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12 Tips for Success with Antidepressants How Do Antidepressants Work? They Balance Brain Chemicals Brain chemicals called neurotransmitters affect mood. People who suffer from depression and other mood disorders may have altered levels of these chemicals. Antidepressants work by helping to normalize the levels of these compounds. This makes the brain chemicals more available to do their job in the brain. All physicians have the ability to prescribe antidepressants. People who have severe or difficult-to-treat mood imbalances are best treated by a doctor who is an expert in sing medications to help balance brain chemistry. These doctors are called psychiatrists. Depression and mental health disorders are serious issues that need to be treated by a medical professional. Types of Antidepressants Different classes of drugs work in slightly different ways. Selective serotonin reuptake inhibitors (SSRIs) allow more of the neurotransmitter serotonin to be available in the brain. Sertraline (Zoloft), fluoxetine (Prozac), and proxetine (Paxil) are a few types of SSRIs. Tricyclic antidepressants (TCAs) allow more serotonin and norepinephrine to be available. Protriptyline (Vivactil), trimipramine (Surmontil), and imipramine (Tofranil) are a few kinds of tricyclic antidepressants. Monoamine oxidase inhibitors (MAOIs) slow down the breakdown of serotonin, dopamine, and norepinephrine in the brain. Isocarboxazid (Marplan), phenelzine (Nardil), and rasagiline (Azilect) are a few types of monoamine oxidase inhibitors. Everyone is different, but many depressed patients are first prescribed one of the SSRIs. If that doesn’t work, a tricyclic may be the next option. There are more risks and negative effects associated with these drugs. They Can Take Time Antidepressants work best to treat depression when they are paired with psychotherapy, but they do not work right away. Many antidepressants take between 1 to 3 weeks to start working. It can take even longer before they reach maximum efficacy. Most symptoms associated with depression — lack of interest in things that were once enjoyable and feelings of hopelessness and sadness — will eventually improve with antidepressant treatment. In rare cases, some individuals may be resistant to certain antidepressants and it may take a trial and error approach with other medicines to find one that works. The effects of a drug may not be known for weeks or months. Each different type and class may be associated with different potential risks. Make Adjustments If Necessary Increase the Dose or Switch? In general, it takes approximately 4 to 6 weeks for antidepressants to work. If you are still experiencing symptoms after this amount of time, talk to your doctor. You may need to increase the dose of your current antidepressant drug or switch to another one altogether. Some people experience treatment failure with the first antidepressant they try. In these cases, switching to a medicine in a different class may do the trick. It may take a full 3-month period to experience maximum benefits from an antidepressant. Very rarely, some individuals who have been on an antidepressant for some time may notice that the drug stops working. Always discuss any difficulties you’re having with any drug with your health care professional. Untreated depression is a risk to your mental health. Is Brand Name Better? Generic Is the Same, Usually The US Food and Drug Administration (FDA) says that the safety, strength, and quality of generic drugs are equal to those of brand-name drugs. However, in practical experience, some people notice that they do not experience the same benefits from a generic drug compared to the brand-name version. Results of some studies suggest generic medications may be absorbed and used by the body slightly differently than brand-name drugs. If you notice a generic medicine is not working as well as a brand-name medicine did for you, tell your physician. How Long Does Treatment Last? Do Not Quit Antidepressant Drugs Prematurely Antidepressant treatment for depression can last for several months up to a year. It is important not to lower the dose of your medication or stop taking it just because you start to feel better. Depression will likely return if you do so. Stay on the correct dose for as long as your doctor tells you to do so. Take the drug at the same time every day for maximum benefit. You may want to take your pills at breakfast every morning as an easy way to remember to take your medication. People who are depressed may have a hard time complying with treatment. Discuss any issues with your medical professional. Speak Up About Side Effects Some individuals may experience side effects from antidepressants. Be sure to discuss them with your doctor. Some common side effects may include increased or decreased appetite, difficulty sleeping or sleeping too much, weight gain or weight loss, or difficulties with sexual response. Some people may experience nausea. Your doctor can help you come up with solutions to handle potential side effects. If the medication makes you nauseous, taking it with food may help. If your antidepressant makes you sleepy, try taking it in the evening before bed. In contrast, certain antidepressants are best taken in the morning. Often, side effects from antidepressants are temporary and may go away after a few weeks of being on them. If side effects are severe, your doctor can prescribe a different medication for you. Never stop taking antidepressant medication abruptly. Doing so may cause serious withdrawal symptoms and depression to return. Antidepressant Interactions Antidepressants that are prescribed today are often far more gentle and have fewer side effects and drug interactions compared to older generation drugs in different classes. However, reactions with other medications, herbs, and supplements you are taking are always possible. Interactions may interfere with the way a drug works or may reduce the effectiveness of a drug. Always make sure your prescribing physician knows about all of the prescription and over-the-counter medications, supplements, and herbs you are taking. Keep Up with Checkups Regular follow up visits with your health care professional are essential. Depression and anxiety are serious