Depression is a chemical change that originates in the brain. When depression arrives, a certain heaviness is felt in the head, almost like an invasion from a foreign substance. It is palpable, like the clouds flowing across the sun. The light is replaced with a much heavier shadow that blocks the warm rays of the sunlight.
I am not a chronic depressive, yet like most of us, the cloud comes over me when I feel exceptionally neglected or misunderstood. Most mild depressions are a simple case of getting the blues.
It helps to remember that we only feel emotionally good because we know about feeling emotionally bad.
Severe or mild, depression is caused by brain chemistry. When our chemical neurotransmitters are out of balance, we fall into depressive symptoms. Hormones, disease, inherited traits and life events all play a part in depression.
Some claim that women are more susceptible to depression than men, but that could be because women seek treatment for depression more than men do.
Severe depression often requires medical treatment. Because the causes are chemical changes, chemicals are often used for treatment. Some can have very serious consequences. Many people do not believe in chemical treatments, or feel the primary purpose of these treatments is to enrich pharmaceutical companies.
Many types of antidepressant medications are available to treat depression, including those below. Discuss possible major side effects with your doctor or pharmacist.
- Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These medications are safer and generally cause fewer bothersome side effects than do other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs). Examples of SNRI medications include duloxetine (Cymbalta), venlafaxine (Effexor XR) and desvenlafaxine (Pristiq).
- Norepinephrine and dopamine reuptake inhibitors (NDRIs). Bupropion (Wellbutrin) falls into this category. It’s one of the few antidepressants not frequently associated with sexual side effects.
- Atypical antidepressants. These medications don’t fit neatly into any of the other antidepressant categories. They include trazodone and mirtazapine (Remeron). Both are sedating and usually taken in the evening. A newer medication called vilazodone (Viibryd) is thought to have a low risk of sexual side effects.
- Tricyclic antidepressants. Tricyclic antidepressants — such as imipramine (Tofranil) and nortriptyline (Pamelor) — tend to cause more severe side effects than do newer antidepressants. So tricyclics generally aren’t prescribed unless you’ve tried an SSRI first without improvement.
- Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate) and phenelzine (Nardil) — may be prescribed, typically when other medications haven’t worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods ― such as certain cheeses, pickles and wines ― and some medications including birth control pills, decongestants and certain herbal supplements. Selegiline (Emsam), a newer MAOI that you stick on your skin as a patch, may cause fewer side effects than other MAOIs do. These medications can’t be combined with SSRIs.
- Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications might also be added for short-term use.
St. John’s wort is a popular means of treating depression in Europe, though it is not approved in the United States. This herbal remedy can interfere with quite a few medications, so a doctor’s advice is recommended to make certain that there is no interaction with other prescriptions.
Another European drug not approved in the US is called SAMe (pronounced ‘sam-E’) is the synthetic version of a naturally occurring chemical that the body manufactures.
Some people believe that diets high on Omega-3 fatty acids – found in cold water fish, walnuts, and flaxseed and oil – also helps to relieve mild depressions.
My depressions, I find, are most often caused by taking myself too seriously. I can often cure them by doing something else and not thinking about myself so much. Enlarging one’s self identification is always a good idea when the blues pay us a visit.
Helping others often rewards us as well. It is another method of bringing us out of ourselves and into a practical world where people can care about one another.
Taking our consciousness away from our limited definitions of ourselves and is a step toward expanding mental pictures of ourselves to include the rest of nature and humanity. For this we rely on many things, from mediation to music, exercise to entertainment.
Depression is a curse that falls on all of us. Looking from the top of the hill, we can see the valleys below, but from the valley itself, the mountain often looks insurmountable.