other kinds of polar disorders

Some other types of depression are anxiety depression, chronic depression, atypical depression, reactive depression, psychotic depression, agitated depression, melancholic depression and catatonic depression. Anxiety depression is not an official type of depression. But, anxiety always occurs with depression. A depressed person may experience anxiety symptoms such as panic attacks or anxiety disorders such as social phobia, panic disorder, generalized anxiety disorder. Some of the symptoms of atypical depression are oversleeping, heavy feelings in legs or arms and significant weight gain or increase in appetite. Endogenous depression is another type where a person feels depressed for no apparent reason. Psychotic depression causes major depressive episode with some psychotic symptoms such as delusions and hallucinations.

The treatment for mood disorder includes a combination of antidepressant medications and different therapies such as psychotherapy or talk therapy. Electroconvulsive therapy, light therapy, Vagus Nerve Stimulation (VNS) therapy and Transcranial Magnetic Stimulation therapy are some of the other forms of depression treatments

bipolar disorder types of treatment

Signs and symptoms of bipolar depression

In the past, bipolar depression was lumped in with regular depression. But a growing body of research suggests that there are significant differences between the two, especially when it comes to recommended treatments. Most people with bipolar depression are not helped by antidepressants. In fact, there is a risk that antidepressants can make bipolar disorder worse–triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.

Despite many similarities, certain symptoms are more common in bipolar depression than in regular depression. For example, bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings, and feelings of restlessness. People with bipolar depression also tend to move and speak slowly, sleep a lot, and gain weight. In addition, they are more likely to develop psychotic depression–a condition in which they’ve lost contact with reality–and to experience major disability in work and social functioning

Signs and symptoms of a mixed episode

A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression. Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood makes for a particularly high risk of suicide.

