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.
Exercise and pleasurable activities are natural ways to improve mood. Exercise increases the levels of endorphins which can elevate mood. Foods high in omega-3-fatty acids may increase serotonin levels in the brain and contribute to relieving depression. During winter months some people may suffer from seasonal depression. Increasing exposure to light alleviates seasonal depression.
Bupropion inhibits neuronal dopamine reuptake and decreases the rate of norepinephrine activity. In addition to major depressive disorder, the indications for bupropion include smoking cessation. Off-label indications include attention-deficit/hyperactivity disorder and depression associated with bipolar disorder. Common side effects include headache and mild weight loss. Unlike other antidepressants, bupropion does not cause sexual dysfunction.
Offidani, E., Fava, G. A., Tomba, E., & Baldessarini, R. J. (2013). Excessive mood elevation and behavioral activation with antidepressant treatment of juvenile depressive and anxiety disorders: A systematic review. Psychotherapy and psychosomatics, 82, 132-141. Retrieved from https://pdfs.semanticscholar.org/467a/0936752c67af496c727d48b6513f3f48d2f3.pdf
But with all three of these treatments, there is the promise of alternative medications to treat depression that might help people feel better — sometimes faster — and hopefully with fewer troubling side effects. No one treatment is right for everyone (that’s why we made our iPhone app called Start, to help people figure out if their antidepressant works), so better research into safe alternatives is important.
As of today, there is no laboratory test, blood test, or X-ray that can diagnose a mental disorder. Even the powerful CT, MRI, SPECT, and PET scans, which can help diagnose other neurological disorders such as stroke or brain tumors, cannot detect the subtle and complex brain changes in psychiatric illness. However, these techniques are currently useful ruling out the presence of a number of physical disorders and in research on mental health and perhaps in the future they will be useful for the diagnosis of depression, as well.
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.
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.
All antidepressants on the market are potentially effective. [120] Usually, 2–6 weeks at a therapeutic-dose level are needed to observe a clinical response. The choice of medication should be guided by anticipated safety and tolerability, which aid in compliance; physician familiarity, which aids in patient education and anticipation of adverse effects; and history of previous treatments. Often, treatment failures are caused not by clinical resistance but by medication noncompliance, inadequate duration of therapy, or inadequate dosing.
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.
Stewart, D., & Vigod, S. (2017, August 11). Antenatal use of antidepressants and risk of teratogenicity and adverse pregnancy outcomes: Selective serotonin reuptake inhibitors (SSRIs). Up-To-Date. Retrieved from https://www.uptodate.com/contents/antenatal-use-of-antidepressants-and-risk-of-teratogenicity-and-adverse-pregnancy-outcomes-selective-serotonin-reuptake-inhibitors-ssris
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.
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.
Antidepressant medications are not habit-forming, so there need not be concern about that. However, as is the case with any type of medication prescribed for more than a few days, physicians must carefully monitor antidepressant use to ensure that the patient is getting the correct dosage. The doctor will want to check the dosage and its effectiveness regularly.
Behavioral activation is the practice of gradually increasing activity to experience more pleasure and mastery in life, according to Joel Minden, Ph.D., a clinical psychologist at the Chico Center for Cognitive Behavior Therapy. The therapeutic technique is relatively new, so it has a limited amount of research backing it. Nonetheless, it did spring from cognitive behavior therapy [CBT], which has mountains of research to support its efficacy.
If you have have experienced depression and bipolar disorder, you will be able to track your progress, share information, ask questions, and evaluate your treatments. How? Become a participant in the MoodNetwork. Participants will also be contributing to the largest pool of data ever collected about mood disorders, which will lead to evaluating treatments and helping to set priorities for future research studies.
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 ADAA 2020 40th Annual Conference (March 19-22, San Antonio, Texas) will bring together clinicians and researchers who want to improve treatments and find cures for anxiety, depression and related disorders. Join more than 1,400 peers from across the US and around the world. Connect, share and collaborate. Choose from 160+ sessions, hear engaging keynotes, learn about cutting-edge thinking in research and clinical practice, and earn continuing education credits (CEs and CMEs). Find your professional home and leave more connected to your peers, and better able to integrate research, practice, and community. #ADAA2020
Self-help—For mild depression, or when moderate or severe depression begins to improve with other treatments, there are some things you can do on your own to help keep you feeling better. Regular exercise, eating well, managing stress, spending time with friends and family, spirituality, and monitoring your use of alcohol and other drugs can help keep depression from getting worse or coming back. Talking to your doctor, asking questions, and feeling in charge of your own health are also very important. Always talk to your doctor about what you’re doing on your own.
People with chronic anxiety disorders may find themselves having lots of thoughts about death, and worry this means they are suicidal, or even homicidal. People with Panic Disorder often have lots of worrisome thoughts about dying, particularly of heart attacks and terrible diseases. People with OCD may have thoughts in which they wonder what stops them from committing some terrible crime, like killing people they love. People with Generalized Anxiety Disorder may have "what if" thoughts in which they worry about becoming so anxious and hopeless that they become suicidal.

Education for people with depression is extremely valuable. Education provides a knowledge base that potentially gives the person greater control over his or her disorder. Greater control in turn may lead to reduced feelings of helplessness and an increased sense of well-being. Providing education for families or carers is also very important to help increase the support and assistance they provide to the person.


