The kind of depression that will most likely benefit from treatment with medications is more than just “the blues.” It is a condition that is prolonged, lasting two weeks or more, and interferes with a person’s ability to carry on daily tasks and to enjoy activities that previously brought pleasure.
The depressed person will seem sad, or “down,” or may show a lack of interest in his surroundings. That person may have trouble eating and lose weight (although some people eat more and gain weight when depressed). He may sleep too much or too little, have difficulty going to sleep, sleep restlessly, or awaken very early in the morning. She may speak of feeling guilty, worthless, or hopeless. He may complain that his thinking is slowed down. She may lack energy, feeling “everything’s too much,” or she might be agitated and jumpy.
A person who is depressed may cry. He may think and talk about killing himself and may even make a suicide attempt. Some people who are depressed have psychotic symptoms, such as delusions (false ideas) that are related to their depression. For instance, a psychotically depressed person might imagine that she is already dead, or “in hell,” being punished.
Not everyone who is depressed has all these symptoms, but everyone who is depressed has at least some of them. A depression can range in intensity from mild to severe.
Antidepressants are used most widely for serious depression, but they can also be helpful for some milder depressions. Antidepressants, although they are not “uppers” or stimulants, take away or reduce the symptoms of depression and help the depressed person feel the way he did before he became depressed.
Antidepressants also are used for anxiety disorders. They can block the symptoms of panic, including rapid heartbeat, terror, dizziness, chest pains, nausea and breathing problems. They also can be used to treat some phobias.
The physician chooses a particular antidepressant based on the individual patient’s symptoms. When someone begins taking an antidepressant, improvement generally will not begin to show immediately. With most of these medications, it will take from one to three weeks before changes begin to occur.
Some symptoms diminish early in treatment; others, later. For instance, a person’s energy level or sleeping or eating patterns may improve before his depressed mood lifts. If there is little or no change in symptoms after five to six weeks, a different medication may be tried. Some people will respond better to one than another.