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Facts About Antidepressants

A new study says some antidepressants are mostly ineffective, but many previous studies show the opposite.

Can alternative treatments help in treating depression?

For minor depression (dysthymia), Fieve says that exercising regularly, reducing stress, and improving sleep can help patients relax and feel better.

But what about those with major depressive disorder? "Medications are necessary," Fieve says. "Psychotherapy is also a useful adjunct in combination with medications."

What about teens and antidepressants?

The latest findings published in The Journal of the American Medical Association show that depressed teens who don't respond well to the first  prescribed antidepressant medication begin to improve if they are switched to a different antidepressant medication and also offered "talk" therapy.

The combination -- switching medications and offering talk therapy -- works better than simply changing medications, the researchers found, although switching medications alone also offers improvement.

What are the common signs of depression?

Symptoms of depression vary per person but may include depressed mood most of the day, particularly in the morning, diminished interest or pleasure in activities, weight loss or gain, insomnia or excessive sleep, fatigue or loss of energy, impaired concentration, and feelings of worthlessness or guilt, among others.

Teens and children with depression may experience apathy, social withdrawal, weight loss, insomnia, fatigue, isolation from family and friends, a drop in school performance, and even drug or alcohol abuse.

Fieve said there are standard guidelines for diagnosing and treating a host of mood disorders, including major depression, dysthymia, seasonal affective disorder (SAD), bipolar depression, and others published in the American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition – the DSM-IV.

What causes depression?

The causes of depression are many. For some, depression occurs after loss of a loved one, a change in one's life such as getting divorced, or after being diagnosed with a serious medical disease. For others, depression just happens, possibly because of their family history. Medications can cause depression, and nearly 30% of people with substance abuse problems also have major depression.

How do most doctors treat depression?

Standard treatment of depression includes antidepressants and/or psychotherapy, as well as a multifaceted program of diet and lifestyle changes and alternative therapies. Experts believe that different treatment approaches work for different people -- and it's not easy to predict what might work.

What if my antidepressant doesn’t seem to work?

Talk to your doctor. You may need to try a different type of antidepressant until you find the right fit and may need additional treatment, such as talk therapy. Just like with any chronic medical condition, it takes patience and perseverance to get the best outcome with depression.

Reviewed on February 28, 2008

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