The different faces of bipolar disorder

• Bipolar I Disorder (mania or a mixed episode) – The classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Usually—but not always—Bipolar I Disorder also involves at least one episode of depression.
• Bipolar II Disorder (hypomania and depression) – In Bipolar II disorder, the person doesn’t experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
• Cyclothymia (hypomania and mild depression) – Cyclothymia is a milder form of bipolar disorder. It consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.
• Treatment for bipolar disorder
  If you spot the symptoms of bipolar depression in yourself or someone else, don’t wait to get help. Ignoring the problem won’t make it go away; in fact, it will almost certainly get worse. Living with untreated bipolar disorder can lead to problems in everything from your career to your relationships to your health. Diagnosing the problem as early as possible and getting into treatment can help prevent these complications. 
  If you’re reluctant to seek treatment because you like the way you feel when you’re manic, remember that the energy and euphoria come with a price. Mania and hypomania often turn destructive, hurting you and the people around you.
  Basics of bipolar disorder treatment
  • Bipolar disorder requires long-term treatment. Since bipolar disorder is a chronic, relapsing illness, it’s important to continue treatment even when you’re feeling better. Most people with bipolar disorder need medication to prevent new episodes and stay symptom-free.
  • There is more to treatment than medication. Medication alone is usually not enough to fully control the symptoms of bipolar disorder. The most effective treatment strategy for bipolar disorder involves a combination of medication, therapy, lifestyle changes, and social support.
  It’s best to work with an experienced psychiatrist. Bipolar disorder is a complex condition. Diagnosis can be tricky and treatment is often difficult. For safety reasons, medication should be closely monitored. A psychiatrist who is skilled in bipolar disorder treatment can help you navigate these twists and turns
• Treatment for bipolar disorder is about more than the relief of symptoms. The true goal of treatment is recovery – getting to the point where bipolar disorder no longer disrupts your life. The right treatment plan can help you reach this goal.
• Self-help for bipolar disorder
  While dealing with bipolar disorder isn’t always easy, it doesn’t have to run your life. But in order to successfully manage bipolar disorder, you have to make smart choices. Your lifestyle and daily habits have a significant impact on your moods. Read on for ways to help yourself:
  • Get educated. Learn as much as you can about bipolar disorder. The more you know, the better you’ll be at assisting your own recovery.
  • Keep stress in check. Avoid high-stress situations, maintain a healthy work-life balance, and try relaxation techniques such as meditation, yoga, or deep breathing.
  • Seek support. It’s important to have people you can turn to for help and encouragement. Try joining a support group or talking to a trusted friend.
  • Make healthy choices. Healthy sleeping, eating, and exercising habits can help stabilize your moods. Keeping a regular sleep schedule is particularly important.
  Monitor your moods. Keep track of your symptoms and watch for signs that your moods are swinging out of control so you can stop the problem before it starts
• Bipolar disorder and suicide
  The depressive phase of bipolar disorder is often very severe, and suicide is a major risk factor. In fact, people suffering from bipolar disorder are more likely to attempt suicide than those suffering from regular depression. Furthermore, their suicide attempts tend to be more lethal.
  The risk of suicide is even higher in people with bipolar disorder who have frequent depressive episodes, mixed episodes, a history of alcohol or drug abuse, a family history of suicide, or an early onset of the disease.
• Therapy for bipolar disorder: An important part of treatment
  Research indicates that people who take medications for bipolar disorder are more likely to get better faster and stay well if they also receive therapy. Therapy can teach you how to deal with problems your symptoms are causing, including relationship, work, and self-esteem issues. Therapy will also address any other problems you’re struggling with, such as substance abuse or anxiety.
  Three types of therapy are especially helpful in the treatment of bipolar disorder:
  • Cognitive-behavioral therapy
  • Interpersonal and social rhythm therapy
  • Family-focused therapy
  Cognitive-behavioral therapy
  In cognitive-behavioral therapy, you examine how your thoughts affect your emotions. You also learn how to change negative thinking patterns and behaviors into more positive ways of responding. For bipolar disorder, the focus is on managing symptoms, avoiding triggers for relapse, and problem-solving.
  Interpersonal and social rhythm therapy
  Interpersonal therapy focuses on current relationship issues and helps you improve the way you relate to the important people in your life. By addressing and solving interpersonal problems, this type of therapy reduces stress in your life. Since stress is a trigger for bipolar disorder, this relationship-oriented approach can help reduce mood cycling.
  For bipolar disorder, interpersonal therapy is often combined with social rhythm therapy. People with bipolar disorder are believed to have overly sensitive biological clocks, the internal timekeepers that regulate circadian rhythms. This clock is easily thrown off by disruptions in your daily pattern of activity, also known as your “social rhythms.” Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these rhythms are stable, the biological rhythms that regulate mood remain stable too.
  Family-focused therapy
  Living with a person who has bipolar disorder can be difficult, causing strain in family and marital relationships. Family-focused therapy addresses these issues and works to restore a healthy and supportive home environment. Educating family members about the disease and how to cope with its symptoms is a major component of treatment. Working through problems in the home and improving communication is also a focus of treatment.
  For tips on choosing the right therapist and making therapy work for you, read Psychotherapy and Counseling: Finding a Therapist and Getting the Most Out of Therapy.
  Complementary treatments for bipolar disorder
  Most alternative treatments for bipolar disorder are really complementary treatments, meaning they should be used in conjunction with medication, therapy, and lifestyle modification. Here are a few of the options that are showing promise:
  • Light and dark therapy – Like social rhythm therapy, light and dark therapy focuses on the sensitive biological clock in people with bipolar disorder. This easily disrupted clock throws off sleep-wake cycles, a disturbance that can trigger symptoms of mania and depression. Light and dark therapy for bipolar disorder regulates these biological rhythms—and thus reduces mood cycling— by carefully managing your exposure to light. The major component of this therapy involves creating an environment of regular darkness by restricting artificial light for ten hours every night.  
  • Mindfulness meditation – Research has shown that mindfulness-based cognitive therapy and meditation help fight and prevent depression, anger, agitation, and anxiety. The mindfulness approach uses meditation, yoga, and breathing exercises to focus awareness on the present moment and break negative thinking patterns.
  • Acupuncture – Acupuncture is currently being studied as a complementary treatment for bipolar disorder. Some researchers believe that it may help people with bipolar disorder by modulating their stress response. Studies on acupuncture for depression have shown a reduction in symptoms, and there is increasing evidence that acupuncture may relieve symptoms of mania also.
  • Medication treatment for bipolar disorder
    Most people with bipolar disorder need medication in order to keep their symptoms under control. When medication is continued on a long-term basis, it can reduce the frequency and severity of bipolar mood episodes, and sometimes prevent them entirely.
    If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right drug or combination of drugs for your needs. Because everyone responds to medication differently, you may have to try several different medications before you find one that relieves your symptoms.
    • Check in frequently with your doctor. It’s important to have regular blood tests to make sure that your medication levels are in the therapeutic range. Getting the dose right is a delicate balancing act. Close monitoring by your doctor will help keep you safe and symptom-free.
    • Continue taking your medication, even if your mood is stable. Don’t stop taking your medication as soon as you start to feel better. Most people need to take medication long-term in order to avoid relapse.
    • Don’t expect medication to fix all your problems. Bipolar disorder medication can help reduce the symptoms of mania and depression, but in order to feel your best, it’s important to lead a lifestyle that supports wellness. This includes surrounding yourself with supportive people, getting therapy, and getting plenty of rest.
    • Be extremely cautious with antidepressants. Research shows that antidepressants are not particularly effective in the treatment of bipolar depression. Furthermore, they can trigger mania or cause rapid cycling between depression and mania in people with bipolar disorder.
    Learn more about bipolar disorder medication
    Mood stabilizers, antidepressants, and antipsychotics are the main types of medication used to treat bipolar disorder. Learn how to find the right drug or drug combination for you, work with your doctor, and manage side effects.

