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Deborah Bershel, MD
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Carmen Phillips, NP
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Depression
What is depression?

Depression is a medical illness like diabetes or high blood pressure. It affects about 17% or people at some time in their lives. It's twice as common in women as in men. Symptoms of depression include the following (you do not need to have all of these symptoms in order to have a diagnosis)

1.Feeling sad most of the day, nearly every day, for two weeks or longer

2. Loss or interest in things you used to like and enjoy

3. Lack of energy

4.Sleep and appetite disturbances

5.Weight changes

6.Feelings of hopelessness, helplessness and worthlessness

7. Not being able to make decisions

8. Persistently anxious or irritable

9.Thoughts of death and suicide

Is it my fault I'm depressed?

The answer is "no." Depression is an illness, not something you choose to get.

What causes depression?

The exact cause of depression is not known. Doctors think it may be caused by a chemical imbalance in the brain. The imbalance could be caused by your genes. It could be caused by the effects of events in your life. It seems that sometimes there aren't enough chemical messengers (called neurotransmitters) in the brain. These neurotransmitters carry messages (nerve impulses) from one nerve cell to another. When there aren't enough of these messengers in a person with depression, certain messages don't get carried to some areas of the brain. Two primary messengers, called serotonin and norepinephrine , are responsible for your moods (how you feel).

How will my clinician treat my depression?
Sometimes depression resolves on its own, especially if it was due to a specific situation that has itself improved (such as financial stress or difficulties at work). Depression can be treated with antidepressants and counseling. Regular exercise and avoiding street drugs and alcohol excess can also be helpful.

There is no absolute rule as to which treatment option is best for you - counseling, medication or both. Cognitive behavioral therapy has been shown to have the same success rate as antidepressants. But perhaps a different style of counseling or a combination of counseling and medication is what is best for you.

If you do want to consider medication, there are many classes of antidepressants available now. Studies seem to show that there is little way to predict which medication will work best for you.

How will I know if my antidepressant is working?
If you can sleep better, you know the medicine is working. If you can take care of yourself better (such as hair care, dressing well, eating regularly), you know the medicine is working. When the medicine is working well, you are better able to meet your day-to-day obligations. You have more energy. Your weight problems will get better, and your appetite will be closer to "normal." You will have an increased desire to live. Both you and your family and friends will notice these changes. Your doctor might also give you short "tests" to check your progress.

How long will I take the antidepressant?
If this is the first time you have been treated for depression, you will probably take this medicine for about six months after you begin to feel better again. If this is the second time you've had depression you might keep taking the medicine for at least a year. Depression that comes back a third time may require you to take an antidepressant for a long time, maybe forever. Nobody will ever be forced to take a medication that they donít want to though.

What if I forget to take a dose of my antidepressant?
If you forgot your dose less than three hours ago, go ahead and take it now. Otherwise, just skip it. Take your next dose at the regular time. Don't take a double dose unless you ask your doctor first.

Can I drink alcohol when I'm taking antidepressants?
You should not drink alcohol because it might have a bad effect with the antidepressant. You might be strongly affected by even a little bit of alcohol.

How should I stop taking the antidepressant?
All antidepressants should be cut back little by little. This helps to decrease the risk of the depression coming right back. Don't stop taking an antidepressant all of a sudden. Talk with your clinician first.

If I am taking an antidepressant and I get a strong urge to hurt myself, what should I do?
Talk to your doctor right away. If this isn't possible, have someone drive~ you to the nearest hospital emergency' room.


Where can I get more information about depression?
Your doctor is the first person you should talk to. The following agencies can also give you more information:

The National Depressive
Manic-Depressive Association
Public Affairs Department
730 N. Franklin St., Suite 501
Chicago, IL 60610
Telephone: 1-312-642-0049 or 1-800-826-3632


The Depression Awareness, Recognition and Treatment Program of the National Institute of Mental Health
5600 Fishers Lane, Room 10-85
Rockville, MD 20857
Telephone: 1-800-421-4211 or 1-301-443-4140


For Women Only
Can I take birth control pills while I'm -taking an antidepressant
Yes, antidepressants won't harm the actions or effectiveness or your birth control pill.

If I get pregnant while I am taking an antidepressant, what should I do?
Tell your doctor right away. With some antidepressants, there is a small risk that they will hurt your baby. Your doctor can talk with you about the risks and benefits of your antidepressant.

How long should I stop taking an antidepressant before I get pregnant?
This depends on how long the medicine stays in your body. Some, antidepressants stay in your body a long time after you quit taking them. For example, fluoxetine (brand name: Prozac) takes several weeks to leave your body. No matter which antidepressant you have been taking, talk with your doctor before you get pregnant.

Can I breast feed while I am taking an antidepressant?
Most antidepressants would get into your breast milk. This can affect your baby; Before you decide to go on breast feeding and keep taking an antidepressant, ask your doctor if it's a good idea.

Last screened and modified by Dr. Bershel 1/2010
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