Depression Archive

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Medications for depression: Which is best?

There are many medications that can be used to treat mood disorders. But finding the right one can be a lengthy process, and the choice can be more complicated than you might imagine. Just because a particular drug worked for a friend doesn't mean it will work for you. Psychiatrists and doctors who prescribe antidepressants choose a particular drug and dosage based on many factors, including the following:

  • Diagnosis. Certain drugs are a better choice for specific symptoms and types of depression. For example, an antidepressant that makes you sleepy may be better when insomnia is an issue. The severity of your illness or the presence of anxiety, obsessions, or compulsions may also dictate the choice of one drug over another.
  • Side effects. You may first want to choose a drug based on which side effect you most want to avoid. Medications vary in the likelihood they will cause such problems as sexual effects, weight gain, or sedation.
  • Age. As you age, your body tends to break down drugs more slowly. Thus, older people may need a lower dose. For children, only a few medications have been studied carefully.
  • Health. If you have certain health problems, it's best to avoid certain drugs. For example, your doctor will want to consider factors such as heart disease or neurological illnesses when recommending a drug. For this reason, it's important to discuss medical problems with a primary care doctor or psychiatrist before starting an antidepressant.
  • Medications, supplements, and diet. When combined with certain drugs or substances, antidepressants may not work as well, or they may have worrisome or dangerous side effects. For example, combining an SSRI or another antidepressant with the herbal remedy St. John's wort can boost serotonin to dangerous and, in rare cases, fatal levels. Mixing St. John's wort with other drugs—including certain drugs to control HIV infection, cancer medications, and birth control pills—might lower their effectiveness. Women receiving tamoxifen for breast cancer should take an antidepressant that does not interfere with tamoxifen's effectiveness. Eating certain foods, such as aged cheeses and cured meats, while taking an MAOI can cause a dangerous rise in blood pressure.
  • Alcohol or drugs. Alcohol and other substances can cause depression and make antidepressants less effective. Doctors often treat alcohol or drug addiction first if they believe either is causing the depression. In many instances, simultaneous treatment for addiction and depression is warranted.
  • Personal and family mental health and medication history. If you or a member of your family has had a good response to a medication in the past, that information may guide your choice. Depending on the nature and course of your depression (for example, if your depression is long-lasting or difficult to treat), you may need a higher dose or a combination of drugs. This may also be true if an antidepressant has stopped working for you, which may occur after you've used it for some time or after you've stopped and restarted treatment with it.
  • Cost. Since all antidepressants are roughly equivalent in their effectiveness, you won't lose anything by trying a generic version first.
  • Your preference. Once you have learned as much as you can about the treatment options, your doctor will want to know what approach makes most sense given your lifestyle, your interests, and your judgment.

To learn more strategies for battling depression, check out Understanding Depression, a Special Health Report from Harvard Medical School. 

Know the facts about CBD products

The extract from the cannabis plant is the hot new treatment for all kinds of ailments, but don't buy into it just yet.

Cannabidiol (CBD), extracted from the cannabis or hemp plant, has been promoted as the latest miracle cure for everything from aches and pains to anxiety and sleep disorders. There is a good chance you've heard a friend share his or her story about the wonders of CBD.

But is it miraculous — or just a mirage?

"CBD is being used over the counter in a range of ways that is not supported by the science," says Dr. Jordan Tishler, instructor of medicine at Harvard Medical School and president of the Association of Cannabis Specialists. "There is still much we don't know. But aggressive marketing, hype, and word of mouth have made CBD like a drug version of the emperor's new clothes. Everyone says it works, but lab studies suggest that it's really not what people think."

An underused option for severe depression

A new study supports the use of noninvasive brain stimulation in people with severe depression who haven't responded to medication.

If medication isn't helping to ease severe depression, nonsurgical brain stimulation may be an effective alternative to consider, according to a study published online March 27 by The BMJ. Specifically, the study found that evidence seems to back the use of repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT) over other, newer brain stimulation therapies.