Bipolar Disorder

We all have our ups and downs, our "off" days and our "on" days, but if you're suffering from bipolar disorder, these peaks and valleys are more severe. The symptoms of bipolar disorder can hurt your job and school performance, damage your relationships, and disrupt your daily life. And although bipolar disorder is treatable, many people don’t recognize the warning signs and get the help they need. Since bipolar disorder tends to worsen without treatment, it’s important to learn what the symptoms look like. Recognizing the problem is the first step to getting it under control.

Bipolar disorder (also known as manic depression) causes serious shifts in mood, energy, thinking, and behavior–from the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function.

During a manic episode, a person might impulsively quit a job, charge up huge amounts on credit cards, or feel rested after sleeping two hours. During a depressive episode, the same person might be too tired to get out of bed and full of self-loathing and hopelessness over being unemployed and in debt.

The causes of bipolar disorder aren’t completely understood, but it often runs in families. The first manic or depressive episode of bipolar disorder usually occurs in the teenage years or early adulthood. The symptoms can be subtle and confusing, so many people with bipolar disorder are overlooked or misdiagnosed–resulting in unnecessary suffering. But with proper treatment and support, you can lead a rich and fulfilling life.

Myths and Facts About Bipolar Disorder

Myth: People with bipolar disorder can’t get better or lead a normal life.

Fact: Many people with bipolar disorder have successful careers, happy family lives, and satisfying relationships. Living with bipolar disorder is challenging. But with treatment, healthy coping skills, and a solid support system, you can live fully while managing your symptoms.

Myth: People with bipolar disorder swing back and forth between mania and depression.

Fact: Some people alternate between extreme episodes of mania and depression, but most are depressed more often than they are manic. Mania may also be so mild that it goes unrecognized. People with bipolar disorder can also go for long stretches without symptoms.

MYTH: Bipolar disorder only affects mood.

Fact: Bipolar disorder also affects your energy level, judgment, memory, concentration, appetite, sleep patterns, sex drive, and self-esteem. Additionally, bipolar disorder has been linked to anxiety, substance abuse, and health problems such as diabetes, heart disease, migraines, and high blood pressure.

MYTH: Aside from taking medication, there is nothing you can do to control bipolar disorder.

Fact: While medication is the foundation of bipolar disorder treatment, therapy and self-help strategies also play important roles. You can help control your symptoms by exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding yourself with supportive people.

Side effects of atypical antidepressants

There are a variety of newer depression drugs, called atypical antidepressants, which target other neurotransmitters either alone or in addition to serotonin. Some of the brain chemicals they affect include norepinephrine and dopamine.

The side effects vary according to the specific drug. However, many of the atypical antidepressants can cause nausea, fatigue, weight gain, sleepiness, nervousness, dry mouth, and blurred vision.

