As the name implies, antidepressants are used for the treatment of depression. It is now clear that in addition to improving one’s mood, antidepressants also have an anti-anxiety effect. Antidepressants are believed to affect certain (chemical messengers) in the brain, resulting in a better mood and less anxiety. Today, antidepressants are the usual choice of medication intervention for major depressive disorders and anxiety disorders.
People living with high-functioning anxiety and depression may appear fine, but they are far from being as emotionally and mentally healthy as they could be. Seeking treatment is an important step to improving overall emotional and mental health to its potential level. High-functioning anxiety and depression is very treatable, but often the difficulty is in identifying the signs and symptoms and realizing there is a problem.
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.
On the other end of the spectrum, researchers are exploring a salvage medication for people with suicidal depression: ketamine, a street drug that can induce hallucinations and out-of-body experiences but that can also provide astonishingly swift relief from depression. Ketamine is currently undergoing clinical trials; meanwhile, physicians warn that this drug can be abused.
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?)
Bennabi D, Yrondi A, Charpeaud T, Genty JB, Destouches S, et al. Clinical guidelines for the management of depression with specific comorbid psychiatric conditions French recommendations from experts (the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental). BMC Psychiatry. 2019 Jan 30. 19 (1):50. [Medline].
SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:
Bear in mind that while effective treatment for anxiety or depression need not be a long-term commitment, it is likely to require regular, ongoing appointments at least in the short-term (e.g., 6-12 months). Therefore, it is critical to find a professional you trust and with whom you feel comfortable speaking about your symptoms. It is equally important to make sure that you find a clinician that you can afford. Before making the commitment for ongoing care, you may want to meet with a couple of providers to get a feel for therapeutic styles/approaches and their treatment recommendations; you can then use this information to determine which path forward feels best to you.
In general, the severe depressive illnesses, particularly those that are recurrent, will require antidepressant medications, phototherapy for winter seasonal depression (or ECT or TMS in severe cases) along with psychotherapy for the best outcome. If a person suffers one major depressive episode, he or she has up to about a 75% chance of a second episode. If the individual suffers two major depressive episodes, the chance of a third episode is about 80%. If the person suffers three episodes, the likelihood of a fourth episode is 90%-95%. Therefore, after a first depressive episode, it may make sense for the patient to come off medication gradually. However, after a second and certainly after a third episode, most clinicians will have a patient remain on a maintenance dosage of the medication for an extended period of years, if not permanently.
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.
Premenstrual Dysphoric Disorder; a severe form of Pre-Menstrual Syndrome that is diagnosed when a woman experiences severe symptoms of depression, tension, and irritability in the week prior to menstruation. While it isn’t uncommon for most women to experience emotional and physical changes prior to menstruation, women who meet criteria for PMDD experience changes that impact their lives in more profound ways.
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
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.
Medication treatment of anxiety is generally safe and effective and is often used in conjunction with therapy. Medication may be a short-term or long-term treatment option, depending on severity of symptoms, other medical conditions, and other individual circumstances. However, it often takes time and patience to find the drug that works best for you.
People should try to avoid mixing medications of any kind (prescribed, over the counter, or borrowed) without consulting their doctor. Patients should inform their dentist or any other medical specialist who prescribes a drug that he or she is taking antidepressants. Some medications that are harmless when taken alone can cause severe and dangerous side effects when taken with other medications. This may also be the case for individuals taking supplements or herbal remedies. Some addictive substances, like alcohol (including wine, beer, and liquor), tranquilizers, narcotics or marijuana, reduce the effectiveness of antidepressants and can cause mental health and/or physical symptoms. Patients should avoid these. These and other drugs can be dangerous when the person's body is either intoxicated with or withdrawing from their effects due to increasing the risk of seizure or heart problems in combination with antidepressants medications.
Venlafaxine and its active metabolite inhibit neuronal serotonin and norepinephrine reuptake. They are weak inhibitors of dopamine reuptake. In addition, it causes beta-receptor down-regulation. Venlafaxine is sometimes prescribed for non–FDA-approved indications, such as obsessive-compulsive disorder, hot flashes, neuropathic pain, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder.
