Drugs to relieve depression

Not all depressive moods require medication, and drugs are by no means the only solution to relieve depressive moods. The specific choice requires a comprehensive judgment based on the degree of depression, physical tolerance, and personal wishes.

When I was working in the outpatient clinic two months ago, I picked up three children under the age of 20 in one morning. They were all just starting college and were under a lot of pressure during the mid-term week. They couldn't get excited for more than a week. I saw on the Internet that taking Prozac could "save emo", so I thought about taking some prescription. At this time, I usually ask them to take a scale first, and then ask about the situation one by one: if they just stayed up a few late nights to catch up with dues, had troubles with friends, and could still go to class, eat and go out to play normally, but were only occasionally in a low mood, then I would never prescribe medication. At most, I would give them some suggestions on adjusting their work and rest, and let them run two more laps on the playground.

To be honest, the "depressive mood" that everyone often talks about is too broad. I was sad for three days after losing my wallet, and was called an emo by my boss for a week. These are all normal mood swings, and there is no need to take medicine. Only this low state lasted for more than 2 weeks. I couldn't even get excited about the things I loved to do before. I couldn't eat or sleep. I even found it difficult to get up and wash up. It had affected my normal life at school and work. I went to the hospital and was diagnosed with a depressive episode, and then I needed to consider medication.

Nowadays, the most commonly used antidepressants in clinical practice are the new SSRI antidepressants, which are also commonly known as the "Five Golden Flowers": fluoxetine (Prozac), sertraline, paroxetine, fluvoxamine, and citalopram. They have relatively small side effects and can be tolerated by most people. They are currently the first-line drugs. I was particularly impressed by a girl who was a sophomore in high school. She couldn’t even go to school before she was diagnosed with moderate depression. She stayed at home for a month and took sertraline for three weeks before coming back for a follow-up visit. She told me that she finally went to see a new anime movie with her classmates last week, and her eyes lit up when she talked about it. Of course, it is not completely free of side effects. Many people will feel a little nauseous and slightly irritable in the week before taking it. Generally, it will be fine after the tolerance period. ； Paroxetine is also particularly effective for patients who also suffer from anxiety, but it must be tapered off slowly when stopping the medication. I have seen several people who suddenly stopped taking the medication and were dizzy for several days. They said it was like riding a 24-hour roller coaster, which was extremely uncomfortable.

If depression is accompanied by inexplicable physical pain, such as headaches and back pain, and a search in orthopedics and neurology can’t find the problem, then SNRIs such as venlafaxine and duloxetine will generally be given priority. There used to be an aunt in her 50s who was like this. She was in pain for more than half a year and couldn't even dance in the square. After taking Loxetine for two months, she said that the pain was completely gone. Now she can dance for two hours at night without any trouble. Oh, by the way, agomelatine, which has been used more and more in recent years, regulates biological rhythms. It is especially friendly to depressed patients who can’t fall asleep at three or four in the morning every day, and can’t lie down after waking up early. Take one before going to bed at night, and your sleep will be adjusted first, and your mood will be much better. I have a friend who works in Internet operations who was like this before. He was still changing plans in the middle of the night for several months. Later, even if he didn't work overtime, he would keep his eyes open until dawn. His mood was so low that he didn't even want to eat his favorite crayfish. After taking this medicine for more than half a month, his sleep returned to normal, and his overall state suddenly returned.

As for traditional antidepressants such as tricyclics and monoamine oxidase inhibitors that were commonly used in the past, they are basically not used as first-line drugs now. They have relatively serious side effects, such as dry mouth, constipation, and some people will develop orthostatic hypotension when they stand up violently. They will only be considered when other drugs fail to work.

There is a lot of controversy online about this type of medicine right now. I have seen the two most quarrelsome factions: one group says that depression means "can't think straight" and "hypocritical", and that taking medicine is a scam by doctors, and taking it will make you stupid.； Another school of thought says that depression is a lack of 5-hydroxytryptamine in the brain, so one must take medicine, and psychological counseling is all useless metaphysics. In fact, both of these statements are too extreme. Taking the cases I have come into contact with as an example, more than half of the patients with mild depression can get better without taking medicine by exercising, mindfulness, talking to reliable psychological counselors, and adjusting their living conditions. ； But if it has reached a moderate or even severe condition and you don’t even have the strength to talk to people, it is simply unrealistic for you to ask them to exercise and get counseling at this time. The medicine will help you hold the "bottom" of your emotions and drag you out of the emotional mud pit onto flat ground. After that, you can decide for yourself whether you want to run or take a walk.

Many people ask me whether taking medicine will make me addicted or make me stupid. Don't believe the rumors on the Internet. Antidepressants are not addictive. Those who say they feel uncomfortable when they stop taking the medicine are 90% of them because they did not follow the doctor's advice. They were supposed to reduce the medicine slowly, but they stopped right away when they felt better. This is why withdrawal reactions occur. As long as you follow the doctor's advice and reduce the medicine slowly, there will be no problem at all. As for becoming stupid, it is even more nonsense. When you are depressed, your brain can't turn around and you can't remember things. That's the impact of the disease itself. After the medicine helps you adjust your mood, your reflexes and memory will return. I have seen too many patients who take medicine and their work and study efficiency is much higher than before.

In fact, in the final analysis, no matter whether you use medicine or not, or what medicine you use, the most important thing is your own feelings. There is no need to think that taking medicine means you have a "mental problem" and it is embarrassing. Just like you need to wear glasses if you are short-sighted, or you need to take anti-hypertensive drugs if you have high blood pressure. These are all normal things. There is no need to force yourself to take medicine. If you think you can ease it by adjusting your living conditions, that is of course better. If you really need to take medication, don't take it hard. See a psychiatrist in a regular hospital for evaluation and follow the doctor's instructions. It is much more reliable than searching blindly on the Internet. Oh, by the way, don’t just buy medicines for yourself. Everyone’s situation is different. Medicines that are suitable for others may not be suitable for you. The dosage and timing of addition and subtraction of medicines must be evaluated by a doctor. Don’t try it on your own body.