:: What is depression?
Depression is a medical condition. It is not a sign of personal weakness or a condition that will run its coarse and just go away.
Depressive episodes include constant feelings of sadness, worthlessness and guilt with a loss of interest or pleasure in most activities previously enjoyed.
Many depressed people go untreated but proper treatment can help more than 70% of patients with depression improve.
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:: How common is depression?
At any given time, approximately 12-16 million people in the United States suffer from depression. It is also estimated that up to 10% of the population will become depressed during their lives.
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:: Who suffers from depression?
Depression can occur in people of all backgrounds, ages and ethnic groups. Nearly twice as many women as men are afflicted with depression, but this result may be due to the fact that fewer men are willing to admit that they are suffering from depression and therefore more reluctant to seek medical treatment.
Symptoms most commonly appear for the first time in people in their mid-20s. Often overlooked, symptoms of depression also occur in approximately 15% of people over 65 years of age. It is also estimated that as many as 25% of patients with a chronic medical illness will suffer from depression during the course of their illness.
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:: Will my depression just go away on its own?
If you're suffering from depression, it might not just go away on its own. If you don’t get treatment, your depression can last for 6 months or longer. Some people’s depression can last for years.
It is also important to realize that depression is a recurring illness. If you have one episode of depression, there is a 50% chance you will have a second one. The chance of recurrence is even higher, at 70% after two episodes, and 90% after three episodes.
This makes it even more important to seek treatment, which can not only relieve depressive symptoms but also reduce your chances of recurrent episodes.
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:: What causes depression?
There are a variety of factors that can contribute to the development of depression. These can include:
1. A stressful life event such as divorce, unemployment, death of a loved one.
2. Medical conditions such as cancer, heart disease, Alzheimer’s disease, multiple
sclerosis, Parkinson's disease, stroke, infectious diseases, hypo- or hyper-
thyroidism, Addison's disease, Cushing's disease, diabetes, severe anemia, lupus
and others.
3. Medications such as certain pain relievers, antibiotics, anticonvulsants,
antihypertensives, antiparkinsons agents, antituberculosis agents, oral
contraceptives, steroids and others.
4. Psychiatric disorders such as anxiety disorders, eating disorders, schizophrenia,
drug and alcohol abuse.
5. Genetic factors: people with a family history of depression are more likely to
suffer from depression themselves.
Even though many people have experienced some of the above factors, not everyone becomes clinically depressed. Most people will only have mild, short-term sad feelings. However, other patients, as a result of experiencing some of the above factors, or sometimes for no apparent reason at all, will develop depression.
Although the exact reason is not known, it is believed that these patients suffer from an imbalance of the brain’s neurotransmitters. Neurotransmitters are the chemical messengers of the brain that allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotrans- mitters. An imbalance of these chemicals is thought to affect the symptoms of depression. Medications used to treat depression and other psychiatric disorders work to help symptoms by restoring the balance of the levels of these chemicals in the brain.
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:: What are the signs and symptoms of depression?
The main signs of depression are depressed mood most of the day nearly every day and/or loss of interest or pleasure in most activities most of the day nearly every day for at least 2 weeks. Either or both of these signs are accompanied by at least four of the following additional symptoms:
1. Significant weight loss or weight gain.
2. Inability to sleep or oversleeping nearly every day.
3. Restlessness and agitation or decreased activity that others notice.
4. Fatigue or loss of energy nearly every day.
5. Feelings of worthlessness or excessive guilt nearly every day.
6. Difficulty concentrating or making decisions nearly every day.
7. Frequent thoughts of death or suicide.
These symptoms should be serious enough to cause worry and to disrupt your social, work or daily life.
* It is important to let your doctor know, during either a physical or online consultation, about any prescription or over-the-counter medications you are taking, if you have or have had other medical conditions and your family medical history. This will help your doctor determine if these factors are contributing to your depression. These factors can then be addressed in determining your need for antidepressant therapy.
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:: What are the risks of suicidal thoughts or actions?
Depression can make you feel like you don't want to live. Frequent thoughts of suicide or attempts at suicide are an affect depression can have on you. Studies estimate that up to 15 percent of people with severe depression commit suicide. This makes it even more critical that you seek treatment if you suspect that you or a loved one may be suffering from depression.
