Tyler's Research on Depression


 

I. Introduction:

Depression is a serious but treatable illness that affects millions of people every year. It has a number of causes that all lead to a chemical imbalance occurring in the brain and nervous system, and it is often treated with prescription medications. Depression can have a devastating effect on people's lives if it goes untreated.

The purpose of this research is to define some key concepts associated with the illness and examine the different methods currently being used to treat it. During the course of the project, the following questions will be answered: What is depression? What are the medications currently on the market, and are they safe? What are some alternative methods of treatment?

This research will be helpful to those who think they may be suffering from depression or who are searching for the best way to treat it. It is by no means comprehensive and will require follow-up on an individual basis, but it should provide a good starting point.

II. The Essay: Nobody Likes Living in the Dumps!

Depression involves more than just feeling down in the dumps. It is an illness that has the power to profoundly diminish the enjoyment of pleasurable activities and has a crippling effect on the way people live their lives. This short essay explores the illness, its causes and its treatments.

Depression attacks more than 17 million people every year in the United States alone. Women are almost twice as likely to be plagued with the illness than men (for reasons that are still undiscovered). The good news is 80 to 90 percent of cases can be successfully combated by a wide range of treatments. (1)

Depression is caused by sudden changes in levels or imbalances of neurotransmitters in the brain (chemicals that carry signals from the nervous system to the brain). This can be caused by a number of things ranging from genetics to stress. What ever the cause, the outcome is always the same; There is an unusually high level of cortisol (the chemical produced by increased levels of stress) maintained in the brain for a long period of time. (2) This imbalance results in a mood change that is usually directly related to a combination of four or more of the following symptoms occurring for a period exceeding two weeks: fatigue, insomnia (or the opposite), inability to make decisions, loss of sex drive, changes in eating behavior (this can go both ways), anxiety, phobias, unjustified guilt, hopelessness, lack of interest in once-pleasurable or important activities, irritability, social withdrawal, physical symptoms (nausea, chest pains, constipation, stomach cramps, rapid breathing, etc.), suicidal thoughts, and even delusions or hallucinations. (3) A combination of any four of these makes for a miserable experience that could last indefinitely without treatment.

So how do you get rid of depression? There are several effective methods. The most popular and most proven is the use of a prescription antidepressant drug like Prozac or Zoloft in conjunction with psychotherapy. The drugs serve to alleviate the symptoms while the psychotherapy helps to identify and snuff out the underlying causes of the symptoms. The most popular drugs currently on the market are know as SSRIs (selective serotonin reuptake inhibitors) which counteract high cortisol levels in the brain by keeping a sufficient amount of serotonin (a neurotransmitter) in the system. SSRIs, which include the popular brands Prozac, Paxil, and Zoloft, are hot because the have fewer side effects than comparable drugs and are safe in overdose. Other antidepressants like trycyclics and monoamine oxidase inhibitors (MAOIs) should be avoided if possible because they react dangerously with other drugs (including some over-the-counter drugs) and can have serious cardiovascular side effects like severe and sudden high blood pressure. (1)

Antidepressants are not habit forming, but do have some side effects including nausea, headache, nervousness, insomnia, fatigue and sexual dysfunction. None or any combination of these may occur depending on body chemistry. (4) Studies have shown that many doctors are reluctant to sufficiently discuss side effects with their patients for fear of scaring them away from the treatment. There are several options for medication. Be prepared to talk with your doctor for more than 10 minutes, ask questions and take notes. Also, keep in touch with your doctor and work with him or her to determine which medication best suits you. (5)

There are also several non-prescription alternatives to antidepressant medication. These methods are not approved by the Food and Drug Administration, so caution should be exercised when exploring them. There is little good information on these methods pertaining to possible drug-to-drug reactions and side effects. (1)
St. John's wort is heavily used in Germany and is known for producing SSRI-like advantages without as many gastrointestinal and sexual side effects. Some research has concluded that St. John's wort reacts with MAOIs and SSRIs, so taking it with any other antidepressant is not advisable. (1)

