How do antidepressants affect the body. What are the common side effects of antidepressant medications. Can antidepressants cause fatigue and insomnia. How long do antidepressant side effects typically last.

Understanding the Mechanism of Antidepressants

Antidepressants are powerful medications designed to alleviate symptoms of depression, anxiety disorders, and seasonal affective disorder. These drugs work by altering the chemical balance in the brain, specifically targeting neurotransmitters like serotonin, dopamine, and noradrenaline. By modulating these brain chemicals, antidepressants aim to regulate mood and emotional responses.

The duration of antidepressant treatment typically ranges from six months to a year, with the exact regimen determined by a healthcare professional. It’s crucial to adhere strictly to the prescribed dosage and schedule to maximize the benefits and minimize potential side effects.

How do antidepressants interact with brain chemistry?

Antidepressants primarily function by increasing the availability of certain neurotransmitters in the brain. For instance, selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants, work by preventing the reabsorption of serotonin, thereby increasing its levels in the brain. This mechanism helps to improve mood, reduce anxiety, and alleviate depressive symptoms.

Common Side Effects of Antidepressants

While antidepressants can be highly effective in treating depression and related disorders, they may also produce various side effects. It’s important to note that not everyone experiences these side effects, and their intensity can vary from person to person. Here are some of the most commonly reported side effects:

• Nausea
• Lower libido
• Weight gain
• Fatigue
• Dry mouth
• Insomnia
• Constipation
• Dizziness
• Restlessness, agitation, and anxiety

Are antidepressant side effects permanent?

Most side effects associated with antidepressants are temporary and tend to subside within a few weeks as the body adjusts to the medication. However, if side effects persist or worsen, it’s essential to consult with a healthcare provider. They may adjust the dosage or switch to a different antidepressant to minimize adverse effects while maintaining therapeutic benefits.

Nausea: A Common Initial Side Effect

Nausea is one of the most frequently reported side effects when starting antidepressant treatment. This gastrointestinal disturbance occurs due to the medication’s impact on both the central nervous system and the digestive tract.

Why do antidepressants cause nausea?

Antidepressants affect the production and regulation of serotonin, a neurotransmitter that plays a role in mood regulation. The increase in serotonin levels stimulates receptors in both the brain and the gastrointestinal tract. This dual stimulation can lead to feelings of nausea, especially during the initial stages of treatment.

Interestingly, abrupt discontinuation of antidepressants can also trigger nausea as a withdrawal symptom. The body, accustomed to the medication’s effects, struggles to adapt to the sudden change, resulting in discomfort and the urge to vomit.

Sexual Side Effects: Impact on Libido and Function

Sexual side effects are a significant concern for many individuals taking antidepressants, affecting approximately 50% of patients. These effects can manifest as decreased libido, vaginal dryness, or erectile dysfunction.

How do antidepressants affect sexual function?

The primary mechanism behind sexual side effects involves the increased levels of serotonin in the body. While this elevation in serotonin helps to stabilize mood and reduce depressive symptoms, it can also dampen sexual desire and make it more challenging to achieve orgasm. The sense of calmness induced by the medication may inadvertently lower libido and sexual responsiveness.

It’s important for patients experiencing sexual side effects to communicate openly with their healthcare providers. In some cases, adjusting the medication dosage or switching to an alternative antidepressant with a different mechanism of action can help mitigate these issues while maintaining the therapeutic benefits.

Weight Changes: Understanding the Connection

Weight fluctuations are common among individuals with depression, and the introduction of antidepressant medications can further influence body weight. Some people may initially lose weight due to depression-related appetite suppression, only to regain it once antidepressant treatment begins.

Why do some people gain weight on antidepressants?

The weight gain associated with antidepressant use can be attributed to several factors. As mood improves, appetite often increases, leading to higher calorie intake. Additionally, the elevation in serotonin levels caused by antidepressants may trigger cravings for carbohydrate-rich foods such as pasta, bread, and desserts. These dietary changes, combined with potential metabolic effects of the medication, can contribute to unwanted weight gain.

To manage weight while on antidepressants, it’s advisable to maintain a balanced diet, engage in regular physical activity, and monitor portion sizes. If weight gain becomes a significant concern, consulting with a healthcare provider about potential alternatives or adjunct treatments may be beneficial.

Fatigue and Sleep Disturbances: Balancing Energy Levels

Fatigue and sleep disturbances are paradoxical side effects of antidepressants, as these medications can cause both drowsiness and insomnia. Understanding the underlying mechanisms can help patients and healthcare providers manage these symptoms more effectively.

Why do antidepressants cause fatigue?

While antidepressants primarily target mood-regulating neurotransmitters, they also affect other brain chemicals such as histamine and acetylcholine. Changes in these neurotransmitters can lead to feelings of weakness and fatigue throughout the day. The sedative effects of some antidepressants may be more pronounced, particularly in the initial stages of treatment.

Can antidepressants cause insomnia?

