Wednesday, June 12, 2024

Can Depression Get Worse Even With Medication

Psychological Depression Symptoms Include:

Why Antidepressants Make You Feel Worse – At First
  • doing poorly at work
  • difficulties with your family or home life

It’s not always possible to tell that you’re having symptoms of depression right away it can start and progress gradually. A lot of people don’t realise they’re ill and try to carry on and cope with their symptoms. Sometimes it takes a friend or family member to notice that there’s a problem.

Starting New Antidepressant Can Make Depression Worse Before It Gets Better

Im an impatient patient.

When I was first diagnosed with depression seven or so years ago, my doctor prescribed me an antidepressant medication, warning me that it might take 2 to 4 weeks before it made any difference.

Boy was that an understatement. I vividly remember getting worse before getting better, even dealing with physical pain caused by my depression.

The first depression drug he prescribed proved ineffective, even after a month, so we tried another. The same cycle repeated itself. I didnt start feeling better until my third antidepressant prescriptiona few months after being diagnosed.

I know that is not very encouraging to those who have recently been diagnosed with depression. Hearing that it may get worse before it gets better is frustrating. But its true.

Psychotherapy For Depression Treatment

If there is no underlying medical cause for your symptoms of depression, talk therapy can be an extremely effective treatment. What you learn in therapy gives you skills and insight to feel better and help prevent depression from coming back.

There are many types of therapy available. Three of the more common methods used in depression treatment include cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. Often, a blended approach is used.

Some types of therapy teach you practical techniques on how to reframe negative thinking and employ behavioral skills in combating depression. Therapy can also help you work through the root of your depression, helping you understand why you feel a certain way, what your triggers are for depression, and what you can do to stay healthy.

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How Are Depression And Anxiety Diagnosed

There are no specific tests but your GP may perform some blood tests for other health conditions that share similar symptoms with depression or anxiety.

Your GP will need to get a good picture of the way youre feeling mentally and physically. They will ask you lots of questions about your symptoms and the changes youve noticed.

It can be difficult to think about specific answers on-the-spot but the following suggestions might help you plan ahead for your appointment.

  • Make a list of all your symptoms, whether they are worse at certain times of the day or on particular occasions, how long youve had them and their effect on your day-to-day life and relationship with others.
  • Explain any circumstances that could be contributing to these symptoms and the way you feel.
  • Take a list of all medications you currently take, including any supplements or non-prescription medication.
  • Be as open and honest as you can remember anything you say is confidential.

What Might Indicate That Both Anxiety And Depression Are Present

Treating Depression With Medications: Antidepressants And ...

Traits that may signal the presence of both anxiety disorder and depression include:

  • Irrational worries or fears that wont go away
  • Physical symptoms, such as fatigue, headaches, rapid heartbeat, labored breathing or abdominal pain
  • Difficulty going to sleep or staying asleep
  • Changes in eating habits either too much or too little
  • Trouble remembering, making decisions or concentrating
  • Constant feelings of sadness or worthlessness
  • Loss of usual interest in activities or hobbies
  • Feeling often tired and cranky
  • Inability to relax and live in the moment
  • Suffering from panic attacks, including the sense of losing inner control2

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Smoking Drugs And Alcohol

If you have depression it may be tempting to smoke or drink to make you feel better. Cigarettes and alcohol may seem to help at first, but they make things worse in the long run.

Be extra cautious with cannabis. You might think it’s harmless, but research has shown a strong link between cannabis use and mental illness, including depression.

The evidence shows that if you smoke cannabis you:

  • make your depression symptoms worse
  • feel more tired and uninterested in things
  • are more likely to have depression that relapses earlier and more frequently
  • will not have as good a response to antidepressant medicines
  • are more likely to stop using antidepressant medicines
  • are less likely to fully recover

A GP can give you advice and support if you drink or smoke too much or use drugs.

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What To Do Next

If you believe that you may be experiencing symptoms of depression, whether they are related to a drug that you are taking or not, you should consult with your personal physician.

Do not stop taking your medication without your doctor’s permission. If you are experiencing severe depression or having thoughts of suicide, do not hesitate to seek immediate medical attention.

Every situation is different, so your doctor will look at your health history and symptoms in order to determine what steps to take next. In some cases, it may involve switching to a different medication or adjusting your dosage.

