Emotional health is an important part of your overall health. People who are emotionally healthy are in control of their thoughts, feelings, and behaviors. They’re able to cope with life’s challenges. They can keep problems in perspective and bounce back from setbacks. They feel good about themselves and have good relationships.

Being emotionally healthy doesn’t mean you’re happy all the time. It means you’re aware of your emotions. You can deal with them, whether they’re positive or negative. Emotionally healthy people still feel stress, anger, and sadness, but they know how to manage their negative feelings. They can tell when a problem is more than they can handle on their own. They also know when to seek help from their doctor.

Research shows that emotional health is a skill. There are steps you can take to improve your emotional health.

Path to improved health

Emotional health allows you to work productively and cope with the stresses of everyday life. It can help you realize your full potential. It also helps you communicate with other people and contribute to society.

Your emotional health affects your physical health. Research shows a link between an upbeat mental state and physical signs of good health. These include lower blood pressure, reduced risk of heart disease, and a healthier weight.

There are many ways to improve or maintain good emotional health:

• Be aware of your emotions and reactions. Notice what in your life makes you sad, frustrated, or angry. Try to address or change those things.
• Express your feelings in appropriate ways. Let people close to you know when something is bothering you. Keeping feelings of sadness or anger inside adds to stress. It can cause problems in your relationships at home, work, or school.
• Think before you act. Give yourself time to think and be calm before you say or do something you might regret.
• Manage stress. Learn methods to cope with stress. These could include deep breathing, meditation, and exercise.
• Strive for balance. Find a healthy balance between work and play, and between activity and rest. Make time for things you enjoy. Focus on positive things in your life.
• Take care of your physical health. Exercise regularly, eat healthy meals, and get enough sleep. Don’t abuse drugs or alcohol. Try to keep your physical health from affecting your emotional health.
• Connect with others. Make a lunch date, join a new group, or say hi to strangers. We need positive connections with other people.
• Find purpose and meaning. Figure out what’s important to you in life, and focus on that. This could be your work, your family or friends, volunteering, caregiving, or something else. Spend time doing what feels meaningful to you.
• Stay positive. Focus on the good things in your life. Forgive yourself for making mistakes and forgive others. Spend time with healthy, positive people.

Things to consider

People who have good emotional health can still have problems. Mental illness often has an emotional and physical cause. There could be a chemical imbalance in your brain. Stress and problems with family, work, or school can trigger mental illness or make it worse.

Counseling, support groups, and medicines can help people who have emotional problems or mental illness. If you have an ongoing emotional problem, talk to your doctor right away. They can help you find the right type of treatment.

Questions for your doctor

• What steps should I take to improve my emotional health?
• Are there medicines that could help me cope better?
• Should I see a therapist or counselor?
• How does my physical health affect my emotional health?
• What stress management techniques would work best for me?

Resources

National Institutes of Health: Emotional Wellness Toolkit

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Chronic pain is a type of pain that continues over time. It can last anywhere from 3 months or more to several years. Chronic pain may be caused by certain health conditions. It is more common in people who are older.

Treatment of chronic pain usually involves medicines and therapy. Medicines used for chronic pain include pain relievers, antidepressants, and anticonvulsants. Different types of medicines help people who have different types of pain. You usually use long-acting medicines for constant pain. Short-acting medicines treat short-term, or acute, pain.

Path to improved health

The goal of chronic pain treatment is to increase function and quality of life. Different types of medicines help people who have different types of pain. For instance, short-acting medicines treat pain that comes and goes. Long-acting medicines treat constant pain.

The most common medicines are listed below. Each one has side effects. These can range from mild to severe. It’s important to follow your doctor’s orders on how to use your pain medicine. If you have questions about side effects or about how much medicine to take, ask your doctor or pharmacist.

Acetaminophen

Acetaminophen helps many kinds of chronic pain. One brand name is Tylenol. It is also found in many and prescription and over-the-counter pain medicines. If you’re not careful, you could take more acetaminophen than is good for you. Too much acetaminophen can cause liver damage, especially if you drink alcohol. Tell your doctor if you take more than 2 acetaminophen pills a day.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Other drugs that help with pain are nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include aspirin, ibuprofen (two brand names: Motrin, Advil), and naproxen (one brand name: Aleve). NSAIDs come in both prescription and over-the-counter forms. These medicines can be taken sometimes or every day. When taken regularly, they build up in the blood to fight inflammation (swelling) and give general pain relief.