Paradoxically, some individuals experience insomnia as a side effect of antidepressant use. This occurs because antidepressants influence neurotransmitters involved in regulating sleep-wake cycles, including serotonin, norepinephrine, and acetylcholine. The alteration in these chemical levels can disrupt normal sleep patterns, leading to difficulties falling asleep or maintaining restful sleep throughout the night.

If sleep disturbances persist beyond the initial adjustment period, it’s crucial to address them promptly. Chronic insomnia can exacerbate fatigue and negatively impact overall well-being, potentially compromising the effectiveness of antidepressant treatment.

Gastrointestinal Effects: Dry Mouth and Constipation

Antidepressants can have various effects on the gastrointestinal system, with dry mouth and constipation being two common complaints among patients. These side effects, while often manageable, can be uncomfortable and may impact quality of life if left unaddressed.

Why do antidepressants cause dry mouth?

The sensation of dry mouth experienced by some antidepressant users is linked to the medication’s effect on neurotransmitters beyond those primarily targeted for mood regulation. Specifically, changes in histamine and acetylcholine levels can reduce saliva production, leading to a persistently dry feeling in the mouth and throat. This dryness can make talking and swallowing uncomfortable and may increase the risk of dental issues if proper oral hygiene is not maintained.

How do antidepressants contribute to constipation?

Constipation as a side effect of antidepressants is primarily due to the medications’ impact on acetylcholine, a neurotransmitter involved in muscle contractions. By blocking the action of acetylcholine, antidepressants can reduce muscular contractions in the digestive tract, slowing down the movement of waste through the intestines. Additionally, the drying effect of these medications can lead to harder, drier stools, further contributing to constipation.

To manage these gastrointestinal side effects, staying well-hydrated, maintaining a fiber-rich diet, and engaging in regular physical activity can be helpful. In some cases, over-the-counter remedies or adjustments to the medication regimen may be necessary to alleviate persistent symptoms.

Cardiovascular and Neurological Side Effects

While less common than some of the previously discussed side effects, antidepressants can occasionally impact the cardiovascular and neurological systems. Two notable side effects in this category are dizziness and a cluster of symptoms including restlessness, agitation, and anxiety.

Why might antidepressants cause dizziness?

Dizziness associated with antidepressant use can stem from several factors. One primary cause is the medication’s potential to lower blood pressure, particularly when starting treatment or adjusting dosages. This drop in blood pressure can lead to feelings of lightheadedness or unsteadiness, especially when changing positions quickly.

Interestingly, dizziness can also occur as a withdrawal symptom when discontinuing antidepressants abruptly. This underscores the importance of gradually tapering off these medications under medical supervision to minimize withdrawal effects.

How do antidepressants sometimes increase restlessness and anxiety?

While antidepressants are designed to alleviate symptoms of depression and anxiety, they can paradoxically induce feelings of restlessness, agitation, and anxiety in some individuals. This effect is often attributed to the increased brain cell activity stimulated by the medication. As neurotransmitter levels shift, some patients may experience a surge of energy that manifests as restlessness or difficulty staying still.

In some cases, this increased activation can lead to feelings of anxiety or irritability. Patients may find themselves more impulsive or struggle to relax. It’s crucial to communicate these symptoms to a healthcare provider, as they may indicate the need for dosage adjustment or a switch to a different antidepressant.

Managing Antidepressant Side Effects

While side effects can be challenging, it’s important to remember that many are temporary and tend to improve as the body adjusts to the medication. However, proactive management of side effects can significantly improve the overall treatment experience and outcomes.

What strategies can help mitigate antidepressant side effects?

Several approaches can be employed to manage side effects effectively:

1. Open communication with healthcare providers: Regularly discussing symptoms and concerns allows for timely adjustments to treatment plans.
2. Gradual dose titration: Starting with a lower dose and gradually increasing it can help minimize initial side effects.
3. Timing of medication: Taking antidepressants at specific times of day (e.g., before bed for sedating medications) can help manage certain side effects.
4. Lifestyle modifications: Adopting a balanced diet, regular exercise routine, and good sleep hygiene can counteract some side effects and improve overall well-being.
5. Adjunct treatments: In some cases, additional medications or therapies may be prescribed to address specific side effects without discontinuing the antidepressant.

It’s crucial to avoid abruptly stopping antidepressant medication, as this can lead to withdrawal symptoms and potentially worsen the underlying condition. Any changes to the treatment regimen should be made under the guidance of a healthcare professional.

When should you seek medical attention for antidepressant side effects?

While many side effects are manageable and subside over time, certain symptoms warrant immediate medical attention:

• Severe allergic reactions (e.g., rash, difficulty breathing)
• Suicidal thoughts or behaviors
• Significant changes in mood or behavior
• Severe gastrointestinal symptoms
• Persistent or worsening side effects that significantly impact daily life

By staying vigilant and maintaining open communication with healthcare providers, patients can navigate the challenges of antidepressant side effects while maximizing the benefits of their treatment.

