.

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]
Many medications and therapies help with symptoms of depression and anxiety. Antidepressants reduce symptoms of depression and anxiety because they change how the brain sends chemical signals. Sometimes a single method can help both symptoms of depression/anxiety and headache. However, many patients require two different drugs or behavioral treatments for a period of time. They need one to treat depression/anxiety and another to prevent migraines.
The second most important way to help someone with depression is to offer emotional support. This support involves understanding, patience, affection, and encouragement to the depression sufferer. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Always take them seriously and report them to the depressed person's therapist.
As a matter of fact, many researchers think that antidepressant medications should work more quickly — that people shouldn’t have to take a medication for weeks before they see some improvement. Especially because the most common antidepressants cause short- and long-term side effects — all antidepressants can produce psychological side effects, tricyclic antidepressants (TCAs) can cause heart problems, and SSRI and SNRI medications cause issues ranging from nausea to weight gain and low sex drive, among others. Alternatives and better options are a good thing.
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.

It's also common for people who are having a difficult time with an anxiety disorder to feel depressed as a result of the way anxiety is interfering with their lives. It's my experience that most patients who experience this will find that their depression lifts naturally as a result of doing better with anxiety, and no special treatment for the depression is necessary.
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?)
The presence of maternal-fetal stress is another risk factor for depression. It seems that maternal stress during pregnancy can increase the chance that the child will be prone to depression as an adult, particularly if there is a genetic vulnerability. Researchers believe that the mother's circulating stress hormones can influence the development of the fetus' brain during pregnancy. This altered fetal brain development occurs in ways that predispose the child to the risk of depression as an adult. Further research is still necessary to clarify how this happens. Again, this situation shows the complex interaction between genetic vulnerability and environmental stress, in this case, the stress of the mother on the fetus.
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.
People living with high-functioning anxiety and depression usually do not fit the stereotype of either disorder. In fact, many appear to be overachievers. The anxiety can serve as an energizer, driving the person towards achieving his or her goals. It’s later, when in private, that the symptoms of depression tend to emerge. Feelings of self-doubt and self-criticism, fatigue, helplessness or guilt, moodiness, and a desire to avoid interaction with others become intensified. Because the stereotypical image of depression or anxiety doesn’t match up with what people living with high-functioning anxiety and depression “look like,” it is hard to spot, even for sufferers to recognize in themselves. However, the symptoms of high-functioning anxiety and depression are the same as for non-high functioning anxiety and depression. The main difference is the ability to suppress or diminish the appearance of disruptions in life activities.
Depressed mood may not require professional treatment, and may be a normal temporary reaction to life events, a symptom of some medical condition, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition which may benefit from treatment. The UK National Institute for Health and Care Excellence (NICE) 2009 guidelines indicate that antidepressants should not be routinely used for the initial treatment of mild depression, because the risk-benefit ratio is poor.[36] Physical activity can have a protective effect against the emergence of depression.[37]
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.
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