Wednesday, February 1, 2023

What Do Doctors Prescribe For Depression And Anxiety

Can I Have Depression And Anxiety At The Same Time

CAN YOU TAKE PRESCRIBED BENZODIAZEPINES Every Day? (For Depression & Anxiety)

Depression and anxiety are two different mental health disorders that are often comorbid. Meaning, they occur at the same time.

Depression is a mental disorder that is commonly identified with intense feelings of hopelessness, despair, worthlessness, and overwhelming sadness. More than 16% of Americans will experience depression at some point during their lifetime, according to theCleveland Clinic. While most people will experience feelings of sadness at some point, with depression, these feelings are prolongedlasting two weeks or moreand severe enough to impact daily life.

Anxiety disorders are characterized by excessive worry, nervousness, or fear that impacts everyday functioning. Without treatment, anxiety can get worse over time. There are a number of anxiety disorders, with their own set of unique symptoms.

About 2% of people in the U.S. have generalized anxiety disorder . According to Richard Shelton, MD, a psychiatrist and the vice chair of research at the University of Alabama at Birmingham, GAD symptoms include persistent fear and worry that is often difficult to control. Other anxiety disorders include:

Depression and anxiety may share some of the same signs and symptoms, such as avoiding activities that were once previously enjoyed, headaches or changes in appetite, and exhaustion.

Management Of Depression In The Primary Care Setting

The aggressive and appropriate management of depression in the primary care setting is crucial, not only from a clinical perspective, but from a health economics perspective as well. Untreated or inadequately treated patients are more likely to have negative medical consequences of their depression, including a substantial risk of suicide and longer, more treatment-resistant episodes of depression.42 Such patients will continue to use valuable health care resources inappropriately, including significantly more general medical services.43

Thus, the challenge for clinicians is to make a rapid and accurate diagnosis and then to ensure adequate and effective treatment. Not surprisingly, a study from the early 1990s showed that only 30% of depressed patients seen at a tertiary care center were given any antidepressant medication, and as many as 50% were treated incorrectly with anxiolytics rather than antidepressants.44 Furthermore, when evaluating the results of the Medical Outcomes Study in depressed patients given minor tranquilizers and antidepressants, Wells et al.45 noted that more patients used minor tranquilizers and that of those who were taking antidepressants, 39% were taking inappropriately low dosages.

Side Effects Of Antidepressant Medications

All medications can have side-effects. Some people experience no side-effects. Others may find the side-effects distressing. In most cases, side-effects lessen as treatment continues.

Treatment is usually started at a low dose, to minimize side-effects, and then slowly increased until the ideal dose is found. The ideal dose is one that provides the greatest benefit with minimum side-effects.

If you are experiencing side effects, check the information given to you by your doctor or pharmacist on the specific effects of any drug you have been prescribed. If side-effects are not mild and tolerable, it is best to continue taking your medication as prescribed but let your doctor know as soon as possible. Your doctor may:

  • encourage you to wait a little longer for the side-effects to fade
  • adjust your dose
  • suggest you take the medication at a different time of day
  • prescribe other medications to help control side-effects
  • change your medication
  • stop medication treatment and suggest a different type of treatment approach.

Side-effects vary depending on the type of medication. More information on side-effects is included for each type of types of antidepressant.

You can help to control possible side-effects on your own by:

Do antidepressants increase the risk of suicide?

Before starting treatment, prepare for the possibility of feeling worse before you feel better. Know what supports are available to you and who you can call.

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Activity: Working Through Itthinking About Your Diagnosis

Writing your thoughts, concerns, questions and goals down can be a very helpful tool to help you make sense of your diagnosis and next steps. Working it out by writing can also help you describe what youâre going through to loved ones or health professionals. Also, if you need to access different services and supports, various professionals may start to ask you about your diagnosis including who provided the diagnosis and when it happened. Writing things down can help you remember what youve been told. If you add your thoughts and concerns too, writing can help you see your own progress over time in your recovery journey.

