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The prevalence of depression and anxiety disorders has increased largely over the past couple of decades. These two mental disorders affect adults and adolescents alike.

According to the World Health Organization, around 40 million people have anxiety in the US, making it the most common mental disorder in the country. Depression also affects 5% of the world’s population every year.

Fortunately, there are a number of ways anxiety and depression can be managed, and in some cases, even overcome completely. But first, let’s briefly look at some of the symptoms of depression and anxiety.

Depression

Depression is a mental disorder that is characterized by extremely low mood, loss of interest and pleasure in daily activities, feelings of despair, worthlessness, hopelessness, and physiological symptoms like lethargy and fatigue.

Depression affects around 16% of the American population every year. Do not confuse normal feelings of sadness with depression; in depression, these feelings are very intense, last at least two weeks, and take a serious toll on your physical and mental health.

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Image Credit: helpguide.org

Anxiety

Anxiety disorders are a group of disorders that include social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), specific phobia, panic disorders, and post-traumatic stress disorder (PTSD).

All of these disorders encompass excessive worrying and crippling nervousness that affects a person’s everyday functioning.

Generalized anxiety disorder is the most common anxiety disorder, affecting around 2% of the United States population. If the person does not receive proper treatment, the symptoms of anxiety may worsen over time.

That being said, anxiety and depression share numerous symptoms and signs, affecting the sufferer’s social and personal life. It may take a toll on the patient’s physical health as well.

Luckily, many medications have been developed that target the comorbid symptoms of depression and anxiety.

Best Medicine for Anxiety and Depression

Today, numerous different treatment options are available for treating anxiety and depression. Pharmacological treatment is widely paired with other forms of treatment, such as therapy or counseling.

The treatment that is prescribed to the patient depends largely on his or her symptoms. Some medications are better are treating either depression or anxiety, while others can treat both effectively.

You should always choose a medication after a detailed consultation with your doctor, and stay mindful of the potential side effects.

The following are the best medications for the treatment of anxiety and depression.

1.   Antidepressants

Antidepressants are the most popular choice of doctors for the treatment of anxiety and depression. Around 70-80% of people who take antidepressants experience a reduction in their symptoms.

Many new forms of antidepressants have been developed that target comorbid depression and anxiety, and not only improve the symptoms but also prevent relapse and remission.

Antidepressants are prescribed based on an individual’s specific needs and symptoms.

How do antidepressants work?

Antidepressants work by increasing the availability of certain neurotransmitters in the brain. Neurotransmitters are chemical substances in the brain that perform different functions.

Monoamine neurotransmitters, such as dopamine, serotonin, norepinephrine, etc. are responsible for regulating a person’s mood and emotions.

Anxious and depressed individuals have low levels of monoamine neurotransmitters in their brains, and antidepressants function by increasing the availability of these neurotransmitters. They do this by preventing their reuptake in the brain, improving the patient’s mood.

Following are some of the most common classes of antidepressants.

1.    Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs work by blocking the reuptake of the neurotransmitter serotonin in the brain, increasing its availability. Higher levels of serotonin in the brain relieve the symptoms of anxiety and depression by regulating the individual’s emotions.

The SSRIs that are most commonly prescribed include Prozac (fluoxetine), Celexa (citalopram), Zoloft (sertraline), Lexapro (escitalopram), and Paxil (paroxetine). Out of these antidepressants, Lexapro and Prozac are approved by the FDA for adolescents and teens as well.

2.    Serotonin-noradrenaline reuptake inhibitors (SNRIs): Serotonin-noradrenaline reuptake inhibitors are the second most prescribed class of antidepressants by doctors for the treatment of depression and anxiety.

These drugs prevent the reuptake of serotonin as well as noradrenaline, also known as norepinephrine, therefore, increasing their levels in the brain and improving the mood of the individual.

Some of the most commonly prescribed SNRIs include duloxetine, venlafaxine, desvenlafaxine, levmilnacipran, and milnacipran.

3.    Tricyclic Antidepressants (TCAs): Tricyclic antidepressants are one of the oldest classes of antidepressants that are still used when patients do not respond to SSRI and SNRI-based medications.

This class of antidepressants also works by blocking the reuptake of serotonin and norepinephrine in the brain. This increases the levels of these neurotransmitters in the brain, hence, improving anxiety and depressive symptoms.