illnesses and can be associated with suicidal thoughts and other symptoms. It is imperative to go for follow up appointments as instructed. Treatment with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoanmine oxidase inhibitors (MAOIs), and other antidepressants requires monitoring and fine tuning. The goal is to alleviate depression and anxiety without side effects and symptoms returning. You may also need adjustments to treatment if you undergo a major life change such as being diagnosed with a serious illness or losing a job. Women who are pregnant may also need to adjust the type or dose of medication they are taking. Some medications can have negative effects on a developing fetus. Drug Myths Many people are afraid to take antidepressant drugs to treat depression and anxiety because they believe the myths perpetuated about treatment. Some worry that antidepressant drugs will make them robotic and emotionless. They can help eliminate feelings of sadness and hopelessness, but they won’t make you out of touch with your emotions. Some people also falsely believe they will need to be treated with antidepressants for life. Most people are treated for between 6 to 12 months. Follow your health care professional’s guidance about starting, increasing, decreasing, or stopping prescribed drugs. Not following instructions may lead to uncomfortable side effects. Abruptly stopping antidepressants is dangerous and may lead to withdrawal symptoms. Combination Treatment Is Best Consider Psychotherapy Results of several studies suggest that a combination of antidepressant medication with psychotherapy is the most effective treatment for depression. Mental illness is serious. It is important to take depression medication as directed and to see a therapist regularly. Mental illness is nothing to be ashamed of. Millions of people suffer from depression, anxiety, and other mental health disorders. People should feel comfortable seeking help for mental health disorders just as they would for other organic medical conditions like heart disease or diabetes. Cognitive behavioral therapy (CBT) helps monitor and change unwanted thoughts and behaviors. Interpersonal therapy helps patients have better and more effective relationships with others. Exercise Helps Depression Studies prove that exercise helps alleviate depression as well as medication in cases of mild depression. Some studies suggest exercise can help medicine work better. Get a check-up and your health care professional’s permission before embarking on an exercise program for the first time to make sure you’re healthy enough for physical activity. Walking is a great activity if you are new to exercise. Working out with a friend or group can help you stay dedicated to your program and provide the added benefit of social support, which is also beneficial for depression. Exercise releases endorphins, chemicals that boost mood and promote well-being. Weaning Off Antidepressants Weaning off an antidepressant must be done carefully to avoid withdrawal symptoms. Follow your health care professional’s instructions for reducing your dose and eventually stopping the medicine. Getting off antidepressants too soon could make depression come back. In general, lowering the dose very gradually is the best plan. Let your doctor know if you experience side effects or symptoms when lowering the dose of your medicine or stopping it altogether. Getting help for depression is the right thing to do. The risks of untreated depression outweigh the potential side effects of medication. Ongoing clinical trials continue to study new potential therapies for depression and other mood disorders. The US FDA has placed a black box warning on some SSRIs, MAOIs, and TCAs advising of a potential increased risk of suicidal thoughts and behavior in teens and young adults aged 18 to 24 within the first initial 2 months of treatment. Reviewed by Melissa Conrad Stöppler, MD on 8/10/2017 Sources: This tool does not provide medical advice. See additional information: © 1996-2018 WebMD, LLC . All rights reserved.
Source slideshow at OnHealth CONTINUE SCROLLING FOR RELATED SLIDESHOW Healthy Aging: Sneaky Depression Triggers in Pictures Midlife Can Make You Miserable Feel like middle age is closing in on you? You’re not alone. A 2008 study of data from 2 million people found that midlife depression spans the globe. In the U.S., it peaks at around age 40 for women and 50 for men, and usually starts to lift in the 50s. Why? People may learn to adapt to their strengths and weaknesses and value life more, the researchers say. Depression Trigger: Overload Squeezed between the demands of children, aging parents, marriage, and your job? Feeling sad, worthless, and guilty? Women tend to shoulder more of the “sandwich generation” burdens — and up to half become depressed as a result. Solution: Make sure you’re caring for yourself, too. Exercise, get enough rest, eat healthy, see friends, and get help — for caregiving demands and depression — if you need it. Trigger: Low Vitamin B12 If you’re feeling lethargic or depressed, too little vitamin B12 may be to blame. If you’re older, you’re more at risk for the B12 blues because you may not have enough stomach acid to release B12 from food. Solution: Ask your doctor to measure levels of B12 in your blood. If it’s low, talk to your doctor about diet, oral supplements, or an injection to see what might be right for you. Trigger: Changes in Sex Drive As men age, their bodies produce less of the important sex hormone testosterone. Low testosterone levels can cause depression, as well as erectile dysfunction (ED) — trouble getting or keeping an erection — and a decreased interest in sex. Solutions: Ask your doctor to test the levels of testosterone in your blood. If it is low, ask your doctor about replacement therapy and other treatment options. Trigger: Thyroid Disorders Depression can be one symptom of an underactive or occasionally overactive thyroid. And if you are older, it may be the only symptom. Or it may appear with a subtle symptom. In the case of overactive thyroid, it could be accompanied by heart flutters, tremors, or fatigue. An underactive thyroid can cause constipation or fatigue. That’s why this very treatable problem is often mistaken for bowel or nervous system disorders in older