Step 1

Before you can be expected to deal with your diagnosis, you need to be able to put your diagnosis into words. Answer the following questions in your journal:

What diagnosis were you given?

Who provided you with the diagnosis?

When was it given to you ?

Did anyone else confirm this diagnosis? When?

What investigations were done to arrive at the diagnosis?

In lay words, what does this diagnosis mean? What does it involve?

What questions did you ask after you were given the confirmed diagnosis? If you can remember, what answers were you given for your questions?

How much did you already know about depression? Little? Some? A lot?

What attitudes and assumptions did you have about people with depression before this?

How much do you accept this diagnosis? Fully, Unsure, Dont accept it?

How much does it make sense with what you were experiencing?

Step 2

How Long Do Antidepressants Take To Work

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If you have depression, you may start to feel better 2 to 4 weeks after starting an antidepressant but it can take up to 6 to 8 weeks to feel the full effect. Many side effects go away after a few weeks, so allow time.

If you have an anxiety disorder, it may take 4 to 6 weeks before you start feeling better and it may take up to 12 weeks to feel the full effect of the antidepressant.

In some people, antidepressants are not effective, no matter how long they are taken for.

Anybody who takes antidepressants should see their doctor regularly, especially in the first few weeks.

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The Most Commonly Prescribed Ones Include:

Selective serotonin reuptake inhibitors are the most prescribed type of antidepressant and include:

Serotonin and norepinephrine reuptake inhibitors are similar to SSRIs. Common ones include venlafaxine and duloxetine.

Bupropion works differently than SSRIs or SNRIs. It also treats seasonal affective disorder and helps people stop smoking.

Older antidepressant medications include tricyclics, tetracyclics, and monoamine oxidase inhibitors . They are prescribed less often than other medications because they tend to cause more side effects. However, they work better for some people.

Who Can Prescribe Antidepressant Medications

Thankfully, its reported that between 80-90% of people with depression respond well to treatment, and nearly all people experience some relief from their symptoms with treatment.

Antidepressants are a prescription medication and therefore require a prescription from a health care professional.

Generally, you can obtain a prescription for antidepressant medication from two types of health care professionals.

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Ssri Antidepressants For Anxiety

Many medications originally approved for the treatment of depression are also prescribed for anxiety. In comparison to benzodiazepines, the risk for dependency and abuse is smaller. However, antidepressants take up to 4 to 6 weeks to begin relieving anxiety symptoms, so they cant be taken as needed. Their use is limited to chronic anxiety problems that require ongoing treatment.

The antidepressants most widely prescribed for anxiety are SSRIs such as Prozac, Zoloft, Paxil, Lexapro, and Celexa. SSRIs have been used to treat generalized anxiety disorder , obsessive-compulsive disorder , panic disorder, social anxiety disorder, and post-traumatic stress disorder.

Common side effects of SSRIs include:

  • Increased sweating

Children With Anxiety Have A Greater Risk Of Having Psychological Problems As Adults

Wellbutrin for depression, anxiety, and ADHD

One of the reasons that it is important to get medical help for your child if they appear to be having unhealthy anxiety is that children with anxiety appear to have a greater risk of developing mental illness as adults. For example, childhood social anxiety disorder predicts adolescent social anxiety disorder. Overanxious disorder is associated with later OAD, panic attacks and depression. Social phobia in childhood is associated with adolescent OAD, social phobia, and attention-deficit/hyperactivity disorder .

So it is important to seek help for your child if he or she seems to be overly anxious. If you do, it will help them to avoid having psychological problems in adolescence and adulthood.

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How Do I Know If I Have Generalized Anxiety Disorder

The first step is to rule out the possibility that your symptoms are being caused by a medical condition that is not psychiatric. Among the conditions that produce symptoms similar to those of anxiety are hyperthyroidism or other endocrine problems, too much or too little calcium, low blood sugar, and certain heart problems. Certain medicines also can sometimes cause anxiety. A thorough evaluation by your health care provider will determine if any of these conditions are the cause of your symptoms.