Always take NSAIDs with food or milk because the most common side effects are related to the stomach. Other side effects include:

• Increased bruising
• Risk of bleeding in the stomach
• Kidney damage (when taken for long periods of time)
• High blood pressure
• Interference with blood pressure medicines

If you take other pain medicines, do not take NSAIDs without talking to your doctor first.

Antidepressants

Many drugs that treat other illnesses can also treat chronic pain. For example, antidepressants can improve function and provide pain relief. Antidepressants may be used to treat nerve damage, arthritis, and fibromyalgia. They also may help with headaches, facial pain, low back pain, and pelvic pain. It can take several weeks for the medicines to start working.

Types of antidepressants your doctor may prescribe include:

• Tricyclic antidepressants (TCAs), such as amitriptyline (Elavil), imipramine (Tofranil), nortriptyline (Pamelor), and doxepin.
• Selective serotonin/norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta).
• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Possible side effects of antidepressants include:

• Nausea
• Drowsiness
• Insomnia (trouble sleeping)
• Dry mouth
• Dizziness
• Constipation
• Weight gain
• Heart problems

TCAs tend to have more side effects than SNRIs or SSRIs, but they usually are mild. Your doctor may start you on a low dose of medicine. This helps prevent side effects and allows your body to adjust. The doctor may increase the amount over time. If at any point while taking medicine you become depressed or have suicidal thoughts, call your doctor right away.

Anticonvulsants

Your doctor may want you to try an anticonvulsant medicine. It may help reduce some types of chronic pain, such as low back pain or nerve damage. Examples of anticonvulsants are:

• Gabapentin (Neurontin)
• Carbamazepine (Tegretol)
• Phenytoin (Dilantin)
• Pregabalin (Lyrica)
• Topiramate (Topamax)

Like antidepressants, your doctor may start you on a low dose of anticonvulsants. This helps prevent or reduce side effects. The doctor may increase the amount over time. Contact your doctor right away if you have suicidal thoughts. Minor side effects may include:

• Drowsiness
• Nausea or vomiting
• Restlessness
• Dizziness
• Loss of appetite
• Weight gain
• Itching or swelling

Narcotics

Doctors rarely prescribe narcotics or opioids to treat chronic pain. This is because they are highly addictive. Currently, there is an opioid crisis in the United States. People who become addicted can develop severe symptoms, such as increased pain, depression, or suicidal thoughts. They may begin to abuse other substances, or their behaviors could become harmful or violent. Addicts are at risk of misusing or overdosing on narcotics, which can cause death. Talk to your doctor about all risks of narcotics before starting a new medicine.

If your doctor does prescribe a narcotic, be sure to follow their directions. Do not drive or operate heavy machinery when taking narcotics. Do not use alcohol. Tell your doctor if you have side effects from narcotics. These may include nausea, constipation, and trouble focusing or thinking clearly. Your doctor can prescribe an anti-nausea drug or laxative to help with side effects.

When you’re taking narcotics, it’s important to remember the difference between physical dependence and psychological addiction. Physical dependence means that your body adjusts to a medicine and needs it to function. When you function has improved, your doctor will help you slowly and safely decrease the amount of medicine. Doing this helps prevent or reduce symptoms of withdrawal. It is critical to tell your doctor about these symptoms and work through the process together.

Psychological addiction is the desire to use a drug whether or not it’s needed to improve function and relieve pain. Using a narcotic this way is harmful to your health. Talk to your doctor if you think you are addicted to narcotics. They may give you other medicines to help your addiction. They could lower the dose, change to another drug, or stop the medicine. They may recommend counseling or rehab as well.

Things to consider

Always tell your doctor what other drugs you take. This includes medicines, vitamins, and supplements. The doctor also should know about all ongoing health conditions. Some medicines may not be safe to take. Do not start a new drug without your doctor’s approval.

It is important to follow instructions when taking chronic pain medicines. Some side effects can be harmful and cause other health concerns. They can also be harmful to your lifestyle if you develop a problem. Do not stop taking a drug without your doctor’s approval.

People who take medicine for chronic pain should have regular check-ups with their doctor. Contact your doctor right away if you have severe or abnormal side effects. This includes if you have an unplanned reaction. The doctor will tell you what you should do. Seek help if you think you are dependent on or addicted to a drug.