The SSRIs work by keeping serotonin present in high concentrations in the synapses. These drugs do this by preventing the reuptake of serotonin back into the sending nerve cell. The reuptake of serotonin is responsible for turning off the production of new serotonin. Therefore, the serotonin message keeps on coming through. This, in turn, helps arouse (activate) cells that have been deactivated by depression, thereby relieving the depressed person's symptoms. SSRIs have fewer side effects than the tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). SSRIs do not interact with the chemical tyramine in foods, as do the MAOIs, and therefore do not require the dietary restrictions of the MAOIs. Also, SSRIs do not cause orthostatic hypotension (sudden drop in blood pressure when sitting up or standing) and are less likely to predispose to heart-rhythm disturbances like the TCAs do. Therefore, SSRIs are often the first-line treatment for depression. Examples of SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), fluvoxamine (Luvox), escitalopram (Lexapro), vortioxetine (Trintellix), and vilazodone (Viibryd).
Monoamine oxidase inhibitors were the first antidepressants discovered, in the early 1950s. They are widely effective in a broad range of affective and anxiety disorders. MAOIs irreversibly block monamine oxidase, which has 2 forms, including MOAa and MOAb. MAOa breaks down serotonin and norepinephrine. MOAb metabolizes phenylethylamine. Both forms break down dopamine.
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.
Sadness can be a difficult emotion to deal with, not only due to the pain it causes, but also because of the factors that caused the sadness in the first place. Sadness can be the result of loss, helplessness, or disappointment, among many other things. It is important to remember, though, that sadness is one of the most common and natural human emotions, and is something that will ultimately help us appreciate our happy times.
Getting support plays an essential role in overcoming depression. On your own, it can be difficult to maintain a healthy perspective and sustain the effort required to beat depression. At the same time, the very nature of depression makes it difficult to reach out for help. When you’re depressed, the tendency is to withdraw and isolate so that connecting to even close family members and friends can be tough.
Following a major life-changing event like a disabling illness, it is normal to feel a great deal of stress. Stress can build up over time and can lead to anxiety. Anxiety can be a response to a specific situation such as learning to walk all over again; it can also be more generalized such as not wanting to leave the house after being discharged from the hospital.
Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.
For treatment with antidepressants to work, a careful diagnosis has to be made first. Experts believe that some people are prescribed antidepressants unnecessarily. The fact that significantly more people take antidepressants nowadays suggests that. These medications are sometimes already prescribed for milder cases, even though there is doubt about how well they work in mild depression.
See a psychiatrist, not a family physician. Your family physician might help you or your loved one first realize that you need depression treatment. But although any medical doctor can prescribe medications, psychiatrists are doctors who specialize in mental health treatment. They are more likely to be familiar with the newest research on antidepressants and any safety concerns. Your health depends on your doctor’s expertise, so it’s important to choose the most qualified physician.
Krill oil may have benefits, but for now it's best to rely on omega-3 sources that have received greater scientific scrutiny, including fish, fish oil, and plant sources of ALA. The American Heart Association recommends that healthy adults eat at least two servings per week of EPA- and DHA-rich fish, such as salmon, herring, mackerel, sardines, and albacore or bluefin tuna. People with heart disease should consume 1 gram of EPA plus DHA daily from fatty fish or fish oil supplements. Heart experts also recommend getting ALA from food sources such as soy products, flaxseed, walnuts, and oils extracted from flaxseed, canola seed, olives, walnuts, or soybeans.
Thyroid disease and disorder symptoms and signs depend on the type of the thyroid problem. Examples include heat or cold intolerance, sweating, weight loss or gain, palpitations, fatigue, dry skin, constipation, brittle hair, joint aches and pains, heart palpitations, edema, feeling bloated, puffiness in the face, reduced menstrual flow, changes in the frequency of bowel movements and habits, high cholesterol, hoarseness, brittle hair, difficulty swallowing, shortness of breath, a visible lump or swelling in the neck, tremors, memory problems, depression, nervousness, agitation, irritability, or poor concentration.
