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Non-DrugTreatment
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WHAT NON-DRUG OPTIONS ARE AVAILABLE FOR
TREATMENT OF DEPRESSION?
WHERE TO FIND MORE INFORMATION
Psychotherapy (counselling with a psychiatrist or other
qualified professional) usually involves a short-term,
goal-oriented approach. If underlying factors
contributing to depression such as an inability to get
along with others or difficulty finding your place in life
exist, a longer period of counselling may be required.
General Information
Canadian Mental Health Association
180 Dundas St. W., Suite 2301
Toronto, Ontario M5G 1Z8
Phone: 416-484-7750
e-mail: [email protected]
www.cmha.ca
Mood Disorders Society of Canada
3-304 Stone Road W., Suite 763
Guelph, Ontario N1G 4W4
Phone: 519-824-5565
e-mail: [email protected]
www.mooddisorderscanada.ca
Canadian Health Network
www.canadian-health-network.ca
Canadian Mood and Anxiety Network
www.canmat.org
Light therapy using lights of specific wavelengths
may help people with seasonal affective disorder
(SAD). Light therapy is available in many different
formats (e.g. light boxes, glasses). It is thought that
light therapy reduces the production of melatonin
in the brain. Melatonin is a brain hormone that
depresses mood. You should visit your doctor if
you feel you have symptoms of SAD (see over).
Electroconvulsive therapy (ECT) is generally safe
and effective in the treatment of severe depression
for people who don’t respond to medications or who
are at high risk for suicide. It is administered with the
aid of a light general anesthesia and a muscle relaxant.
An electrical current is passed through the brain for
a period of 1 to 3 seconds. The stimulus causes
a controlled seizure, which lasts for 20-90 seconds.
The person being treated wakes up in 5-10 minutes.
Most people require about 6-10 treatments and the
most common side effect is confusion that lasts from
a few minutes to several hours.
The Organization for Bipolar Affective Disorders
Society (OBAD)
Phone: 1-866-263-7408
e-mail: [email protected]
www.obad.ca
The information found in this PROfile health brochure is of
a general nature only. It is not intended to replace the advice
of your pharmacist, physician, or other healthcare provider.
If you have questions relating to your specific health
concerns, please contact your personal healthcare provider.
Your PROfile Pharmacist
Emotional Health
has many resources to assist you
in understanding and treating depression
and is always available to discuss
your health concerns!
EXCLUSIVELY AT
& Depression
962856 Revised 2008
Group therapies (e.g. bereavement groups, stress
management classes, marital counselling) may help
depending on the circumstances.
CloserLook
One in four Canadians suffer from depression at some
time in their lives. Fortunately depression is treatable;
however, only one in three people with this debilitating
disease seeks help.
WHAT ARE THE SYMPTOMS OF DEPRESSION?
If 3 or 4 of the following 9 symptoms have been present
continuously over the last two weeks, you may be
depressed and should visit your doctor
• Persistent sad feelings or feeling down, low or gloomy
for no reason
• A lack of interest in activities previously enjoyed such
as socializing with family and friends
• Thoughts of death or suicide – talk with your doctor
regardless of other symptoms
• Difficulty with sleep, such as: difficulty falling asleep,
restless or broken sleep, a need for more sleep, or
oversleeping
• Trouble concentrating and making decisions
• A change in appetite – either eating more or eating less
• Feelings of worthlessness and guilt
• Feeling intensely agitated or irritable with pacing,
fidgeting and restlessness
• Frequent or constant tiredness or feeling run down with very
little activity, getting easily fatigued with minimal activity
Any of the symptoms listed above that are interfering with your
quality of life should prompt you to call your doctor.
WHAT CAUSES DEPRESSION?
Depression is not caused by weakness of character.
Episodes of depression may be brought on by stresses
such as the death of a loved one, loss of job, marriage or
work problems. In addition, diseases such as cancer, heart
disease, and hormonal disorders can trigger depression,
as well as certain medications and over-indulgence of
alcohol on a regular basis. It is widely believed that these
influences can lead to a change in the regulation and
balance of the chemicals in the brain (i.e. serotonin,
norepinephrine, dopamine) that help to control how we
react. Treatment with medication is based on restoring
the levels of these chemicals in the brain (see over).
The tendency to develop depression may be inherited.
Medication
TYPES OF DEPRESSION
Major depression is one of the most common types
of depression. Symptoms can be chronic (ongoing)
or may appear in episodes. Most episodes go away
on their own within weeks or months, but others can
last much longer. It is very important to seek medical
help early so that treatment can be started with the
best possible chance for early recovery.
Dysthymia is a chronic, low-grade depression that affects
about three percent of the general population. People
with dysthymia have a depressed mood for most of the
day, for a majority of days, for at least two years. You
should see a doctor if you have a chronically depressed
mood as well as two or more of the following symptoms:
poor appetite or overeating, insomnia or oversleeping,
low energy or fatigue, low self-esteem, poor concentration
or difficulty making decisions, or feelings of hopelessness.
Seasonal affective disorder (SAD) occurs at a particular
time every year in about two to four percent of the
population and is related to lack of exposure to sunlight.
The more common symptoms of SAD are overeating,
oversleeping and sensitivity to changes in weather
conditions. Two or three consecutive wintertime
depressions are needed before the diagnosis is made.
Postpartum depression follows the birth of a child and
may have symptoms of either major depression or
bipolar disorder.
Bipolar disorder or manic depression results in periods
of depression alternating with mania (persistent feelings
of extreme elation with boundless energy, racing
thoughts, lack of focus, impulsive decision making
and dramatic over-estimation of personal ability).
The medications designed to correct the chemical
imbalances associated with major depressive
illness are very effective and not addictive.
Selective serotonin reuptake inhibitors or SSRIs
are the most commonly used class of antidepressants
for the treatment of depression. Examples include
paroxetine, fluoxetine, fluvoxamine, sertraline and
citalopram. They work by increasing the availability
of the chemical serotonin in the brain.
Additional medications increase availability in
the brain of both serotonin and norepinephrine
(e.g. venlafaxine) or dopamine (bupropion).
Tricyclic and tetracyclic antidepressants are not
used as often as the newer previously mentioned
medications because, although they are as effective,
they are associated with more side effects. Examples
include amitriptyline, imipramine and nortriptyline.
Monoamine Oxidase Inhibitors (e.g. moclobemide,
phenelzine) are used for certain types of depression
or when other antidepressants have failed, but are
associated with potentially serious side effects if
combined with certain foods, alcoholic beverages
or drugs.
Mood-stabilizing medications such as lithium,
valproic acid, divalproex and carbamazepine are used
to treat the symptoms of bipolar depression. They are
effective 50-80% of the time.
SIDE EFFECTS
Side effects vary between antidepressants but may
include dry mouth, constipation, urinary problems,
sexual problems, nausea or diarrhea (usually
temporary), dizziness, headache (usually temporary),
nervousness and trouble falling asleep. Be sure to talk
with your PROfile® Pharmacist about which side effects
and warnings are associated with your particular
medication. You should report any bothersome side
effects to your doctor or PROfile® Pharmacist.
You may not feel the beneficial effects from your
antidepressant medication until you have been taking it for
two weeks, and many don’t achieve full benefit for 6-8 weeks.
You should not stop taking a medication for treatment of
depression without first talking with your doctor.