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       Understanding Depression 
And Its Treatment
                           by Lee J. Tuan RPH, CPT

Depression is a common medical condition which strikes men and women of all ages, backgrounds and races.  The cause of depression is unknown, but research has shown that it may be caused by lack of serotonin in the brain. The common symptoms of depression include feeling sad, angry or irritable, loss of interest in hobbies and or  activities once enjoyed, changes in appetite and/or sleeping patterns, loss of energy, not able to concentrate, difficulty in making decisions, an overwhelming feeling of worthlessness, and thoughts of suicide or a total lack of emotional display of any kind. Symptoms can last for weeks, months or years.

Consider the need to 
Avoid certain foods

Life style and eating habits can greatly affect the management of depression.  Poor diets especially constant snacking on junk food may contribute to depression.  Eat well-balanced meals with good portions of complex carbohydrates, protein and essential fatty acids, add plenty of fresh fruits and vegetables into diet.  Avoid sugar, saturated fat, alcohol and caffeine.  B vitamins are essential for normal brain and nervous system function, which can be easily supplemented by taking a B-complex vitamin tablet daily.

Regular exercise is also very important for depression.  During exercise, the brain produces a feel-good chemical called endorphine, which produces a natural “high”.  This may be the reason exercise is one of the best ways to fight depression.

Most people experiencing depression can benefit from treatment.  When recognized early, drug treatment seems to decrease the length and severity of depression.  The most commonly prescribed medications with clinically useful antidepressant effects include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and other miscellaneous groups of antidepressants.  

Antidepressant drug selection is based on patients history of drug response.  TCAs (nortriplyline, or Pamelor particularly) are preferred in patients without a history of response to a specific antidepressant.  Sedation, dry mouth, arrhythmia, and weight gain are common side effects.  

SSRIs (Prozac, Zoloft, Paxil) are prescribed most often today mainly because they have fewer side effects than TCAs.  However, their use is associated with other side effects such as headache, nervousness, weight loss, and insomnia.

MAOIs (Nardil, Parnate) are much less prescribed because they are less effective than other antidepressants and have a high risk of hypertensive crisis from drug interactions or eating foods containing tyramine.  MAOIs are generally used today for atypical depression.

There are other drugs (Wellbutrin, Trazodone, Effexor, Serzone) that are used in managing depression.  However, most of them are used only if TCAs and SSRIs are not showing effectiveness.  In cases of mild depression, drug therapy and psychotherapy (talk therapy) appear to be equally effective.  

St. John’s Wort, an herbal remedy, has a mild antidepressant effect and is sometimes used to manage mild cases of depression.  Side effects include photosensitivity in high doses and sedation.  Although it is available without prescription, people should always consult a health professional before using this preparation.  

Help is available

Depression is not a sign of weakness.  It is a medical condition and it can be treated.  With psychological therapy and antidepressant medications, people can relieve depression symptoms and feel better about themselves.  Professional counselors, doctors, and support groups for depression are out there helping people realize that depression can be overcome.

Always consult your physician or local pharmacist when ever you experience side affects or have concerns about any medication. Keeping your health care professional informed is your way of ensuring your best care. 

 

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