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Treatment of Depression

and Bipolar Disorder

What causes Depression?

Family History

a family members who have

depression may increase a persons
Imbalances of certain chemicals in
the brain may lead to depression

Major Life Changes


or negative events can

trigger depression. Examples
include the death of a loved one
or a promotion.
Major Illnesses such as heart
attack, stroke or cancer may
trigger depression.


medications used
alone or in combination can
cause side effects much like
the symptoms of depression.
Use of Alcohol or other Drugs
can lead to or worsen
Depression can also occur for
no apparent reason!

Symptoms of Depression
Vary from person to


2 key signs are loss of

interest in things you

like to do and sadness
or irritability

Additional Signs include:

Changes in feelings which may include:

Feeling empty
Inability to enjoy anything
Loss of warm feelings for family or friends
Feelings of self blame or guilt
Loss of self esteem
Inexplicable crying spells, sadness or irritability

Changes in behavior and

These may include:
General slowing down
Neglect of responsibilities and appearance
Poor memory
Inability to concentrate
Suicidal thoughts, feelings or behaviors
Difficulty making decisions

Physical Complaints
These may include:
Sleep disturbances such as early morning
waking, sleeping too much or insomnia
Lack of energy
Loss of appetite
Weight loss or gain
Unexplained headaches or backaches
Stomach aches, indigestion

Common Types of Depression

Major Depression
Bipolar I Disorder
Seasonal Affective Disorder


Major Depression
This type causes symptoms that may:
Diagnosed after a single major depressive
episode lasting at least 2 weeks.
Symptoms must include depressed mood,
anhedonia, and impairment of functioning.
May continue for months or years

Mild, chronic form of Major

Depressive Disorder.
Constant symptoms lasting at least
2 years.

Bipolar I Disorder
People with this type of illness change back and forth

between periods of depression and periods of mania

(an extreme high).

Symptoms of mania may include: (DIG FAST)

Flight of ideas
Activity increases
Sleep decreases

Seasonal Affective Disorder

This is a depression

that results from

changes in the
Most cases begin in
the fall or winter, or
when there is a
decrease in sunlight.

Professional treatment is
necessary for all these types
of depression.

Treatment for Depression


can help ease the

symptoms of
depression and
return a person to
normal functioning.

Main Classification of antidepressants
1. Tricyclics (TCAs)
2. Monoamine Oxidase Inhibitors
3. Selective Serotonin Reuptake
Inhibitors (SSRIs)

Tricyclics (TCAs)
- Blocks reuptake of serotonin and norepinephrine.
- Are very effective but have potentially unacceptable
side effects: anticholinergic, and orthostatic hypotension
- Can be lethal in overdose
-Examples include:

Monoamine Oxidase Inhibitors (MAOIs)

-Blocks the enzyme monoamine oxidase, which is used
to break down norepinephrine, dopamine and serotonin.
-Are very effective and inexpensive
-Hypertensive crisis can develop when MAOIs
are taken with tyramine-rich foods such as wines, beer,
aged cheese, and over-the-counter cold medications.
-Examples include:

Selective Serotonin Reuptake

Inhibitors (SSRIs)
-Block the reuptake of serotonin, leading to increased
serotonin levels.
-Safest and most commonly used anti-depressants
-Most common side effects include GI upset,
sexual dysfunction (30%), anxiety, nervousness,
insomnia, or sedation

Select Serotonin Reuptake

Inhibitors (SSRIs)
Paxil (Paaroxetine)
Zoloft (Sertraline)
Prozac (Fluoxetine)
Celexa (Citalopram)