Joy and the Journey

SSRIs (selective serotonin reuptake inhibitors) block the reuptake of the brain’s key feel-good neurotransmitters, including serotonin, dopamine, and norephinephrine. The most commonly prescribed SSRIs are citalopram (Celexa, Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). TCAs (tricyclic antidepressants), are similar to SSRIs, but are less selective in which receptors they block, which means they also have more side effects, and are thus typically used only as a last resort. Common TCAs are imipramine (Tofranil) and malprotiline (Ludiomil).

SNRIs (serotonin-norepinephrine reuptake inhibitors) block the reuptake of norepinephrine to a greater extent than SSRIs. Common SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), and desvenlafaxine (Pritiq).

Like all prescription medications, antidepressants should only be used under the careful direction of a doctor or psychiatrist. Antidepressants can increase the risk of suicide in teens and young adults ages 13-24, so please be careful. However, as long as you communicate with your doctor and take antidepressants exactly as they are prescribed, they can be extremely helpful in alleviating the pain of major depressive disorder.

Therapists can help patients understand their depression, find the depression’s cause (often a life problem), and learn to cope. There are many different types, but the most popular include:

Psychoanalytic therapy. An unconscious problem from the patient's childhood is brought to the surface, through free association, projective tests, or other methods, allowing the patient to work through it, thus enabling growth. This is the typical "Freudian" method of psychoanalysis

Cognitive-behavioral therapy. This is shown to be the most effective form of psychotherapy in treating the majority of depressed patients. Cognitive-behavioral therapists believe that if depressed patients learn to notice, prevent, and reverse the negative thoughts that they experience, they can also prevent and reverse the perpetually low moods that plague a depressed mind. This is a “thoughts create feelings, which create behaviors”  theory.

Behavioral therapy. Behavioral therapists encourage patients to change the behaviors that are causing depression and replace them with constructive behaviors. Exercise boosts serotonin transmission, certain foods may need to be avoided or increased (like those with Omega-3s), high-stress situations can be avoided, unrealistic self-expectations can be balanced (that inevitably lead to failure and the ensuing depression), and restful and/or pleasurable activities can be added to a depressed patient’s life to reverse depression.

Cognitive therapy. Cognitive therapists focus solely on changing thought processes, not behaviors, believing that the mind is totally the cause of the depression.

Depression has shown to be most often effectively treated through a combination of antidepressant medication and cognitive-behavioral therapy. However, many other treatments exist in the world today. See your doctor to decide which treatment is best for you. Remember, treatments are not one-size-fits-all. You might have to try many different things before you find the one that works for you. But don't give up. Depression is certainly treatable.