Side Effects of Antidepressants – Fatigue, Insomnia, & More

By Faraz khan +2
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Last updated: Jun 23, 2023

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Antidepressants are medicines that provide relief from symptoms of depression, anxiety disorders and seasonal affective disorder among other conditions. They are prescribed usually for six months to one year and should be taken exactly as directed by the doctor.

Table of Contents

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Potential Side Effects of antidepressants are:

• Nausea
• Lower Libido
• Weight Gain’
• Fatigue
• Dry Mouth
• Insomnia
• Constipation
• Dizziness
• Restlessness, Agitation, Anxiety

1) Nausea

This is the most common side effect of antidepressant drugs. These drugs affect the CNS (Central Nervous System) and the production of serotonin, a neurotransmitter that affects your mood. With the increase in serotonin levels, the medicines stimulate serotonin receptors in the gastrointestinal tract and the brain. The combined effect on both the central nervous system and gastrointestinal tract makes you nauseous. If you stop the medication all of a sudden, you can feel nauseous because of antidepressant withdrawal. The body doesn’t register the sudden change and reacts, resulting in uneasiness and the urge to vomit.

2) Lower Libido

This is another very common side effect of antidepressants but it isn’t addressed too often. About 50% of patients on antidepressants complain about decreased libido. Symptoms include vaginal dryness, low libido and erectile dysfunction. As the medications increase serotonin levels in the body, the sense of calmness and stability can lower the libido and prevent you from achieving an orgasm.

3) Weight Gain

Anomaly in weight comes with depression. Some people lose weight initially but start gaining it back after taking antidepressants. With improved mood and appetite, some people end up gaining a lot of weight. With increased levels of serotonin due to antidepressants, people start craving carbohydrate-rich foods like pasta, bread and desserts that might lead to unwanted weight gain.

4) Fatigue

Have you been feeling extremely tired and drowsy after taking your antidepressant medications? They might be side effects of the drug that you have been prescribed. While antidepressants work on the mood-affecting neurotransmitters, they also have some effect on other chemicals in the brain like histamine and acetylcholine. The changes in these neurotransmitters might make the body weak and make you feel fatigued throughout the day.

5) A Dry Mouth

Does your mouth feel unusually dry once you pop in your antidepressant? Do not worry as it is a very common side effect of the medications. As discussed above, antidepressants affect neurotransmitters other than mood-inducing ones like serotonin. Changed levels of histamine and acetylcholine result in dry mouth. That, in turn, makes the throat dry due to which talking, swallowing become irritable.

6) Insomnia

Fatigue is a direct result of insomnia that in turn is a possible  antidepressant drug side effect. Antidepressants affect serotonin, adrenaline, and acetylcholine that are known to shape sleep and wakefulness. When the levels of these chemicals are altered, the sleep cycle gets altered too resulting in insomnia. Most side effects do not stay for longer than a few weeks but if sleeplessness persists, do not take it lightly as it will make you feel terrible during the daytime.

7) Constipation

Have you been facing problems with bowel movements? Have passing bowels become very difficult and/or less frequent than normal? Your antidepressants might be causing them. Antidepressant drugs block the action of a neurotransmitter known as acetylcholine. As a result, muscular contractions diminish and the passage for the bowels becomes drier causing constipation.

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8) Dizziness

Antidepressants sometimes cause low blood pressure. It results in dizziness. Be careful when you go about your day whilst on these medications. The abrupt withdrawal from antidepressants can also cause dizziness.

9) Restlessness, Agitation & Anxiety

Antidepressants make your brain cells more active. While all that increased levels of energy may feel great, it sometimes tags along with restlessness and agitation as side effects. Relaxing or staying still in one place becomes very tough. You might start feeling anxious, irritable and impulsive.

Also Read: Treatment for Depression

How Do Antidepressants Work?

Antidepressants work by altering the chemical balance in the brain. They help to correct the levels and pathways of serotonin, dopamine and noradrenaline that regulate moods in the brain. Antidepressants are usually prescribed along with talk therapy. As with most medicines, antidepressant drugs have side effects too. If the side effects of antidepressants do not go away after a week or two, consult your doctor.

It is important to keep track of the side effects once you start taking your antidepressants. Do not wait too long before going to the doctor if any of the problems affect you too much and for a long time. Together, you and your doctor can come up with viable solutions that can subdue the bad  effects of antidepressants.

Also Read: Different Types of Antidepressants

Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.

Side effects – Antidepressants – NHS

The side effects of antidepressants can cause problems at first, but they generally improve with time.

It’s important to continue treatment, even if you’re affected by side effects, as it will take several weeks before you begin to benefit from treatment. With time, you should find that the benefits of treatment outweigh any problems from side effects.

During the first few months of treatment, you’ll usually see your doctor or a specialist nurse at least once every 2 to 4 weeks to see how well the medicine is working.

For more information about your specific medicine, see the patient information leaflet that comes with it.

