Understanding Different Treatment Options for Depression

This article is for people who are living with major depressive disorder (MDD) and their care partners, or anyone who wants to learn more about depression. The goal of this activity is to help you talk to and work with your doctor and healthcare team about ways to help manage depression and its symptoms. If your doctor doesn’t manage patients with depression, you may ask for a referral to someone who does.

You will learn about:

• What MDD, or depression, is and its symptoms

• Ways to help manage MDD and its symptoms

• Antidepressant medicines for MDD

• Making a treatment plan with your doctor and healthcare team

• Questions you can ask

Major depressive disorder (MDD) -- depression, for short -- is a condition that causes feelings of sadness that won't go away and a loss of interest in things you normally enjoy.

Everyone feels down once in a while, but people who are living with MDD feel depressed most of the time on most days of the week. MDD can affect your mood and emotions, relationships, ability to function and do daily activities, and your quality of life. It impacts how you feel, think, and act, and can even lead to physical problems.

People who are living with MDD have symptoms most of the day, and nearly every day, for at least 2 weeks.

Symptoms can be different for different people and, in addition to sadness and loss of interest, may include:

• Feeling sluggish and physically or mentally slowed down

• Tiredness (fatigue), lack of energy

• Trouble concentrating or making decisions

• Anxiety, agitation, restlessness

• Irritability, frustration, angry outbursts

• Feeling guilty or worthless

• Sleep problems

• Changes in appetite or weight

• Sexual problems

• Unexplained physical problems

• Recurring thoughts of death or suicide

MDD is treatable, and the first step is to let your doctor or healthcare team member know how you’re feeling. So having open and honest communication with them is key.

The goals of treatment are to help control your symptoms and improve your daily functioning and quality of life. Ways to help manage MDD and its symptoms that your doctor or healthcare team member may recommend -- alone or in combination -- can include lifestyle changes, medicine, and counseling (therapy), as well as other types of treatment if your symptoms are severe.

Antidepressants are the main medicines used to help manage MDD and its symptoms.

Different antidepressants can work in different ways. But many help increase the levels of chemicals in your brain called neurotransmitters -- such as dopamine, glutamate, norepinephrine (noradrenaline), or serotonin -- that regulate or improve your mood, emotions, motivation, attention, memory, and cognition (how you think).

Types of antidepressants can include:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Atypical antidepressants

• Serotonin modulators

• Serotonin receptor agonists

• Tricyclic antidepressants (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

• NMDA (N-methyl-D-aspartate) antagonists

Some antidepressants may help certain symptoms better than others. So your doctor or healthcare team member may recommend a combination of antidepressants and/or other medicines.

All medicines can have side effects, and different medicines can have different ones.

Depending on the antidepressant that you’re taking, some common side effects that may happen can include:

• Nausea, diarrhea, constipation, stomach pain, heartburn

• Increased appetite, weight gain

• Sleep problems

• Fatigue, drowsiness, dizziness

• Headache, blurred vision

• Sweating, anxiety, dry mouth

• Irritability, agitation, feeling jittery

• Sexual problems

Not all side effects are listed here -- be sure to ask your doctor or healthcare team member for a complete list.

Treatment for depression is not one-size-fits-all and different treatments can work for different people. So you and your doctor and healthcare team will work together to create a plan that best manages your symptoms with the fewest side effects. In addition to symptoms, they will consider your overall health, other conditions you may have and medicines you take, your lifestyle and daily habits, and your personal preferences for care.

Some people may feel hesitant or uncomfortable bringing up certain symptoms or side effects, but talking openly with your doctor and healthcare team can help you make a plan that fits your individual needs.

Medicines can work differently for different people. Some may take several days or weeks to work. With side effects, certain ones can go away on their own over time. But others may last longer, so you and your team will work together to find ways to help manage them.

Be sure to tell your doctor and healthcare team about your symptoms, any changes, and how they affect your daily life. They may recommend different medicines, doses, or combinations to find what works for you.

And it's important to remember to stick to your treatment plan. Don't stop or change treatment without talking to your doctor or healthcare team member first as this may cause feelings of withdrawal or symptoms to get worse.

Questions you can ask about MDD can include:

• What types of treatment do you recommend?

• Are there any lifestyle changes I should make?

• What medicines are available, and what are their possible side effects?

• If treatment isn’t working or side effects can’t be managed, is there another one we can try?

• What should I do if I feel anxious or stressed?

• Is there a peer group or support group I can join?

• Where can I find more information and resources?

Congratulations!

You have successfully completed the program Understanding Different Treatment Options for Depression.

View Additional Materials on this topic that you may find useful:

Depression

Depression -- National Library of Medicine

Mental Health Conditions: Depression and Anxiety