* Note: Sometimes people with depression who have thoughts or plans of suicide are so depressed that they lack the energy to actually carry out their plans. This can change when they start taking antidepressants: Early in treatment, just as they start to feel better, they may finally have the energy to act. This seems to be even more frequent with children and teenagers who may even initially have increased thoughts of suicide caused by antidepressants themselves. This risk of suicidal thoughts or actions should be closely monitored, especially during the first few months of antidepressant therapy.
If your loved one has mentioned feelings of wanting to harm themselves or others, call 911 or your doctor immediately.
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:: What are signs of suicidal thoughts?
It is important for you and your family to pay close attention to any changes in the mood or actions of the person taking antidepressants, especially if the changes occur suddenly.
Behavior changes indicating signs of suicidal thoughts may include:
- thoughts or talking about suicide or death
- previous attempts at committing suicide
- new or worse depression or anxiety
- feeling very agitated or restless
- panic attacks
- difficulty sleeping
- new or worse irritability
- acting aggressive, angry or violent
- acting recklessly
- an extreme increase in activity and talkativeness
- other unusual changes in behavior or mood
A person who is considering suicide may also start giving away valued possession and put their lives in order by arranging finances and other obligations. They also may suddenly act extremely happy or relieved, from having finally made up their mind to go through with their plan of suicide.
Contact your doctor immediately if you or your loved one exhibits any of the above signs for the first time.
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:: How is depression treated?
There are three treatment options for depression:
1. Prescription medications are the main method of treating major depression. There are several classes of medications available for use. Each class has its own characteristics such as different ways in which they work, different side effects profiles, different drug or disease interactions and cost. You and your doctor can select the most appropriate drug for you based on these factors. It is also important to know that not everyone responds the same to individual drugs therefore a different drug in the same or different class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat?  and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Psychotherapy involves visiting a psychiatrist, psychologist, therapist or counselor and talking about your feelings and experiences that may cause or make your depression worse. Therapy helps you recognize negative feelings and behaviors and learn how to change them to promote a healthier outlook. Psychotherapy is not usually used alone but generally used together with antidepressant medications, as the combination is more beneficial for patients with severe depression than medication therapy alone.
3. Electro-convulsant Therapy (ECT) is a safe and effective treatment used for severely depressed patients that need an immediate response (because they are suicidal), whose risk of medication treatment poses serious risks or have not responded to any medication treatments. ECT is thought to work by acting on the balance of chemicals in the brain. The most common side effect of ECT is temporary short-term memory loss.
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:: Can I use herbal alternatives to treat depression?
Herbal products such as St John’s Wort are also sold as depression remedies claiming to be natural alternatives to prescription antidepressants. Unlike prescription medications, these products do not have to prove that they actually work to be on the market. Their efficacy, safety, side effects and drug interactions are often not known.
People mistakenly believe that because it is a natural product is cannot cause harm. There is no good reason to use a product with unknown or possible harmful effects when there are many prescription medications that have been tested and proven to be highly effective and safe. Combining St John’s Wort with prescription antidepressants is not recommended.
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:: What are the benefits of antidepressant therapy?
The goal of treatment is to reduce the symptoms of depression and to return you to the normal healthy condition you were in before the onset of depressive symptoms.
The earlier you start treatment, the quicker you will feel better, and the more likely it is that you will prevent the symptoms from getting more severe and long-lasting. Treatment can also reduce the risk of recurrent episodes of depression. Additionally, treatment can reduce thoughts and risk of suicide.
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:: How long will I need antidepressant therapy?
Depression is treated in three phases:
1. Acute Phase - 4 to 8 weeks
Antidepressant therapy is started with the aim to reduce and eliminate symptoms. Dosage adjustments or switching to a different drug be made based on your response. Most people start to feel better in 4-6 weeks. Psychotherapy along with antidepressants is helpful at this stage.
2. Continuation Phase - 4 to 9 months
Therapy is continued at full dosage with the aim to prevent relapse and return of depressive symptoms. Studies have shown that continuing antidepressant treatment reduces your chance of having another episode of depression. Continuing psychotherapy during this period is also helpful for some people.
3. Maintenance Phase - 1 to 2 years or longer
Therapy is continued at full dosage with the aim to prevent relapse of depression. Your doctor will determine how long you should continue therapy based on several factors including your history of prior depressive episodes. Your doctor may also recommend continuing psychotherapy.
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:: What is premenstrual dysphoric disorder (PMDD)?