people. Solution: See your doctor, especially if a close relative has thyroid disease. Trigger: Achy Joints Living with a condition that causes chronic pain, such as rheumatoid arthritis or osteoarthritis, increases the chance of having depression. In fact, people with chronic pain are three times as likely to have depression or an anxiety disorder. And depression can make pain worse. Solution: Exercise, meditate, or listen to music. An hour of classical music a day has been shown to ease arthritis pain and depression. If the depression or pain doesn’t lift, talk to your doctor. Trigger: Perimenopause and Menopause Hormone fluctuations, hot flashes, and life changes related to perimenopause and menopause can make your mood plummet. If you have trouble sleeping, a history of depression, or PMS, mood swings or depression may worsen during this transitional period. Solutions: For mild depression, try self-calming skills such as yoga or deep breathing. Do things that make you feel better, such as exercise or going out with friends, or find a creative outlet. For more serious, long-lasting symptoms of depression, prescription medication or talk therapy can help. Trigger: The Empty Nest If your child has left home, an “empty nest” can make you feel empty. Going through menopause or retirement at the same time may make it harder. Solutions: Try to see it as an opportunity. Reconnect with your spouse, other family members, and friends. Pursue hobbies and interests you didn’t have time for before. Give yourself time to adjust. If your mood doesn’t lift in a few months, talk to your doctor. Trigger: Type 2 Diabetes Do you feel too listless to check your blood sugar regularly? Are unpredictable blood sugar levels making you feel out of control? Depression is a common and dangerous complication of many chronic conditions, including diabetes. Depression also may keep you from taking good care of your diabetes. Solution: Talk to your doctor if you’ve been depressed for more than two weeks. Talk therapy, medication, and better diabetes control can help you manage both conditions. Depression is serious and if left untreated can be life threatening. Trigger: Drinking About 1 in 4 older people who drink heavily has major depression. Some older people start drinking more because of stressful events, such as retirement or a spouse’s death. Yet alcohol problems are often mistaken for other age-related issues. Solutions: A combination of medications can treat both alcohol dependence and depression. Individual or group therapy can also help deal with issues that may trigger drinking. Trigger: Poor Sleep Insomnia and other sleep disruptions, which are common as we age, are closely related to depression. Insomnia can be a sign that you are depressed, and if you have insomnia but aren’t depressed, you’re at higher risk of developing mood changes. Obstructive sleep apnea and restless legs syndrome also have been linked to depression. Solutions: Talk to your doctor about possible reasons for your sleep problems and get treatment for them. Learn good sleep hygiene habits, such as regular bedtime hours. Exercise early regularly and avoid caffeine, alcohol, or nicotine, which interfere with sleep. Prescription medication may also help. Trigger: Retirement If you were forced into retirement — because of poor health or other reasons — you might very well be depressed. Factors such as financial insecurity or lack of social support can also make retirement a downer. Solutions: Busy retirees tend to be happier retirees. Learn new skills, take classes, get exercise. Be flexible: For example, if your health makes activities like travel difficult, take in museums and foreign films. Trigger: Heart Problems It’s common to feel depressed after a diagnosis of heart disease or having a heart attack or cardiac surgery. But many people with heart disease go on to experience severe, long-term depression. And that can worsen heart health. Solutions: A healthy diet and sleep, mild exercise, relaxation techniques, and joining a support group can help you get through the blues. If depression lasts, antidepressants or talk therapy can help. Trigger: Blood Pressure Pills Could the drugs you take for high blood pressure or other health problems also be bringing you down? Some blood pressure medicines — as well as certain antibiotics, antiarrhythmics, acne products, and steroids, among other drugs — may be associated with depression or other mood changes. Solutions: Be sure to ask your doctor if any new medications you may be taking could be linked with changes in mood. If it is, you may be able to switch to another drug. Trigger: Loneliness Social support can help prevent or ease depression. But some kinds of social support may be better than others. A study of people in a retirement community found that those who stayed connected with friends living elsewhere had less depression. Support from within the community didn’t affect mood. Solution: Maintain ties with close friends and family members. Explore Internet technology that can give you virtual face-time with distant friends. Health Hurdles Any chronic or serious condition — such as Parkinson’s disease or a stroke — can lead to depression. A stroke can also affect the areas of the brain that control mood. Solution: Be realistic but positive. Learn how to cope with physical effects of your illness. Don’t let them get in the way of taking care of yourself and having fun. If you have symptoms of depression, don’t wait — get help right away. Trigger: Senior Moments Feeling foggy and forgetful? It could be depression or dementia, a condition marked by memory loss. The signs and symptoms can be similar. Or it could be both — depression is more common in older people who have dementia, especially Alzheimer’s. Solutions:If you don’t know what’s causing your symptoms, see your doctor so you can get the right treatment, if necessary. Trigger: Grief It’s normal to grieve after losing a spouse or other loved one. But grief can grow into depression. Memory problems, confusion, and social withdrawal can be symptoms of depression in older people. Both grief and depression raise the risk for heart-related deaths. Solutions: Let yourself grieve. Express your feelings to friends, in a support group, or to a grief counselor. For depression, medication