If no other medical culprit can be found and the symptoms seem out of proportion to any situation you are facing, you may be diagnosed with an anxiety disorder.

Drug Interactions And Overdose

While benzodiazepines are relatively safe when taken only occasionally and in small doses, they can be dangerous and even deadly when combined with other central nervous system depressants. Always talk to your doctor or pharmacist before combining medications.

Dont drink on benzodiazepines. When mixed with alcohol, benzodiazepines can lead to fatal overdose.

Dont mix with painkillers or sleeping pills. Taking benzodiazepines with prescription pain or sleeping pills can also lead to fatal overdose.

Antihistamines amplify their effects. Antihistaminesfound in many over-the-counter sleep, cold, and allergy medicinesare sedating on their own. Be cautious when mixing with benzodiazepines to avoid over-sedation.

Be cautious when combining with antidepressants. SSRIs such as Prozac and Zoloft can heighten benzodiazepine toxicity. You may need to adjust your dose accordingly.

Paradoxical effects of benzodiazepines

The benzodiazepines work because they slow down the nervous system. But sometimes, for reasons that arent well understood, they have the opposite effect. Paradoxical reactions are most common in children, the elderly, and people with developmental disabilities. They include:

  • Increased anxiety, irritability, agitation, aggression, and rage
  • Mania, impulsive behavior, and hallucinations

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Which Lab Tests Can Help Make The Depression Diagnosis

After reviewing the information from your appointment, including the signs and symptoms, patient history, family history, and physician exam, your doctor may ask for some lab tests to rule out a physical condition that may be causing your symptoms. Certain viruses, medicines, hormonal or vitamin deficiencies, and illnesses can cause depression-like symptoms. Your doctor will also want to review all medications youâre taking as well as the alcohol or recreational drugs you may be using.

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How Experts First Treat Anxiety

Depression, Anxiety

Once you understand the type of anxiety youre dealing with, you can start to explore measures with a physician or mental health professional who can help you manage the symptoms. While anxiety can present itself in many different forms, all anxiety disorders have one thing in common: They are highly treatable, and most of them respond well to medication, said Chelsea Hudson, licensed therapist in Chicago and founder of Cityscape Counseling.

However, that doesnt mean you should immediately head to your doctor to get a prescription. Many people think medication is a magic bullet to feeling better, Baksh said, but in reality, its part of a comprehensive treatment plan that should also include other interventions, such as lifestyle changes and therapy.

Seeking professional help from a counselor, guided imagery, family and peer support and meditation have all been shown to help alleviate anxiety, Baksh said. Cognitive behavioral therapy in particular has been shown to be effective in treating anxiety disorders, Sistrunk said.

Lifestyle changes can also play a big role in managing anxiety. Incorporating more exercise into your day, improving your sleep and eating healthier can all help, said Katie Ziskind, a licensed marriage and family therapist in Connecticutand owner of Wisdom Within Counseling.

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How Do Antidepressants Work

Various antidepressant medications are available for prescription use. There is no single best antidepressant, and the best one for you depends on your symptoms and individual needs.

Usually, antidepressants help balance the levels of neurotransmitters, which are chemicals responsible for communications between neurons in the brain. These chemicals include serotonin, dopamine and norepinephrine. Higher levels of these chemicals usually correspond with lower levels of depression.

While antidepressants can be helpful in depression, effectiveness varies from patient to patient. How long the drugs stay in your body also varies. Some drugs stay in your body for about 36 hours, while others last as long as several days.

Why Are Antidepressants Prescribed

Antidepressants are often prescribed to treat depression.

They work by affecting chemicals in the brain called neurotransmitters that are associated with depression, including serotonin, norepinephrine, and dopamine.

There are five main classes of antidepressants, each of which works to affect these neurotransmitters in different ways.

If one type of antidepressant doesnt help to relieve your symptoms, another type may work better for you.

