Drugs to relieve depression

Currently, there are no over-the-counter foods, health products, or "natural herbs" that can achieve the clinically recognized effect of alleviating pathological depression. The officially available drugs to relieve depression are psychiatric prescription drugs, which are mainly divided into two categories: traditional antidepressants and new antidepressants. They are only suitable for pathological depression that lasts for more than two weeks and has affected normal work and life. Depression caused by short-term mood swings does not require medication at all. All drugs must be evaluated by a psychiatrist and used in accordance with the doctor's advice. It is absolutely prohibited to purchase drugs, adjust dosages, or stop taking drugs on your own.

Last week, I accompanied Xiao Yang, who was diagnosed with moderate depression, to the Sixth Hospital of Peking University for a follow-up consultation. He was sitting outside the clinic scrolling through his mobile phone and came across a blogger who said, "Eating St. John's wort can fight depression without side effects." He rolled his eyes and showed it to me - he believed this when he was first diagnosed last year. He bought imported St. John's wort extract and took it for two months. His mood did not improve. Instead, because it interacted with the antihypertensive drugs he had been taking all year round, he fell dizzy and went to the emergency room, where he was scolded by the doctor. It’s not that St. John’s wort is completely useless. Some European countries do list it as an auxiliary treatment option for mild depression. However, the dosage of its active ingredients is unstable, and it also has serious interactions with most commonly used drugs such as birth control pills, anticoagulants, and antihypertensive drugs. It has never been included in the list of regular antidepressant prescription drugs in China. The risks of ordinary people taking it indiscriminately far outweigh the benefits. Real criminals cannot gamble.

Nowadays, the most commonly used antidepressants in clinical practice are the SSRIs, which are commonly known as SSRIs. Fluoxetine, paroxetine, and sertraline, commonly known as the "Five Golden Flowers," all fall into this category. Internet people like to call them "adult happy water," but this is not the case. I have seen too many patients complain during the first week of taking it, saying that not only were they not happy, they felt more like vomiting, and felt groggy every day, thinking that the medicine was wrong. In fact, this thing is like lubricating a rusty gear that hasn't been turning for a long time. It will get a little stuck when you first put it on. The serotonin receptors in the brain that regulate mood have not received enough signals for a long time. You have to adapt to it for about a week. Most people will gradually feel the feeling after taking it for two to four weeks - it is not like a sudden happy event. Ecstasy is when you were stuck in an emotional quagmire before and couldn't climb out no matter how hard you tried. You didn't even have the strength to raise your hands. After taking the medicine, you found that you seemed to be able to grab the grass next to you and slowly move up two steps. The voice of "I can't do anything well" that had been circulating in your brain for the past 24 hours would gradually become smaller and no longer tightly grip your attention.

But when it comes to this, we have to ask a question that has been quarreling in the industry for many years: What kind of depression requires medication? Several psychologists I know who do cognitive behavioral therapy feel that many people who have just encountered sudden stress events, such as the death of a loved one, lost their job, or lost a relationship, and have been in a bad mood for a week or two in a row have not yet reached the level of pathological depression. They can go through a few psychological consultations and adjustments first, and there is no need to prescribe medication immediately. After all, drugs have side effects. Common ones include temporary sexual function effects and weight gain, which are also real problems. However, many clinical psychiatrists hold different opinions, saying that if the patient has severe physical symptoms, such as being able to sleep only one or two hours a day for a week, or losing more than ten kilograms for no apparent reason in a month, even if the depression scale score is mild, a small dose of medicine can be used to suppress the symptoms first. Otherwise, if the patient continues to use it, it will easily lead to chronic depression, which will be more troublesome. Both statements are supported by clinical data, and there is no absolute right or wrong. The final choice depends on the specific condition of the patient.

As for traditional antidepressants such as tricyclics and monoamine oxidase inhibitors, they are rarely used as first-line drugs now. It is not that they are useless, but they have serious side effects. Dry mouth, constipation, and hand tremors are common. I have met an old patient who took tricyclics before. He said that when he first started taking tricyclics, he drank two liters of water a day and still felt his mouth tasted bitter. Nowadays, doctors generally only consider using these drugs for refractory depression that has failed to work with several new drugs.

There are also many people who ask, "Will antidepressants become addictive?" It's really not the case. Unlike sleeping pills or drugs, you won't take more and more, and you won't go crazy looking for medicine after you stop taking them. But drug withdrawal reactions do exist. There was a little girl from 985 who took sertraline for three months and felt that she was completely healed. She stopped without telling the doctor. As a result, she felt dizzy the next day and vomited while holding the toilet. Her mood suddenly fell back to the state before taking the drug. She called the doctor crying. Later, she slowly stopped for a month and then stopped. Nothing happened. Therefore, you must follow the doctor's lead when reducing and stopping medications, and don't try to act on your own.

In fact, depression is really not something you can’t think about, nor is it because you are not strong enough. It’s just that your brain has some temporary problems and you need medication to help. Just like you need to wear glasses if you are short-sighted, or you need a plaster for a broken bone. There is nothing shameful about it. Of course, the premise is that you must find a regular psychiatric hospital. Don't believe in any folk remedies or magical medicines, and don't blindly search for information to prescribe medicine for yourself. Medicines that are suitable for others may not be suitable for you. After all, everyone's brain condition is different, right?