Your doctor will also try to determine if your depressive symptoms are linked to the new medication or some other cause. If there is an underlying depressive disorder, your doctor may recommend treatments such as antidepressants and psychotherapy.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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Depression In People With Dementia

Depression is common in people with Alzheimers and related dementias. Dementia can cause some of the same symptoms as depression, and depression can be an early warning sign of possible dementia. Suicide attempts may also increase in people recently diagnosed with dementia. It is important to have support systems in place to help cope with a dementia diagnosis and possible depression symptoms that follow. More research is needed to determine effective depression treatment options for people with dementia.

What Are Symptoms And Signs Of Depression

Can a Depressed Person Have Good Days? – Atypical Depression

Clinical depression is not something you feel for a day or two before feeling better. In true depressive illnesses, the symptoms last weeks, months, or sometimes years if you don’t seek treatment. If you are depressed, you are often unable to perform daily activities. You may not care enough to get out of bed or get dressed, much less work, do errands, or socialize.

  • Adults: You may be said to be suffering from a major depressive episode if you have a depressed mood for at least 2 weeks and have at least 5 of the following clinical symptoms:
  • Feeling sad or blue
  • Feelings of worthlessness or excessive guilt
  • Thoughts of death or suicide

Men and women sometimes show depression differently. Specifically, men are more likely to experience irritability, sleep problems, fatigue, and loss of interest in activities they liked previously as a result of depression whereas women tend to have overt sadness and feelings of worthlessness and guilt when depressed. For people who tend to suffer from an increase in appetite, tiredness, and the tendency to sleep , carbohydrate craving, sometimes specifically for chocolate, may occur. That has been found to sometimes be an indication that the person tends to suffer from irritability and anxiety in addition to depression.

Since symptoms of depression tend to be more physical in elderly individuals compared to younger individuals, this puts these individuals at risk for having their depressive symptoms erroneously attributed to medical problems.

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A Bipolar Features: Depression With Mixed Features

And thats the second type of patient who can get worse on an antidepressant: Depression with mixed features. This diagnosis is new in DSM 5 and you dont have to have bipolar disorder to have it. Its actually quite common in unipolar depression one meta-analysis found that 25% of patients with depression had at least 3 manic features which is the DSM-5 cut off for mixed features. We dont know much about how to treat these unipolar depressions with mixed features. On the one hand, they are more likely to get worse on antidepressants, but on the other hand some will respond to them so its tricky.

Most of the patients I see in practice who have mixed features are already taking an antidepressant.

We covered this in our January 2018 issue, which has a link to the Bipolarity Index. This is a validated rating scale that uses non-symptomatic markers of bipolar like age of onset, treatment response, and family history to assess the likelihood that a patient has bipolar disorder on a 100-point scale. Its particularly helpful when faced with mixed features, because the symptoms are so hard to identify they can look like anxiety, PTSD, or even ADHD.

Mixed features are an area of diagnostic as well as treatment confusion, but we do know that the more the patient has the more likely they are to get worse with antidepressants.

What Should I Know About Clinical Depression

Throughout the course of our lives, we all experience episodes of stress, unhappiness, sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy or difficulty such as divorce or loss of a job, we may feel depressed . Most of us are able to cope with these and other types of stressful events.

Over a period of days or weeks, the majority of us are able to return to our normal activities. But when these feelings of sadness and other symptoms make it hard for us to get through the day, and when the symptoms last for more than a couple of weeks in a row, we may have what is called “clinical depression.” The term clinical depression is usually used to distinguish the illness of depression from less difficult feelings of sadness, gloom, or the blues.

Clinical depression is not just grief or feeling sad. It is an illness that can challenge your ability to perform even routine daily activities. At its worst, depression may lead you to contemplate, attempt, or commitsuicide. Depression represents a burden for both you and your family. Sometimes that burden can seem overwhelming.

There are several different types of clinical depression :

Adjustment disorder is a state of distress that occurs in relation to a stressful life event. It is usually an isolated reaction that resolves when the stress passes. Although it may be accompanied by a depressed mood, it is not considered a depressive disorder.

Depression Statistics

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What To Do If Antidepressants Make You Feel More Suicidal

The best thing you can do for yourself if the medication you are on is making you feel more suicidal is to gradually stop taking it. It isnt rocket science that people have adverse reactions to medications. Some people respond well to antidepressants, others dont. There have been cases of people committing suicide after taking less than a weeks worth of doses with no prior history of mental illness.

Consult your psychiatrist and/or pharmacist to talk about what you are experiencing while taking the drug. Most of them know people have adverse reactions and cannot cope with various side effects of these drugs. If you are feeling more suicidal than before you started taking the drug, its obvious that you arent responding well. What makes these medications difficult is the fact that they sometimes make people feel worse before they become beneficial.

