Buspirone is marketed as an antianxiety medication; however, it may have antidepressant effects at doses above 45 mg/day. The antidepressant effects may increase when buspirone is used in combination with SSRIs and TCAs in patients with treatment-resistant depression. Buspirone is a partial 5-HT1A agonist with serotonergic and some dopaminergic effects in the CNS. It has anxiolytic effects but may take up to 2-3 weeks for full efficacy.
High-functioning anxiety and depression is treated the same way as other anxiety and depressive disorders, through psychotherapy and medication. Cognitive behavioral therapy (CBT) combined with antidepressants or antianxiety medications can be very effective and shows improved outcomes over treatment that employs only therapy or medication. Residential treatment can also be beneficial for people living with high-functioning anxiety and depression. Residential treatment allows for individuals to get care in a home-like setting, but in a controlled environment away from home, possible triggers, and the rigors of daily life.
While this newly approved treatment offers hope as a fast acting and durable antidepressant option for patients who have not responded adequately to conventional SSRI or SNRI medications, it is important to be cautious. Many patients may seek out esketamine have not received trials with other evidence-based treatments including pharmacotherapy and psychotherapy or rTMS or ECT.
Cognitive-behavioral therapy (CBT) is one form of psychotherapy that has been shown to be successful in treating depression and anxiety disorders. CBT combines the fundamental concepts of behavioral therapy and cognitive therapy. The term “cognitive” refers to our thought process and reflects what we think, believe and perceive. Put together, CBT focuses on our behaviors and thoughts and how they are contributing to our current symptoms and difficulties.
Connect with others. It’s common to withdraw when you’re feeling depressed, but this can make you feel worse. Try to reconnect with friends. Again, make your goal realistic: if you’ve been avoiding your friends altogether, a starting point might be to send a text or (finally) to reply to one. If you don’t feel like leaving the house, you could ask them to come and hang out with you at home.
Depression is a common and debilitating mood disorder. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. The feelings of helplessness, hopelessness, and worthlessness can be intense and unrelenting, with little, if any, relief.
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.
Left untreated, depression can be a debilitating illness for individuals and their families. Often, symptoms are not recognized for their severity and can worsen, and severe depression may lead to suicidal thoughts and actions. Common treatments for depression include individual and group therapy, and medications as appropriate. Other treatments may include TMS (transcranial magnetic stimulation) and ECT (electroconvulsive therapy), both of which have been found to have profound effects on individuals with depression, especially for those who have not found relief in symptoms through other treatment methods.