SSRIs and SNRIs

Common side effects of selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) can include:

• feeling agitated, shaky or anxious
• feeling and being sick
• indigestion and stomach aches
• diarrhoea or constipation
• loss of appetite
• dizziness
• not sleeping well (insomnia), or feeling very sleepy
• headaches
• loss of libido (reduced sex drive)
• difficulties achieving orgasm during sex or masturbation
• difficulties obtaining or maintaining an erection (erectile dysfunction)

These side effects should improve within a few weeks, although some can occasionally persist.

Tricyclic antidepressants (TCAs)

Common side effects of TCAs can include:

• dry mouth
• slight blurring of vision
• constipation
• problems passing urine
• drowsiness
• dizziness
• weight gain
• excessive sweating (especially at night)
• heart rhythm problems (arrhythmia), such as noticeable palpitations or a fast heartbeat (tachycardia)

The side effects should ease after a couple of weeks as your body begins to get used to the medicine.

Potential health risks

Serotonin syndrome

Serotonin syndrome is an uncommon, but potentially serious, set of side effects linked to SSRIs and SNRIs.

Serotonin syndrome occurs when the levels of a chemical called serotonin in your brain become too high. It’s usually triggered when you take an SSRI or SNRI in combination with another medicine (or substance) that also raises serotonin levels, such as another antidepressant or St John’s wort.

Symptoms of serotonin syndrome can include:

• confusion
• agitation
• muscle twitching
• sweating
• shivering
• diarrhoea

If you experience these symptoms, you should stop taking the medicine and get immediate advice from your GP or specialist. If this is not possible, call NHS 111.

Symptoms of severe serotonin syndrome include:

• seizures (fits)
• irregular heartbeat (arrhythmia)
• unconsciousness

If you experience symptoms of severe serotonin syndrome, get emergency medical help immediately by dialling 999 to ask for an ambulance.

Hyponatraemia

Elderly people who take antidepressants, particularly those who take SSRIs, may experience a severe fall in sodium (salt) levels, known as hyponatraemia. This may lead to a build-up of fluid inside the cells of the body, which can be potentially dangerous.

This can happen because SSRIs can block the effects of a hormone that regulates levels of sodium and fluid in the body. Elderly people are vulnerable because fluid levels become more difficult for the body to regulate as people age.

Mild hyponatraemia can cause symptoms similar to depression or side effects of antidepressants, such as:

• feeling sick
• headache
• muscle pain
• reduced appetite
• confusion

More severe hyponatraemia can cause:

• feeling listless and tired
• disorientation
• agitation
• psychosis
• seizures (fits)

The most serious cases of hyponatraemia can cause you to stop breathing or enter a coma.

If you suspect mild hyponatraemia, you should call your GP for advice and stop taking SSRIs for the time being.

If you suspect severe hyponatraemia, call 999 and ask for an ambulance.

Hyponatraemia can be treated by feeding a sodium solution into the body through an intravenous drip.

Diabetes

Long-term use of SSRIs and TCAs has been linked to an increased risk of developing type 2 diabetes, although it’s not clear if the use of these antidepressants directly causes diabetes to develop.

It may be that the weight gain some people using antidepressants experience increases the risk of them developing type 2 diabetes.

Suicidal thoughts

In rare cases, some people experience suicidal thoughts and a desire to self-harm when they first take antidepressants. Young people under 25 seem particularly at risk.

Contact your GP, or go to A&E immediately, if you have thoughts of killing or harming yourself at any time while taking antidepressants.

It may be useful to tell a relative or close friend if you’ve started taking antidepressants and ask them to read the leaflet that comes with your medicines. You should then ask them to tell you if they think your symptoms are getting worse, or if they’re worried about changes in your behaviour.

Page last reviewed: 4 November 2021

Next review due: 4 November 2024

What are mood disorders – Poster Daily

Mood or mood disorders are the most common mental disorders in the world, affecting more than 10% of all people. Afisha Daily asked psychiatrist Anna Ushkalova to explain how to distinguish just a bad mood from an illness, and whether to worry if you are always cheerful.

How does mood work?

Mood is our emotions that are in constant motion and depend on many circumstances. They react to a joyful event or danger, change if we are waiting for important news or overcome obstacles. For normal functioning, both positive and negative emotions (sadness, longing, anxiety, hatred, anger, and so on) are equally important, because they allow you to adequately respond to what is happening around, understand other people and interact with them.

Emotions are determined not by the events themselves, but by the individual reactions to them of a particular person, which depend both on his psychological characteristics and physiological characteristics to another (serotonin, norepinephrine, dopamine and others). Depending on which of them prevails at the moment, we can experience the whole gamut of feelings – from delight to despair. This means that emotions can occur “from within” – due to physiological changes that are not related to something external. Everyone knows this well from the example of emotional storms in adolescence or during pregnancy.

When do mood fluctuations go beyond the normal range?

In a healthy person, under normal conditions, the complex mood system is well balanced. For example, you are sad because you broke up with a loved one. You may even lose sleep and appetite, but after some time the balance is restored and you can again enjoy the good things in your life.

But it may also be that a month has passed, and you still have a lump in your throat and have neither the strength nor the desire to do anything. There is cause for concern if your mood has changed significantly from what it was before, and this continues for more than two weeks in a row. It is also worth considering if these changes do not allow you to lead your usual lifestyle: you cannot communicate normally, work, eat, sleep.