The most common TCAs are Pamelor (nortriptyline), Tofranil (imipramine), and Elavil (amitriptyline).

4.    Monoamine oxidase inhibitors (MAOIs): Monoamine oxidase inhibitors are the oldest antidepressants for the treatment of anxiety and depression that were approved by the FDA.

They work by increasing the level of dopamine in the central nervous system. Some examples of MAOIs include Parnate (tranylcypromine), Nardil (phenelzine), and Marplan (isocarboxazid).

5.    Norepinephrine and dopamine reuptake inhibitors (NDRIs): NDRIs are commonly prescribed by doctors for the treatment of depression, anxiety, seasonal affective disorder, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Bupropion, sold under the brand name Wellbutrin, is the most popular NDRI.

Antidepressants are slowly built into your routine, so the doctor will prescribe a smaller dose initially and will instruct you to keep increasing it gradually.

If you have tried antidepressants and decided they are not a good fit for you, you can try alternative medications which are listed below.

2.   Benzodiazepines

Benzodiazepines are another effective medication used to relieve anxiety symptoms. They enhance the activity of a neurotransmitter in the brain and generate a sedative effect.

They are quick in action and help to relieve anxiety for many hours. These medicines are usually prescribed for people that have a generalized anxiety disorder, panic disorder, and social anxiety disorder. 

How do benzodiazepines work?

They enhance the activity of gamma-aminobutyric acid which is a chemical found in the brain that has a suppressive effect on nerves and movement.

According to research, benzodiazepines show effects within 30 to 60 minutes after their intake  These active drugs may help with symptoms of anxiety such as panic attacks, muscle tension, and insomnia.

 Examples of benzodiazepines include:

·         alprazolam (Xanax)

·         clonazepam

·         diazepam

·         lorazepam

Side effects of benzodiazepines

The negative side of these drugs is that the person may develop resistance to the medication. This means they will need a higher dose of this drug to have the same effect as before.

Due to this, a person may become dependent on these drugs. The doctors mostly prescribe benzodiazepines for short-term use only.

A person using benzodiazepines for anxiety may experience some side effects, as follows:

·         drowsiness

·         dizziness

·         sedation

·         loss of balance

The long-term use of benzodiazepine increases the risk of being unable to grasp or remember new information. The person is also unable to do certain physical and cognitive activities. These side effects usually decrease once the drug is cleared out of the body.

Other risk factors associated with long-term use of benzodiazepine are dementia, impaired motor function, aggressive behavior, debilitated cognitive function, and addiction to the drug.

3.   Beta-blockers

Beta-blockers are effective drugs that help to lower stress on the heart and blood vessels. They block the actions of hormones like adrenaline and noradrenaline that play a vital role in the fight or flight response of a body.

Doctors usually prescribe beta-blockers to lower the symptoms of anxiety, such as:

·         a fast heart-rate

·          trembling voice

·         dizziness

·         sweating

·         shaking of hands

Examples of beta-blockers that a doctor may usually prescribe for anxiety include propranolol and atenolol. 

Side effects of Beta-blockers:

Beta-blockers are an effective tool to relieve anxiety but long-term use of beta-blockers may prove harmful to the human body and may have several side effects:

·         drained feeling

·         numb fingers and toes

·         slow heart rate

·         low blood pressure

4.   Buspirone (Buspar)

Buspirone is an effective drug that is prescribed by doctors to treat several common anxiety disorders or symptoms of anxiety, such as sweating, a fast heart rate, fear, irritability, tiredness or dizziness, and several other symptoms.

This drug must not be used for anxiety symptoms that are caused by everyday stress and it shouldn’t be used as an alternative to antipsychotic treatment.

This medicine belongs to a class of drugs called anxiolytics. It works effectively in reducing anxiety by changing the amount of certain natural substances produced by the brain.

Buspirone was approved by The U.S. Food and Drug Administration (FDA) in 1986. The dosage of this drug depends on the following factors:

·         medical condition of a person

·         number of doses taken in a day

·         age of the person

The starting dose of this drug for adults is usually 7.5 milligrams (mg), twice a day. Doctors may increase this dose depending on the condition of the person, but typically it is not exceeded more than 60 milligrams (mg) per day.

5.   Antipsychotics

Antipsychotics were originally developed for the treatment of schizophrenia and bipolar disorder. However, the FDA has also approved their administration for the treatment of anxiety and depression.