However, in the experiences of many people , the antidepressants that work tend to work pretty quickly. When I was taking Paxil, I noticed it working within a few days of taking it. Additionally, I had no increased suicidal thoughts during the period in which the drug worked. When the effect wore off and Paxil pooped out, I began feeling more suicidal than I had ever felt in my entire life.

Diagnosing And Treating Depression

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There’s no physical test for depression.

If you experience depression symptoms most of the day, every day, for more than two weeks, you should visit your GP. This is especially important if:

  • you have symptoms of depression that aren’t getting any better
  • you have thoughts of self-harm or suicide
  • your work, relationships with friends and family, or interests are affected by your mood

It can be hard for people with depression to imagine that anything can help them but the sooner you seek help, the sooner the symptoms start to get better.

Your GP may examine you and perform blood or urine tests to make sure there isn’t another condition causing your depression symptoms, like an underactive thyroid.

When you see your GP, they’ll try to find out if you have depression by asking you questions. These are likely to be about your health, how you’re feeling, and how that is affecting you mentally and physically.

Telling your doctor your symptoms and the affect they are having on you will help your GP to tell if you have depression, and how severe the condition is. It’s important to be as open as possible.

Your conversation with your GP will be confidential. This rule can only be broken if your GP thinks there is a significant risk of harm to you or others, and that telling a family member or carer would make that risk lower.

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Seeing A Doctor About Depression

Big changes in your life, like bereavement, losing a job, or even having a baby, can cause symptoms of depression. You’re also more likely to experience depression if you have a family history of depression. However, it’s also possible to become depressed without there being an obvious reason.

You can learn more about depression causes here.

Social Isolation And Depression In Older Adults

Everyone needs social connections to survive and thrive. But as people age, they often find themselves spending more time alone. Studies show that loneliness and social isolation are associated with higher rates of depression.

The COVID-19 pandemic has brought new attention to this issue however, many Americans felt socially isolated and lonely before the pandemic. If youre feeling socially isolated or lonely, and you cannot see your friends and family in person for any reason, try reaching out over the phone or joining a virtual club. Find tips to help you stay more connected.

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Helping A Suicidal Friend Or Relative

If you see any of the above warning signs in a friend or relative:

  • get professional help for them
  • let them know they are not alone and you care about them
  • offer support in finding other solutions to their problems

If you feel there’s an immediate danger, stay with the person or have someone else stay with them, and remove all available means of attempting suicide, such as medicine.

Over-the-counter medicine, such as painkillers, can be just as dangerous as prescription medicine. Also, remove sharp objects and poisonous household chemicals such as bleach.

You Feel More Energetic But Still Feel Blue

Depression Treatment Options: A Quick-Start Guide: What to Do If You’re Diagnosed With Depression

If you feel more physical energy after starting an antidepressant, but you still have depression, thats good and bad news, says Gabriela Cora, MD, a psychiatrist in Miami. It means the depression medication is starting to work, but not in the right way.” Increased physical energy combined with depression is a bad combination that can make you act out or increase your risk of suicide, she explains. So, report these symptoms to your doctor right away, urges Dr. Cora.

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Symptoms And Causes Of Depression

Symptoms of depression can be very different from person to person. However, as a general rule, if you are depressed you feel hopeless, sad and lacking interest in things that used to make you feel happy.

Depression symptoms are bad enough to interfere with work, social life and family life, and can persist for weeks or months.

Doctors describe depression in one of three ways, depending on how serious it is:

  • mild depression it has some impact on daily life
  • moderate depression it has a significant impact on your daily life
  • severe depression this makes it nearly impossible to get through your life day to day

A few people with severe depression may have symptoms of psychotic depression.

Below is a list of depression symptoms it’s unlikely that one person would have all of them.

The Relationship Between Anxiety And Depression

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While anxiety is generally considered a high-energy state and depression a low-energy state, anxiety and depression are more closely related than you might think. A person with depression often experiences a lot of anxiety, possibly even to the extent of having panic attacks.1

Anxiety disorders involve more than common nervousness and worry. They can cause terrifying fear about things other people wouldnt think twice about. Many people with anxiety disorders fully comprehend that their thoughts are irrational. But they still cant stop them. Feelings of losing inner control haunt them. This angst is one of the entry ways for depression.2

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Selective Serotonin Noradrenaline Reuptake Inhibitors

Both SSNRI and SSRI medications affect serotonin levels, but SSNRI drugs also impact the level of norepinephrine, another neurotransmitter that may affect mood. This type of medication is helpful for those who have extreme fatigue associated with depression, or who have had side effects or poor response to SSRI drugs.

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