Anti-depressants explained

As depression is a brain disorder, it is not surprising that medications can effectively treat the symptoms of depression. At present there are several medication types used to treat depression and anxiety. In the past, they were all called anti-depressants, but as we have found that drugs that were originally used for depression are effective for other conditions modern medicine tends to call them by their function in the body or chemical category and the term anti-depressant is not used as often.

The medications used to treat depression are selective inhibitors of serotonin reuptake inhibitors (SSRIs). These drugs increase the amount of serotonin between the brain cells and thereby improve the symptoms of depression. Serotonin is a chemical used by brain cells (neurons) to transmit signals within and outside the brain. It has been found that people with depression or anxiety have low levels of serotonin in their brains, hence the use of drugs that increase serotonin in the brain. Regulating serotonin in the brain stabilizes the areas of the brain that regulate mood thus eradicating depression. Drugs in this class include Prozac, Paxil, Zoloft, Celexa, Laxapro, Luvox and others.

There is another class of drugs that increases both serotonin and norepinephrine (another chemical that the brain uses to transmit signals). These medicines function similarly to those of serotonin reuptake and are equally effective. Examples of these drugs are Effexor, Cymbalta, and Pristiq.

There are also the tricyclic drugs, which are drugs which regulate both norepinephrine and serotonin. They were developed several years ago but are not as often used because they tend to cause more side effects compared to the newer medications. Examples of these medications include imipramine, nortriptyline and amitriptyline.

There are also medications that when added to an anti-depressant enhance its effect. This is specially useful in people who have only partially responded to treatment with an anti-depressant. Adding one of these medicines can help the person achieve complete remission of depressive symptoms. This method is called an augmentation strategy. Common medicines used for augmentation include lithium, buspirone, Seroquel, Abilify, and others.

There are many other medications that work in different ways in the brain to combat depression. It is noteworthy that all the drugs mentioned above are generally very safe and effective. None of them is addictive. The purpose of the drugs is that the person feel better, without feeling sedated, and can recover the ability to function normally.

The information in this blog is not a substitute for a medical evaluation. Consult with your physician about any health concerns you have.

For appointments with Dr. Douglas J. Romero call 787-764-5642 or visit www.mimejoramiento.com

As always your opinions are important. Share them so that others benefit from your experiences and perspectives.

Psychotherapy explained

Over the next few days we will explore the different therapeutic modalities for treating anxiety and depression. In the past depressive and anxiety disorders were considered distinct clinical entities. That is, anxiety and depression were not related conditions. In the last decade however, brain studies and the fact that many drugs work to treat both depression and anxiety have led the field of psychiatry reconsider that position. Today it is considered that depression and anxiety are related medical conditions.

We begin by exploring the oldest type of intervention for the treatment of depression and anxiety: psychotherapy. The essence of psychotherapy (talk therapy as some call it) is to explore a person’s thought and behavior patterns so that a person can make changes that will help him feel better.

There are different types of psychotherapies. Each is practiced according to the philosophy of the person giving treatment. Psychoanalysis explores the experiences of the person, seeking the meanings of these experiences and how they affect the person. The idea is that if a person becomes aware of the effects past events have had on him that person may change their personal patterns of meaning and behavior. And in that way the person can change his life. There are other similar therapies are usually referred to as introspective therapies. They all have in common that the person explores personal symbols and personal meanings. By becoming more aware of them the person can modify the effects of these influences in his life and feel better. The person generally tries to change to a healthier personality.

The other commonly practiced type of psychotherapy is cognitive-behavioral therapy. This type of therapy does not focus much on the meanings of events in the life of the person. It is intended that a person changes his thought patterns and behavior to healthier ones and this will achieve symptom relief. This kind of therapy is considered more focused and tends to be shorter than introspective therapy. Many people with neuropsychiatric conditions have distortions of perceptions and interpretations of their events. These so called cognitive distortions are corrected so that the person can see more clearly the reality and behave in healthier ways.