Questions for your doctor

• What are my options to treat chronic pain?
• What medicine(s) do I need to take?
• How long do I need to take them?
• How much and how often do I take the medicine?
• Do I need to take the medicine with anything or avoid things when I take the medicine?
• What are the possible side effects? What should I do if I have them?
• How do I safely start and stop chronic pain medicines?
• Are there alternative forms of treatment, besides medicine, that can treat chronic pain?

Resources

American Academy of Family Physicians: Chronic Pain

American Academy of Family Physicians: Opioid Addiction

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Professional therapy and counseling can improve your mental wellness. This therapy can help people who are experiencing emotional or behavioral problems. Also, it can help people who have a mental health disorder. Therapy is sometimes called psychotherapy or talk therapy. Many times, therapy is used in combination with prescription medicine to treat a mental health disorder. Therapy will usually improve the results you get from the medicine.

There are different types of mental health providers. Professionals trained in psychotherapy include those representing the following types:

• Psychiatry
• Clinical psychology
• Mental health counseling
• Clinical social work
• Marriage and family therapy
• Rehabilitation counseling
• Psychoanalysis

Fee structures and access to prescriptions is different for each. For example, a psychiatrist has a medical degree and is allowed to write prescriptions. A counselor does not have a medical degree and is not allowed to write a prescription. Your doctor can suggest a professional that is right for you.

Some people do not want professional therapy or counseling. They feel ashamed of their problems. Others believe therapy and counseling are for seriously mentally ill or “crazy” people. However, this is not true. Don’t let shame and fear stop you from getting the help you need. Good mental health is part of your overall health and wellness.

Path to improved health

Different types of therapy use different techniques. In most types of therapy and counseling, the person receiving treatment talks with a professional therapist. However, therapy is more than just talking about your problems. Therapy can teach you new ways to think about the situations that bother you. It can help you cope with feelings and situations. It can help with feelings of anger, fear, anxiety, shyness, and panic. It also can give you tools to help fight low self-esteem and depression.

Therapy can help treat a variety of problems. Some common reasons people seek therapy include:

• Depression
• Marriage problems, infidelity, divorce, or other relationship issues
• Sexual problems
• Stress and anxiety
• Addictions and compulsions
• Grief, loss, or bereavement
• Anger
• Career choice
• Parenting or family problems
• Phobias
• Insomnia
• Fertility issues
• Chronic pain or illness
• Domestic violence or abuse
• Eating disorders

If you are not sure if therapy and counseling are right for you, talk to your family doctor. Your doctor can refer you to a trained professional who can help with your problems.

If you choose therapy or counseling, you’ll talk about any problems you’ve been having and how you’ve been feeling. You’ll also talk about your goals for therapy. You and your doctor will decide how frequently you will meet. Your doctor, therapist, or counselor will help you decide what’s right for you.

Things to consider

Different kinds of therapy and counseling are based on different ideas about how the brain works. Also, it considers what causes people to act in certain ways. Many therapists use more than one type of technique to help you. Common kinds of therapy include:

• Family counseling. This helps family members understand problems within the family and how to resolve them.
• Cognitive therapy. This is sometimes called cognitive behavior therapy. It’s based on the idea that your thoughts cause your feelings and actions. If you change the way you think about something, you can feel or behave better even if the situation doesn’t change. This kind of therapy helps you understand negative or false thought patterns. Negative thought patterns cause troubling feelings and behavior.
• Behavior therapy. Sometimes called behavior modification therapy, this treatment focuses on changing unwanted or unhealthy behaviors. You replace them with healthy ones. This treatment involves using a system of rewards and reinforcement of positive behavior.
• Psychoanalytic therapy. This type of treatment encourages you to think and talk about memories and feelings from the past. These memories will help you understand how you act and feel today.
• Group therapy. Group therapy is led by a qualified professional. He or she facilitates a small group of people who have similar issues or problems. Groups can improve honesty with others. Members support each other during times of crisis.
• Couples therapy or marriage counseling. This treatment can help couples solve problems together, communicate in healthier ways, and learn to work out differences.

Questions to ask your doctor

• What if my partner or child is resistant to therapy?
• How do I find a therapist that’s right for me?
• Can my child’s therapist tell me what they talked about?
• Will my therapist recommend prescription medicine?
• What if I don’t like my therapist? Can I change?