and talk therapy can help. Any-Age Mood Booster: Pets To keep your mood up, it helps to have good emotional and social support. But who says social support needs to be human? Studies show that pets can help people have less depression and loneliness and more self-esteem and happiness. Pets are friends with other benefits, too. Walking a dog, for example, is good exercise and a great way to meet people. Any-Age Mood Booster: Laughter A good laugh can relax muscles, reduce stress, and relieve pain. And research suggests that a good sense of humor can take the bite out of depression. For humor on demand, create a laugh library of funny books, cartoons, and DVDs. Or try laughter yoga, which uses playful activities and breathing exercises to provoke giggles. Any-Age Mood Booster: Volunteer Helping others can help you forget your own problems. Volunteering feels good at any age, but it may hold special benefits for older people. If retirement has you adrift, for example, it can give your life a new sense of purpose and satisfaction. Recent research suggests that it may even prevent frailty in older people. Find a cause that has special importance to you and get involved. Reviewed by Joseph Goldberg, MD on 5/7/2016 Sources: This tool does not provide medical advice. See additional information: © 2005-2018 WebMD, LLC . All rights reserved.
Source slideshow on WebMD CONTINUE SCROLLING FOR RELATED SLIDESHOW Learn to Spot Depression: Symptoms, Warning Signs, Medication What Is Depression? While everyone feels sad from time to time, if that occurs most days for more than two weeks, it could mean that clinical depression is occurring. Major depression is a period of sadness, irritability, or low motivation that occurs with other symptoms, lasts at least two weeks in a row, and is severe enough to negatively affect one’s life. Depression is not a sign of weakness or a character flaw. It is a real and treatable medical illness. These PET scans of the brain indicate low activity in a person suffering from depression compared to someone who is not depressed. Depression: Emotional Symptoms The most prominent symptoms of depression are usually a sad or irritable mood and/or loss of interest in all or most activities that used to be pleasurable. Patients may also experience guilt despite having done nothing wrong, as well as feeling worthless, hopeless, and/or have recurring thoughts of wanting to die, kill, or otherwise harm themselves, as in cutting or burning themselves. Depression Symptoms: Physical Depression can sometimes be associated with physical symptoms. Examples may include the following: · Tiredness and low energy level · Trouble sleeping, particularly early morning waking · Sleeping too much · Aches or pains, especially headaches, muscle cramps, or digestive problems (for example, stomachaches, diarrhea, or constipation) that do not improve even with pain focused treatment · Feeling or seeming slowed down or agitated Depression can worsen many other medical problems, especially those that cause chronic pain. Certain brain chemicals affect pain and mood, and treating depression tends to improve the symptoms and outcomes of many physical illnesses. Depression: Appetite Symptoms Some individuals with depression experience an increase or decrease in appetite, which may lead to substantial loss or gain in weight. How Depression Can Impact Daily Life Left untreated, the symptoms of depression can negatively impact the sufferer’s activities, relationships, and career. Depressed people often have trouble concentrating and making decisions. They may stop participating in activities they used to enjoy, including sex, as well as no longer spending time with loved ones. In severe cases, depression can be fatal as the result of homicide or suicide. Warning Signs of Suicide People with depression are at risk for trying to commit suicide. Warning signs may include talking about suicide or dying, threatening to hurt others, becoming irritable or taking excessive risks, giving away personal belongings, or otherwise settling personal affairs. Any warning signs for suicide should be taken very seriously and immediate help should be sought, either through the closest emergency room or in discussion with a suicide hotline. Two suicide hotlines include 800-SUICIDE (800-784-2433) and 800-273-TALK (800-273-8255). Who Is at Risk for Developing Depression? While anyone can develop depression, it is widely thought that a family history of depression is a risk factor for the illness. For example, being the child or sibling of a depressed person increases one’s risk of developing a depressive disorder. Women are twice as likely as men to have this condition at some point in their lives. How often depression occurs may be difficult to determine since symptoms of this illness can vary somewhat based on gender, age, and ethnic background. Causes of Depression While it is not clear what specifically causes depression, a widely accepted theory is a change in brain structure and chemistry. Specifically, substances called neurotransmitters are out of balance in depressed people. Possible causes for the imbalance include certain medications, alcohol or substance abuse, hormonal or seasonal changes, or enduring a traumatic event, like being the victim of abuse or losing a loved one or a job. Seasonal Depression If someone has a pattern of feeling depressed in a particular season, he or she may have a type of depression called seasonal affective disorder (SAD). Although SAD may occur in any season, it is most likely to occur fall and winter, when the daylight hours are shorter. Research shows that SAD occurs in 3%-20% of all people, depending upon where they live. Postpartum Depression What people commonly call the “baby blues” afflicts up to 75% of new mothers. More than 10% of those women experience more severe and persistent sadness even if their baby is healthy. That condition, called postpartum depression, has symptoms that are very similar to the symptoms of major depression. However, in postpartum depression, the baby’s well-being may become at risk since a depressed mother may have trouble enjoying, bonding with, and caring for her infant. In rare instances, the mother may become a danger to herself or her infant. Depression in Children Depression afflicts 2% of