If the depression continues for 2 weeks or longer, the doctor should be contacted for tests and treatment.
However, in cases of mild or major depression, the following self-care steps can help:
- Get enough sleep.
- Follow a healthy, nutritious diet.
- Exercise regularly.
- Avoid alcohol, marijuana, and other recreational drugs.
- Get involved in activities that make you happy, even if you don’t feel like it.
- Spend time with family and friends.
- Try talking to clergy or spiritual advisors who may help give meaning to painful experiences.
- Consider prayer, meditation, tai chi, or biofeedback as ways to relax or draw on your inner strengths.
- Add omega-3 fatty acids to your diet, which you can get from cold-water fish like tuna, salmon, or mackerel.
- Take folate (vitamin B9) in the form of a multivitamin (400 to 800 micrograms).
Depression often continues if left untreated. Intervention may include medication to regulate chemicals in the brain, talk therapy, or a combination of the two. Electroconvulsive therapy (ECT), sometimes referred to as “shock therapy,” uses electrical stimulation in the brain to help treat chronic depression that has proven resistant to the more conventional means of treatment.
Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) andsertraline (Zoloft), reduce depression by increasing levels of serotonin, a neurotransmitter. Some clinicians prefer SSRIs for treatment of dysthymic disorder. Anxiety, diarrhea, drowsiness, headache, sweating, nausea, poor sexual functioning, and insomnia all are possible side effects of SSRIs.
Tricyclic antidepressants (TCAs) are less expensive than SSRIs, but have more severe side effects including persistent dry mouth, sedation, dizziness, andcardiac arrhythmias. Because of these side effects, caution is taken when prescribing TCAs to elderly patients. TCAs include amitriptyline (Elavil),imipramine (Tofranil), and nortriptyline (Aventyl, Pamelor).
Monoamine oxidase inhibitors (MAO inhibitors), such as tranylcypromine(Parnate) and phenelzine (Nardil), block the action of monoamine oxidase (MAO), an enzyme in the central nervous system. Patients taking MAOIs must avoid foods high in tyramine (found in aged cheeses and meats) to avoid potentially serious hypertensive side effects.
Heterocyclics include bupropion (Wellbutrin) and trazodone (Desyrel). Bupropion is prescribed to patients with a seizure disorder. Side effects include agitation, anxiety, confusion, tremor, dry mouth, fast or irregular heartbeat, headache, low blood pressure, and insomnia. Because trazodone has a sedative effect, it is useful in treating depressed patients with insomnia.