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Depression can be a serious ailment though treatable. It is a disease that silently sucks out the joy and energy from somebody. A continued state of sadness or emotions different from a person's usual behaviour is termed as depression. If this behaviour starts interfering with one's daily activities, it is time to consult a psychiatrist. The primary symptoms of depression include anger, irritability, social withdrawal, a feeling of hopelessness or sadness, changes in sleep and appetite, fear of rejection, crying, fatigue and difficulty in concentrating. Often, suicidal tendencies tend to develop in many individuals suffering from prolonged depression. Depression can attack anybody irrespective of age.

Depression can be treated through both counseling and medications. If the depressed condition lasts for more than two weeks and interferes with one's ability to work and enjoy, medicinal treatment should be started after consulting a psychiatrist. Antidepressants are used mostly for severe depressions. These medications reduce the symptoms and help the depressed person feel happy. They can block the symptoms of panic and terror.

A psychiatrist prescribes medications depending on the patient's symptoms. It takes some time before improvement begins to show, about one to three weeks. Often, the patient's energy level or sleeping or eating patterns improve before the lifting of depression. And if no changes are visible after five to six weeks, the medication is changed. Treatment needs to be continued for several months and sometimes for years. For some people, depression can occur frequently and become severe with age. They need to continue with antidepressants.

The commonly used medications have no long-term side effects and can be continued indefinitely. The dosage varies depending on the person's age, body weight and the type of drug. Usually, dosages are started low and gradually increased until the desired result is achieved. If side effects occur, the dosage is changed. An overdose of antidepressants can be lethal and requires immediate medical attention.

Tricyclic antidepressants are commonly used for treating major depressions. Monoamine oxidase inhibitors or MAOIs are helpful in 'atypical' depressions which have symptoms like anxiety, oversleeping, phobias and panic attacks. Among the new antidepressants are the selective serotonin reuptake inhibitors or SSRIs. These include fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft). Luvox is used for obsessive-compulsive disorder and Paxil for panic disorder. Two other antidepressants approved by the FDA are venlafaxine (Effexor) and nefazodone (Serzone). These new medications have few side effects than the earlier tricyclic ones.

Tricyclic antidepressants can make people feel drowsy or anxious and restless. Tricyclics can complicate certain heart problems. Other side effects include dry mouth, blurred vision, weight gain, constipation, fatigue and changes in sexual desire. Some side effects disappear after a few days but some can remain for the entire length of treatment. Tricyclics can also interact with certain other medications and hormone like the thyroid hormone, antihypertensive medications, oral contraceptives and some blood coagulants.

Among the common side effects of the newer antidepressants are gastrointestinal problems, headache, insomnia and agitation. Some SSRIs can affect metabolism of certain other medications in the liver. MAOIs can react with certain foods, alcoholic beverages and medications like cold and allergy preparations, insulin and some narcotics.


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