What are mood disorders and where do they come from? It can be chronically low or high, and periods of ups (manias) and downs (depressions) can also alternate. This group includes various forms of depression and bipolar disorder.

In these diseases, emotions cease to fulfill their function of evaluating reality and begin to deceive you: for example, at work, someone did not say hello to you, and you feel how everyone hates you and dreams of being fired

Along with the mood, the level of energy and activity also changes greatly.

It is not so easy to draw a line between normality and pathology, since the severity of the disorder can be different. Therefore, they often talk, for example, about a bipolar spectrum of diseases, which includes disorders from cyclothymia, in which a person does not experience severe depression and remains able to work, to schizoaffective disorder, which is complicated by psychotic attacks (or psychoses), as in schizophrenia. Mood disorders often coexist with other psychiatric disorders, most often with anxiety disorders, personality disorders (such as borderline), and addictions.

It is not possible to isolate one specific cause of affective disorders. They develop due to a combination of several factors at once: hereditary predisposition, psychological characteristics, social conditions. Genetics play a big role, so if you have emotionally unstable relatives, you should be especially vigilant. But external conditions are just as important, since usually the disease first manifests itself under the influence of a trigger (strong stimulus), such as the loss of a loved one or the use of psychoactive substances. If life goes smoothly and safely, the disease may make itself felt much later or not develop at all.

Why are affective disorders dangerous?

Over time, affective disorders can lead to maladjustment, that is, to the loss of the ability to adapt to the surrounding reality. Inappropriate emotional reactions destroy relationships with loved ones and make productive work impossible.

In their extreme form, these disorders are accompanied by psychotic symptoms such as delusions and hallucinations. And this is not at all uncommon: with depression, such symptoms occur in 15-20% of patients, and with bipolar disorder – more than 50%. In a state of psychosis, a person poses a threat both to others and to himself, because he does not control his actions. The risk of suicide is high, not only during depression, but also in mania.

Mood disorders have enormous social consequences: they are already catching up with cardiovascular and oncological diseases in the number of cases of disability and loss of ability to work.

Five main signs of mood disorders

Your mood is very different from your usual , and this continues every day for more than two weeks.

Changes can be either for the worse or for the “better” side. For example, you are usually modest and reserved, but now you feel amazingly cheeky. I want to dress brightly, attract attention and meet new people, even with random passers-by on the street.

Sleep patterns have changed dramatically: you don’t feel like sleeping at all, after three hours of sleep you feel fresh and ready for adventure. Or, on the contrary, you cannot force yourself to wake up and even after 12 hours in bed you do not feel that you have had enough rest.

Your work and life suffer: you find it difficult to concentrate on familiar tasks, you forget what you just did, get confused in a well-known topic. You have to force yourself to do the most routine things: go to the store for food, wash your hair.

Relations with people are changing: you have lost the desire to communicate even with friends, and the company of strangers is tiring or even frightening. Or, conversely, you suddenly become hypersociable and ready to flirt with strangers.

You experience constant discomfort in your body: physical tension, irritation or even pain, your level of anxiety and restlessness increases. These can be severe headaches, stomach pains, sensations like suffocation.

What if you suspect you have an affective disorder?

Any emotional disturbance that causes severe discomfort or disrupts performance should not be ignored. The sooner you contact a specialist, the more likely you are to stop the development of the disease.

It is worth making an appointment with a psychotherapist with a medical education (psychotherapist) or a psychiatrist. Treatment must be individualized: mild depression can be treated with psychotherapy, while bipolar disorder will require medication.

If your loved one is in a state of psychosis or mania, it is useless to convince them to see a doctor. In such cases, hospitalization and the appointment of antipsychotic drugs are required. If his behavior becomes dangerous, it’s time to call an ambulance. If you do not want to send your loved one to a public hospital, you can contact a private clinic.

Is there a way to prevent affective disorders?

No matter how trite it may sound, the main condition for the balance of mood is the balance in life.

Even a healthy psyche can be shaken by a complete absence of a routine and constant stress

And people prone to mood swings simply need a clear schedule of sleep, work, rest and physical activity. They should avoid frequent overwork, beware of excessive stress and not test themselves for strength.

Each person with an affective disorder has their own triggers that can cause a sharp deterioration. The most typical of them are alcohol and psychoactive substances, as well as severe stress.

Some medications, such as antidepressants, can also be a trigger. If a person has bipolar disorder, antidepressants can “switch” depression to mania. This is dangerous for illiterate treatment, and even more so for self-treatment.

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The story of one depression. How to help yourself, and why you need to talk about it – Personal experience on vc.ru

Hello, my name is Alina. I am a PR manager in IT, a teacher at a university, in 2021 I became a candidate of sociological sciences. That same year, I was diagnosed with anxiety depression. Coming out is a tricky path for me, but I hope this helps someone with a similar problem. Because depression in Russia is not easy.