Another remedy heavily used in Europe is SAM-e. This naturally occurring drug is believed by many to have fast results similar to those achieved with tricyclics. The most common side effect is upset stomach. (1) Taking Vitamin B6, Vitamin C, fish oils (omega 3 fatty acids) and a multivitamin supplement has also been known to have a positive impact on depression symptoms since it is sometimes a lack of "raw materials" that leads to an abnormally low number of neurotransmitters in the body. (3)

NOTES:
(1) Author Unknown, "Relieving Depression," Harvard Women's Health Watch, Feb. 2000, v7 n6, pp. 4-6. Also Available [online]: Health Source: Consumer Edition/ 2761969 [Accessed: 2002, Feb. 3].
(2) Author Unknown, "What Causes Depression?," Health and Stress, April 30, 1999, n4, pp. 2-3. Also Available [online]: Alt-HealthWatch [Accessed: 2002, Feb. 3].
(3) Birkner, Kathy, "Depression, the Hidden Illness," MMRC Health Educator Reports, Jan. 31, 1997, pp. 1-3. Also Available [online]: Alt-HealthWatch [Accessed: 2002, Feb. 3].
(4) Author Unkown, "Drugs for Depression and Anxiety," Medical Letter on
Drugs & Therapeutics, Apr. 1999, v41 n1050, pp. 33-39. Also Available [online]: Health Source: Consumer Edition/1761036 [Accessed: 2002, Feb. 2].
(5) Author Unknown, "The Treatment of Depression: A Consumer Report," Harvard Mental Health Letter, July 2001, v18 n1, pp. 7-9. Also Available [online]: Health Source: Consumer Edition/4634003 [Accessed: 2002, Feb. 3].

III. Sources on the Web:

1. Title: Depression
Address:
http://www.4therapy.com/consumer/conditions/item.php?uniqueid=71&categoryid=2&
Description: This is a comprehensive page listing the types of depression, their
symptoms and some methods of treatment. It includes links to therapists and an online
quiz to see if you might have depression. A good general information site with a
professional advisory board.
Source: 4therapy.com NETWORK, INC.

2. Title: Medication for Depression
Address: http://www.psychologyinfo.com/depression/medication.htm
Description: This site provides an abundant amount of information about different
antidepressant medications and their side effects. There are also links on this page to
many more topics pertaining to depression.
Source: Donald J. Franklin, Ph.D., also the National Institute of Mental Health (see
the bottom of the page for a complete list of references). The page is provided by
Psychology Information Online.

3. Title: Psychotherapy Versus Medication for Depression: Challenging the
Conventional Wisdom With Data
Address: http://www.apa.org/journals/anton.html
Description: This site provides a thorough examination of antidepressants and their
alternatives. The page is scholarly and a long read, but is worthwhile for someone
looking at alternative methods for treating depression.
Source: David O. Antonuccio and William G. Danton (University of Nevada School
of Medicine and Reno Veterans Affairs Medical Center). Also, Garland Y. DeNelsky
(Cleveland Clinic Foundation).

4. Title: Depression
Address: http://www.healthyplace.com/Communities/Depression/nimh/
Description: Another comprehensive website with links to information on research,
depression in adolescents and students, women, older adults, and even information for
employers. This is an excellent site for general information on the illness.
Source: The National Institute of Mental Health.

5. Title: Treatment Strategies for Depression
Address: http://www.mhsource.com/narsad/anti-d.html
Description: Another site on treatments for depression. This site is geared toward
physicians and offers a detailed description of the available medications and their side
effects. The site also includes some alternative methods for treating depression.
Source: The National Alliance for Research on Schizophrenia and Depression
(NARSAD Research).

IV. Print and Other Sources:

1. Author Unknown. Depression, Effective Treatments are Available. Rockville,
Maryland: National Institutes of Mental Health, National Institutes of Health, 1996. HE 20.8102:D 44/20 (Davis).

2. Glenmullen, Joseph. Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft,
Paxil, and Other Antidepressants With Safe, Effective Alternatives. New York: Simon & Schuster, 2000. RC483.5.F55 G56 2000 (Davis)

3. Montano, C. Brendan, and Andrew E. Skodol. Depression in Primary Care:
Optimizing Outcomes, [video recording]. Clifton, New Jersey: Network for Continuing Medical Education, 1998. NCME #735 (HSL Educational Media-Basement)

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