Side effects of older depression drugs

Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are older classes of antidepressants. Their side effects are more severe than those of the newer antidepressants, so they are only prescribed as a last resort after other treatments and medications have failed.

Antidepressant withdrawal

Once you’ve started taking antidepressants, stopping can be tough; many people have withdrawal symptoms that make it difficult to get off of the medication.

If you decide to stop taking antidepressants, it’s essential to consult a doctor and taper off slowly. If you stop abruptly, you may experience a number of unpleasant withdrawal symptoms such as crying spells, extreme restlessness, dizziness, fatigue, and aches and pains. These withdrawal symptoms are known as “antidepressant discontinuation syndrome." Antidepressant discontinuation syndrome is especially common when you stop taking Paxil or Zoloft. However, all medications for depression can cause withdrawal symptoms.

Antidepressant withdrawal symptoms

• Anxiety, agitation
• Depression, mood swings
• Flu-like symptoms
• Irritability and aggression
• Insomnia, nightmares
• Nausea and vomiting
• Dizziness, loss of coordination
• Stomach cramping and pain
• Electric shock sensations
• Tremor, muscle spasms

Depression and anxiety are also common symptoms when withdrawing from antidepressants. When depression is a withdrawal symptom, it’s often worse than the original depression that led to drug treatment in the first place. Unfortunately, many people mistake this withdrawal symptom for a return of their depressive illness and resume medication, creating a vicious circle.

In order to avoid antidepressant withdrawal symptoms, never stop your medication “cold turkey.” Instead, gradually taper your dose, allowing for at least 1-2 weeks between each dosage reduction. This tapering process may take up to several months, and should only be attempted under a doctor's supervision.

Exploring your depression treatment options

Antidepressants aren’t a cure. Medication may treat some symptoms of depression, but can’t change underlying contributions to depression in your life. Antidepressants won’t solve your problems if you’re depressed because of a dead-end job, a pessimistic outlook, or an unhealthy relationship. That’s where therapy and other lifestyle changes come in.

Studies show that therapy works just as well as antidepressants in treating depression, and it’s better at preventing relapse once treatment ends. While depression medication only helps as long as you’re taking it, the emotional insights and coping skills acquired during therapy can have a more lasting effect on depression. However, if your depression is so severe that you don't have the energy to pursue treatment, a brief trial of antidepressants may boost your mood to a level where you can focus on therapy.

In addition to therapy, other effective treatments for depression include exercise, meditation, relaxation techniques, stress management, support groups, and self-help steps. While these treatments require more time and effort initially, their advantage over depression medication is that they boost mood without any adverse effects

Self-help for depression

Depression recovery begins with positive daily lifestyle choices. If you cultivate supportive relationships, challenge negative thoughts, and nurture your physical health, you can help yourself, slowly but surely, overcome your depression.

Read Self-help for depression

Other depression treatment options

It sometimes takes time to find the depression treatment that’s right for you. Don’t be fooled into thinking that antidepressants are the best choice, just because they're sometimes the easiest choice. Alternate treatment options include:

• Psychotherapy. Therapy has proven to be extremely effective in the long-term treatment of depression. It can also provide you with the tools to help prevent depression from coming back. There are many types of therapy available. For help finding the right therapist see: Psychotherapy and Counseling
• Acupuncture. Acupuncture, the technique of using fine needles on specific points on the body, is increasingly being investigated as a treatment for depression, with some research studies showing promising results. If you decide to try acupuncture, make sure that you find a licensed qualified professional.
• Light therapy. Not all people with depression have a seasonal worsening of mood, but those who do may benefit from light therapy. Exposure to bright light from a light therapy box causes biochemical changes in the brain that can help control symptoms of seasonal affective disorder (SAD) and certain kinds of depression. As with any treatment, always consult a mental health professional before using.

Deciding if depression medication is right for you

Self-prescription risk

Self-prescribing antidepressant medication is extremely dangerous. It can even be fatal. At the very least you should consult a primary care doctor. Unfortunately, studies have shown that many primary care physicians lack the specialist training necessary to provide the highest quality mental health care. Therefore, the best case scenario is to confer with a psychiatrist or other mental health professional before taking antidepressants.