PMDD or Postmenstrual Dysphoric Disorder is a distinct medical condition and is much more serious than premenstrual syndrome (PMS). Premenstrual dysphoric disorder is characterized by severe changes in both mood and physical changes of the body around the time of a woman’s period. These changes interfere with daily life.
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:: How common is premenstrual dysphoric disorder (PMDD)?
Approximately 3 to 8% of women in their reproductive years suffer from PMDD. Any woman who has periods can have PMDD. It may get worse with age, but it goes away after menopause.
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:: What causes premenstrual dysphoric disorder (PMDD)?
The exact cause of PMDD is not known but scientists believe that it may be caused by an imbalance of the brain’s neurotransmitters.
Neurotransmitters are the chemical messengers of the brain, which allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of PMDD.
Medications used to treat PMDD and other psychiatric disorders work to help symptoms by restoring the balance of the levels of these chemicals in the brain.
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:: What are the symptoms of premenstrual dysphoric disorder
(PMDD)?
The main signs of PMDD are depressed mood, anxiety or tension, mood swings and constant anger or irritability starting a week or two before your period lasting up to a few days after your period. These changes disrupt your normal daily life. Either one or more the main signs are accompanied by the following additional symptoms:
1. Loss of interest in usual activities.
2. Inability to fall or stay asleep.
3. Sense of being overwhelmed.
4. Fatigue or loss of energy.
5. Difficulty concentrating or making decisions.
6. Cramping, bloating, breast tenderness, headache and weight gain.
7. Increased appetite or food cravings.
Symptoms of postmenstrual dysphoric disorder, depression and anxiety disorders often occur at the same time. More than 60% of women suffering from PMDD may also suffer from depression or anxiety disorders at some time in their lives. See What are the signs and symptoms of depression?
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:: How is premenstrual dysphoric disorder (PMDD) treated?
The main treatment options for PMDD are:
1. Prescription medications. Selective serotonin reuptake inhibitors (SSRIs) are recommended for use in treating PMDD. It is important to know that not everyone responds the same to individual drugs therefore a different drug in the same class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Lifestyle changes such as regular exercise 3 to 5 times per week, a healthy balanced diet and adequate rest may also be helpful in reducing the symptoms of PMDD. See our extensive Weight Loss FAQ for many guidelines including:
- How many calories should I consume in order to lose weight?
- How much weight should I lose?
- What kind of activities can I do?
- How many calories can I burn doing various activities?
- Sample exercise plans
- Sample reduced calorie menus
3. Physical symptoms may be relieved with pain relievers such as ibuprophen for headaches and cramps, while diuretics can be used for bloating (fluid retention).
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:: What are anxiety disorders?
The primary anxiety disorders are:
1. Generalized anxiety disorder (GAD)
2. Panic disorder
3. Social anxiety disorder (or social phobia)
4. Posttraumatic stress disorder (PTSD)
5. Obsessive compulsive disorder (OCD)
Approximately 19 million people in the United States suffer from anxiety disorders.
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:: What are the benefits of anti-anxiety therapy?
Treatment can reduce your symptoms of anxiety and help stop symptoms from interfering with your normal activities. The earlier you start treatment the quicker you will feel better and greater the chance that you will prevent the symptoms from getting more severe and long-lasting. Treatment can also reduce the risk of recurrent episodes of anxiety.
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:: How long will I need anti-anxiety therapy?
Anti-anxiety therapy is started with the aim to reduce and eliminate symptoms. Depending on the specific drug, it may take 2 to 4 weeks before you notice improvement. Dosage adjustments or switching to a different drug may be necessary based on your response.
Psychotherapy along with prescription medications will yield the best results. Once your symptoms are reduced, therapy is usually continued to prevent the relapse and return of anxiety symptoms. Your doctor will probably continue your treatment as long as you experience benefits with periodic evaluations of your continued need for treatment. It is not uncommon to receive medication therapy for several months or even years.
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:: What is generalized anxiety disorder (GAD)?
General anxiety disorder is a medical condition. Generalized anxiety disorder is characterized by a constant, overpowering worry and anxiety that interferes with daily life and lasts at least six months. The anxiety is usually about work, family, relationships, money or health.
Although most people with GAD may realize that their anxiety is excessive, they are unable to control their responses so that even the thought of dealing with daily activities make them more anxious.
Many people go untreated but, proper treatment can help more than 80% of patients with generalized anxiety disorder improve.
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:: How common is generalized anxiety disorder (GAD)?
