Depression is a common mental health condition that negatively affects how you think, feel, act and respond to certain situations. In 2021, approximately 8% of adults in the United States reported having at least one major depressive episode. Of those individuals, only three-fourths received treatment due to lack of access or the stigma surrounding professional help. Occasional feelings of intense sadness are normal, but when they last more than a few weeks and start to interfere with daily life, it may be time to consider therapy and medicine for depression.
Recognizing When You Might Need Medicine for Depression
Worry, feelings of nervousness and anxiety are common symptoms during times of stress. Most people watch a movie, talk to a friend or engage in hobbies to manage sad feelings. When traditional coping mechanisms fail to work, it may be time to seek help. Knowing when to schedule an appointment with a mental health provider to get medicine for depression isn’t always straightforward, but there are a few warning signs you can look for.
- Persistent feelings of sadness
- Feeling hopeless
- Increased irritability
- Loss of interest in hobbies and activities
- Changes in appetite
- Insomnia
- Thoughts of self-harm or death
- Constant fatigue
- Unexplained aches and pains
Finding and Consulting a Mental Health Professional
There are several types of mental health professionals, so it helps to understand who can prescribe antidepressants. Start by checking with your insurance company for a list of covered providers. You can also ask friends and family for referrals or seek a recommendation from your primary care provider for mental health providers in your area.
Psychologist
Psychologists are mental health professionals who use talk therapy to treat mental and behavioral issues. Sometimes a psychologist will work with other health care providers, such as your primary care doctor or a psychiatrist, to ensure you receive the care you need because they can’t prescribe medications. Psychologists can teach coping mechanisms and are ideal if you need advice and someone to talk to.
Clinical Social Workers
Clinical social workers typically hold a master’s degree in social work and must have a license. They work in hospitals, schools and private practices to help diagnose and prevent mental illness. Social workers help create a treatment plan and refer individuals to doctors and other health care providers to receive prescriptions and other forms of treatment.
Counselors and Therapists
Counselors and therapists usually have at least a master’s degree in psychology or counseling. These professionals use a combination of treatment approaches, including cognitive behavioral therapy and behavioral therapy, to improve an individual’s well-being. Neither of these mental health workers can prescribe medicines for depression.
Psychiatrists
Psychiatrists are medical doctors who treat mental health disorders, such as depression, anxiety and substance abuse. They have a license to prescribe medications and perform medical procedures related to mental health.
Primary Care Physicians
Your primary care physician may be the first professional you turn to for help with mental health issues. Your primary care physician may refer you to a mental health professional who’ll work with them to determine the best treatment plan. However, they may prescribe medicines for depression for mild cases.
Common Evaluation Processes and Diagnostic Steps
It can be difficult for a doctor to make a diagnosis of depression because it can look different from one person to another. Some clinically depressed people may withdraw from friends and family, while others may seem overly agitated and have problems sleeping. Receiving a diagnosis is one of the first steps in getting on antidepressants.
Criteria lists can assist a mental health professional in making a diagnosis. For minor depression, you must have at least two to four symptoms that last at least 2 weeks. For major depression, an individual should have at least four symptoms and experience feelings of hopelessness that last at least 2 weeks. Some of these symptoms include:
- Unexplained weight loss or gain
- Insomnia
- Agitation
- Constant fatigue
- Difficulty concentrating
- Feeling worthless
- Suicidal thoughts or tendencies
- Lack of interest in activities and hobbies
- Lack of emotion
The Hamilton Depression Rating Scale is a multiple-choice questionnaire used to rate the severity of depression. Your health care provider may also perform a standard physical exam to rule out other causes. Additional tests may include a CT or MRI scan, an EKG or an EEG.
What to Expect With Your First Prescription
Antidepressants change the way your brain uses certain chemicals or neurotransmitters to regulate your mood and behavior. These medications can take several weeks to work, so you may not have any immediate side effects. Your health care provider will start you on a low dose to minimize side effects and increase the dose as needed. You may need to try several medications until you find the most effective one.
- Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are the most prescribed antidepressants. They work well to reduce symptoms of moderate to severe depression and tend to cause fewer side effects. Common drugs include fluoxetine, sertraline and escitalopram. - Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs)
SNRIs are more effective at treating major depression, fibromyalgia and osteoarthritis. They inhibit the reuptake of serotonin and norepinephrine to improve mood, regulate sleep and relieve social anxiety. Side effects may include nausea, vomiting, dry mouth, dizziness, sweating, headache and fatigue. Common SNRIs include duloxetine and venlafaxine. - Noradrenaline and Specific Serotonergic Antidepressants (NaSSAs)
NaSSAs are prescribed to individuals who can’t tolerate SSRIs or SNRIs. These medications are ideal for patients who struggle with both anxiety and depression. Common medications include mirtazapine. At the beginning of treatment, individuals may feel very sleepy and experience dizziness. These symptoms typically go away after a few weeks. - Tricyclic Antidepressants (TCAs)
Tricyclic antidepressants are older medications that work by blocking the reuptake of serotonin and norepinephrine. These medications aren’t prescribed or used as often as other antidepressants because doctors recognize the side effects. Common TCAs include amitriptyline and doxepin.
Ongoing Monitoring and Adjustments
The effective treatment of depression requires ongoing medical care and follow-up visits. Medication is also best used alongside other therapies, such as cognitive behavioral and group therapy. Lifestyle changes, including improved diet, exercise and sleep, can complement your treatment.
Getting Help
If you’re struggling with depression and feel you can’t go it alone, help is available. Contact FHE Health to learn about available treatment options or talk to someone today.