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In Russia, in addition to two well-known problems, there are two more – stigmatization and denial of psychological disorders. They seem to be mutually exclusive, but in practice you encounter both. Therefore, many people prefer to hide.

My coming out is caused by social responsibility: the more people are informed about the scientific view of depression, the more loyal public opinion will become, and depression will be treated as the same disease as problems with the gastrointestinal tract, heart, etc. If it weren’t for people in my life who share their stories, accept them and help me get on the path to recovery, my standard of living would still leave much to be desired.

Personal history

For as long as I can remember, I have been a very anxious person: I was very worried about any negative events, constantly replaying dialogues and best scenarios in my head that were not destined to come true. When you experience anxiety and/or frustration about almost anything, it’s hard to understand that other people perceive the same circumstances differently. It seems to you that everyone lives like this.

As a child, I grew up in an incomplete family, like many in Russia. Adults in my environment did not see me as a child and assigned emotional responsibility for words and actions beyond my strength for such an age. This blurred my personal boundaries a lot and forced me to always “be good”. I learned to read emotions from micro facial expressions and act in such a way that everyone around me felt good. Of course, there were breakdowns, and no one understood them: I was an almost perfect child – I studied “excellently”, I never asked for help, I always understood everything without further ado.

Constant anxiety grew out of total personal responsibility for one’s life. There was never an adult nearby to help cope with difficulties. All this was reflected in adult life: I did not feel safe and constantly solved other people’s problems. It was only after 25 years, an abusive relationship that turned into marriage (here I went to graduate school, apparently to prove that I mean something), and an imminent painful divorce that I began to deal with this seriously.

I went to regular psychologists, devoured YouTube videos about relationships and tried to figure out what was wrong with me. New information was received, but the anxiety did not go away, it became even worse: after all, now I knew the base, but still I was not good enough in my understanding.

Then a course of rationality took place in my life from the guys from “Kocherga”. The first classes became a therapy session for me, because I did not think that it was possible to think and act THAT way. I wanted to improve the quality of my life and received excellent tools for this. But although rationality helps to reconcile emotions with reason, it cannot solve a physiological problem, only relieve symptoms.

A year later I defended my dissertation and a wonderful person who was nearby convinced me that I would definitely not get worse from a consultation with a good psychotherapist. Do you know why he suggested it? When I was finalizing my dissertation, I made a speech error in the introduction, and the work was posted on the site in this form. And I was so afraid to tell my supervisor about this that I hardly slept for 3 days, and if I fell asleep, I woke up in a cold sweat. And this is just one example. Now it seems impossible to me, but then it was my reality.

After the consultation and the diagnosis of “moderate anxiety-depressive episode” I had a wild denial. I wanted to convince myself that the doctor was wrong and I was just sad. It’s good that common sense won out and I started taking drugs. A few months later, I found a CBT specialist and fixed the result. Remembering my reactions, I want to hug that past me and say that everything will be fine.

I am not sharing my story to make anyone feel sorry. I rewrote this text dozens of times, shortened it and tried to leave only the facts. I was afraid to post this article. To be honest, I’m afraid even now. But I want to show, contrary to Spleen, that there is a way out. And I will tell you what is useful along the way, and google the rest.

What is depression: a scientific view “on the fingers”

Depression and its varieties are officially recognized diseases. If it is quite simple: your brain cannot experience joy, it has forgotten how, and it feels bad. Physiologically, this is due to a functional impairment of serotonin production.

Unfortunately, the word “depression” is often used to describe sadness. Feeling sad and negative emotions is normal: this is how your psyche reacts to something bad and really happened.

Being really depressed is also normal from a social point of view, but in this case you don’t need a sad dance with friends, but the help of professionals. Therefore, if you had a fight with a partner or something happened at work, do not call such experiences “depression”: this devalues ​​the problem of people with depression-disease. Grieve, experience the emotions and move on.

If the state of sadness and anxiety becomes permanent, not directly related to anything outside and lasts more than two weeks, this is not the norm from a physiological point of view.

To diagnose depression, a consultation with a certified psychotherapist or psychiatrist is required. Sometimes your symptoms can also be caused by neurological problems, which means that a neurologist will help in this case. It is not worth diagnosing depression on your own, you can only note the symptoms before contacting a specialist.

Types of depression

There are many types of this disease, they differ from each other in severity. In this article, I talk about the condition of moderate severity, which many people experience, but do not understand that it is depression. Severe conditions such as schizophrenia or bipolar disorder have pronounced symptoms that are very noticeable to others.

A person with a moderate depressive episode appears positive, active, and you are unlikely to suspect a problem. At the moment of the most vivid manifestation of depression, outwardly I became as cheerful and sociable as possible. Why? Hard to tell. You are afraid that your true state will scare away the people whose support you so need. You are afraid that you will be judged or laughed at if you tell the truth. You think that you are doing something wrong or not trying hard enough, since everything is bad for you.