Source: American Psychosomatic Society

If you’re considering antidepressants as a treatment option, make sure you carefully consider all of your treatment options. The following questions may help you make your decision.

Questions to ask yourself and a mental health professional

• Is my depression severe enough to justify drug treatment?
• Is medication the best option for treating my depression?
• Am I willing to tolerate unwanted side effects?
• What non-drug treatments might help my depression?
• Do I have the time and motivation to pursue other treatments such as therapy and exercise?
• What self-help strategies might reduce my depression?
• If I decide to take medication, should I pursue therapy as well?

Questions to ask your doctor

• How much mental health care training have you had?
• Are there any medical conditions that could be causing my depression?
• What are the side effects and risks of the antidepressant you are recommending?
• Are there any foods or other substances I will need to avoid?
• How will this drug interact with other prescriptions I’m taking?
• How long will I have to take this medication?
• Will withdrawing from the drug be difficult?
• Will my depression return when I stop taking medication?

Guidelines for taking antidepressants

If you decide to take depression medication, it’s prudent to learn all you can about your prescription.  The more you know about your antidepressant, the better equipped you’ll be to deal with side effects, avoid dangerous drug interactions, and minimize other safety concerns.

Some suggestions:

• See a psychiatrist, not a family physician. Your family physician might help you or your loved one first realize that you may need depression treatment. But although any medical doctor can prescribe medications, psychiatrists are doctors who specialize in mental health treatment. They are more likely to be familiar with the newest research on antidepressants and any safety concerns. Your health depends on your doctor's expertise, so it's important to choose the physician who is best qualified.
• Be patient. Finding the right drug and dosage is a trial and error process. It takes approximately 4 to 6 weeks for antidepressant medications to reach their full therapeutic effect. Many people try several medications before finding one that helps.
• Monitor side effects – Keep track of any physical and emotional changes you’re experiencing and talk to your doctor about them. Contact your doctor or therapist immediately if your depression gets worse or you experience an increase in suicidal thoughts.
• Don’t stop medication without talking to your doctor – Be sure to take your antidepressant according to the doctor's instructions. Don't skip or alter your dose, and don't stop taking your pills as soon as you begin to feel better. Stopping treatment prematurely is associated with high relapse rates. It can also cause serious withdrawal symptoms.
• Go to therapy – Medication can reduce the symptoms of depression, but it doesn’t treat the underlying problem. Psychotherapy can help you get to the root of your depression, change negative thinking patterns, and learn new ways of coping.

Antidepressants and suicide risk

There is a danger that, in some people, antidepressant treatment will cause an increase, rather than a decrease, in depression and with it, an increased risk of suicide. While this is particularly true of children and young adults on antidepressant medication, anyone taking antidepressants should be closely watched for suicidal thoughts and behaviors. The suicide risk is particularly great during the first month to two months of antidepressant treatment.

Monitoring is especially important if this is the person’s first time on depression medication or if the dose has recently been changed. Signs that medication is making things worse include anxiety, insomnia, hostility, and extreme agitation—particularly if the symptoms appear suddenly or rapidly deteriorate. If you spot the warning signs in yourself or a loved one, contact your doctor or therapist immediately.

Antidepressant warning signs

• Suicidal thoughts or attempts
• New or worse depression
• New or worse anxiety
• New or worse irritability
• Feeling agitated or restless

• Difficulty sleeping
• Aggression and anger
• Acting on dangerous impulses
• Extreme hyperactivity
• Other unusual changes in behavior

What You Need to know About Depression Medication

If you’re suffering from major depression, antidepressant medication, used under the guidance of a mental health professional, may relieve some of your symptoms. But antidepressants aren’t a silver bullet for depression. Medication doesn’t cure the underlying problem and is rarely a long-term solution. Not only do antidepressants come with significant side effects and dangers, but recent studies have also raised questions about their effectiveness.

Learning the facts about antidepressants and weighing the benefits against the risks can help you make an i

Is depression caused by a chemical imbalance in the brain?

This information is not intended to be a substitute for medical advice. If you are taking an antidepressant, do not change your dosage without consulting your physician!

