Understanding the main pharmaceutical options requires becoming familiar with a number of acronyms: SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), NDRIs (norepinephrine–dopamine reuptake inhibitors), TCAs (tricyclic antidepressants), and MAOIs (monoamine oxidase inhibitors). These represent categories of drugs, grouped together because of their effect on various neurotransmitters (chemical messengers) in the brain.
Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
Many factors contribute to depression, and it is likely caused by an imbalance of brain chemicals. Life events (such as stressful life changes) may also contribute to a depressed mood. Depression also tends to run in families. The exact biological cause of depression is still being investigated, including by scientists at McLean like Diego A. Pizzagalli, PhD.
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.
Track your thoughts. Writing down your thoughts is a good way to identify those that are contributing to making you feel down and depressed; these might include thoughts like ‘I’m useless’ or ‘no one cares about me’. Just because we think something, it doesn’t mean it’s true, so learn how to challenge negative thinking. If your mood is really low and you have difficulty challenging your thoughts, avoid writing them down on your own and instead seek help from a mental health professional.
Some 16 million Americans a year struggle with depression, an illness that comes in many forms—from major depression to dysthymia and seasonal affective disorder. In addition, depressive episodes are features of bipolar disorder. Depression is an illness that increasingly afflicts people worldwide, interfering with concentration, motivation, and many other aspects of everyday functioning. It is a complex disorder, involving many systems of the body, including the immune system, either as cause or effect. It disrupts sleep and it interferes with appetite, in some cases causing weight loss, in others weight gain. Because of its complexity, a full understanding of depression has been elusive.
Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.