Depression can affect any one of us at any time of our lives and is more than just feeling a bit fed up or down in the dumps. When you cannot just snap out of it and the symptoms of depression persist for more than a couple of weeks, and interfere with your ability to carry out your normal routines on a daily basis, then your health care provider or GP may prescribe some form of medication to help you combat the depression.

There are many different types of anti-depressants available and the earlier ones include Tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Newer types include Selective Serotonin Reuptake Inhibitors (SSRIs) and others, which may not fall into one specific category but which all work by impacting on the chemicals in the brain that are responsible for our mood and how we feel.

The following list represents the most commonly prescribed drugs for depression, their brand names and the name of the pharmaceutical company producing them (in brackets), as well as a brief description of how the different types are believed to work.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants are so called because of their molecular structure in that they contain three rings of atoms. Although no one understands exactly how they work, it is thought that the beneficial effects are due to their ability to balance the natural neurotransmitter chemicals in the brain. The most common side effects are dry mouth and drowsiness and possibly blurred vision, sweating, and a slight hesitancy when passing urine. The following list represents some of the most commonly prescribed Tricyclic antidepressants:

o Doxepin – Brand names: Adapin (Lotus Biochemical Corporation) and Sinequan (Pfizer Inc)

o Clomipramine – Brand names: Anafranil (Geneva Pharmaceuticals)

o Nortriptylene – Brand Names: Aventyl (Eli & Lilly) and Pamelor (Novartis Pharmaceuticals)

o Imipramine – Brand Names: Tofranil (Novartis Pharmaceuticals)

o Protriptyline – Brand Names: Vivactil (Merck & Co)

o Trimipramine – Brand Names: Surmontil (Wyeth-Ayerst Pharmaceuticals)

Monoamine Oxidase Inhibitors (MAOIs)

This type of medication works by inhibiting the activity of the enzyme monoamine oxidase, which in turn increases the levels of the neurotransmitters serotonin and norepinephrine. They are not prescribed as often as they used to be as the newer type of medication known as SSRIs have become more popular. MAOIs would usually be prescribed when other medications have proved ineffective. MAOIs can interact with foods containing tyramine and raise blood pressure; they can also interact unfavourably with many other drugs and over the counter preparations. Some MAOIs include:

o Isocarboxazid – Brand Name: Marplan (Oxford Pharmaceutical Services)

o Phenelzine – Brand Name: Nardil (Pfizer Inc)

o Tranylcypromine – Brand Name: Parnate (Glaxo Smith Kline)

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs work by selectively inhibiting the reuptake of the neurotransmitter serotonin in the brain so that levels of serotonin are increased. They are generally considered safer than other types. Side effects include nausea, anxiety, sleep disturbances and sexual dysfunction. They can also interact with other drugs. Some of the more commonly prescribed SSRIs include:

o Citalopram – Brand Name: Celexa (Forest Pharmaceuticals)

o Escitalopram – Brand Name: Lexapro (Forest Pharmaceuticals)

o Fluoextine – Brand Name: Prozac (Eli & Lilly)

o Fluvoxamine – Brand Name: Luvox (Solvay Pharmaceuticals)

o Paroxetine – Brand Name: Paxil (Glaxo Smith Kline)

o Setraline – Brand Name: Zoloft (Pfizer Inc)

Some other types of medication

There are other types of medication available for depression which are not included in the previous categories but which all work in various ways to alter the balance of chemicals in the brain to alleviate depression. For example:

o Bupropion – works by inhibiting the reuptake of both norepinephrine and dopamine. Often used to treat the type of depression known as Seasonal Affective Disorder (SAD), as well as ADHD and as part of a stopping smoking programme. Brand Name: Wellbutrin (Glaxo Smith Kline)

o Duloxetine – works by inhibiting the reuptake of both serotonin and noradrenaline (SNRI). Brand Name: Cymbalta (Eli & Lilly)

o Venlafaxine – Also an SNRI. Brand Name: Effexor (Wyeth-Ayerst Pharmaceuticals)

o Maprotiline – Known as a tetracyclic antidepressant because its molecular structure consists of 4 rings in a T shape. Brand Names: Ludiomil (Novartis Pharmaceuticals)

Which type medication is most suitable?

