Antidepressants should be gradually tapered and should not be abruptly discontinued. Abruptly stopping an antidepressant in some patients can cause discontinuation syndrome.
For example, abruptly stopping an SSRI such as paroxetine can cause dizziness, nausea, flu-like symptoms, body aches, anxiety, irritability, fatigue, and vivid dreams. These symptoms typically occur within days of abrupt cessation, and can last one to two weeks (up to 21 days). Among the SSRIs, paroxetine and fluvoxamine cause more pronounced discontinuation symptoms than fluoxetine, sertraline, citalopram, escitalopram, vortioxetine, and vilazodone. Some patients experience discontinuation symptoms despite gradual tapering of the SSRI. Abrupt cessation of venlafaxine, duloxetine, desvenlafaxine, or levomilnacipran can cause discontinuation symptoms similar to those of SSRIs.
Abruptly stopping MAOIs can lead to irritability, agitation, and delirium. Similarly, abruptly stopping a TCA can cause agitation, irritability, and abnormal heart rhythms.
What are complications of depression?
Depression can have a significant impact on the structure and function of many parts of the brain. This can result in many negative consequences. For example, people with severe depression are at higher risk of suffering from anxiety, chronic depression, other emotional issues, or having more medical problems or chronic pain. People with a chronic illness, such as diabetes and heart disease, who also have depression tend to have worse outcome of their medical illness.
What is the prognosis for depression?
Even though clinical depression tends to occur in episodes, most people who experience one such episode will eventually have another one. Also, it seems that any subsequent episodes of depression are more easily triggered than the first one. However, most depression sufferers recover from the episode. In fact, individuals who have mild depression and are treated with medication tend to respond equally as well to sugar pill (placebo). Those with more severe depression seem to be less likely to get better when taking placebo versus taking antidepressant medication. Other encouraging information is that research shows that even people from teenage through adulthood who do not improve when treated with a first medication trial can improve when switched to another medication or given another medication in addition to psychotherapy. For individuals who experience thoughts of suicide, it is thought that preventing access to firearms and other highly lethal means of committing suicide are important ways to improve their safety and that of those around them.
Is it possible to prevent depression?
Programs that use mental-health professionals to teach thinking skills (cognitive techniques) that assist in coping with stress seem to be effective in preventing depression. Key aspects in the prevention of postpartum depression include helping new mothers decrease those specific aspects of their lives that may contribute to depression, like having little social support and poor adjustment to their marriage or other domestic union. Engaging in religious or spiritual practices can often prevent depression, thought to be the result of decreasing stress, increasing a sense of hope, and providing a sense of community. On the other hand, people who feel they are unable to live up to the standards set by their family, societal, religious, or spiritual practices may feel a sense of guilt that becomes a risk factor for depression.
What about self-help and home remedies for depression?
Depressive disorders can make those afflicted feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depressive illness and typically do not accurately reflect the actual situation. It should be remembered that negative thinking fades as treatment begins to take effect. In the meantime, the following are helpful tips for how to fight depression:
- Eat healthy foods. The frequent lack of adequate nutrients and presence of excessive fats, sugars, and sodium in fast foods can further sap the energy of depression sufferers.
- Many may find that folate and vitamin D food supplements help coping with depression.
- Make time to get enough rest to physically promote improvement in your mood.
- Express your feelings, either to friends, in a journal, or using art to help release some negative feelings.
- Do not set difficult goals for yourself or take on a great deal of responsibility while dealing with depression.
- Break large tasks into small ones, set some priorities, and do what you can when you can.
- Do not expect too much from yourself too soon as this will only increase feelings of failure.
- Try to be with other people, which is usually better than being alone.
- Participate in activities that may make you feel better.
- You might try exercising, going to a movie or a ball game, or participating in religious or social activities.
- Don't rush or overdo it. Don't get upset if you do not feel "cured" right away. Feeling better takes time.
- Do not make major life decisions, such as changing jobs or getting married or divorced until your depression has improved without consulting others who know you well. These people often can have a more objective view of your situation.
- Remember, do not accept your negative thinking. It is part of the depression and will disappear as your depression responds to treatment.
- Plan how you would get help for yourself in an emergency, like calling friends, family, your physical or mental-health professional, a local emergency room, or mental-health crisis center if you were to develop thoughts of harming yourself or someone else.
- Limit your access to things that could be used to hurt yourself or others (for example, do not keep excess medication of any kind, firearms, or other weapons in the home).
How can someone help a person who is depressed?
Family and friends can help! Since depression can make the affected person feel exhausted and helpless, he or she will want and probably need help from others. However, people who have never had a depressive disorder may not fully understand its effects. Although unintentional, friends and loved ones may unknowingly say and do things that may be hurtful to the depressed person. If you are struggling with depression, it may help to share the information in this article with those you most care about so they can better understand and help you.
The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This help may involve encouraging the individual to stay with treatment until symptoms begin to go away (usually several weeks) or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication for several months after symptoms have improved. Always report a worsening depression to the patient's physician or therapist.
The second most important way to help someone with depression is to offer emotional support. This support involves understanding, patience, affection, and encouragement to the depression sufferer. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Always take them seriously and report them to the depressed person's therapist.
Invite the depressed person for walks, outings, and to the movies and other activities. Be gently insistent if your invitation is refused. Encourage participation in activities that once gave pleasure, such as hobbies, sports, or religious or cultural activities. However, do not push the depressed person to undertake too much too soon. The depressed person needs company and diversion, but too many demands can increase feelings of failure and exhaustion.
Do not accuse the depressed person of faking illness or of laziness. Do not expect him or her "to snap out of it." Eventually, with treatment, most depressed people do get better. Keep that in mind. Moreover, keep reassuring the depressed person that, with time and help, it is highly likely that he or she will feel better.