Resources

National Alliance on Mental Illness: Types of Mental Health Professionals

National Institute of Mental Health: Psychotherapies

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If you have depression, your doctor may prescribe medicine to treat it. This medicine is called an antidepressant. There are many types of antidepressants. Finding the one that’s right for you can take time. It’s important to work with your doctor to find it.

Path to improved health

Your doctor will consider many factors when choosing the antidepressant medicine to give you:

• If you were depressed before and a certain antidepressant worked well, that medicine might be the right choice for you again.
• If any of your brothers, sisters, parents, uncles, or aunts had depression and a certain antidepressant worked well for them, that medicine might work for you, too.
• The choice of an antidepressant depends on your health. Certain antidepressants may have a bad effect on a health problem you have. That medicine wouldn’t be the right choice for you.
• Antidepressants can have side effects. The right medicine for you may be the one that gives you the fewest side effects.
• The choice of an antidepressant may depend on how often you must take it. It is important to take antidepressants as prescribed and daily medications may make this easier.
• Some antidepressants cost more than others. Your doctor will choose an antidepressant that works for you and your budget.
• Your doctor will likely choose a medicine they have experience prescribing.
• Some antidepressant can help you with sleeplessness, anxiety, and lack of energy if these are part of your symptoms.
• If you’re taking other medicines, your doctor will consider how an antidepressant will work with these other medicines.
• Some antidepressants don’t work well with certain foods. If your doctor gives you one of these antidepressants, they will let you know which foods you should stop eating.

Keep in mind that antidepressant medicines are not “downers”  or “uppers.” You will not get  high when you take them. They are not addictive.

You’ll know if your antidepressant is working based on how you feel. You’ll be able to sleep better. You’ll have more energy to meet your day-to-day obligations. You can take care of yourself. Your appetite will be closer to normal. You’ll have an increased desire to engage in life. You and your family and friends will notice these changes. Be patient, though. It may take some time to get back to the way you felt before the depression.

While antidepressants can help with symptoms of depression, that’s only part of the treatment. These medicines work best when you try to have an active lifestyle with exercise, get eight hours of sleep a night, and eat healthy foods. Your doctor may also recommend working with a counselor to help you improve the thoughts of depression.

How to take antidepressants

Antidepressants are usually taken every day. It can take 1 or even 2 months to see the full results. You may need to try different doses or change medications to find the antidepressant that works best for you.

Your doctor will let you know how long to take your antidepressant. If this is the first time you have been treated for depression, you will probably continue to take this medicine for at least 6 months after you begin to feel better. If this is the second time you’ve been depressed, you might keep taking the medicine for at least a year. Depression that comes back a third time may require you to continue taking an antidepressant for a longer time.

Do not stop taking antidepressants suddenly.  You can get unwanted side effects if you stop taking your antidepressant suddenly. If you want to stop taking your medicine, talk to your doctor first. They can try to help you avoid these side effects.

Alcohol and antidepressants

Talk to your doctor about drinking alcohol while taking an antidepressant. You should be careful about drinking until you know how the medicine affects you. The effects of alcohol can combine with the effects of the antidepressant and cause problems. Regular heavy drinking can make it harder to treat depression. Certain kinds of medicine can lead to seizures for heavy drinkers.

Antidepressants and other medicines

Antidepressants can effect many other medicines. If you’re taking an antidepressant, tell your doctor about all other medicines you take, including over-the-counter (OTC) medicines and herbal health products (such as St. John’s wort). They can let you know if your regular medicines may cause problems when combined with an antidepressant.

Antidepressants for children and teens

In some cases, the use of antidepressants has been linked to an increase in suicidal thoughts and behavior in children, teens, and young adults. The Food and Drug Administration (FDA) now requires antidepressants to carry a warning about the risk of suicide in children, teens, and young adults 24 years of age or younger. However, this doesn’t mean that people in this age group shouldn’t take antidepressants. It means they should be carefully monitored by their doctor and loved ones while taking the antidepressant.

Many doctors will want to see a child or teen sometime in the first few weeks after starting an antidepressant to assess any risk for suicide. If you’re worried your child may be suicidal, call your doctor right away or take your child to the nearest emergency room.

