Bipolar II disorder is a significant variant of the bipolar disorders. (The usual form of bipolar disorder is referred to as bipolar I disorder.) Bipolar II disorder is a syndrome in which the affected person has repeated depressive episodes punctuated by hypomania (mini-highs). These euphoric states in bipolar II do not completely meet the criteria for the full manic episodes that occur in bipolar I.
Depressed mood can be the result of a number of infectious diseases, nutritional deficiencies, neurological conditions[18] and physiological problems, including hypoandrogenism (in men), Addison's disease, Cushing's syndrome, hypothyroidism, Lyme disease, multiple sclerosis, Parkinson's disease, chronic pain, stroke,[19] diabetes,[20] and cancer.[21]
Nortriptyline blocks the reuptake of serotonin and, more potently, norepinephrine at the presynaptic neuronal membrane. It has less affinity for H1 and M1 receptors and, thus, is better tolerated than other TCAs. Although nortriptyline is FDA approved only for depression, it has also been prescribed for chronic pain, myofascial pain, anxiety disorders, and attention-deficit/hyperactivity disorder. As with desipramine, there is a therapeutic window for nortriptyline
Several specific antipsychotic medications have been shown to enhance the effects of an antidepressant when an initial response is poor. These include aripiprazole (Abilify), brexpiprazole (Rexulti), and quetiapine (Seroquel). Symbyax, a combination of the antipsychotic drug olanzapine (Zyprexa) and an SSRI (Prozac, or fluoxetine), is approved for treatment-resistant depression or depression in people with bipolar disorder.
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.
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.

Depression and Anxiety, the official journal of the Anxiety and Depression Association of America (ADAA), welcomes original research and synthetic review articles covering neurobiology (genetics and neuroimaging), epidemiology, experimental psychopathology, and treatment (psychotherapeutic and pharmacologic) aspects of mood and anxiety disorders and related phenomena in humans.
Monoamine oxidase inhibitors (MAOIs) are the earliest developed antidepressants. Examples of MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate). MAOIs elevate the levels of neurochemicals in the brain synapses by inhibiting monoamine oxidase. Monoamine oxidase is the main enzyme that breaks down neurochemicals, such as norepinephrine. When monoamine oxidase is inhibited, the norepinephrine is not broken down and, therefore, the amount of norepinephrine in the brain is increased.
Remember, antidepressants aren’t a cure. Medication may treat some symptoms of depression, but can’t change the underlying issues and situations in your life that are making you depressed. That’s where exercise, therapy, mindfulness meditation, social support and other lifestyle changes come in. These non-drug treatments can produce lasting changes and long-term relief.
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.
Serotonin and norepinephrine reuptake inhibitors or SNRIs are the newest class of antidepressants. SNRIs work by increasing the levels of serotonin and norepinephrine that are active in the brain. Serotonin and norepinephrine are produced by nerves and released into the surrounding tissues where they can attach to nearby receptors on other nerves, thereby stimulating the other nerves. The released serotonin and norepinephrine then are taken up and released again by the nerves that produce them. SNRIs block the uptake ("reuptake") of the serotonin and norepinephrine so that more of the serotonin and norepinephrine are free in the tissues surrounding the nerves.
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
Americans are obsessed with happiness, yet we are increasingly depressed: Some 15 million Americans battle the disorder, and increasing numbers of them are young people. Mental anguish is hard on your health. People suffering from depression have three times the risk of experiencing a cardiac event. In fact, depression affects the entire body. It weakens the immune system, increasing susceptibility to viral infections and, over time, possibly even some kinds of cancer—a strong argument for early treatment of depression. It interferes with sleep, adding to feelings of lethargy, compounding problems of focus and concentration, and generally undermining health. Those suffering from depression also experience higher rates of diabetes and osteoporosis. Sometimes depression manifests as a persistent low mood, a condition known as dysthymia. It is usually marked by years-long periods of low energy, low self-esteem, and little ability to experience pleasure.

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?)

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
A person’s personality characteristics are an important factor. When people are depressed, they usually have a very negative view of themselves and the world. They do not appreciate good things, and bad things seem overwhelming. Some people have a tendency to view things this way even when they are not depressed. In other words, they may have a depressive personality style.
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).
Whether or not someone has side effects, which side effects they have, and how frequent they are will depend on the drug and on the dose used. And everyone reacts slightly differently to drugs as well. The risk of side effects increases if other medication is also being taken. One of the drugs may make the side effects of the other worse. These kinds of drug interactions are common in older people and people with chronic illnesses who are taking several different kinds of medication.

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.

People from different cultures—Depending on your cultural background, you may have certain beliefs about depression that can affect the way you deal with it. For example, people from some cultures notice more of the physical symptoms of depression and only think of the emotional ones when a professional asks them. Attitudes from our cultures can also affect who we may ask for help. For example, in one BC study Chinese youth were twice as reluctant to talk to their parents about depression as their non-Chinese counter parts. Aboriginal people, on and off-reserve, may also have higher rates of depression, from 12–16% in a year, or about double the Canadian average.


Lithium (Eskalith, Lithobid), valproate (Depakene, Depakote), carbamazepine (Epitol, Tegretol), and lamotrigine (Lamictal) are mood stabilizers and, except for lithium, are used to treat seizures (anticonvulsants). They treat bipolar depression. Certain antipsychotic medications, such as ziprasidone (Geodon), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), asenapine (Saphris), paliperidone (Invega), iloperidone (Fanapt), lurasidone (Latuda), and brexpiprazole (Rexulti), may treat psychotic depression. They have also been found to be effective mood stabilizers and are therefore sometimes been used to treat bipolar depression, usually in combination with other antidepressants.
The signs of high-functioning anxiety and depression can get hidden within seemingly reasonable justifications. Even though one might be holding down a job, going to school, or in a healthy relationship, he or she experiences disruptions in life activities that may not be necessarily obvious. Some of these hidden disruptions can be seen in behaviors such as declining social invitations with the excuse that work has been busy or stressful, sleeping more or sleeping less, and an overreliance on coping mechanisms like excessive exercise, overeating, or overindulging in alcohol or illicit substances.
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.
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