Towards the end of the treatment, the dose is gradually reduced over the course of several weeks. You may experience temporary sleep problems, nausea or restlessness while coming off the medication. These problems are especially common if you stop taking antidepressants suddenly. Sometimes people stop taking their medication as soon as they start feeling better. But doing so increases the likelihood of the depression returning. Unlike many sleeping pills and sedatives, though, antidepressants do not cause physical dependence.
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.
See a depression expert. It's important to talk with a trained professional during your treatment. Although psychologists cannot prescribe medication, they are well-trained in psychiatric assessment and psychotherapy. You can work with a psychologist while taking antidepressants prescribed by your regular doctor, or you can see a psychiatrist for both your depression medication and talk therapy. Try to find someone who has a lot of experience helping people with treatment-resistant depression. Mood disorder experts can often be found through university-based hospitals or organizations such as the American Society of Clinical Psychopharmacology, the American Psychiatric Association, or the Depression and Bipolar Support Alliance (DBSA) "Find a Pro" online search engine.
People with substance use problems—There is a direct link between depression and problem substance use. Many people who are experiencing depression turn to drugs or alcohol for comfort. Overuse of substances can actually add to depression in some people. This is because some substances like alcohol, heroin and prescription sleeping pills lower brain activity, making you feel more depressed. Even drugs that stimulate your brain like cocaine and speed can make you more depressed after other effects wear off. Other factors, like family history, trauma or other life circumstances may make a person vulnerable to both alcohol/drug problems and depression.
Self-help approaches to treating depression are best thought of as adjuncts or additions to professionally prescribed treatments. Don't delay treating your depression professionally, or attempt to treat your depression solely on your own. Instead, seek a professional diagnosis at the earliest opportunity. Early diagnosis of depression is critical. The sooner your depression has been properly diagnosed and treated, the sooner you will have a good chance of recovering. Many people think that their low mood is temporary and will resolve by itself. While some depressions are temporary and relatively mild conditions, others really aren't. Delaying treatment in such cases allows symptoms to worsen and can cause serious problems to occur such as severely impaired health and occupational functioning, damage to your interpersonal relationships, and suicidal thoughts and behavior. A small but significant minority of people die from depression-caused suicides each year.
Losing a loved one, getting fired from a job, going through a divorce, and other difficult situations can lead a person to feel sad, lonely and scared. These feelings are normal reactions to life's stressors. Most people feel low and sad at times. However, in the case of individuals who are diagnosed with depression as a psychiatric disorder, the manifestations of the low mood are much more severe and they tend to persist.
People who are depressed will usually show a style of thinking that focuses on negative views of the world. They often think of themselves as worthless and of the world as being a bad or unfair place, and they are without hope that their lives will improve in the future. When something bad happens, they blame themselves, but when good things happen, they tell themselves they are just lucky. Furthermore, people with depression are less likely to recognize and appreciate positive events when they happen; rather, they tend to be more tuned into the bad things in their lives and brood over those events.
However, some depressive mood disorders might have an adverse effect for creativity. Upon identifying several studies and analyzing data involving individuals with high levels of creativity, Christa Taylor was able to conclude that there is a clear positive relationship between creativity and depressive mood. A possible reason is that having a low mood could lead to new ways of perceiving and learning from the world, but it is unable to account for certain depressive disorders. The direct relationship between creativity and depression remains unclear, but the research conducted on this correlation has shed light that individuals who are struggling with a depressive disorder may be having even higher levels of creativity than normal people, and would be a close topic to monitor depending on the future trends of how creativity will be perceived and demanded.
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.
Patients generally tolerate SSRIs well, and side effects are usually mild. The most common side effects are nausea and other stomach upset, diarrhea, agitation, insomnia, and headache. However, these side effects generally go away within the first month of SSRI use. Some patients experience sexual side effects, such as decreased sexual desire (decreased libido), delayed orgasm, or an inability to have an orgasm. Sexual side effects occur less often with newer SSRIs like vortioxetine and vilazodone, compared to the older medications in this category. For those patients, especially for whom anxiety is a prominent symptom of depression, the addition of buspirone may help enhance the effectiveness (augment) the effect of the SSRI while decreasing or eliminating sexual side effects. Uncommonly, some patients experience tremors, hair loss, or gradual weight gain with SSRIs. The so-called serotonergic (meaning caused by serotonin) syndrome is a serious neurologic condition associated with the use of SSRIs, usually when given in high doses or in combination with another SSRI. High fevers, seizures, and heart-rhythm disturbances characterize serotonergic syndrome. This condition is very rare and tends to occur only in very ill psychiatric patients taking multiple psychiatric medications.
There is no shame in taking medication to manage your depression. People routinely take medication for physical ailments, and a mental illness isn’t any different. If you’re worried about the possible side effects, call your doctor to discuss them. Any medication can be tapered down or ceased, and there are different types available to suit your individual needs and chemistry.
There are a number of potential reasons for this. Women may be reluctant to reveal negative feelings at a time in their lives when society, family, and friends all expect them to be joyful. Women who are poor or who became pregnant unintentionally may regard symptoms of depression as a realistic response to their situation. Plus, some of the signs of depression — fatigue, changes in eating habits, sleep disturbances —are similar to the changes that many women experience as a typical part of pregnancy, making it harder to spot depression.
Tricyclic antidepressants (TCAs) were one of the first approved antidepressants. Although they are effective, they have been replaced by newer antidepressants that generally cause fewer side effects. Like SNRIs, TCAs work by blocking the reabsorption of the neurotransmitters serotonin and norepinephrine in the brain. Additionally, they block muscarinic M1, histamine H1, and alpha-adrenergic receptors.
It is important to communicate regularly with your doctor when you are taking an antidepressant, especially if you are prescribed any other medications. Keep track of your symptoms so that they can find the best medication for your depression, and also keep track of any side effects you experience. If you’re having trouble finding a medication that works, drug-genetic testing can help your doctor determine appropriate options. If you become pregnant or are breastfeeding, be sure to ask what medication is safest.
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.
Do your best to not be this way. Instead, choose to accept your diagnosis and to take the medications and other therapies that have been prescribed for you regularly. Make it a point to talk with your doctor when you are not getting relief as expected or new symptoms develop so that your doctor has a chance to address these concerns. Tell the people that you are close to that you are clinically depressed and ask for their help in overcoming the problem. For instance, your friends can help you resist the urge to withdraw and isolate, and give you feedback as to how you appear to be doing both physically and emotionally. Allow the time necessary for medication therapies to pass before you decide that they aren't working. In general, accept your diagnosis and cooperate as best you can with the people who are trying to help you recover.
MAOIs are older drugs that treat depression. They work by stopping the breakdown of norepinephrine, dopamine, and serotonin. They’re more difficult for people to take than most other antidepressants because they interact with prescription drugs, nonprescription drugs, and some foods. They also can’t be combined with stimulants or other antidepressants.
It’s the Catch-22 of depression recovery: The things that help the most are the things that are the most difficult to do. There is a big difference, however, between something that’s difficult and something that’s impossible. You may not have much energy, but by drawing on all your reserves, you should have enough to take a walk around the block or pick up the phone to call a loved one.
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.
Depression drains your energy, hope, and drive, making it difficult to take the steps that will help you to feel better. But while overcoming depression isn’t quick or easy, it’s far from impossible. You can’t just will yourself to “snap out of it,” but you do have more control than you realize—even if your depression is severe and stubbornly persistent. The key is to start small and build from there. Feeling better takes time, but you can get there by making positive choices for yourself each day.
To search for a clinical trial near you, you can visit ClinicalTrials.gov. This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world (search: depression). ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations, and contact information for more details. This information should be used in conjunction with advice from health professionals.