Some symptoms of depression as described above are normal after any kind of loss including the onset of a disability or severe illness. If you have had these symptoms for a long time it may be helpful to talk with a mental health professional. It is also helpful to talk to someone if you have other symptoms such as feeling guilty or worthless, or if sadness interferes with the ability to do important life tasks (take medication; go to therapies, work or school).
TCAs are safe and generally well tolerated when properly prescribed and administered. However, if taken in overdose, TCAs can cause life-threatening heart-rhythm disturbances. Some TCAs can also have anticholinergic side effects, which are due to the blocking of the activity of the nerves that are responsible for control of the heart rate, gut motion, visual focus, and saliva production. Thus, some TCAs can produce dry mouth, blurred vision, constipation, and dizziness upon standing. The dizziness results from low blood pressure that occurs upon standing (orthostatic hypotension). Anticholinergic side effects can also aggravate narrow-angle glaucoma, urinary obstruction due to benign prostate enlargement (hypertrophy), and cause delirium in the elderly. Patients with seizure disorders or a history of strokes should avoid TCAs.
Women are twice as likely to become depressed as men. However, scientists do not know the reason for this difference. Psychological factors also contribute to a person's vulnerability to depression. Thus, persistent deprivation in infancy, physical or sexual abuse, exposure to community violence, clusters of certain personality traits, and inadequate ways of coping (maladaptive coping mechanisms) all can increase the frequency and severity of depressive disorders, with or without inherited vulnerability.
Once you have your list of questions, it’s time to seek out referrals. If you know other people in your area who suffer (or have suffered) from depression, ask them. Word of mouth can be a great way to find a good match. If this is not possible, begin with your physician. It’s always a good idea to get a physical if you suspect major depressive disorder because some medical problems can cause similar symptoms. If medical conditions are ruled out as a cause of the symptoms of depression, ask your primary care physician for a list of referrals for therapists.
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 care incorporates individual, group, and family therapy, behavioral therapies, diagnostic assessment, consultation services, tailored treatment plans, and medication evaluation and management. McLean is committed to providing robust patient and family education and support including informational materials, support groups, and assistance with community resources.
The main aim of treatment with antidepressants is to relieve the symptoms of depression, such as feeling very sad and exhausted, and prevent them from coming back. The medications are designed to restore emotional balance and help people to get on with everyday life. They are also taken to relieve symptoms such as restlessness, anxiety, sleep problems and suicidal thoughts.
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.
Everyone experiences a range of emotions over the course of days and weeks, typically varying based on events and circumstances. When disappointed, we usually feel sad. When we suffer a loss, we grieve. Normally these feelings ebb and flow. They respond to input and changes. By contrast, depression tends to feel heavy and constant. People who are depressed are less likely to be cheered, comforted or consoled. People who recover from depression often welcome the ability to feel normal sadness again, to have a “bad day,” as opposed to a leaden weight on their minds and souls every single day. More

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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).
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.
Thus far in this document, we've described therapies that are generally best prescribed and monitored by clinical professionals. However, it is also possible to take a self-help approach to the treatment of depression under certain circumstances. Self-help approaches emphasize what people can do for themselves rather than what professionals can offer.

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.
The SSRIs are not thought to be as worrisome in patients with cardiac disease, as they do not appear to exert any effect on blood pressure, heart rate, cardiac conduction, or cardiac rhythm; however, dose-dependent QT prolongation has been reported with citalopram. Because of the risk for QT prolongation, citalopram is contraindicated in individuals with congenital long QT syndrome. [103, 104]
Sometimes people have prejudices about physical disability that make them feel like “second class citizens” when they become disabled themselves. Sometimes people with a disability get into the habit of letting other people do things for them and as a result they start to feel helpless. Sometimes people with a disability start to avoid situations that make them nervous (for example going out in public where others can see that they look or act differently). This makes those situations much more scary or upsetting when they can no longer be avoided.

No matter how hopeless things may feel today, people can get better with treatment — and most do. The key to successful treatment is usually dependent upon the person recognizing there’s a problem, seeking out treatment for it, and then following the treatment plan agreed to. This can be far more challenging for someone who’s depressed than it sounds, and patience is a core necessity when starting treatment.


Teenagers go through various phases. There’s often a lot of mood swings and emotional episodes that comes with adolescence, and it can be hard to know when their behavior is a part of growing up and when it’s more serious. The first step towards helping your child battle depression is to learn how to spot it. Become familiar with the warning signs. 
Everyone worries or gets scared sometimes. But if you feel extremely worried or afraid much of the time, or if you repeatedly feel panicky, you may have an anxiety disorder. Anxiety disorders are among the most common mental illnesses, affecting roughly 40 million American adults each year. This Special Health Report, Anxiety and Stress Disorders, discusses the latest and most effective treatment approaches, including cognitive behavioral therapies, psychotherapy, and medications. A special section delves into alternative treatments for anxiety, such as relaxation techniques, mindfulness meditation, and biofeedback.

When taking these medications‚ it is important to follow the instructions on how much to take. Some people start to feel better a few days after starting the medication‚ but it can take up to 4 weeks to feel the most benefit. Antidepressants work well and are safe for most people‚ but it is still important to talk with your doctor if you have side effects. Side effects usually do not get in the way of daily life‚ and they often go away as your body adjusts to the medication.

Atypical antidepressants work in a variety of ways. Thus, atypical antidepressants are not TCAs, SSRIs, or SNRIs, but they can be effective in treating depression for many people nonetheless. More specifically, they increase the level of certain neurochemicals in the brain synapses (between nerves, where nerves communicate with each other). Examples of atypical antidepressants include nefazodone (Serzone), trazodone (Desyrel), and bupropion (Wellbutrin). Serzone has come under scrutiny due to rare cases of life-threatening liver failure that have occurred in some individuals while taking it. The United States Food and Drug Administration (FDA) has also approved bupropion (Zyban) for use in weaning from addiction to cigarettes. This drug is also being studied for treating attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). These problems affect many children and adults and restrict their ability to manage their impulses and activity level, focus, or concentrate on one thing at a time.
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.
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