Anxiety depression or an anxiety-depressive episode is now common. The pandemic and the events since February 24 last year have acted as catalysts for many. Anxiety and depression are always very close. More often than not, anxiety turns into depression if you don’t have the tools to deal with it (and you do). At the same time, not every bad mood and experience means that you need professional help.

But in Russia, the problem is more often reversed: people ignore serious symptoms. As I. It is impossible to feel the way another person feels, and you extrapolate – you decide that everyone experiences the same emotions and lives that way.

I’m sure our world would be a much better place if more people took care of their mental health.

What are the symptoms of anxious depression

– Apathy. Lying on the couch for one day is normal. When there are many days, and the desire and energy to do something does not appear, it is not the norm.

– Rumination. Constant disturbing thoughts that swirl in the head endlessly during the day or do not allow you to fall asleep quickly. If you constantly remember your fuckup in the 5th grade, turn it in a circle, you can’t stop and, for example, cold sweat breaks through you, remember: this is not the case for everyone, this can and should be fixed.

– Rapid heartbeat for no reason. You are not being chased by a maniac and you are not running a marathon. These states are regularly repeated.

– Panic attacks. This is a combination of physical and mental symptoms: palpitations, existential anxiety, hyperventilation.

– Frequent thoughts about death. Before diving into the topic, it seemed to me that many people were thinking about death. This is wrong. If you do this several times a week, this is not normal brain function.

– Suicidal thoughts. This is an extreme expression of thinking about death. In this case, you can not make physical attempts.

– Inability to rejoice and experience vivid emotions. Enjoying even the little things in life is normal for the brain. If something used to please you, but now it doesn’t, this may be a symptom. If you enjoy only very bright events, and ordinary life does not bring any positive emotions, this is also not normal, your brain does not produce enough serotonin.

If one or more symptoms persist for more than two weeks, a doctor should be consulted.

Who is at risk

– Genetic predisposition. If there were people in the family with a diagnosed disease or there were obvious symptoms.

— Endocrine pathologies and diseases of the central nervous system. This is about physiology, you have nothing to do with it. In general, you never have anything to do with it, like if you have a hernia in your back. This is important to remember.

– Serious traumatic event (loss of loved ones, divorce, unemployment, childhood trauma, etc.).

– Personality traits. Perfectionists, people with impostor syndrome, workaholics, people with low self-esteem, highly sensitive people are often prone to depression.

– From the non-obvious, but logical – people living in cold regions . Vitamin D deficiency affects both the physical and psychological state. By the way, taking vitamin D in doses up to 5000 IU daily is preventive and is recommended to all Russians without exception. In winter, especially.

Why are we all a little at risk

Above, I briefly wrote about my path, but many external circumstances affect us all. It’s just that someone won the genetic lottery and did it, and someone didn’t. And no one is to blame for this.

For the most part, we are the children of the “cold” generation, in turn, brought up by an even more traumatized previous generation, which never learned to experience, convey and express their love – neither tactilely nor verbally. We were not loved, we were not squeezed, we were not hugged in childhood, we grow up knowing little about attachment, we constantly experience anxiety and, in order to get rid of it, we anesthetize our body, alienate ourselves from it, ignore the signals that it sends us.

Tatyana Salakhieva-Talal, clinical psychologist

How to treat depression: antidepressants and cognitive behavioral therapy

Prescribed together: pharma helps at the physiological level, and CBT fixes the result by creating new neural connections to respond to negative events.

How do antidepressants work?

“Repair” failures in the work of neurotransmitters (these are substances that transmit a signal between nerve and muscle cells and can positively affect mood and well-being).

In many cases, depression is the result of a malfunction in the production of serotonin or the body’s ability to absorb it. The hormone must strengthen the contacts between neurons, so antidepressants do not instantly lift mood, like, for example, your favorite food, but begin to act after an average of two weeks of use.

The most modern and easily tolerated antidepressants are selective serotonin reuptake inhibitors (SSRIs) . They allow you to increase the level of serotonin in the synapses, reduce the reuptake of serotonin in the brain.

If you have been prescribed antidepressants, drinking alcohol is not recommended, especially during the first 3 months. It is during this period that the effect of specific drugs is monitored, and alcohol will reduce your efforts to zero.

There are side effects from antidepressants, the most common being nausea, dizziness, stool disturbance, increased anxiety. It is not necessary that they will be, and certainly will not be all together, the manifestations are individual. Pass within 2 weeks. If not passed, the drug is changed. I got lucky the first time. To combat symptoms such as increased anxiety, tranquilizers are prescribed (I had Atarax, it is often prescribed by neurologists).

Recent research suggests that taking medications within a year of remission and concomitant CBT minimizes the likelihood of future relapses. My course began in October 2021, remission came somewhere in March 2022. If a new episode does not cover me, in March of this year I will stop drinking pharma: within 1.5 months the dose will decrease so that there is no pronounced withdrawal syndrome.

A little sad clarification: antidepressants do not help everyone. Sometimes it takes a long time to select, and sometimes the brain is not receptive. The good news is that the percentage of such cases is quite low and scientists continue to conduct research to solve the problem definitively.