Things to consider

All antidepressants have some side effects. However, not all people taking antidepressants have these side effects. Most of the side effects happen in the early weeks of therapy and lessen over time. You may experience the following:

• Anxiety
• Bladder problems
• Blurred vision
• Constipation
• Diarrhea
• Dizziness when standing up
• Dry mouth
• Excessive tiredness
• Feeling of weakness
• Hand tremors
• Increased heart rate
• Increased sleepiness
• Insomnia
• Muscle twitching
• Nausea
• Sexual dysfunction (inability to ejaculate or to have an orgasm)
• Tremor
• Vomiting
• Weight gain or loss

Talk to your doctor if these side effects don’t go away. They may change your dosage or suggest another medication.

Considerations for women

If you’re planning to get pregnant, talk to your doctor about your medicines before you try to get pregnant. If you accidentally get pregnant while taking an antidepressant, tell your doctor right away. Your doctor will know if your antidepressant is safe to take while pregnant.

Most medicines you take can pass into your breast milk. That means it may be passed on to your baby. If you’re planning to breastfeed or you currently breastfeed, talk to your doctor about your medicine.

In most cases, it’s okay to take birth control pills or hormone replacement therapy (also called HRT) at the same time as depression medicines. Taking hormones may even help some depressed women feel better. However, if your birth control pills seem to be causing symptoms of depression, discuss it with your doctor. They may suggest you use another method to prevent pregnancy for several months to find out if your birth control pills are causing depression.

Antidepressant discontinuation syndrome

Antidepressant discontinuation syndrome can occur if you suddenly stop taking your antidepressant medicine. Antidepressant discontinuation syndrome is not dangerous or life threatening. It usually goes away within a week. The symptoms include:

• Anxiety
• Feelings of sadness
• Irritability
• Fatigue
• Headaches
• Nausea and vomiting
• Dizziness

You’re more likely to have antidepressant discontinuation syndrome if you stop taking certain antidepressants, such as paroxetine and sertraline. However, you can get symptoms from stopping any antidepressant medicine.

If you accidentally missed a dose of your antidepressant medicine, start taking it again as soon as possible. If you’re out of medicine, call your doctor so they can refill your prescription.

If you decided to stop taking your antidepressant medicine on your own, talk to your doctor about why you stopped. For example, was the medicine causing an unpleasant side effect? Did it cost too much? Your doctor can help by altering your dosage or suggesting another antidepressant.

If your doctor recommended you take a lower dosage of your medicine and you’re experiencing symptoms of antidepressant discontinuation syndrome, talk with your doctor. You may need to take a higher dosage before weaning your body from the medicine completely.

To keep antidepressant discontinuation syndrome from happening again, take your medicine exactly as your doctor tells you. If you want to stop taking it, talk to your doctor first. Just because you’re unable to stop taking your medicine suddenly doesn’t mean you’re addicted. Your body often needs time to adjust to lower levels of the medicine. That’s why your doctor may recommend tapering off an antidepressant rather than abruptly stopping it.

Questions to ask your doctor

• How can I know if I have depression?
• Are there ways to treat depression that don’t involve medicine?
• If I am depressed, should I also be talking to a mental health professional?
• Are there coupons I can use to help lower the cost of antidepressants?
• How long will it take to get the dosage right for my medication?
• How will I know the medicine is working?

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Mental health or psychiatric conditions are common. Many times, they run in families. Some of the most common mental health conditions are depression, anxiety, and bipolar disorder. These illnesses and others like them interfere with your thoughts, feelings, and behaviors. Learning you have a mental health condition can be upsetting. But there is hope. There are a variety of treatments available for mental health conditions. Don’t be afraid to ask for help.

Path to improved health

There are several types of treatment for mental health problems. They include:

