Other treatments

St John's Wort (hypericum)
This is a herbal antidepressant that you can buy from pharmacies without a prescription. It recently became a popular 'over the counter' treatment for depression. However, many doctors now do not advise that you take this because:

• It is not clear how well it works. Although some studies suggest that it may help depression, other studies have failed to confirm this.
• Side-effects sometimes occur. (Some people think that because St John's wort is 'natural' then it is totally safe. This is not true. It contains many chemicals which sometimes cause problems.)
• It may react with other medicines that you may take. Sometimes the reactions can cause serious problems. For example, you should not take St John's wort if you are taking warfarin, cyclosporin, oral contraceptives, anticonvulsants, digoxin, theophylline, or certain anti-HIV medicines. Also, you should not take it at the same time as certain other prescribed antidepressants.

Specialist and hospital based treatments
Other treatments such as specialist medicines or electrical treatment (ECT) may be advised if you have severe depression which has not improved with other treatments.

Some dos and don'ts about depression

• Don't bottle things up and 'go it alone'. Try and tell people who are close to you how you feel. It is not weak to cry or admit that you are struggling.
• Don't despair - most people with depression recover. It is important to remember this.
• Do try and distract yourself by doing other things. Try doing things that do not need much concentration but can be distracting such as watching TV. Radio or TV is useful late at night if sleeping is a problem.
• Do eat regularly, even if you do not feel like eating.
• Don't drink too much alcohol. Drinking alcohol is tempting to some people with depression as the immediate effect may seem to relieve the symptoms. However, drinking heavily is likely to make your situation worse in the long run. 医学.全在.线www.med126.com
• Don't make any major decisions whilst you are depressed. It may be tempting to give up a job, or move away, to solve the problem. If at all possible you should delay any major decisions about relationships, jobs, or money until you are well again.
• Do tell your doctor if you feel that you are getting worse, particularly if suicidal thoughts are troubling you.
• Sometimes a spell off work is needed. However, too long off work might not be so good as dwelling on problems and brooding at home may make things worse. Getting back into the hurly-burly of normal life may help the healing process when things are improving. Each person is different, and the ability to work will vary.
• Sometimes a specific psychological problem can cause depression, but some people are reluctant to mention it. One example is sexual abuse as a child leading to depression or psychological difficulties as an adult. Tell your doctor if you feel something like this is the root cause of your depression. Counselling may be available for such problems.

Will it happen again?

A 'one-off' episode of depression at some stage in life is common. However, some people have two, three, or more episodes of depression. You can have treatment for each episode. However, if you are prone to recurring episodes of depression, you may be advised to take an antidepressant long-term to prevent depression from recurring.

Some related conditions

Postnatal depression
Some women develop depression just after having a baby. See separate leaflet called 'Postnatal Depression' for details.

Bipolar affective disorder
In some people, depression can alternate with periods of elation and over-activity (mania or hypomania). This is called bipolar affective disorder or manic-depression. Treatment tends to include mood stabiliser medicines such as lithium. See separate leaflet called 'Bipolar Affective Disorder' for details.

Seasonal affective disorder
Some people develop recurrent depression in the winter months only. This is called 'Seasonal Affective Disorder' or SAD. For people in the UK with SAD, symptoms of depression usually develop each year sometime between September and November, and continue until March or April. You, and your doctor, may not realize that you have SAD for several years. This is because recurring depression is quite common. You may have been treated for depression several times over the years before it is realized that you have the seasonal pattern of SAD. Treatment of SAD is similar to other types of depression. However, 'light therapy' is also effective. See separate leaflet called 'Seasonal Affective Disorder' for details.

Other mental health problems
Depression sometimes occurs at the same time as other mental health problems.

• People with anxiety, panic disorder, and personality disorders quite commonly also develop depression. As a rule, depression should be treated first, followed by treatment of the other disorder. In particular, anxiety will often improve following treatment of depression.
• Eating disorders such as anorexia and bulimia may accompany depression. In this situation the eating disorder is usually the main target of treatment.

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