Despite the popularity of social media platforms and the rapidity with which they’ve inserted themselves into nearly all facets of our lives, there’s a remarkable lack of clear data about how they affect us personally: our behaviors, our social relationships, and our mental health. In many cases, the information that’s available isn’t pretty. Studies have linked the use of social media to depression, anxiety, poorer sleep quality, lower self-esteem, inattention, and hyperactivity — often in teens and adolescents.
The following information is not intended to provide a medical diagnosis of major depression and cannot take the place of seeing a mental health professional. If you think you are depressed‚ talk with your doctor or a mental health professional immediately. This is especially important if your symptoms are getting worse or affecting your daily activities.
You may feel too exhausted to talk, ashamed at your situation, or guilty for neglecting certain relationships. But this is just the depression talking. Staying connected to other people and taking part in social activities will make a world of difference in your mood and outlook. Reaching out is not a sign of weakness and it won’t mean you’re a burden to others. Your loved ones care about you and want to help. And if you don’t feel that you have anyone to turn to, it’s never too late to build new friendships and improve your support network.
Try to notice good things. Depression affects a person's thoughts, making everything seem dismal, negative, and hopeless. If depression has you noticing only the negative, make an effort to notice the good things in life. Try to notice one thing, then try to think of one more. Consider your strengths, gifts, or blessings. Most of all, don't forget to be patient with yourself. Depression takes time to heal.
Another type of depression is related to changes in the length of days or seasonality. This type of depression is called Seasonal affective disorder (SAD). People with SAD suffer the symptoms of a Major Depressive Disorder only during a specific time of year, usually winter. This appears to be related to the shorter days of winter, and the lack of sunlight in many parts of the country.
A key feature of depression is inactivity. People find that they are doing less and then feel even worse because they are doing less. Behavioural strategies for depression aim to identify and change aspects of behaviour that may worsen depression. People are encouraged to act against the depression by increasing activities, even though this is the last thing that they feel like doing. Relevant behavioural strategies include activity scheduling, social skills training, structured problem solving, and goal planning. One of the advantages of this form of treatment for depression is that once acquired, these new behavioural styles can be applied throughout life, minimising relapse or recurrence of depression.
Many people living with high-functioning anxiety and depression are described as Type-A personalities or overachievers. They often excel at work or appear to be “super mom/dad” and seem to have it all under control. Other people may notice signs of high-functioning anxiety and depression but characterize the behaviors as “anal retentive” quirks or bad habits. And, many times, signs and symptoms of high-functioning depression and anxiety that others observe are given positive attributes, rather than being seen for what they are. For instance, anxiety and worry may be expressed as dwelling on minor details and viewed as perfectionism. What observers generally do not see are the private struggles with stress, sleeplessness, digestive issues, self-criticism, or feelings of sadness and gloom that had to be overcome to attain achievements.
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 Apr 2019), Cerner Multum™ (updated 1 Apr 2019), Wolters Kluwer™ (updated 29 Mar 2019) and others.
The relationship between these emotions — and their associated clinical conditions, anxiety disorders and mood disorders — is complex and somewhat idiosyncratic. For one person, anxiety can lead to avoidance and isolation, and isolation, in turn, can result in a lack of opportunity for pleasurable experiences and then, low mood. For another individual, feeling down may zap them of the energy to do things they typically enjoy, and attempts to re-engage with the world after being out of practice may result in some nervousness.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Develop good habits. Take your depression medicine at the same time every day. It's easier to remember if you do it along with another activity such as eating breakfast or getting into bed. Get a weekly pillbox, which will make it easy to see if you've missed a dose. Since people sometimes forget a dose now and then, make sure you know what to do if that happens.
Medical problems. Dealing with a serious health problem, such as stroke, heart attack, or cancer, can lead to depression. Research shows that people who have a serious illness and depression are more likely to have more serious types of both conditions.4 Some medical illnesses, like Parkinson’s disease, hypothyroidism, and stroke, can cause changes in the brain that can trigger depression.