• Psychotherapy or counseling. This also is called talk therapy. It is one of the most common treatments for mental health disorders. It involves talking about your problems with a mental health professional but is so much more. The is an education element, a focus on relaxation exercises and coping skills as well as stress management. There are many types of talk therapy. Some common ones include cognitive behavioral therapy or dialectical behavior therapy. Talk therapy is often done one-on-one. It can also be done in a group setting or with your family. Individual and group talk therapy is sometimes helpful. This type of therapy can be useful even for those who do not have a mental health condition and are simply going through challenging life situations (grief, divorce, etc.).
• Prescription medicine. Prescription medicine is another popular treatment method. Medicines for mental disorders make changes to brain chemicals that are involved in emotions and thought patterns. Medicines don’t cure psychiatric conditions or health problems. But they can improve your symptoms. They can make other treatments, such as counseling, more effective. There are many kinds of prescription medicines available that work in different ways. Your doctor will make a recommendation and share any side effects.
• Support groups. Self-help and support groups can help you gain insight into your condition. They can provide friendships, support, resources, and tips on how to live with your condition. They also help address the feelings of isolation that often go along with mental health conditions.
• Other therapies. There are many types of therapies people use to help treat mental health problems. These can include physical activity, such as exercise or yoga. They can also include creative therapies. These are therapies done using means of expressing yourself creatively. They can include using art, music, movement, or writing.
• ECT or other brain stimulation therapy. Electroconvulsive therapy (ECT) is a safe procedure that sends electric currents into the brain. This causes changes in the brain that can improve and even reverse troubling symptoms. ECT and other brain stimulation therapies are often used when other kinds of treatment haven’t worked.
• Eye Movement Desensitization and Reprocessing (EMDR) therapy. This type of therapy is used to relieve psychological stress. It has become an effective way to help treat trauma, especially post-traumatic stress disorder (PTSD).
• Hospital or residential treatment program. Sometimes your mental health issues become so bad that you need to receive treatment in a hospital or a long-term program. This can happen when you can’t take care of yourself. Or it happens when you are in danger of harming yourself or others.

Not every treatment works or is necessary for everyone. Some people benefit from a combination of treatments. Your doctor will help you find the treatment that’s right for you.

Things to consider

Sometimes, there is an unfair stigma that surrounds mental health and mental conditions. This stigma can prevent people from getting the help and support they need. They are afraid of what people will think of them. So they don’t seek treatment. Their condition often gets worse. Sometimes people even take their own lives because the stigma of mental illness kept them from seeking help.

Healthcare professionals, educators, and organizations are working to overcome the stigma. Individuals and their loved ones are more likely to speak up about mental health disorders. They are encouraged to get treatment.

Look for these signs that you or a loved one may be experiencing signs of mental health conditions:

• Feeling sad or depressed
• Trouble concentrating
• Extreme feelings (including fear, guilt, sadness, or anger)
• Withdrawal from friends or activities
• Extreme mood changes
• Alcohol or drug abuse
• Unexplained hostility or violence
• Inability to cope with stress or your feelings
• Delusions, paranoia, or hallucinations (such as hearing voices)
• Thinking about hurting yourself or others

Don’t be afraid to ask for help. You have many treatment options available to you. Mental illness is nothing to be embarrassed by or ashamed of. Being aware of mental health issues and learning the truth can help you and others. It can even save lives.

Questions to ask your doctor

• I have some of these symptoms. Could I have a mental health condition?
• What is the best kind of treatment for me?
• Do I need to take prescription medicine? Do I need to see a psychiatrist?
• Do I need psychotherapy?
• Can you recommend a counselor or therapist I could see?
• Is this a temporary problem or is it permanent?
• Will I need treatment for the rest of my life?
• What can I do at home to help me recover?
• How can I explain to other people the mental problem that I’m having?

Resources

MentalHealth.gov: Local Organizations with Mental Health Expertise

National Institutes of Health, MedlinePlus: Mental Disorders

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Antidepressants are a group of prescription medicines that treat depression. They may also be used to treat other health conditions. The chemicals in them affect people in different ways. This is why there are several types. You may have to try one or more types before finding one that works. Learn about the different types and talk to your doctor to see which one(s) works for you.

Although prescription antidepressants have the most evidence for their use, there are over-the-counter medications and supplements that are recommended to treat the symptoms of depression. These include 5-HTP and SAMe, among others. These may not be clinically proven to work and may not be FDA approved or regulated. Talk to your doctor before trying any of these types of medicines or supplements.

Path to improved health

Prescription antidepressant medicines are sorted into types. They are based on which chemicals in the brain they affect. Neurotransmitters are the brain chemicals that communicate information throughout your brain and body.

Your doctor may prescribe an antidepressant to treat your depression symptoms. Below are the different types of prescription medicines that regulate the levels of different neurotransmitters in your brain.

Always share with your family doctor if you have a family history of depression or bipolar disease. Antidepressants could make bipolar disorder worse.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs affect a chemical in your brain called serotonin. SSRIs usually are the first kind of antidepressant your doctor will prescribe. These types tend to have fewer side effects.

