There are several options a healthcare provider and patient may consider when creating a therapeutic plan for depression treatment. Click on one of the options on the right to find out more information or read about all of these options below.
|Psychotropic drugs (antipsychotics, anticonvulsants, lithium, etc)|
|Medical food (Deplin®)|
|Psychotherapy / counseling|
|Any combination of the above|
Each of these options can help. A healthcare provider may choose one or more of these as part of your plan.
Here is some helpful information about each option.
There are several antidepressant drugs available to relieve the symptoms of depression. The most commonly used are called SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors).
These drugs work on the neurotransmitters that impact mood. They help change the levels of the neurotransmitters by preventing them from being processed too quickly by brain cells. Changing this balance can help to improve mood.
|How do antidepressants work?|
Each neurotransmitter is believed to be associated with certain depression symptoms. The diagram below shows what each neurotransmitter impacts and how an imbalance of a combination of these neurotransmitters may cause other depressive symptoms.
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Antidepressants usually begin to work within about 2 weeks, although it can take 4- 6 weeks to feel the full effect. Antidepressant drugs need to build up in the body to change the chemical balance in the brain.
Finding the right antidepressant may not happen right away. Only about one third of people living with depression get full symptom improvement with their first, single antidepressant. Most people need to try a different antidepressant or a combination of therapies to discover the antidepressant therapy that will work for them.
Antidepressant Side Effects:
Many patients experience side effects from their SSRI or SNRI antidepressant therapy. The most common are sexual dysfunction and weight gain. Anyone who has side effects they cannot tolerate should contact their healthcare provider. He or she may decide to change the treatment or suggest ways to reduce the side effects. Always talk to a healthcare provider before stopping any medication.
Many people become frustrated when they do not see results from their antidepressant drug quickly. It is important to remain on antidepressant therapy and allow enough time for symptoms to improve. If someone stops their medication, their depression symptoms may get worse. As depression gets worse, it can be more challenging to treat it.
How long does someone need antidepressant therapy? Every case is different. Some people with depression take antidepressant therapy for a relatively short period of time (3-4 months). Others may need to remain on the medication for longer periods. It’s possible someone may need to take an antidepressant at various times in life to control the symptoms of recurring clinical depression. It’s important to follow a healthcare provider’s directions and keep all doctor visits and follow-up appointments.
Medical Food (Deplin®)
Medical foods are different from vitamins and supplements because they provide the distinct nutritional requirements needed to manage a particular condition or disease. Vitamins and supplements that can be purchased over the counter are generally only intended to maintain the well-being of a normally healthy person. Medical foods are only used under a healthcare provider’s supervision.
Deplin® (L-methylfolate) is a medical food dispensed by prescription. It is used only under medical supervision for the metabolic management of depression. It addresses a metabolic need that cannot be met with diet alone. Some depressed individuals may have an imbalance of L-methylfolate levels in their brain. Deplin® helps increase levels of L-methylfolate in some depressed individuals who, may not be able to obtain enough through normal diet, to allow the brain to produce important chemicals linked to mood (serotonin, norepinephrine, and dopamine.)
|A Patient’s Experience|
|A Doctor’s Perspective|
Psychotropic drugs affect the mind including mental activity, behavior, perception and mood. Some categories of psychotropic medications, other than antidepressants, include antipsychotics, anti-anxiety agents, mood stabilizers, and anti-panic agents. Some of these medications are also used to treat medical conditions such as seizures and migraine headaches.
Psychotherapy / Counseling
Psychotherapy or counseling can help people cope with depression. This kind of treatment is usually provided by a therapist, such as a psychiatrist, psychologist or mental health professional. Counseling may be one-on-one with the therapist or involve group sessions with other people who have depression. Psychotherapy and/or counseling may include several appointments over a set time period or require a longer-term, more open-ended commitment.
Making some simple changes in lifestyle can be an important part of treatment. For instance, improving overall health may help reduce some of the symptoms of depression. A healthcare provider is the best person to discuss lifestyle changes in detail.
Exercise can be a way to lift depression symptoms. Exercise produces more serotonin, one of the chemicals in the brain associated with mood. It also increases the production of endorphins. These are chemicals in the body that naturally reduce pain and help people feel calm. Beginning even a moderate exercise program of walking 30-60 minutes on most days can help improve depressive symptoms.
Poor nutrition has also been shown to reduce the level of L-methylfolate, an important nutrient that the body uses to create neurotransmitters. Instead, a healthy diet of balanced meals provides the brain with the nutrients it needs. Sugary foods and caffeinated beverages may seem like the easiest way to get a boost, but energy from these sources doesn’t have lasting power. Protein and complex carbohydrates are much healthier choices that help people feel energetic for longer periods.
Sleeping too much or too little can increase irritability, moodiness and fatigue. Most adults need 7 to 9 hours of sleep each night. Anyone having difficulty sleeping should talk to their healthcare provider.
People with depression often isolate themselves. They may feel unable to make the effort to maintain social relationships. Just getting out of the house, chatting on the phone, or trying not to let their depression show may all seem very difficult, even impossible. But support from friends and family can really help someone work through their depression symptoms.
Stress Reduction Activities
Stress reducing activities like walking or taking part in hobbies, such as reading, gardening or painting, may be helpful.
Smoking and Alcohol
Smoking and excessive alcohol use may affect the body’s natural ability to fight depression. People who smoke or drink may have less L-methylfolate which the brain needs to create the neurotransmitters linked with mood. Alcohol use may also interact with antidepressant and other drug therapies.
Your questions answered:
Should I talk to someone?
Your doctor will consider several options to create a treatment plan that suits your needs. One of these options may be psychotherapy or counseling. Psychotherapy and counseling may help to find healthy ways to face emotions and issues that can help resolve depressive symptoms.
Do I need to take drugs to feel better?
Antidepressants are drugs that are prescribed to help people with depression. When patient and doctor have found the right antidepressant medication, the patient should begin to experience relief from depressive symptoms. As treatment continues, the goal will be to relieve all depressive symptoms.
Your doctor may also prescribe Deplin® in addition to your antidepressant to help metabolically manage the production of important neurotransmitters (serotonin, norepinephrine and dopamine).
How long will it take me to feel better?
You may begin to feel some relief within two weeks of starting your antidepressant therapy. Most depressed individuals will experience some improvement in their depressive symptoms in two weeks but it may take 4 to 6 weeks of starting an antidepressant for fuller benefits. Your doctor will want to follow-up with you within this time to determine if your antidepressant drug is working. If it is not, your doctor may increase the dosage of your antidepressant, add another medication, add Deplin® or change you to a different antidepressant.
Will I always have to take medication?
Some people only experience one depressive episode in their lifetime, and after completing their treatment plan, they may not have problems with depression again. After having one depressive episode, you are more likely to have a second episode. You should discuss this with your doctor.
Once you have achieved relief of your depressive symptoms, the American Psychiatric Association (APA) guidelines recommend that antidepressant therapy continue for four to nine months with close monitoring as the risk of relapse is highest at this point.