children in grade school and about 10% of teens In the United States. It can impair the child or adolescent’s friendships and school performance. Many of the symptoms are similar to those in depressed adults, but depression can be harder to diagnose in children, partly because they may revert to earlier behaviors (regress), seem angry, or engage in risky behaviors. Preschoolers Can Suffer From Depression, Too HealthDay news article on MedicineNet MONDAY, August 4, 2014 — “Depression can strike at any age, even among preschoolers, researchers report. And if it does strike, the odds are that the disorder will recur throughout childhood, a new study shows…” Read full article on MedicineNet Diagnosing Depression A specific blood test for depression has yet to be developed. Therefore, doctors must use the sufferer’s description of their symptoms in order to diagnose this condition. Other information that is usually gathered as part of the assessment include information about medical history, substance abuse, and medication use since these issues may contribute to symptoms of depression. Understanding someone’s family medical and mental-health history can help determine what he or she is at risk for developing. Discussing moods, behaviors, and daily activities can help the mental-health professional assess the severity and type of depression the person is experiencing. Gathering all this information is important to the professional in order to provide the best treatment. Talk Therapy for Depression Research shows that different forms of talk therapy (psychotherapy) can help alleviate depression that is of mild to moderate severity. The goal of cognitive behavioral therapy is to help the individual alter ways of thinking and behaving that may lead to depression. Interpersonal therapy works with the depressed person to understand how his or her ways of interacting with others can contribute to depression. Psychodynamic therapy helps the depression sufferer understand and come to terms with how issues from their past may unconsciously affect their current moods and actions. Studies indicate that most people who are having their first episode of major depression need at least six months of treatment to resolve the depressive episode. Medications for Depression Many medications, antidepressants, are effective for the treatment of depression. These medications affect the levels of brain chemicals, like serotonin and norepinephrine. It may take some weeks to feel the positive effect of these medications, so it is important to remain vigilant in taking them and working with a doctor in the process. Studies show that people suffering from depression tend to get better faster and more robustly when treated with a combination of psychotherapy and medication compared to treatment with either medication or therapy alone. Exercise for Depression Studies show that moderate exercise can be an important part of alleviating mild to moderate depression because it causes the release of chemicals called endorphins. In addition to the medical benefits of exercise, the release of endorphins tends to elevate mood and self-esteem, decrease stress, increase energy level, and improve sleep. Engaging in just 30 minutes of activity that elevates heart rate three to four times per week is enough for anyone to reap the benefits of exercise. Light Therapy (Phototherapy) Light therapy, also called phototherapy, can be an effective treatment for SAD and other types of depression. This form of treatment involves sitting in front of a medical light box that emits a specific kind of light for several minutes per day. Phototherapy should only be used when recommended by a doctor and is often used with psychotherapy or medication to achieve the best effects. St. John’s Wort for Depression St. John’s wort is an herbal supplement that has been found to be a potential help for mild depression, but two large studies have shown it is ineffective against moderate or severe depression. Also, St. John’s wort can interact poorly with other medications. It is therefore important to ask a doctor before taking this or any other supplement. Pets for Depression While loving pets cannot take the place of psychotherapy and medication in treating depression, these family members can be helpful for many people who suffer from mild depression. Pets relieve stress by providing love and companionship. Research shows that animal-assisted therapy can also decrease agitation that often goes with depression. The Role of Social Support Since loneliness often accompanies depression, having good relationships and social support can be an important part of recovery from this illness. Joining a support group, either in person or online, having regular contact with loved ones, or joining a club can help ward off becoming socially isolated. Spiritual connectedness, either with other people at a place of worship or just believing in a power bigger than oneself, can help decrease depression as well. Vagus Nerve Stimulation (VNS) Vagus nerve stimulation (VNS) helps patients who suffer from chronic treatment-resistant depression that does not improve with the combination of psychotherapy and medication. VNS requires the surgical insertion of an electrical device that alleviates depression by inducing a normal electrical pattern in the brain by sending electrical pulses through the vagus nerve in the neck. Electroconvulsive Therapy (ECT) Electroconvulsive therapy (ECT) is another treatment option for people who struggle with severe treatment-resistant depression. This treatment involves administering electric impulses to create a controlled seizure while the patient is under sedation. ECT helps 80% to 90% of people who receive it, which is significant given that most of those individuals would otherwise continue to suffer. While this form of treatment has a history of stigma attached to it, changes in the way it was implemented decades ago have significantly decreased side effects and improved its effectiveness. Transcranial Magnetic Stimulation Repetitive transcranial magnetic stimulation (rTMS) is another option for people with severe depression that does not respond adequately to medication and psychotherapy. With rTMS, physicians aim electromagnetic currents at the skull to stimulate a small electrical current in a part of the brain linked to depression. In contrast to ECT, rTMS does not cause a seizure and seems to have few side effects. However, not many doctors have the training and experience to implement this form of treatment. Good Outlook While afflicted with the symptoms of major depression, one might feel hopeless and unable to function. However, this condition is quite treatable and as much as 80% of people with the condition recover with the help of medication, talk therapy, or both forms of treatment. For those who do not improve with those traditional treatments, interventions like VNS, ECT, or rTMS can bring significant relief for many people. Reviewed by Ashraf Ali, M.D. on 8/3/2016 Sources: This tool does not provide medical advice. See additional information: © 1996-2018 WebMD, LLC . All rights reserved.