Types of SSRIs are:

• Citalopram
• Escitalopram
• Fluoxetine
• Fluvoxamine
• Paroxetine
• Sertraline

Common side effects of SSRIs include:

• Dry mouth
• Nausea
• Headaches
• Nervousness
• Restlessness
• Trouble sleeping
• Sexual problems

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SNRIs affect two chemicals in your brain. They are serotonin and norepinephrine. Your doctor may prescribe them because they don’t interact with your other medicines.

Types of SNRIs are:

• Duloxetine
• Venlafaxine
• Desvenlafaxine

Common side effects of SNRIs include:

• • Nausea (especially in the first 2 weeks)
  • Loss of appetite
  • Anxiety and nervousness
  • Headaches
  • Trouble sleeping
  • Lack of energy
  • Dry mouth
  • Constipation
  • Weight loss
  • Sexual problems
  • Increased heart rate
  • Increased cholesterol levels

Atypical antidepressants

These medicines are called “atypical” because they don’t easily fit into their own category.

Types of atypical antidepressants are:

• Bupropion
• Trazodone
• Mirtazapine

Each drug has different side effects. Like most antidepressants, side effects include nausea, fatigue, and nervousness. Dry mouth, diarrhea, and headaches are common as well.

Trazodone may be used along with an SSRI. This can help with insomnia with depression.

Bupropion may be recommended for people who have certain health issues. The most common is attention-deficit hyperactivity disorder (ADHD). Other issues are nicotine or cocaine dependence. You should not take this kind of medicine if you have a seizure disorder or bulimia. Side effects include agitation, loss of appetite, and trouble sleeping. Bupropion typically has fewer sexual side effects.

Tricyclic antidepressants

Tricyclic antidepressants affect three brain chemicals. They are serotonin, norepinephrine, and dopamine. This is one of the oldest types of antidepressants. The drugs are effective but are used less often because of increased side effects. They take a long time to start working compared to SSRIs and SNRIs. These drugs are not used for older patients, people who have glaucoma, or men who have enlarged prostates.

Types of tricyclic antidepressants are:

• Amitriptyline
• Clomipramine
• Desipramine
• Doxepin
• Imipramine
• Nortriptyline
• Protriptyline
• Trimipramine

Common side effects of tricyclics include:

• Dry mouth
• Blurred vision
• Constipation
• Trouble urinating
• Impaired thinking
• Tiredness
• Worsening of glaucoma

This type of antidepressant also can affect your blood pressure and heart rate.

Monamine oxidase inhibitors (MAOIs)

MAOIs affect an enzyme in your brain called monamine. These drugs typically are used as a last resort if other types haven’t worked.

Types of MAOIs are:

• Isocarboxazid
• Phenelzine
• Selegiline
• Tranylcypromine

MAOIs can have severe side effects. These include:

• Weakness
• Dizziness
• Headaches
• Trembling

They also can have harmful reactions when combined with certain foods or medicines (other antidepressants and cold and flu medicines). The reaction is known as “serotonin syndrome.” These reactions include:

• Hallucinations
• Changes in blood pressure
• Agitation
• Fever

Things to consider

Talk to your doctor about the different types of antidepressants. Be sure they know what other medicines, vitamins, or supplements you take. It is important to follow your doctor’s instructions. You may want to stop taking the medicine(s) once you feel better. However, this can cause your depression to come back. Do not stop taking antidepressants without talking to your doctor. You often need to decrease the dose over time. You cannot get addicted to antidepressants. You may have worse symptoms or withdrawal if you stop taking them at once.

Call your doctor right away or go to the emergency room if you have the following symptoms.

• Attempt to commit suicide
• Have thoughts about suicide or death
• Have thoughts about hurting someone else
• Act angry, violent, or aggressive
• Have sudden onset of mania
• Have panic attacks
• Have severe or ongoing insomnia (trouble sleeping)
• Have new or worsening depression
• Notice heightened symptoms
• Have unusual changes in mood or behavior

Questions to ask your doctor

• What type(s) of antidepressants are best for me?
• How do I know if I should stop taking my medicine(s)?
• What should I do if I accidentally overdose?
• What are the symptoms of withdrawal?

Resources

American Academy of Family Physicians, Clinical Recommendation: Depression

National Institutes of Health, MedlinePlus: Antidepressants

National Institute of Mental Health: Mental Health Medications

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