You’ve seen it in television ads, read it in newspaper articles, maybe even heard it from your doctor: depression is caused by a chemical imbalance in the brain that medication can correct. According to the chemical imbalance theory, low levels of the brain chemical serotonin lead to depression and depression medication works by bringing serotonin levels back to normal. However, the truth is that researchers know very little about how antidepressants work. There is no test that can measure the amount of serotonin in the living brain—no way to even know what a low or normal level of serotonin is, let alone show that depression medication fixes these levels.

While antidepressant drugs such as Prozac increase serotonin levels in the brain, this doesn’t mean that depression is caused by a serotonin shortage. After all, aspirin may cure a headache, but it doesn’t mean that headaches are caused by an aspirin deficiency. Furthermore, many studies contradict the chemical imbalance theory of depression. Experiments have shown that lowering people’s serotonin levels doesn’t always lower mood, nor does it worsen symptoms in people who are already depressed. And while antidepressants raise serotonin levels within hours, it takes weeks before medication is able to relieve depression. If low serotonin caused depression, there wouldn’t be this antidepressant medication lag.

When it comes to depression, serotonin doesn’t tell the whole story

Experts agree that depression involves much more than just “bad” brain chemistry. Serotonin is just one of many factors that may play a role in the disorder. New research points to other biological contributors to depression, including inflammation, elevated stress hormones, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. And these are just the biological causes of depression. Social and psychological factors—such as loneliness, lack of exercise, poor diet, and low self-esteem—also play an enormous role in depression.

How effective are antidepressants?

Researchers agree that when depression is severe, medication can be helpful—even life–saving. However, research shows that antidepressants fall short for many people. A major government study released in 2006 showed that fewer than 50 percent of people become symptom-free on antidepressants, even after trying two different medications. Furthermore, many who do respond to medication slip back into major depression within a short while, despite sticking with drug treatment.

Other studies show that the benefits of depression medication have been exaggerated, with some researchers concluding that, when it comes to mild to moderate depression, antidepressants are only slightly more effective than placebos.

If you have severe depression that’s interfering with your ability to function, medication may be right for you. However, many people use antidepressants when therapy, exercise, or self-help strategies would work just as well or better—minus the side effects. Therapy can also help you get to the bottom of your underlying issues and develop the tools to beat depression for good.

Side effects of antidepressant medication

There are many different types of drugs used in the treatment of depression, including selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Side effects are common in all antidepressants. For many people, the side effects are serious enough to make them stop taking the medication.

Side effects of SSRIs (selective serotonin reuptake inhibitors)

The most widely prescribed antidepressants come from a class of medications known as selective serotonin reuptake inhibitors (SSRIs).

Common side effects of
SSRI antidepressants:

• Nausea
• Insomnia
• Anxiety
• Restlessness
• Decreased sex drive
• Dizziness
• Weight gain or loss
• Tremors
• Sweating
• Sleepiness
• Fatigue
• Dry mouth
• Diarrhea
• Constipation
• Headaches

The SSRIs include:

• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Escitalopram (Lexapro)
• Citalopram (Celexa)

The SSRIs act on a chemical in the brain called serotonin. Serotonin helps regulate  mood, but it also plays a role in digestion, pain, sleep, mental clarity, and other bodily functions. As a result, the SSRI antidepressants cause a wide range of side effects.

Common side effects include sexual problems, drowsiness, sleep difficulties, and nausea. While some side effects go away after the first few weeks of drug treatment, others persist and may even get worse.

In adults over the age of 65, SSRIs pose an additional concern. Studies show that SSRI medications may increase the risk for falls, fractures, and bone loss in older adults. The SSRIs can also cause serious withdrawal symptoms if you stop taking them abruptly.

Other antidepressant drug risk factors

Anyone who takes antidepressants can experience unpleasant or dangerous side effects. But certain individuals are at a higher risk:

• People over 65. Studies show that SSRI medications may increase the risk for falls, fractures, and bone loss in older adults.
• Pregnant women. The use of SSRI's late in pregnancy may lead to short-term withdrawal symptoms in newborns after delivery. Typical symptoms include tremor, restlessness, mild respiratory problems, and weak cry.
• Teens and adolescents. The U.S. Food and Drug Administration requires that all depression medications include a warning label about the increased risk of suicide in children and young adults.