They are mostly only prescribed when all other forms of medications fail to relieve the symptoms.

Side effects of antipsychotics:

Side effects of antipsychotics include weight gain and high blood sugar levels. A significant side effect of these drugs includes akathisia, which can be described as inner restlessness or the urge to move around.

It also causes a significant decrease in the number of white blood cells, and a condition called tardive dyskinesia. It is an irreversible condition that causes repetitive and involuntary movements of the face or body.

The advertisements try to conceal the fact that this drug is just as likely to produce dreadful side effects as it is to rid people of depression.

Keeping in view the harmful side effects associated with antipsychotics, these drugs should be considered only as a last resort for depression.

How to obtain the most benefit from medications?

For obtaining the best possible results from an antidepressant,

  • You have to be patient and observant. Once your healthcare provider has selected a medication for you, you may start to see the improved results in a few weeks, but it can also take six or more weeks for it to fully show its effects.
  • Some medications are safe for people to take the full dose immediately. With other medications, you may need to gradually increase your dose from time to time. You can talk to your health care provider or therapist about handling the depression and anxiety symptoms as you wait for your antidepressant to show its effect in full form.
  • It is important to take your medication consistently at the dose prescribed by your healthcare provider. If the medicine you’re prescribed doesn’t seem to show effects or is causing some troublesome or negative side effects, consult with your healthcare provider instead of making any changes in the dosage yourself. 
  •  Check if the side effects of the drug start to improve. Many antidepressants cause side effects that usually diminish as time passes. For example, side effects in the early stage of starting an SSRI can include dry mouth, nausea, loose bowel movements, headache, and insomnia. These side effects usually go away as our body starts adjusting to the drug.
  • Psychotherapy is another effective tool in relieving anxiety. It is a talk therapy session. In many cases, taking medicine along with regular psychotherapy is proven to be more effective than taking medication alone. It also helps block your depression from coming back once you start to feel better.
  •  It is advised that you shouldn’t stop taking the medication without consulting with your healthcare provider first. Some medications cause significant side effects and withdrawal-like symptoms if you stop taking the drug all of a sudden instead of reducing the dosage gradually. Quitting the drug suddenly can become cause a worsening of your condition and increase your depression and anxiety symptoms.
  • Avoiding alcohol and other substances related to alcohol has been proven to be beneficial in cases of reducing anxiety. It may seem as if alcoholic substances reduce anxiety and depression, but in reality, they generally make the symptoms worse.

FAQs

What are some non-medical treatments one should try for curing depression and anxiety?

Medications do not suit everyone. Some people may prefer other treatment options available for depression and anxiety instead of subjecting themselves to long-term medication. They should consider:

·         Cognitive behavioral therapy (CBT):  It is a type of therapy that identifies behaviors that have effects on dealing with anxiety and depression. The therapist helps to change our unhelpful thoughts and behavior. It may be helpful in providing individuals with the skills to react more productively in certain conditions.

·         Exposure therapy: This type of therapy encourages a person to move towards those situations which they normally avoid because they cause anxiety for them. It helps them to learn how to deal with anxiety and reduce the anxiety -related symptoms.

·         Arts and creative therapy: This involves creative stuff like using music, painting, or drama. It helps a person to express their feelings which helps to reduce their symptoms by distracting them using their creativity.

·         Talk therapy: Also known as psychotherapy. This involves speaking to a professional about your experiences and feelings and it may help find new methods to deal with anxiety-causing situations. You can go for in-person or online therapy. There are many platforms, like BetterHelp, that have made it easier for people to obtain therapy online.

·         Support groups: This provides a safe space for people where they can discuss their symptoms without feeling of being judged by others. These provide a setting for people to meet others with the same anxiety or depression symptoms, with whom they can share their feelings.

·         Stress management techniques: Several techniques such as exercise, mindfulness, and meditation may prove to be effective in dealing with depression and anxiety symptoms.

What supplements can I try for reducing my anxiety and depression symptoms?

Studies have shown that certain dietary supplements may be helpful in reducing depression and anxiety symptoms in some people. These supplements include:

·         omega-3s

·         vitamin D

·         Rhodiola

·         B12

·         saffron

Always consult your healthcare provider before making any changes in your diet or medication. Your healthcare provider will prescribe you medications while taking into account your past medical history and current health conditions.

They will help you understand the effects of the drug you’re prescribed and will guide you through your medication journey.

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