In recent times there is an emergence of different types of spiritual therapies. The approach is to seek a transcendental element in the person's belief system to help him better manage his personal situations. It focuses on a person’s frame of reference so that events can be put in perspective. This allows a person to better manage his personal reality and manage his situations with greater peace.

Another type of therapy is hypnosis, which I will discuss in the near future.

The ultimate goal of the various psychotherapies is to change the brain of a person so he feels relief from his symptoms. Studies comparing medication alone versus psychotherapy alone in people with mild depression found that both treatments cause similar changes in the brains of people who responded to therapy. This suggests that medication and psychotherapy work similarly in the brain.

For most neuropsychiatric conditions it is recommended to combine psychotherapy and medication. Each of these therapies has its advantages. In general, the medications work more quickly, with relief staring about one or two weeks from the beginning of therapy. But their effect often goes after discontinuing the drug. Psychotherapy usually takes longer to bring relief. Many studies suggest that a person usually needs about eight treatments for relief of symptoms. But the psychotherapies have the advantage that a person learns life skills that may continue to apply long after completing a course of psychotherapy. Hence the current recommendation by most experts is to start medications for prompt symptom relief and combine it with psychotherapy for the person to acquire personal skills for improvement. And of course every psychiatrist and patient has a preference on which method or therapeutic combination is best.

The information in this blog is not a substitute for a medical evaluation. Consult with your physician about any health concerns you have.

For appointments with Dr. Douglas J. Romero call 787-764-5642 or visit www.mimejoramiento.com

As always your opinions are important. Share them so that others benefit from your experiences and perspectives.

Depression explained

Clinical depression, known in psychiatry as major depressive disorder, is a brain disorder in which the brain loses its capacity to properly regulate a person’s emotions, thought patterns, and behavioral reactions. This is due to the brain losing it ability to balance its information connections and biochemistry leading to frequent feelings of sadness, inability to enjoy activities, disruption of sleep and eating patterns, poor energy, irritability, feelings of guilt, concentration problems, and difficulty in making decisions. It is estimated that around 15% of the population that suffers from major depression eventually commits suicide.

There are other neuropsychiatric conditions which might lead to depressive symptoms. Such conditions include adjustment disorders (a very strong reaction to adjusting to changes), bipolar illness, dysthymic disorder (a low level, chronic depression), and others. Mayor depressive disorder also has some subtypes depending on a person’s symptoms.

Factors such as heredity, chronic stress, emotional stress, substance abuse, medical conditions, medication side effects, history of abuse, and others could predispose a person to depression by affecting brain function. Studies indicate that depression is slightly more common in women than in men, meaning gender is also another factor in the condition. 

Depression is unfortunately a very common medical condition. It is estimated that about 25% of all people will at some point meet criteria for a diagnosis of mayor depressive disorder. And current trends indicate that the incidence of depression is increasing. Despite that fact that depression is very common most depressed people will never seek or receive treatment for their condition. And of the people that are prescribed treatment most will abandon treatment. This are regrettable facts because depression is a treatable (even curable) condition.

Depression deeply affects the lives of those who suffer it and the people close to them. Someone with depressed mood will not be able to enjoy life.  Personal relationships and ability to work are also affected, as symptoms impair ability to appropriately respond to personal situations and  problems with concentration frequently affect job performance. Also, appetite changes affect self esteem with the associated weight changes. Depression might also lead some to try to “self-medicate” with drugs and alcohol leading to addiction. And in severe depression a person might attempt and commit suicide.

Depression is a medical condition of the brain which affects in many ways the life of those afflicted. The first in treatment is to a approach a healthcare professional so the condition might be identified and treated. it’s important to understand that depression is a brain disorder and that there are effective therapies to treat the disorder. Also, as with any health condition there are steps a person might take that will lead to better health (dieting, exercising, change of habits and environment) to improve a depressive condition.

The information in this blog is not a substitute for a medical evaluation. Consult with your physician about any health concerns you have.

For appointments with Dr. Romero call 787-764-5642 or visit www.mimejoramiento.com

As always your opinions are important. Share them so that others benefit from your experiences and perspectives.