If you have treatment-resistant depression, you might have already picked up some of the antidepressant drug lingo -- you know your SSRIs, your SNRIs and your MAOIs. But do you really know how these drugs help?
If you don't, you're not alone. The truth is that even experts aren't really sure how antidepressants work. There's just a lot we don't know about how the brain functions.
The most important thing you need to know when you’re living with treatment-resistant depression is that antidepressants...
Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may seem worse if you're depressed.
Back pain. If you already suffer with back pain, it may be worse if you become depressed.
Muscle aches and joint pain. Depression can make any kind of chronic pain worse.
Chest pain. Obviously, it's very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But depression can contribute to the discomfort associated with chest pain.
Digestive problems. You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.
Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.
Sleeping problems. Many people with depression can't sleep well anymore. They wake up too early or can't fall asleep when they go to bed. Others sleep much more than normal.
Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods -- like carbohydrates -- and weigh more.
Because these symptoms occur with many conditions, many depressed people never get help, because they don't know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.
These physical symptoms aren't "all in your head." Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.
Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.
Treating Physical Symptoms
In some cases, treating your depression -- with therapy or medicine or both -- will resolve your physical symptoms.
But make sure to tell your health care provider about any physical symptoms. Don't assume they'll go away on their own. They may need additional treatment. For instance, your doctor may suggest an antianxiety medicine if you have insomnia. Those drugs help you relax and may allow you to sleep better.
Since pain and depression can sometimes go together, easing your pain may help with your depression. Some antidepressants, such as Cymbalta and Effexor, may help with chronic pain, too.
Other treatments can also help with painful symptoms. Certain types of focused therapy -- like cognitive behavioral -- can teach you ways to cope better with the pain.
SOURCES: Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision. American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Major Depression," 2000. Fochtmann, L. and Gelenberg, A. Guideline Watch: Practice Guideline for the Treatment of Patients With Major Depressive Disorder, 2nd Edition. Focus, Winter 2005: vol 3: pp 34-42. WebMD Medical News: "Study Links Depression and Pain." Manning, J. The Brain-Body Connection and the Relationship Between Depression and Pain. Medscape. Depression and Bipolar Support Alliance: "Finding Peace of Mind: Treatment Strategies for Depression and Bipolar Disorder." National Mental Health Association: "Depression: What You Need to Know."
Joseph Goldberg, MD on September 06, 2011