At any given time approximately 4 million people in the United States suffer from generalized anxiety disorder. It is also estimated that up to 5% of the population will have GAD during their lives.
GAD is almost twice as common in women than men, but this result may be because fewer men are willing to seek medical treatment. Symptoms most commonly appear for the first time in people in their mid-20s.
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:: What causes generalized anxiety disorder (GAD)?
Genetic factors: people with a family history of GAD are more likely to have it also. Stressful life events such as divorce, childhood trauma or death of a loved one may make some people more likely to develop GAD. But everyone who has these characteristics will not have GAD.
Scientists believe GAD may be caused by an imbalance of the brain’s neurotransmitters. Neurotransmitters are the chemical messengers of the brain, which allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of anxiety.
Medications used to treat anxiety and other psychiatric disorders work to help symptoms by restoring the balance of the levels of these chemicals in the brain.
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:: What are signs and symptoms of generalized anxiety disorder
(GAD)?
The main signs of GAD are constant, overpowering worry and anxiety. These symptoms interfere with daily life, last at least six months, and are accompanied by at least three or more of the following additional symptoms:
1. Muscle tension, trembling, shakiness.
2. Inability to fall or stay asleep.
3. Restlessness/agitation.
4. Fatigue.
5. Irritability.
6. Difficulty concentrating.
These symptoms should be serious enough to disrupt your social, work or daily life.
Symptoms of anxiety and depression often occur at the same time. More than 60% of people with GAD may also suffer from depression at some time in their lives. See What are the signs and symptoms of depression?
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:: How is generalized anxiety disorder (GAD) treated?
The main treatment options for GAD are:
1. Prescription medications. There are several classes of medications available for use. Each class has its own characteristics such as different ways in which they work, different side effects profiles, different drug or disease interactions and cost. You and your doctor can select the most appropriate drug for you based on these factors. It is also important to know that not everyone responds the same to individual drugs therefore a different drug in the same or different class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Psychotherapy, which involves visiting a psychiatrist, psychologist, therapist or counselor and talking about your feelings and experiences that may cause or make your anxiety worse. Therapy helps you recognize negative feelings and behaviors and learn how to change them to promote a healthier outlook. Psychotherapy and prescription medications are used together for best results.
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:: What is social anxiety disorder?
Social anxiety disorder is a medical condition. Social anxiety disorder also known as social phobia is characterized by overpowering worry or fear of social or public situations that interferes with daily life. The anxiety may be about public speaking, meeting new people, dating, interacting with authority figures or any activity that may draw attention to you.
Some people may have one specific activity which they fear while others may fear any potential social or public interaction. Although most people with social anxiety disorder may realize that their anxiety is excessive, they are unable to control their responses so that even the thought of dealing with social situations make them more anxious.
Many people go untreated but, proper treatment can help more than 80% of patients with social anxiety disorder improve.
* note: Social Anxiety Disorder is sometimes mistakenly abbreviated as SAD. SAD stands for Seasonal Affective Disorder.
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:: How common is social anxiety disorder?
At any given time approximately 5 million people in the United States suffer from social anxiety disorder.
Social anxiety disorder is almost twice as common in women than men, but this result may be due to the fact that fewer men are willing to seek medical treatment.
Symptoms most commonly appear for the first time in people in their childhood or early teenage years.
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:: What causes social anxiety disorder?
The exact cause of social anxiety disorder is not known but scientists believe that it may be caused by an imbalance of the brain’s neurotransmitters.
Neurotransmitters are the chemical messengers of the brain that allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of anxiety.
Medications used to treat anxiety and other psychiatric disorders work to help symptoms by restoring the balance of the levels of these chemicals in the brain.
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:: What are the signs and symptoms of social anxiety disorder?
The main signs of social anxiety disorder are constant, overpowering worry and fear of one or more social or public situations. These symptoms interfere with daily life and may be accompanied by the following additional symptoms:
1. Avoiding social situations due to intense anxiety or fear.
2. Intense fear and anxiety that leads to panic attacks.
3. Intense self-consciousness or feelings of being scrutinized in public situations.
4. Physical symptoms such as fast heartbeat, nausea, sweating, trembling, blushing
and muscle tension.
These symptoms should be serious enough to disrupt your social, work or daily life.
Up to 50% of people who suffer from social anxiety disorder often experience other problems such as depression, other anxiety disorders, or abuse of alcohol or drugs to deal with their fear of social situations. See What are the signs and symptoms of depression?
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:: How is social anxiety disorder treated?
The main treatment options for social anxiety disorder are:
1. Prescription medications: There are several classes of medications available for use. Each class has its own characteristics such as different ways in which they work, different side effects profiles, different drug or disease interactions and cost. You and your doctor can select the most appropriate drug for you based on these factors. It is also important to know that not everyone responds the same to individual drugs therefore a different drug in the same or different class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Psychotherapy: which involves visiting a psychiatrist, psychologist, therapist or counselor and talking about your feelings and experiences that may cause or make your anxiety worse. Therapy helps you recognize negative feelings and behaviors and learn how to change them to promote a healthier outlook. Psychotherapy and prescription medications are used together for best results.
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:: What is panic disorder?
Panic disorder is a medical condition. Panic disorder causes sudden, severe attacks of uncontrollable anxiety and fear. Panic attacks may be triggered by specific phobias or fears, such fear of snakes or heights or they may just occur suddenly for no apparent reason.
Many people with panic attacks become so anxious about when and where they may experience a panic attack that they avoid certain places or even stop leaving their home. This condition of confining yourself to your home is called agoraphobia and it affects about one third of people with panic disorder.
Many people go untreated but, proper treatment can help more than 80% of patients with panic disorder improve.
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:: How common is panic disorder?
At any given time approximately 2.5 million people in the United States suffer from panic disorder.
Panic disorder is almost twice as common in women than men, but this result may be due to the fact that fewer men are willing to seek medical treatment.
Symptoms most commonly appear for the first time in people in their late teens or early adult years.
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:: What causes panic disorder?
The exact cause of panic disorder is not known but scientists believe that it may be caused by an imbalance of the brain’s neurotransmitters.
Neurotransmitters are the chemical messengers of the brain that allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of panic disorder.
Medications used to treat panic disorder and other psychiatric disorders work to help symptoms by restoring the balance of the levels of these chemicals in the brain.
People with a family history of panic disorder are more likely to suffer from it also. Panic attacks may be triggered by stress, hormonal or chemical imbalances, alcohol or other substances.
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:: What are the signs and symptoms of panic disorder?
The main signs of panic disorder are sudden, severe attacks of uncontrollable anxiety and fear. These signs are accompanied by at least four or more the following additional symptoms:
1. Shortness of breath.
2. Choking feeling.
3. Chest pain or discomfort.
4. Fast or pounding heartbeat.
5. Dizziness or lightheadedness.
6. Sweating.
7. Chills or hot flashes.
8. Trembling or shaking.
9. Numbness or tingling.
10. Nausea or upset stomach.
11. Fear of losing control.
12. Fear of dying.
The immediate symptoms of a panic attack can last for 10-15 minutes and usually occur suddenly without warning, but the anxiety and stress of the attack can persist for hours.
Many people who suffer from panic disorder often experience other psychological problems such as depression, other anxiety disorders, or abuse of alcohol or drugs. See What are the signs and symptoms of depression?
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:: How is panic disorder treated?
The main treatment options for panic disorder are:
1. Prescription medications. Several classes of prescription drugs available for treating panic disorder. Each medication class has specific characteristics such as mechanism of action, possible side effects, drug or disease interactions, and price. You and your doctor can select the most appropriate drug for you based on these factors. It's also important to understand that not everyone responds the same to a particular medication, one drug may work for a person when another drug from the same or different class may not work. You may need to try different medications until you find the one that works for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Psychotherapy involves seeing a psychiatrist, psychologist, therapist or counselor to talk about the feelings and experiences that may cause your panic disorder or make it worse. Psychotherapy helps you recognize these negative feelings and behaviors and learn how to change them to adopt a healthier outlook. For best results, psychotherapy and prescription drugs are used concurrently.
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:: What is obsessive compulsive disorder (OCD)?
Obsessive compulsive disorder (OCD) is a medical condition. OCD is characterized by the presence of recurrent, persistent, and unwanted thoughts, impulses or images (obsessions) and/or the urgent need to perform certain repetitive, specific ritual behaviors (compulsions). These obsessions and compulsions take up more than one hour per day or interfere with daily function.
Most people with OCD realize that their obsessions are unreasonable and they perform their rituals with a desire to resist. Performing the rituals is not pleasurable, but it relieves the tension and anxiety that results from resisting the obsession.
Many people go untreated but, proper treatment can help more than 80% of patients with obsessive compulsive disorder improve.
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:: How common is obsessive compulsive disorder (OCD)?
At any given time approximately 3 million people in the United States suffer from Obsessive compulsive disorder (OCD). OCD is equally common in men and women.
Symptoms usually appear for the first time in people in their teens or early adult years. Obsessive compulsive disorder is a chronic lifelong disorder but for most patients symptoms come and go over time.
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:: What causes obsessive compulsive disorder (OCD)?
Obsessive compulsive disorder is more likely in people with a family history of it. The exact cause of OCD is not known but scientists believe that it may be caused by an imbalance of the brain’s neurotransmitters.
Neurotransmitters are the chemical messengers of the brain that allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of OCD.
Medications used to treat OCD and other psychiatric disorders work to help symptoms by affected the levels of these chemicals in the brain.
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:: What are signs and symptoms of obsessive compulsive disorder
(OCD)?
The main signs of Obsessive Compulsive Disorder (OCD) are the presence of recurrent, persistent, and unwanted thoughts, impulses or images (obsessions) and/or the urgent need to perform certain repetitive, specific ritual behaviors (compulsions). These obsessions and compulsions take up more than one hour per day or interfere with daily function.
Obsessive thoughts or images may be about:
1. Contamination: concerns or disgust with bodily waste, dirt, germs, chemicals or
other substances. Concerns about household items.
2. Sex: socially forbidden or perverse thoughts concerning children, animals, incest
or violent sexual behavior.
3. The need to hoard or collect items.
4. The need for symmetry or exactness. Religion.
5. Aggression: fear of harming oneself or others. Fear of acting impulsively (steal,
curse, etc.).
6. Health: fear of life-threatening illness.
Compulsions or repetitive behaviors are performed to relieve the anxiety of these obsessions. These may include:
1. Cleaning/washing: excessive or ritualized hand washing, showering, tooth
brushing or grooming.
2. Counting.
3. Checking.
4. Repeating rituals or words.
5. Keeping, cataloging or collecting items.
6. Organizing, ordering or arranging items.
More than half of the people who suffer from Obsessive Compulsive Disorder (OCD) experience other problems such as depression, other anxiety disorders, or abuse of alcohol or drugs. See What are the signs and symptoms of depression?
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:: How is obsessive compulsive disorder (OCD) treated?
The main treatment options for Obsessive Compulsive Disorder (OCD) are:
1. Prescription medications. There are several classes of medications available for use. Each class has its own characteristics such as different ways in which they work, different side effects profiles, different drug or disease interactions and cost. You and your doctor can select the most appropriate drug for you based on these factors. It is also important to know that not everyone responds the same to individual drugs therefore a different drug in the same or different class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Behavioral therapy. Involves visiting a psychiatrist, psychologist, therapist or counselor. The most effective techniques include exposure to the triggering situation (touching dirty object) and prevention of the response or compulsion (washing hands) by encouragement and direction of the therapist until the anxiety decreases. Overtime less anxiety from obsessions develop and patients are able to resist compulsions. Behavioral therapy and prescription medications are used together for best results.
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:: What is posttraumatic stress disorder (PTSD)?
Posttraumatic stress disorder (PTSD) is a medical condition. PTSD is a condition that occurs after you have experienced or witnessed a traumatic event involving real or threatened physical danger to you or others that leads to intense fear or helplessness.
Traumatic events which may trigger PTSD include: violent assaults to self or others (rape, kidnapping, torture, murder), devastation caused natural disasters (tornadoes, earthquakes), accidents or war.
Many people go untreated but, proper treatment can help more than 80% of patients with PTSD improve.
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:: How common is posttraumatic stress disorder (PTSD)?
At any given time approximately 5 million people in the United States suffer from Posttraumatic Stress Disorder (PTSD).
PTSD is more common in women, than men, but this may be because fewer men seek medical treatment. Military personnel, firefighters and others professionals who experience traumatic situations consistently as well as individual victims of violent crime, disasters or accidents are at risk for PTSD.
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:: What causes posttraumatic stress disorder (PTSD)?
Not everyone who experiences or witnesses a traumatic event will suffer from Posttraumatic Stress Disorder (PTSD), however, if one is suffering from PTSD, then they must have experienced or witnessed a traumatic event.
The exact reason why one person who lives through a traumatic event develops PTSD while another doesn’t is not known, but it is believed that PTSD is caused in patients with an imbalance of neurotransmitters in the brain.
Neurotransmitters are the chemical messengers of the brain that allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of Posttraumatic Stress Disorder.
Medications used to treat PTSD and other psychiatric disorders work to help symptoms by affected the levels of these chemicals in the brain.
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:: What are symptoms of posttraumatic stress disorder (PTSD)?
There are three groups of common symptoms of Posttraumatic Stress Disorder (PTSD): avoidance, re-experiencing, and hyper-arousal.
Avoidance or emotional numbing
At least three of the following symptoms are present:
1. Avoiding anything that reminds you of the traumatic event.
2. Forgetting an important part of the traumatic event.
3. Distancing yourself from family and friends.
4. Feeling emotionally numb or having difficulty feeling emotions.
5. Losing of interest or pleasure in activities you previously enjoyed.
6. Having a poor outlook for your future.
Re-experiencing or reliving
At least one of the following symptoms is present:
1. Experiencing sudden vivid memories of the traumatic event that interfere with
your daily activities.
2. Having flashbacks to the traumatic event that feel so real that you think you are
re-experiencing the trauma.
3. Recurring nightmare about the traumatic event.
4. Experiencing painful emotions caused by reminders of the traumatic event.
Hyper-arousal (feeling anxious or on guard)
At least two of the following symptoms are present:
1. Difficulty falling or staying asleep.
2. Irritability or outbursts of anger.
3. Difficulty concentrating.
4. Nervousness and feeling jumpy.
5. Always being on guard against another trauma.
In addition to the above symptoms physical symptoms such as headaches, stomach problems, dizziness or chest pain may be present if you have PTSD.
These symptoms need to be present for more than one month and interfere with your daily life for a diagnosis of PTSD. The symptoms of PTSD may occur immediately following the traumatic event and then disappear after several months or the symptoms may appear months or years after the event and last indefinitely, triggered by the anniversary of the event, or from witnessing or experiencing another similar situation.
Many people who suffer from Posttraumatic Stress Disorder often experience other problems such as depression, other anxiety disorders, or abuse of alcohol or drugs. See What are the signs and symptoms of depression?
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:: How is posttraumatic stress disorder (PTSD) treated?
The main treatment options for PTSD are:
1. Prescription medications. There are several classes of medications available for use. Each class has its own characteristics such as different ways in which they work, different side effects profiles, different drug or disease interactions and cost. You and your doctor can select the most appropriate drug for you based on these factors. It is also important to know that not everyone responds the same to individual drugs therefore a different drug in the same or different class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Psychotherapy. Involves visiting a psychiatrist, psychologist, therapist or counselor and talking about your feelings about the traumatic experience. Therapy helps you recognize negative feelings and behaviors and learn how to change them to promote a healthier outlook. Psychotherapy and prescription medications are used together for best results.
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:: What is bulimia nervosa?
Bulimia nervosa is a medical condition. Bulimia nervosa an eating disorder is characterized by the frequent act of binge eating followed by purging. Purging is achieved by vomiting, taking laxatives or diuretics, fasting or exercising excessively.
People with bulimia nervosa eat huge amounts of food to try to reduce feelings of anxiety and stress but then feel guilt, shame and depression that leads to purging to get some temporary relief.
Many people go untreated but proper treatment can help more than most of patient with bulimia nervosa improve.
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:: How common is bulimia nervosa?
Approximately 1-4% of females in the United States will suffer from bulimia nervosa during their lifetime.
Approximately 90% of people with bulimia nervosa are young women. Although men and older women may suffer from bulimia it is much less common.
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:: What causes bulimia nervosa?
Many people believe that bulimia nervosa is caused by our social and cultural environment, which promotes irrational standards of beauty, especially placing stress on young women to be unattainably thin. Although this may be the case, not all young women who are exposed to this pressure develop bulimia nervosa.
Many people with eating disorders have certain common personality traits such as low self-esteem, feelings of helplessness, a desire for perfection and a fear of becoming fat.
The exact cause is not known but it is believed that certain people are vulnerable to bulimia nervosa due to an imbalance of the brain’s neurotransmitters.
Neurotransmitters are the chemical messengers of the brain that allow cells to communicate with each other. Norepinephrine (NE), serotonin (5-HT) and dopamine (DA) are such neurotransmitters. An imbalance of these chemicals is thought to affect the symptoms of bulimia nervosa.