What is CBT

Antidepressants won’t solve all your problems. If we accept that depression is a disease, then the mechanism of action becomes intuitive. Imagine that you have broken your leg. The doctor puts you in a cast, prescribes medicines. But once the bone has healed, you need physical activity to fully recover. If you have heart problems, then in addition to medicines, you need to change your lifestyle and diet. And so on. It’s the same with depression.

Cognitive Behavioral Therapy is one of the most scientifically proven methods of dealing with psychological disorders at the moment. It literally “teaches” the brain to perceive and respond differently to events that previously caused anxiety and apathy. Therapy requires a good specialist and a lot of personal work. But it’s worth it.

Read more if you are interested in learning more about CBT. Maybe in another article I will share which exercises help me the most.

Personally, I do not deny the effectiveness of Gestalt therapy and the classical approach based on traumatic events. Because I started working with them before the diagnosis. If your quality of life improves, then continue to use this tool.

Personal experience with antidepressants and CBT

My dad still imagines that drugs act on me like drugs, and he worries:) But, alas, there is no magic and at the same time legal pill for depression.

I didn’t have the euphoria, the feeling that the joy switch had suddenly turned on. My therapist says that this is a good reaction of the body. Otherwise, you should think about replacing drugs.

I began to fall asleep normally. If I make a mistake, it’s no longer the end of the world and a reason to worry about nausea for a week (literally). My psyche became more stable, my experiences became bearable. I especially felt this after February 24 last year, I don’t know how I would have coped psychologically if not for therapy.

I don’t know if anyone will understand the value of this condition, I sincerely wish everyone not to experience it. Inside, it looks like you don’t know what to do with yourself: you want to scream, run away, be distracted by anything, seek salvation in alcohol or adrenaline, etc. Then it gets even worse because you play the part too long and it doesn’t help. And then you feel total hopelessness, uselessness, insignificance.

So: complex therapy brought me to the point where I remember that it happens, but internally I no longer understand, I don’t feel it. For me, it’s just wow.

“What are you, a fool?!..”, “Didn’t you listen too much during your sessions?..” and other public opinion

These are examples from personal experience. Still sometimes I see “talking” looks: in them fear, disapproval, pity. But there are also wonderful reactions (interest in the problem, acceptance, support), I try to concentrate on them.

I told a wide circle of people that I have depression and I take drugs only after six months. The most public coming-out was made at the Summer Merge conference, where I had a report. By this point, I felt stronger, more stable, and I wanted to help someone else. But it’s still scary to talk, because something negative or sarcastic “arrives” from time to time. It’s as if you are giving someone not very good the opportunity to turn any conflict situation into “ah, well, everything is clear with you.” Such stupid bullying, but it’s still difficult to cope, it’s easier to hide.

Stigmatization and devaluation are two pillars of this problem. But the fact that you pretend that this is not there, or devalue, the problem will not go away. Although I was teased for wearing glasses as a child, now glasses are fashionable. I hope that in 10 years the treatment of depression will become normal, and people with psychological problems will not be afraid to talk about them.

The main thing is not to explain any sadness by depression: to experience negativity for a specific reason is good, it hardens the psyche. Just keep an eye on the condition, like any other system of the body.

How to help a loved one in depression

If you don’t believe in depression or don’t understand it, check out the WHO website. If this does not convince you and you are trying to prove to the person that he invented everything, step aside. You can make things worse.

Stop phrases

— “Up your nose”

— “What problems do you have, you’re not disabled / children in Africa are starving, etc. ”

– “You just need to cheer up”

– “Don’t get sloppy”

– “Don’t worry”

– “Life is great, just don’t get hung up on problems”

Good help is to accept and be there. Say it out loud to the person. It’s so simple and difficult at the same time.

If you yourself are experiencing depression, do not judge your loved ones harshly.

Often they are very worried and try to help in any way they can. This is especially difficult for older relatives. Do not push them away, try to explain how you can support you now. And do not hide your emotions, I allow you to be a little bad. And then, you know, like in the plot from Frozen: at first “don’t open, keep a secret, be a good girl for everyone”, and then it accumulated so much that everything froze and went “to shine like a polar star”. Do not do it this way. Confrontation is also tiring: you will be so disappointed in yourself that you will plunge into depression even deeper.

Another way is not to tell grandparents about the problem. I did so. Telling everyone is not a mandatory part of the program, but it is important to tell at least someone: like a psychotherapist and maybe an empathic friend.

Separately, about tantrums. This is always the result of the misunderstood and unspoken, and not because a person wants to “take out the brain.” If a loved one has signs of depression and he is “hysterical”, do not rush to show negative emotions in response: listen, hug, make it clear that you understand and are there. If there is no internal resource, say it through your mouth: for a person with a psychological disorder, there is nothing worse than uncertainty and the feeling of being left alone with a problem.

Finally, you cannot help a person who does not recognize the problem and does not want to help himself.

You can give information, share personal experience, if any. Because it will not be possible to solve the problem only through drugs, you need the desire of the person himself to deal with the mental state, and this is always scary.