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What If My Anxiety Gets Better But My Depression Doesnt

SSRIs can help treat anxiety and depression, but they dont work the same for everyone. If increasing the dosage of that medication doesnt work, another medication may be added or used to replace the current treatment.

For example, Wellbutrin is a common antidepressant that tackles low mood and low energy, but it can increase feelings of anxiousness. Its one of the reasons why its often combined with an SSRI, says Dr. Shelton, if depression isnt alleviated completely.

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Path To Improved Health

Handling Crying Patients For Primary Care Doctors

Your doctor will consider many factors when choosing the antidepressant medicine to give you. He or she will think about the following:

Keep in mind that antidepressant medicines arent tranquilizers or uppers. You wont get a high when you take them. Also, theyre not addictive.

Youll know if your antidepressant is working based on how you feel. Youll be able to sleep better. Youll have more energy to meet your day-to-day obligations. You can take care of yourself. Your appetite will be closer to normal. Youll have an increased desire to engage in life. You and your family and friends will notice these changes. Be patient, though. It may take some time to get back to the way you felt before the depression.

It is important to remember that antidepressants can help with symptoms of depression. These medicines work best when you try to have an active lifestyle with exercise, get eight hours of sleep a night, and eat healthy foods. Your doctor may also recommend working with a counselor to help you improve the thoughts of depression.

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Do I Need Antidepressants

As with many other medications, there are benefits and risks to taking antidepressants.

They are often effective for moderate to severe depression. They can help to improve mood and increase motivation for people who may have lost interest in activities they once enjoyed. They can also help improve sleep, thinking and concentration.

Antidepressants might also help people with anxiety-related disorders like generalised anxiety disorder , eating disorders, obsessive-compulsive disorder and post-traumatic stress disorder .

However, antidepressants are not particularly effective for mild depression. Lifestyle changes and psychological treatments work better for mild depression.

The decision to start an antidepressant should be made only in consultation with a doctor.

Other medicines may also be needed as well as or instead of antidepressants. These include anti-anxiety medication or sleeping tablets.

Medication Isnt Your Only Option For Anxiety Relief

Anxiety medication wont solve your problems if youre anxious because of mounting bills, a tendency to jump to worst-case scenarios, or an unhealthy relationship. Thats where self-help, therapy, and other lifestyle changes come in. These non-drug treatments can produce lasting changes and long-term relief.

Exercise Exercise is a powerful anxiety treatment. Studies show that regular workouts can ease symptoms just as effectively as medication.

Worry busting strategies You can train your brain to stop worrying and look at life from a more calm and balanced perspective.

Therapy Cognitive behavioral therapy can teach you how to control your anxiety levels, stop worrisome thoughts, and conquer your fears.

Yoga and tai chi Yoga and tai chi are mind-body interventions that engage you emotionally, psychologically, and spiritually. Data has shown their efficacy for many different medical conditions, including anxiety.

Mindfulness and meditation Mindfulness is a state of mind where you learn to observe your thoughts, feelings, and behaviors in a present, compassionate, and non-judgmental way. It often brings a sense of calm and relaxation.

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How Do I Get Tested For Depression

Talkspace offers free depression tests to help you understand your symptoms of depression. For a clinical depression diagnosis, it is important to see a licensed therapist or mental health professional. During your initial appointment with a Talkspace therapist, they will likely ask you several questions about your mood and how it impacts your daily functioning in order to determine if a diagnosis for depression is applicable to you.

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I Need Relief And I Need It Now

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So where does that leave you if youre suffering? Even when anxiety relief comes with side effects and dangers, that can still sound like a fair trade when panic and fear are ruling your life.

The bottom line is that theres a time and place for anxiety medication. If you have severe anxiety thats interfering with your ability to function, medication may be helpfulespecially as a short-term treatment. However, many people use anti-anxiety medication when therapy, exercise, or other self-help strategies would work just as well or better, minus the drawbacks.

Anxiety medications can ease symptoms, but theyre not right for everyone and theyre not the only answer. Its up to you to evaluate your options and decide whats best for you.

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