"Many psychiatrists are unaware of these techniques, or at least don't think to recommend them for their patients," says Dr. Daniel Press, associate professor of neurology at Harvard Medical School and the clinical director for the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center. "So, studies like this are helpful in raising the banner and reminding people that these are very effective options for a large percentage of people."

Trouble keeping information in mind? Could be sleep, mood, or age

Most people experience some degree of decreased memory as they get older, but memory performance is also affected by mood and sleep quality, and these are factors that can be controlled and improved.

Meditation: There's an app for that

This age-old relaxation method can bring health benefits, and there are many tools to help get you started.

These days it seems like there's an app for almost everything you can do for your health, from tracking your diet and exercise to charting your sleep patterns. So, it's no surprise that there's been a surge in apps to help with meditation, an ancient practice designed to help you focus inward to promote relaxation.

In fact, Apple designated "self-care" — a category that includes meditation, mindfulness, and general wellness — as the 2018 "app trend of the year." This mirrors growing interest in meditation as an overall health strategy, a movement likely driven by a growing body of research showing potential health benefits from the practice.

More evidence that exercise can boost mood

Running for 15 minutes a day or walking for an hour reduces the risk of major depression, according to a recent study.

It may be possible to outrun depression, according to a study published online January 23 by JAMA Psychiatry.

"We saw a 26% decrease in odds for becoming depressed for each major increase in objectively measured physical activity," says study author Karmel Choi, a clinical and research fellow at the Harvard T.H. Chan School of Public Health. "This increase in physical activity is what you might see on your activity tracker if you replaced 15 minutes of sitting with 15 minutes of running, or one hour of sitting with one hour of moderate activity like brisk walking."

The mental side of recovery

Dealing with the emotional effects from a physical setback can be a challenge. These three strategies can help.

The physical repercussions of a major health issue, like surgery, an injury, or a heart attack, are tough enough without having to also confront the stress, anxiety, and depression that often accompanies it. Yet managing your mental health is just as important as your physical health when it comes to making a full recovery.

"There is no question that your state of mind can dictate how quickly you can return from a physical setback," says Dr. Jeff Huffman, director of the cardiac psychiatry research program at Harvard-affiliated Massachusetts General Hospital.

Parents don't always realize that their teen is suicidal

Parents often think that they would know if their teen was suicidal. However, this is not always the case. Here's what to be aware of and watch for, and what to do if you see worrisome behavior.

Grief can hurt — in more ways than one

Stress and depression may lead to new health issues or intensify the symptoms of existing conditions.


 Image: © AlexRaths/Getty Images

We tend to think of grieving as an emotional experience, and it is — fraught with intense sadness, profound loss, and psychological pain. But grief has a physical side that sets us up for a number of health risks. "Most of these side effects are the result of emotional distress responses," explains Dr. Maureen Malin, a geriatric psychiatrist with Harvard-affiliated McLean Hospital. Whether you're grieving the loss of a loved one, a job, a home, or a beloved pet, it's important to understand how the process puts your health in jeopardy.

Stress and grief

Grieving takes a toll on the body in the form of stress. "That affects the whole body and all organ systems, and especially the immune system," Dr. Malin says. Evidence suggests that immune cell function falls and inflammatory responses rise in people who are grieving. That may be why people often get sick more often and use more health care resources during this period.

The no-drug approach to mild depression

Looking for a boost or alternative to antidepressant medicines? Here are four therapies that may help relieve your symptoms.


 Image: © RgStudio/Getty Images

Many people suffer bouts of mild or moderate depression as they age. Health issues and the loss of a spouse, family member, or friend are common triggers that can lead to persistent sadness and loss of enjoyment.

While antidepressants like selective serotonin reuptake inhibitors (SSRIs) can be helpful to relieve and control symptoms, they are not always the right choice.

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