The type of medication prescribed by your GP will depend on many factors including the kind of depression diagnosed, the severity of the symptoms, other medication that you may be taking and of course the potential risk of any side effects.

It is not possible to predict with any degree of accuracy which one will be most effective and it can take a number of weeks for any effects to be noticed. If after six weeks or so there is no improvement, then another medication may be prescribed until you find the most appropriate one for you.

Regardless of the type of depression diagnosed, the right medication can alleviate the symptoms of depression and help you get back to your old self again.

By: David Mcevoy

Depression can be like a tremendous weight, keeping you down so you don’t want to function. Sometimes, it’s a constant battle with oneself to get up, get ready and get dressed every day. Life has a way of piling stuff on us, and it is our job to un-freeze our bodies and keep going during even the most difficult of times. Don’t give up on yourself for having depression, it is possible to increase your energy and drive. It just takes finding out what solutions work best for you specifically.

Having battled very severe depression for most of my life, I know first-hand about the strong urges to sleep, to do nothing and just vegg out in front of TV. Been there, done that. We all need “mental health breaks” from time to time, to re-charge ourselves. This is about the kind of apathy that affects everyday functioning, and the ability to do everyday tasks in life. The severely depressed often feel unable to do anything, and let themselves go mentally and physically. It takes energy to take care of oneself, and even small tasks can be a burden when you’re depressed. When you don’t participate in life, it feels harder and harder to function, and the more you put off connecting to others. Strong apathy is a wake-up message to work harder and perservere. The way I look back at my own life, it was either give up or get going. I chose to get going. It takes hard work, but is most definitely worth the effort. If I can do it, so can you.

Every day, push yourself to do one more task than you normally do. It’s your choice, but choose projects that aren’t too hard to accomplish. In time, build up to harder tasks as your confidence grows. Think of what you want to do and work on achieving your goals, one step at a time. Write it all down, if you like. I kept a diary, documenting everything that I did to keep track of my progress. It worked, and kept me motivated. One by one, tasks are accomplished and it feels good. The more you do it, the more those good feelings and confidence grow, like a snowball rolling down a hill, gathering momentum as it goes.

Don’t overanalyze or judge situations that upset you. Minimize the drama in your life. A family member of mine is very high-strung and finds things to worry about that aren’t there. She works herself into a frenzy by overjudging everyone, and being around her can really be exhausting. It is best to limit your exposure to people who consistently bring you down or stress you out. Take situations and problems at face value. Don’t read into them, just accept the reality of each issue as you experience it (don’t pretend it doesn’t exist or waste energy thinking how things “should” be.) It takes practise to accept some problems as they are. Thinking too much about everything drains personal energy and makes you tired. When depression is strong, that is when energy is needed the most. Preserve it by training your mind to minimize drama and criticism in your life.

Simplifying matters helps for coping with problems. Instead of looking at a problem as a big, unsurmountable task; break it into smaller and more manageable ones. Write important appointments down and don’t just commit them to memory. Be as efficient with your energy as you can, since it can be a precious commodity when you have depression. When I get a burst of energy, I do housework. One task at a time. When really motivated, I clean the whole apartment, in an organized and methodical manner. It feels good to get something accomplished. Build on that energy, bit by bit. Exercise, whether it’s housework or jogging, produces endorphins, or “feel good” chemicals in your body. By moving, you are helping yourself, more than you realize.

Work on fighting negative inner thoughts that plague you. Fight it by thinking of a positive statement, for every negative one you think to yourself. It is what therapists teach, to counteract the negative self-talk. It does work, but takes time. Affirmations; short positive statements, are helpful in working on destroying those inner gloomy thoughts. Practise positivity and in time, those negative thoughts may lessen.

Do whatever it takes to fight the “frozen” feelings of depression. We all have good and bad days. Go with the flow, and ride the fluctuation like a wave. Just realize the feelings of apathy are there then let them go. It takes persistence. Being very stubborn, I have spent my life practising these techniques, and am very high-functioning for someone with such strong depression inside. My mood is calm now, and there is a large amount of peace in life now. It took learning how to deal with tough times, and not to freak out when they occur. It’s all about being good to yourself. Inner peace feels great. Life is good, and getting better all the time. You can do it. Just believe in yourself and never stop working to improve your life. Make happiness happen.

By: Carolyn McFann