Source slideshow at OnHealth CONTINUE SCROLLING FOR RELATED SLIDESHOW ADHD: Top Concentration-Killers in Pictures Culprit: Social Media Whether you’re living with ADHD or just have trouble focusing from time to time, today’s world is full of concentration killers. Psychologist Lucy Jo Palladino, PhD offers a few tips to manage distractions, starting with social media. It’s easy to connect with friends — and disconnect from work — many times an hour. Every status update zaps your train of thought, forcing you to backtrack when you resume work. Social Media Fix Avoid logging in to social media sites while you’re working. If you feel compelled to check in every now and then, do it during breaks, when the steady stream of posts won’t interrupt your concentration. If you can’t resist logging in more frequently, take your laptop someplace where you won’t have Internet access for a few hours. Culprit: Email Overload There’s something about an email — it shoots into your inbox and itches to be answered immediately. Although many emails are work-related, they still count as distractions from your current project. You won’t make much progress if you constantly stop what you’re doing to reply to every message. Email Overload Fix Instead of checking email continuously, set aside specific times for that purpose. During the rest of the day, you can actually shut down your email program. This allows you to carve out blocks of time when you can work uninterrupted. Culprit: Your Cell Phone Perhaps even more disruptive than the ping of an email is the ringtone on your cell phone. It’s a sound few of us can ignore. But taking a call not only costs you the time you spend talking — it can also cut off your momentum on the task at hand. Cell Phone Fix Put caller ID to good use. If you suspect the call is not urgent, let it go to voicemail. If you’re working on a particularly intense project, consider silencing your phone so you’re not tempted to answer. Choose specific times to check voicemail. Listening to all your messages at once can be less disruptive than taking every call as it comes in. Culprit: Multitasking If you’ve mastered the art of multitasking, you probably feel you’re getting more done in less time. Think again, experts say. Research suggests you lose time whenever you shift your attention from one task to another. The end result is that doing three projects simultaneously usually takes longer than doing them one after the other. Multitasking Fix Whenever possible, devote your attention to one project at a time, particularly if you’re working on an intense or high-priority task. Save your multitasking skills for chores that are not urgent or demanding — it probably won’t hurt to tidy up your desk while talking on the phone. Culprit: Boredom Some of the tasks we have to do each day are more interesting than others. The boring ones may burn through your attention span in minutes, making you extremely vulnerable to distractions. Your phone, the Internet, even the prospect of dusting your workspace can seem tempting if you’re bored. Boredom Fix Make a deal with yourself: If you stay on task for a certain period of time, you earn a 10-minute break. Reward yourself with coffee, a favorite snack, or a walk outside. Boring tasks are easier to accomplish when you have something to look forward to. This is also one case where multitasking may work well. Listening to the radio while filing receipts could help you stay put long enough to finish the job. Culprit: Nagging Thoughts It’s hard to focus on the work in front of you if you’re worrying about errands you need to run or housework to be done. Or perhaps you’re hung up on a conversation you had yesterday, and you keep replaying it in your mind. Nagging thoughts of any sort can be a powerful distraction. Nagging Thoughts Fix One way to keep nagging thoughts from buzzing around in your brain is to write them down. Make a list of errands, housework, or other tasks you plan to complete later. Vent frustrations over an unpleasant confrontation in your journal. Once these thoughts are on paper, you may be able to let them go for a while. Culprit: Stress When you feel like you have too much on your plate, it can be hard to focus on individual tasks. To make matters worse, stress takes a noticeable toll on the body. You may develop tight shoulders, headaches, or a racing heart, all of which can chip away at your ability to concentrate. Stress Fix Learn stress reduction techniques, such as meditation. This can help you rein in stressful thoughts, so they don’t demand so much of your attention. In one study, researchers found that people who took an eight-week meditation course improved their ability to focus. If you can’t find a meditation class locally, look for one online. Culprit: Fatigue Fatigue can make it tough to concentrate, even when you have few distractions. Studies suggest too little sleep can sap your attention span and short-term memory. Fatigue Fix Most adults need 7-9 hours of sleep per night. Instead of burning the midnight oil, make sleep a priority. This will help you get more done during your waking hours. Also, pay attention to which times of day you feel most alert. Then you’ll know when to schedule your most intense tasks. Culprit: Hunger The brain can’t focus without fuel, so skipping meals — especially breakfast — is a top concentration killer. Research indicates short-term memory and attention suffer when you rise and shine but do not dine. Hunger Fix Keep