Your doctor may arrange for blood tests to rule out physical illnesses that could be affecting your mood and energy. Your doctor may suggest one or a combination of treatments. A reduction in alcohol intake should be advised, as alcohol can aggravate depression. Exercise may be recommended as it can improve general well-being.
Support
Psychotherapy may be suggested; for example, cognitive therapy has been shown to be beneficial. Emotional support from family and friends is very important; support groups may also be beneficial. In addition, help may be needed to cope practically with specific problems, such as unemployment and financial difficulties.
Oral Drugs
Your doctor may prescribe drugs; the exact drug selected depends on the symptoms and the possible side-effects. Symptoms may start to improve after about two weeks. In some cases, the drug may need to be changed if it is not effective (sometimes, more than one drug needs to be tried) or if it causes unacceptable side-effects. Your doctor may prescribe one or more drugs from these antidepressant groups:
- Selective serotonin re-uptake inhibitors (SSRIs), such as fluoxetine and paroxetine, affect serotonin.
- Tricyclic antidepressants, such as amitriptyline and dothiepin, are commonly prescribed. They interfere with the reabsorption of serotonin and noradrenaline so that high levels of these neurotransmitters remain in the body.
- Monoamine oxidase (MAO) inhibitors, such as phenelzine, may be used when other drugs fail to work. They block the action of an enzyme that makes serotonin and noradrenaline inactive.
There are various newer drugs, including reboxetine, which may help when energy levels are low, and mirtazapine, which can be used to help sleep.
Electroconvulsive Treatment (ECT) is occasionally recommended for very severe depression when other treatments fail. A course of ECT is carried out under a general anesthetic and involves passing fluoxetine an electrical current briefly between two electrodes applied to either side of the head. Another technique, transcranial magnetic stimulation, is an alternative to ECT.
ECT and drugs used to treat depression can cause side-effects: ask your doctor to explain these to you. Conventional antidepressants should not be taken at the same time as herbal ones, such as St John’s wort.
Self-Help
If you are recovering from depression, the following measures may help you:
- List the tasks you have to do each day, with the most important at the top.
- Complete these tasks one at a time and think about what you have achieved.
- Practise relaxation every day.
- Take regular exercise to relieve stress.
- Eat a nutritious diet.
- Get involved in an activity (sport, pastime, hobby, etc.) to stop yourself from thinking too much about your worries.
- Join a support group so you can share your thoughts and experiences with likeminded people.
Related posts: