Symptoms
- Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
- Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
- Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
- Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
- Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
- Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
- Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
- Reckless behavior.You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
- Concentration problems. Trouble focusing, making decisions, or remembering things.
- Unexplained aches and pains.An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.
Treatment
Usually include a combination of psychotherapy and medications.
Transcranial Magnetic Stimulation (rTMS) may be recommended if there is inadequate response to psychotherapy and medications, or if a patient cannot tolerate side effects from medications.
Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressants. The group includes Trintellix, Paxil, Prozac, Celexa, Lexapro, Zoloft, and Viibryd.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) - Effexor, Pristiq, Fetzima, and Cymbalta act on serotonin and norepinephrine.
Trintellix - affects the serotonin receptor as well as other receptors related to serotonin function.
Wellbutrin - affects levels of dopamine and norepinephrine
Remeron - increases levels of serotonin and norepinephrine by a different mechanism than SNRIs.