hunger at bay and give your brain a steady source of fuel with these habits: · Always eat breakfast. · Eat high-protein snacks (cheese, nuts) · Skip simple carbs (sweets, white pasta) · Choose complex carbs (whole grains) Culprit: Depression Most people tend to think of sadness as the hallmark of depression. But the National Institute of Mental Health says difficulty concentrating is one of the most common symptoms. If you’re having trouble focusing, and you also feel empty, hopeless, or indifferent, you may be experiencing depression. Depression Fix If you think you might be depressed, the first step is to talk with a doctor or counselor. Depression is highly treatable. Many studies have shown the effectiveness of antidepressant medications and certain types of talk therapy. Culprit: Medication Unfortunately, some of the medications used to treat depression can interfere with concentration. The same is true of many other drugs. Talk to your doctor or pharmacist to check if a medication or supplement you are taking may be affecting your concentration. Medication Fix If you suspect your meds are clouding your concentration, don’t assume there are no other options. Talk to your doctor about adjusting your dosage or switching to a different class of medication. Do not stop taking your medicine unless your doctor tells you to. Culprit: ADHD Attention deficit hyperactivity disorder (ADHD) is not just a problem for children. More than half of kids with ADHD continue to experience symptoms as adults. The classic signs are a short attention span and trouble focusing on tasks. ADHD Fix If you have consistent trouble focusing, and you had attention problems as a child, ask a doctor or counselor about ADHD. There are ways to manage the condition, including behavioral therapy and medications. Reviewed by Melinda Ratini, DO, MS on 4/15/2014 Sources: This tool does not provide medical advice. See additional information: © 2005-2018 WebMD, LLC . All rights reserved.
Source slideshow on WebMD CONTINUE SCROLLING FOR RELATED SLIDESHOW Schizophrenia: Symptoms, Types, Causes, Treatment What Is Schizophrenia? Schizophrenia is a chronic, severe, debilitating mental illness characterized by disordered thoughts, abnormal behaviors, and anti-social behaviors. It is a psychotic disorder, meaning the person with schizophrenia does not identify with reality at times. Who Is Affected? · Schizophrenia affects about 1.1% of the world’s population · 3.5 million Americans have schizophrenia · Schizophrenia is most commonly diagnosed between the ages of 16 to 25 · Schizophrenia can be hereditary (runs in families) · It affects men 1.5 times more commonly than women · Schizophrenia and its treatment has an enormous effect on the economy, costing between $32.5-$65 billion each year How Common Is Schizophrenia in Children? Schizophrenia in young children is rare. The National Institute of Mental Health (NIMH) estimates only 1 in 40,000 children experience the onset of schizophrenia symptoms before the age of 13. Types of Schizophrenia There are five types of schizophrenia (discussed in the following slides). They are categorized by the types of symptoms the person exhibits when they are assessed: · Paranoid schizophrenia · Disorganized schizophrenia · Catatonic schizophrenia · Undifferentiated schizophrenia · Residual schizophrenia Paranoid Schizophrenia Paranoid-type schizophrenia is distinguished by paranoid behavior, including delusions and auditory hallucinations. Paranoid behavior is exhibited by feelings of persecution, of being watched, or sometimes this behavior is associated with a famous or noteworthy person a celebrity or politician, or an entity such as a corporation. People with paranoid-type schizophrenia may display anger, anxiety, and hostility. The person usually has relatively normal intellectual functioning and expression of affect. Disorganized Schizophrenia A person with disorganized-type schizophrenia will exhibit behaviors that are disorganized or speech that may be bizarre or difficult to understand. They may display inappropriate emotions or reactions that do not relate to the situation at-hand. Daily activities such as hygiene, eating, and working may be disrupted or neglected by their disorganized thought patterns. Catatonic Schizophrenia Disturbances of movement mark catatonic-type schizophrenia. People with this type of schizophrenia may vary between extremes: they may remain immobile or may move all over the place. They may say nothing for hours, or they may repeat everything you say or do. These behaviors put these people with catatonic-type schizophrenia at high risk because they are often unable to take care of themselves or complete daily activities. Undifferentiated Schizophrenia Undifferentiated-type schizophrenia is a classification used when a person exhibits behaviors which fit into two or more of the other types of schizophrenia, including symptoms such as delusions, hallucinations, disorganized speech or behavior, catatonic behavior. Residual Schizophrenia When a person has a past history of at least one episode of schizophrenia, but the currently has no symptoms (delusions, hallucinations, disorganized speech or behavior) they are considered to have residual-type schizophrenia. The person may be in complete remission, or may at some point resume symptoms. What Are Causes of Schizophrenia? Schizophrenia has multiple, intermingled causes which may differ from person to person, including: · Genetics (runs in families) · Environment · Brain chemistry · History of abuse or neglect Is Schizophrenia Hereditary? Schizophrenia has a genetic component. While schizophrenia occurs in only 1% of the general population, it occurs in 10% of people with a first-degree relative (parent, sibling) with the disorder. The risk is highest if an identical twin has schizophrenia. It is also more common in people with a second-degree relative (aunts, uncles, cousins, grandparents) with the disorder. Schizophrenia Symptoms Many people with schizophrenia do not appear ill. However, many behavioral changes will cause the person to seem ‘off’ as the disease progresses. Symptoms include: · Social withdrawal · Anxiety · Delusions · Hallucinations · Paranoid feelings or feelings of persecution · Loss of appetite or neglecting to eat · Loss of hygiene Symptoms