Medications used to treat bulimia nervosa and other psychiatric disorders work to help symptoms by affected the levels of these chemicals in the brain.
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:: What are the signs and symptoms of bulimia nervosa?
Bulimia nervosa is the frequent act of binge eating followed by purging.
Purging is achieved by vomiting, taking laxatives or diuretics, fasting or exercising excessively. People with bulimia nervosa eat huge amounts of food to try to reduce feelings of anxiety and stress due to an underlying psychological cause but then feel guilt, shame and depression which leads to purging to get some temporary relief.
Many people who are bulimic hide their problem from those around them. If you suspect someone you know may suffer from bulimia nervosa, look for some of these warning signs:
1. Binging, or eating excessively, but with no noticeable weight gain.
2. Purging by fasting, vigorous exercise, vomiting or abusing laxatives or diuretics.
3. Eating in secret.
4. Always using the bathroom immediately after meals.
5. Obsession with exercise and body weight.
6. Depression or moodiness.
7. Stomach complaints such as heartburn, bloating, constipation, indigestion.
8. Swollen glands in neck and face.
9. Sore throat.
10. Weakness or tiredness.
11. Bloodshot eyes.
12. Irregular menstrual periods.
If you or someone you know suffers from bulimia nervosa it is very important to seek help. The physical consequences of binging and purging can be dangerous to your health possibly leading to:
1. Dehydration and vitamin deficiency.
2. Stomach, bowel, liver and kidney damage.
3. Heart failure from mineral deficiency.
4. Rotting teeth (the acid in vomit corrodes tooth enamel)
5. Inflammation of the esophagus and swollen glands.
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:: How is bulimia nervosa treated?
The main treatment options for bulimia nervosa are:
1. Prescription medications. Selective Serotonin Reuptake Inhibitors (SSRIs) are recommended for use in treating bulimia nervosa. It is important to know that not everyone responds the same to individual drugs therefore a different drug in the same class may work for you when the first did not. It may take more than one try to find the right medication for you.
* See the table with a list of specific medications in What conditions do various antidepressant and anti-anxiety medications treat? and compare medications with What are the advantages and disadvantages of commonly prescribed antidepressants and ant-anxiety medications?
2. Cognitive behavioral therapy teaches you how to change thoughts and behavior such negative body image and binge eating by teaching, supporting and rewarding appropriate thinking and behavior.
3. Group therapy helps resolve underlying emotional issues by sharing them with others who have similar problems.
A combination of therapy and prescription medication is usually used for best results.
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:: What are the different classes of antidepressant medications?
Antidepressants are frequently classified by mechanism of action. All of these antidepressants work by influencing one or more of the neurotransmitters (brain chemicals) serotonin, norepinephrine (NE) or dopamine (DA). By dividing them in this fashion one can determine how each group differs from the other. A reuptake inhibitor reduces the amount of neurotransmitter that is absorbed by cells thereby increasing brain levels of that chemical.
(Click on the featured drug names to see detailed FAQs)
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Class - How it works
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Medication name - Brand (generic)
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Selective serotonin reuptake inhibitors (SSRI)
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Prozac/Sarafem (Fluoxetine),
Zoloft (sertraline),
Paxil (paroxetine),
Celexa (citalopram),
Lexapro (escitalopram),
Luvox (fluvoxamine)
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Mixed serotonin/NE/DA reuptake inhibitors
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Wellbutrin (bupropion)
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Serotonin/NE reuptake inhibitors (SNRI)
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Effexor XR (venlafaxine)
Tricyclic Antidepressants: Elavil (amitriptyline), Anafranil (clomipramine), Asendin (amoxapine),
Sinequan (doxepin), Aventyl/Pamelor (nortriptyline), Surmontil (trimipramine), Norpramin (desipramine), Tofranil (imipramine), Vivactil (protriptyline).
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Monoamine oxidase inhibitors (MAOI)
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Nardil (phenelzine), Marplan (isoocarboxazid),
Parnate (tranylcypromine).
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:: What conditions do various antidepressant and anti-anxiety
medications treat?
FDA approved use: The FDA has reviewed and approved data from clinical studies, which show that the medication is safe and effective for the condition and population (age group) noted.
Off-label Use: The drug is being used for a condition or population not specifically approved by the FDA. Once the FDA has approved a drug, doctors may prescribe it as desired. The uses listed above are generally accepted by the medical community.
(Click on the featured drug names to see detailed FAQs.)
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