may also be grouped into categories, discussed in the following slides. Positive (More Overtly Psychotic) Symptoms The “positive,” or overtly psychotic, symptoms are symptoms not seen in healthy people, include: · Delusions · Hallucinations · Disorganized speech or behavior · Dysfunctional thinking · Catatonia or other movement disorders Negative (Deficit) Symptoms “Negative” symptoms disrupt normal emotions and behaviors and include: · Social withdrawal · “Flat affect,” dull or monotonous speech, and lack of facial expression · Difficulty expressing emotions · Lack of self-care · Inability to feel pleasure (anhedonia) Cognitive Symptoms Cognitive symptoms may be most difficult to detect and these include: · Inability to process information and make decisions · Difficulty focusing or paying attention · Problems with memory or learning new tasks Affective (or Mood) Symptoms Affective symptoms refer to those which affect mood. Patients with schizophrenia often have overlapping depression and may have suicidal thoughts or behaviors. How Is Schizophrenia Diagnosed? The diagnosis of schizophrenia is made both by ruling out other medical disorders that can cause the behavioral symptoms (exclusion), and by observation of the presence of characteristic symptoms of the disorder. The doctor will look for the presence of delusions, hallucinations, disorganized speech or behavior, and/or negative symptoms, along with social withdrawal and/or dysfunction at work or in daily activities for at least six months. The doctor may use physical examination, psychological evaluation, laboratory testing of blood, and imaging scans to produce a complete picture of the patient’s condition. How Is Schizophrenia Diagnosed? (Continued) Mental health screening and evaluation is an important part of the diagnosis process for schizophrenia. Many other mental illnesses such as bipolar disorder, schizoaffective disorder, anxiety disorders, severe depression, and substance abuse may mimic symptoms of schizophrenia. A doctor will perform an assessment to rule out these other conditions. Schizophrenia Treatment – Medications Antipsychotic medications are the first-line treatment for many patients with schizophrenia. Medications are often used in combination with other types of drugs to decrease or control the symptoms associated with schizophrenia. Some antipsychotic medications include: · olanzapine (Zyprexa) · risperidone (Risperdal) · quetiapine (Seroquel) · ziprasidone (Geodon) · aripiprazole (Abilify) · paliperidone (Invega) Schizophrenia Treatment – Medications (Continued) Mood swings and depression are common in patients with schizophrenia. In addition to antipsychotics, other types of medications are used. Mood stabilizers include: · lithium (Lithobid) · divalproex (Depakote) · carbamazepine (Tegretol) · lamotrigine (Lamictal) Antidepressants include: · fluoxetine (Prozac) · sertraline (Zoloft) · paroxetine (Paxil) · citalopram (Celexa) · escitalopram (Lexapro) · venlafaxine (Effexor) · desvenlafaxine (Pristiq) · duloxetine (Cymbalta) · bupropion (Wellbutrin) Schizophrenia Treatment – Psychosocial Interventions Family psycho-education: It is important to include psychosocial interventions in the treatment of schizophrenia. Including family members to support patients decreases the relapse rate of psychotic episodes and improves the person’s outcomes. Family relationships are improved when everyone knows how to support their loved one dealing with schizophrenia. Schizophrenia Treatment – Psychosocial Interventions (Continued) Assertive community treatment (ACT): Another form of psychosocial intervention includes use of out-patient support groups. Support teams including psychiatrists, nurses, case managers, and other counselors, meet regularly with the schizophrenic patient to help reduce the need for hospitalization or a decline in their mental status. Schizophrenia Treatment – Psychosocial Interventions (Continued) Substance abuse treatment: Many people with schizophrenia (up to 50%) also have substance abuse issues. These substance abuse issues worsen the behavioral symptoms of schizophrenia and need to be addressed for better outcomes. Schizophrenia Treatment – Psychosocial Interventions (Continued) Social skills training: Patients with schizophrenia may need to re-learn how to appropriately interact in social situations. This kind of psychosocial intervention involves rehearsing or role-playing real-life situations so the person is prepared when they occur. This type of training can reduce drug use, and improve relationships. Schizophrenia Treatment – Psychosocial Interventions (Continued) Supported employment: Many people with schizophrenia have difficulty entering or re-entering the work force due to their condition. This type of psychosocial intervention helps people with schizophrenia to construct resumes, interview for jobs, and even connects them with employers willing to hire people with mental illness. Schizophrenia Treatment – Psychosocial Interventions (Continued) Cognitive behavioral therapy (CBT): This type of intervention can help patients with schizophrenia change disruptive or destructive thought patterns, and enable them to function more optimally. It can help patients “test” the reality of their thoughts to identify hallucinations or “voices” and ignore them. This type of therapy may not work in actively psychotic patients, but it can help others who may have residual symptoms that medication does not alleviate. Schizophrenia Treatment – Psychosocial Interventions (Continued) Weight management: Many anti-psychotic and psychiatric drugs cause weight gain as a side effect. Maintaining a healthy weight, eating a well-balanced diet, and exercising regularly helps prevent or alleviate other medical issues. What Is the Prognosis for Schizophrenia? The prognosis for people with schizophrenia can vary depending on the amount of support and treatment the patients receives. Many people with schizophrenia are able to function well and lead normal lives. However, people with schizophrenia have a higher death rate and higher incidence of substance abuse. When medications are taken regularly and the family is supportive, patients can have better outcomes. Reviewed by Ashraf Ali, M.D. on 8/3/2016

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